Lesbian, Gay, Bisexual And Transgender Community Research Articles

Older Adults in Administrative Quagmire: A Scoping Review of Policy and Program Coordination Across Six Marginalized Older Adult Populations.

Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on 6 groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual, and transgender) community, and individuals living in a rural area. A 5-stage scoping review methodology was followed, and 53 articles (published between 2000 and 2022) from 5 social science databases were analyzed. The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analyzed in 1 specific policy area or within a clinical setting along the lines of facilitating care coordination. This scoping review reveals a mutual neglect on the part of public administration and policy scholars toward marginalized older adults and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults.

Lesbian, gay, bisexual, and transgender clinical competence of physiotherapy students in Israel

BackgroundClinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel.MethodsConducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender.ResultsThe sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach’s alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual.ConclusionsIn Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence.Trial registration NRNot applicable.

Experiences of Family Medicine Specialists in Providing Health Care for Lesbian, Gay, Bisexual and Transgender Patients: A Qualitative Study in East Coast Peninsular Malaysia

INTRODUCTION: Lesbian, Gay, Bisexual and Transgender (LGBT) patients continue to report discrimination in healthcare setting despite the efforts of the primary healthcare offering community friendly services in Malaysia. This qualitative study aimed to provide understanding of this current issue and to explore the challenges that family medicine specialists (FMSs) from East Coast of Peninsular Malaysia face when dealing with LGBT patients. MATERIALS AND METHODS: 30 FMSs working in East Coast Peninsular Malaysia were interviewed through a phenomenological framework using semi-structured in-depth interviews of LGBT patients. The interviews were recorded in audio format, transcribed verbatim, and subjected to Braun and Clarke’s thematic analysis. We discerned common themes that can be elucidated through the lens of Leininger’s Theory of Culture Care (TCC) and the Sunrise Enabler Model (SEM). RESULTS: Three overlapping themes of the transcriptions were developed; (1) Multidimensional understanding of LGBT described how FMSs saw the LGBT community as diverging from societal norms, yet acknowledge their vulnerability as integral members of the society, (2) obstacles to providing culturally competent care stemmed from inadequate training, an unsupportive clinic environment, and the self-stigma experienced by patients, and (3) barriers to incorporating spiritual needs for holistic care arose in situations where there was insufficient spiritual health training or a preference to concentrate on physical and emotional well-being to uphold trust. CONCLUSION: The findings on this study reflect the need for proper training of healthcare personnel to deliver a holistic, culturally competent care for LGBT patients. A collaborative effort with relevant authorities is also needed to successfully overcome those challenges.

Pressures on Chinas LGBT Community and the Role of the Media in Safeguarding the Rights of This Group

Due to the different historical developments, there are significant differences between China and the West regarding culture and values. As a group that has always been sensitive, there is also a pronounced difference between how the Lesbian, Gay, Bisexual and Transgender (LGBT) group is treated in Chinese society and Western society. These differences include the aspects of social acceptance of the LGBT community, legal protections, as well as the pressures that they face from the family, workplace, and other levels. This research aims to conduct a comparative analysis of the status and treatment of the LGBT community in Chinese and Western societies, with a particular focus on the experiences of LGBT individuals in China. The study will investigate the challenges and discrimination faced by the LGBT community in China, including legal and social barriers to equality and inclusion. Additionally, the research will examine the ways in which LGBT individuals and activists in China are utilizing new media platforms to advocate for their rights and reduce stigma. Based on the findings, the study will propose recommendations for improving the social and legal protection of LGBT individuals in China, as well as strategies for increasing the visibility and representation of the LGBT community through media outreach and public education.

LGBT and Pancasila, Between the Essence of Human Rights Protection and the Existence of Pancasila Values and Islamic Law

Speaking of rights, of course we are talking about rights which are fundamentally inherent in human beings. Be it the right of life, the right of welfare, the right to justice, and the right of social security as embodied in the 1945 constitution. LGBT communities want the same thing, get the same rights, with principles of freedom and principles of equality. Not only does the LGBT community want legal protection against its freedom but also the legality of its existence in Indonesia. This article aims to learn the essence of human rights protection against LGBT (lesbian, gay, bisexual, and transgender) and its conversion to the existence of pancasila values and Islamic law, which is intended to find common points in both, is qualitative in the use of literature study methods (library research). As for the results of this study, LGBT basically has a right to cure abuses, not the claims of freedom to campaign, and to preserve existence in Indonesia. Certainly, one of its restriction reviews or ladsments is a consideration of religious morality that has always held a high regard for human dignity and dignity. There is also a value to maintain, there is a value embodied in the pancasila that gives the message, that every citizen must maintain a value and be irreparable.

Life satisfaction in the Spanish LGBT community: Sexual and gender identities, health and sociodemographic correlates

This paper examines differences in the life satisfaction (LS) of Spanish Lesbian, Gay, Bisexual and Transgender (LGBT) community as a function of sexual and gender identities, health and sociodemographic variables. A cross-sectional study was conducted (1,451 LGBT adults) and non-parametric analyses were performed. LG presented higher LS than bisexuals and non-cisgender participants had lower LS than cisgender. LS was lower among obese persons than overweight and normal range groups. Those participants who accomplished the WHO’s physical activity recommendations reported higher LS than those who did not meet them. The oldest persons and those with higher incomes reported higher LS than other corresponding groups by age and SES. This group of sexual, gender, health and sociodemographic correlates of LS among LGBT people provides additional information that may be useful for social policies aimed at improving the quality of life of this community, especially in the economic and health crises due to COVID-19.

A Review of Monkeypox Infection in LGBT Community

<p><em>The reappearance of the monkeypox virus in 2022 in 58 countries and Indonesia is no exception, which confirmed 1 case in patients post travelling abroad.</em><em> </em><em>The current monkeypox infection is still present, with symptoms that vary from person to person and are typically characterized by reddish rashes. Still, it is primarily confined to the genital, perigenital, and perianal areas. It manifests at various stages of development, in addition to transmission from animals caused by hunting activities or in LGBT ( Lesbian, Gay, Bisexual, and Transgender) communities that have unprotected sex and can be infected through semen and saliva. This review aims to find a relationship between the increasing number of monkeypox cases, especially in LGBT community, based on the literature study approach and case reports.</em><em> </em><em>One of the non-medicamentous ways is to reduce travelling abroad, especially in countries with many monkeypox cases. Preventing direct contact, such as abstaining from sex and using condoms, is also a way to reduce the morbidity of monkeypox infection, especially in LGBT community. The treatment has not proven effective, and the available vaccines, especially in Indonesia, are still limited. Only a few cases in Indonesia have been reported.</em></p>

Understanding LGBT individuals' employment environment in Taiwan: a relational framework perspective

PurposeThe purpose of this study is to examine the aspects of workplace environment and the experiences of LGBT (lesbian, gay, bisexual and transgender) employees in an Asian context; a subject that has hitherto been somewhat neglected. It responds to a call for more contextual research in the field of employment diversity in organizational management in general.Design/methodology/approachThis is a mixed method study, which utilizes multiple sources of primary and secondary data and consists of in-depth personal interviews, a survey of LGBT employees, published data (including legislation and state policies), reports issued by social and media organizations, documentary evidence from Taiwanese companies and insights drawn from the existing literature.FindingsIt was found that there is an interplay between the macro, meso and micro levels in the multilevel relational framework applied to diversity of employment in Taiwan. Macrolevel factors, such as supportive legislation, mass media and social tolerance toward LGBT community positively affect mesolevel factors, such as stable and secure social networks among the LGBT community in the form of legal and social organizations (NGOs, social media, bars, restaurants, etc.) as well as many companies inclusion of sexual orientation in their definitions of diversity. However, this is opposed by macrolevel, cultural values related to family structure and intergenerational relationships that inhibit pro-active integration and equality of LGBT individuals at the meso organizational level. Companies headed by older-generation leadership can be slow to advocate, support and promote sexual-orientation diversity in their workplaces. In contrast, microlevel data shows that LGBT employees receive robust psychological support from their peer group, friends and the LGBT community, although gaining acceptance by family and coworkers remains a challenge.Research limitations/implicationsFuture studies need to focus on the dynamics of the meso- and microlevel factors by investigating how organizational structure, perspectives of leaders and HR managers, diversity management practices and attitudes and behaviors of LGBT employees and other coworkers affect development and integration of sexual-orientation diversity programs within organizations.Practical implicationsManagers, policy makers in organization as well as educators benefit from the context-sensitive findings and recommendations offered in this paper.Social implicationsUnderstanding of LGBT individuals employment environment helps to facilitate or hinder the positive development of equal society and benefit both LGBT employees, their coworkers and managers.Originality/valueLimited research exists on the LGBT employees experiences at work in Asia. This study makes unique contribution to the understanding of sexual orientation category of diversity at work in Taiwan context.

Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review.

Lesbian, gay, bisexual and transgender (LGBT) individuals are often stigmatised and discriminated against. This population is expected to experience poorer mental health outcomes compared with heterosexual and cis-gendered people, a phenomenon healthcare providers need to take note of and act upon. This study aimed to explore and describe the mental health challenges of LGBT people. An integrative literature search was conducted. The following electronic databases were searched: Academic Search Premier, Africa-Wide Information, Business Source Premier, eBook Collection (EBSCOhost), E-Journals, ERIC, Family & Society Studies Worldwide, Health Source: Nursing/Academic Edition, Humanities Source, MasterFILE Premier, MEDLINE, PsycARTICLES, Social Work s, TOC Premier, WorldCat.org, Taylor and Francis Journals, Biomed Central and Wiley Online Library. An internet search was also carried out using Google and Google Scholar databases. The following search terms were identified: ‘LGBT’ OR ‘LGBT community’ AND ‘mental health challenges/problems’ OR ‘mental/psychiatric illness’. The reviewed literature comprised research conducted globally between 2010 and 2019. From the 2545 titles, 345 abstracts were examined, resulting in 57 articles. The 57 full-text articles were examined to verify whether they addressed the scope of the literature review, of them, 21 addressed the mental health challenges of LGBT people. Lesbian, gay, bisexual and transgender people experience the following mental health challenges: emotional distress, stigmatisation, victimisation, discrimination and barriers to accessing healthcare services. The results showed that although LGBT has been legalised in many countries, LGBT communities still experience significant mental health challenges. Healthcare providers are in a position to address challenges related to social and healthcare structures and act as advocates in order to promote the mental health of LGBT individuals.

Malaysian Sikh Youths’ Perception of Diverse Sexual Identities

Malaysia is well known to the world audience as a multicultural nation and a country dominated by religious beliefs, including religions such as Islam, Christianity, Buddhism, Hinduism, Sikhism and Taoism. However, over the years, Malaysia has been doing its rounds in the papers for its strict rules over the denial of human rights for the LGBT (lesbian, gay, bisexual and transgender) community. In 2015, Malaysia’s ex–Prime Minister Najib Razak openly declared his take on the LGBT community by equating them to the Islamic State of Iraq and Syria (ISIS) and claiming that both are ‘enemies of Islam’. Whereas Islamic religious authorities have made clear their stance on LGBT communities, the Malaysian Consultative Council on Buddhism, Christianity, Hinduism, Sikhism and Taoism (MCCBCHST) has taken a much-blanketed approach on the matter. The group is against any violent attack against, harassment or intimidation of and threat to the LGBT community, but the very essence of this stand is oxymoronic, as they have not done anything to prevent such incidents from taking place either. Sikhism has a liberal perspective on acceptance, regarding aspects such as gender, race, ethnicity and age, to name a few, that one would interpret it is an LGBT-friendly religion. Hence, this article is a humble attempt at understanding the Malaysian Sikh youths’ perspectives on the ever-growing branches of sexual identity. This article will add to the literature on Sikhs’ attitudes towards homosexuality, especially in Southeast Asia.

Estudantes de enfermagem relativamente à comunidade LGBT: conhecimentos, atitudes e competência cultural

Enquadramento: as atitudes, conhecimentos e competência cultural dos estudantes de enfermagem relativamente à comunidade de Lésbicas, Gays, Bissexuais e Transgéneros (LGBT) tem repercussões no acesso e na qualidade dos cuidados de saúde destas minorias sexuais. Investigações demostram que, apesar do aumento de informação os estudantes de enfermagem, apresentam défices significativos nesta área. Objetivo: conhecer as variáveis associadas aos conhecimentos, atitudes e competência cultural dos estudantes de enfermagem portugueses relativos à comunidade LGBT. Metodologia: estudo descritivo-correlacional, com amostra de conveniência de uma instituição de Ensino Superior da região norte de Portugal. A recolha de dados foi realizada através de um questionário on-line, composto por questões sócio-demográficas, questões de verificação de conhecimentos e o Questionário Multidimensional do Preconceito Polimorfo (Lopes, Oliveira, Nogueira, & Grave, 2016). Resultados: o estudo integrou uma amostra de 99 estudantes de licenciatura em enfermagem. Encontraram-se variáveis de risco para atitude discriminatória, como idade e ano académico, orientação heterossexual, residência em meios rurais, política de centro e falta de familiaridade com pessoas LGBT, bem como, associação com baixo conhecimento. Conclusão: podemos concluir que os estudantes de enfermagem demonstram necessitar de reforço de conhecimentos, para melhor adequação das atitudes e competências para lidar com a comunidade LGBT.

The lesbian, gay, bisexual and transgender communities' mental health care needs and experiences of mental health services: An integrative review of qualitative studies.

INTRODUCTION: The lesbian, gay, bisexual and transgender (LGBT) communities are a minority population that experience a range of health disparities, including mental health. Because these groups have higher rates of mental disorder than the general population it is, therefore, pertinent to identify their specific mental health needs and their experiences when accessing mental health care. To identify the mental health needs of the LGBT communities and their experiences of accessing mental health care. An integrative review of qualitative studies was conducted. A total of fourteen studies were selected for this review. The studies identified that participants' experiences of accessing mental health care were related to (a) experiencing stigma and (b) staff's lack of knowledge and understanding of LGBT people's needs. They identified a need for mental health care that promotes the principles of equity, inclusion and respect for diversity. The LGBT communities while not a homogenous group, face unique challenges when dealing with their mental health needs. Services that promote health equity and self-acceptance are important for this group. It is vital that mental health nursing education incorporate models that promote equity, inclusion and respect for diversity regarding this group of people.

Lesbian, gay, bisexual and transgender (LGBT) inclusion in nursing services: a reflective case study from stoma care

Speaking with a female patient and her same-sex partner about their experiences of colorectal cancer and ileostomy surgery led to reflection on how specialist nursing care could be made more inclusive of the needs of lesbian, gay, bisexual and transgender (LGBT) people. The LGBT community includes people who are attracted to the same sex and/or identify as a different gender to the one they were assigned at birth. LGBT people in the UK have experienced a long history of discrimination and only begun to win legal protections over the past two decades, an experience that still affects the older generation especially. Compared with the general population, LGBT people are more likely to report poor health status, experience mental health issues and engage in risky behaviours; however, many are reluctant to attend healthcare services due to fear of discrimination. UK LGBT rights charity charity Stonewall surveys have revealed some discriminatory attitudes and widespread unconscious bias among health and social care staff. For health professionals, it can be a challenge to use the correct terminology to avoid causing offen ce, and there is a largely unmet need for inclusion training to improve their understanding and confidence to speak with patients about sexual preference and gender identity. However, confident LGBT inclusivity can be achieved with simple communication skills, such as equal treatment for same-sex partners, acknowledgement of post-transition names and pronouns and discretion in documentation, as well as awareness of verbal and non-verbal cues. Clinic environments can be made more LGBT-friendly with gender-neutral toilets, as well as wearable LGBT symbols, inclusive imagery and posters and literature that promotes LGBT rights, inclusion and support groups. Specialist nurses can act as role models and advocates for LGBT patients and colleagues in their area through small but impactful actions.

Polish adaptation of the Daily Heterosexist Experiences Questionnaire.

The aim of the conducted research was to prepare the Polish adaptation of the Daily Heterosexist Experiences Questionnaire (DHEQ) by Kimberly Balsam et al. (2013) and to verify psychometric characteristics of the Polish adaptation. This original tool manages to address the experiences of prejudice and discrimination affecting LGBT (lesbian, gay, bisexual and transgender) people. Data from 197 Polish LGBT participants were collected online. Mean age of participants was 31 years (M = 31.93; SD = 8.37). Nearly 17% (N = 33) of participants were transgender,alittleover19% (N = 38) described themselves as non-heterosexual women, while the remainder of the sample (N = 127; 64%) were self-described as homosexual, bisexual or pansexual men. The questionnaires included the Polish adaptation of the DHEQ and a control tool designed for the needs of this study. The highest scores were found on factor describing experiences of 'Vicarious trauma', showing that learning about abuse and discrimination of other members of LGBT community is an important stressor for LGBTpeople. Other important stressors were 'Isolation' and 'Vigilance' describing feelings of loneliness and effort made in order to conceal LGBT identity. Of all the groups, the transgender people were the most exposed to heterosexism. The Polish adaptation of the DHEQ is characterized by good psychometric properties. The majority of the factors distinguished in the DHEQ are applicable to Polish cultural context.

Policing between minorities: ‘Asian-Australian’ police recruits and policing of the LGBT community

ABSTRACT Using Social Identity Theory (SIT), an online survey was used to capture Asian-Australian police recruit’s perceptions of policing lesbian, gay, bisexual and transgender (LGBT) people. This research determines that the intersectionality of identity Asian-Australian police recruits (as police officers, as Asian-Australians, and, for a small number of recruits as LGB people) are correlated in relation to perceptions of policing of LGBT people. The results suggest that whilst police training is affective in instilling operational practices and guidelines regarding the policing of minority groups, the overall perceptions of Asian-Australian recruits towards LGBT people are negative. This research supports the idea of increased recruitment of diverse people into police organizations, but it argues that the background characteristics diverse recruits bring into policing (such as cultural influences and levels of bias) can have (like non-diverse recruits) a detrimental effect on perceptions of policing of minority group members.

Virtually caring: a qualitative study of internet-based mental health services for LGBT young adults in rural Australia.

The study explored how lesbian, gay, bisexual and transgender (LGBT) young adults in rural Australian communities experience online mental health services. Online technologies hold potential to overcome health access barriers, but little is known in practice for this community. Interviews were conducted with nine LGBT young adults living in rural areas and six service providers who were responsible for the provision of internet-based mental health services. The results were analysed using thematic analysis. The analysis of the interviews with LGBT young adults and service providers revealed important insights and discrepancies. Findings revealed difficulties locating the right care and variation in views about how online services should be delivered. A potentially critical role for parents/guardians to play was found in facilitating access to services. The needs of LGBT youth in rural areas are complex and are unlikely to be met by an en masse approach to internet-based mental health care. The authors recommend that internet based mental healthcare providers work closely with LGBT and youth communities in rural areas to develop client-centred services that are customised to meet the unique needs of this community.

The Power of Recognition: A Qualitative Study of Social Connectedness and Wellbeing through LGBT Sporting, Creative and Social Groups in Ireland.

The broad research consensus suggesting substantial vulnerabilities among lesbian, gay, bisexual and transgender (LGBT) communities may fail to recognize the protective factors available to these populations. The sparse literature on mental health promotion highlights the importance of understanding strengths-based community approaches that promote LGBT wellbeing. Informed by the Ottawa Charter for Health Promotion, underpinned by Honneth’s Theory of Recognition, this paper outlines the findings of a qualitative Irish study on LGBT social connectedness through a diverse range of sporting, creative and social interests. Ten in-depth interviews were conducted with 11 people (including one couple) who self-identified as lesbian (5), gay (4), bisexual (1) and transgender (1) aged between 22 and 56 years. A university Research Ethics Committee granted approval. The data were transcribed and coded using thematic analysis, enhanced through a memo-writing approach to reflexivity. The theme of ‘connecting’ emphasized the shared nature of activities, with like-minded others through groups established by, and for, LGBT communities. Messages from the study reinforce the central role of LGBT communities in the promotion of mental health and social wellbeing, with important policy and practice implications. This requires the contextualization of the contribution of LGBT communities within understandings of social justice, identity and recognition.

Depok and its effort to criminalise the LGBT community

In recent years, governments in Indonesia have increasingly been targeting the lesbian, gay, bisexual and transgender (LGBT) community with discriminatory regulations, which has led to an increase ...

Homosexuality as a Psychological Problem in "Am I a Feminist or a Womanist" by Staceyann Chinn

: Recently, homosexuality has become a very widespread phenomenon in the world even in the eastern Islamic societies though it is considered a forbidden behavior. It is, therefore, necessary to search behind this problem. The current paper aims at exploring the socio-political aspect of poetry as related to the LGBT (lesbian, gay, bisexual, and transgender) community. The analysis will be conducted through the poem A Feminist or a Womanist by Stacey Ann Chinn which is actually a warning against such approaches. Namely, she does so by developing the poem over an imaginary conversation with another woman who is asking her about her lesbianism. So, as she is being asked in a manner that she finds offensive, she replies to the imaginary conversation partner that she is not asking the right questions. She considered that the issue is not about being lesbian but about being a woman. She basically projects the idea that the problem is in womanhood, not in the fact that she is a lesbian and/or feminist. However, as there are two viewpoints to this behavior-- one is responded to it while the other one is against it, this paper is going to show the religious viewpoint in both Islamic religion and Christianity as well as the medical viewpoints regarding it through discussing the biological and psychological factors behind this disease which actually Chin herself suffers from.

Needs of the Aging LGBT Community in Israel.

Since the late 1980s, there have been changes in attitudes toward the LGBT (lesbian, gay, bisexual, and transgender) community in Israel. Nevertheless, the service system for the elderly is largely characterized by heteronormativity and relies on family members to help their elderly relatives. Goal: To examine the difficulties experienced by old LGBT people, particularly in receiving health and social services. Method: A total of 104 LGBT people aged 55+ years responded to a structured online questionnaire. Findings: Compared with the general elderly population, elderly LGBT people have fewer support networks, they tend to live alone, and suffer from tremendous loneliness. They are afraid of coming out to health and social service providers and of functional dependency, particularly due to their fear of disclosing their sexual orientation or gender identity, the barriers to receiving help, and the absence of family support to assist them.