LGB Adults Research Articles

Culturally Competent Clinical Care for Older Sexual Minority Adults: A Scoping Review of the Literature

As recent efforts to improve culturally competent clinical care (CCCC) have largely overlooked older LGB adults, we conducted a scoping review of position statements, empirical, and non-empirical research and suggest action steps. We followed PRISMA Extension for Scoping Reviews Guidelines and searched for articles 1/1/11-3/14/19 (n = 1210) and other resources (n = 52), deduplicating, dually screening abstracts (n = 1,156), reviewing full-text (n = 107), and conducted a content analysis to identify distinct and cross-cutting domains (n = 44). Most research was based on simple pre/post-training differences in provider knowledge. A majority of sources were non-empirical. We identified three distinct domains (education & staffing, physical environment, and inclusive language & communication) and three cross-cutting domains (subgroup differences, research, and policy). Sparse empirical data that specify best approaches to improve CCCC exist; nevertheless, providers, in collaboration with researchers and policy makers, can initiate improved practices aimed at increasing CCCC for older LGB patients.

The Proverbial Closet: Do Faith and Religiosity Affect Coming Out Patterns?

Disclosing one’s sexual minority identity or “coming out of the closet” is a key milestone in sexual minority identity development. While scholars have explored how race, gender, class, and other social classifications shape coming out patterns among lesbian, gay, or bisexual (LGB) individuals, we know far less about the effect of religious contexts. To address this shortcoming, we extend existing theoretical insights to better understand how faith and religiosity shape coming out patterns among sexual minorities both independently and collectively. Specifically, we examine how religious affiliation and religious attendance (a measure of religiosity) affect when LGB individuals privately realize and publicly disclose their sexual minority identity. Using data from the Pew Research Center’s 2013 Survey of LGBT Adults, we conduct a series of ordinary least squares regressions on a representative sample of LGB adults ( n = 1,136). We find religious contexts—both religious affiliation and attendance—have no independent effect on when a person realizes or publicly discloses their sexual minority identity for the first time. However, evangelical Protestants that frequently attend religious services publicly disclose their sexual minority identity at older ages. These results highlight the social cost of publicly disclosing an LGB identity, especially within conservative religious spaces.

State-Level Alcohol Environments and Sexual Identity Disparities in Binge Drinking in the Behavioral Risk Factor Surveillance System.

Purpose: Binge drinking disparities by sexual identity are well documented. Stronger alcohol policy environments reduce binge drinking in the general population. We examined whether state-level alcohol policy environments have the same association with binge drinking among lesbian, gay, and bisexual (LGB) adults as among heterosexual adults. Methods: Binge drinking, sexual identity, and demographic characteristics were extracted from the 2015 to 2018 Behavioral Risk Factor Surveillance System. The strength of the alcohol policy environment was measured by using the Alcohol Policy Scale (APS) score. We estimated the association between APS score and binge drinking by using logistic regression and included an interaction term between APS score and sexual identity. Results: The interaction between APS score and sexual identity was not significant, and findings differed between women and men. Among women, a higher APS score was associated with lower odds of binge drinking (adjusted odds ratio [aOR]: 0.96, 95% confidence interval [CI]: 0.94-0.99). Differences in binge drinking by sexual identity remained after adjusting for individual and state-level factors (e.g., the percentage of LGB adults in the state). Compared with heterosexual women, the odds of binge drinking were 43% higher (aOR: 1.43, 95% CI: 1.17-1.75) among lesbian women and 58% higher (aOR: 1.58, 95% CI: 1.40-1.79) among bisexual women. A higher APS score was not associated with binge drinking among men. Conclusion: Stronger state-level alcohol policy environments were associated with lower binge drinking among women. Lesbian and bisexual women were still more likely to engage in binge drinking compared with heterosexual women even in states with stronger alcohol policy environments.

Future Nursing Home Placement, Health, and Relationships by Sexual Orientation: Findings From the HRS

This study compares LGB and heterosexual adults on anticipated need for future nursing home (NH) placement and factors that influence NH placement. Using data from the 2016 HRS, we found a trend toward higher anticipated NH placement among LGB adults (M=34.0, SD=29.2) as compared to heterosexual adults (M=26.9, SD=27.3; p=0.05). Compared with LGB respondents (n=137), heterosexual adults (n=3,469) were more likely to have living child/children (37% vs. 82%, p<.001). Although there was no statistical difference in marital status between LGB (50% married/partnered) and heterosexual adults (65% married/partnered; p=.06), married/partnered LGB respondents were more likely to be very/quite close to their spouse/partner (99% vs. 90%, p<0.01) compared to heterosexual respondents. There was no difference in number of health conditions between groups. This study suggests that LGB adults may have higher rates of anticipated need for NH, thus NHs must ensure their workforce is educated and prepared to support this growing population. Part of a symposium sponsored by Rainbow Research Group Interest Group.

Depressive Symptoms Among Older, Sexual Minority Adults and the Influence of Marital Status

Adverse health outcomes, including poor mental health and depression, tend to be more common among those who are lesbian, gay, or bisexual (LGB). Minority stress theory posits that chronic minoritization contributes to disparities in depression. Factors like social support and income can improve mental health outcomes, and these resilience-promoting factors can be gained through marriage. However, whether marriage improves mental health outcomes in old age regardless of sexual orientation is not well established. This study aims to determine if depressive symptoms differ by sexual orientation in old age, and to test whether the association between depression and sexual orientation was moderated by marital status. The 2016 Health and Retirement Study, a nationally representative sample of U.S. adults older than 50 years (n=4,253), was the first wave to include respondent sexual orientation. Depressive symptoms were measured on the 8-item Center for Epidemiologic Studies Depression Scale (CES-D). Those with a score greater than or equal to 3 were considered to have elevated depressive symptoms. When testing main effects in the adjusted model, depression was not more common among LGB persons than heterosexual persons (OR=0.95; 95% CI=0.46-2.00). Yet, marital status significantly moderated the relationship between sexual orientation and depression (p=0.034). Among heterosexual adults, being married was protective against depression (OR=0.48; 95% CI=0.32-0.71) when compared to being never married, whereas marriage was not protective among LGB adults (OR=0.95; 95% CI=0.26-3.45). Findings indicate that LGB adults do not experience the same mental health benefits of marriage as heterosexual individuals.

Applied Scholarship in LGBTQ Aging: Implications for Policy and Practice

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) elders have shown considerable strength while aging in a society predicated on heteronormative and binary expectations for gender and sexuality. The life trajectories of LGBTQ older adults are shaped by discrimination and stigmatization, and the embodied resistance that comes with demanding their full participation and recognition in society. This symposium highlights the innovative scholarship of emerging scholars in the field of LGBTQ aging who are engaging in diverse substantive and methodological investigations. The first study takes a comparative cohort approach to explore differences in stressors and depressive symptomatology between younger and older sexual minorities, highlighting the significance of cohort effects among LGBTQ people. The second paper uses data from the Health and Retirement Study to examine anticipated nursing home placement needs between LGB and heterosexual adults with suggestions to better prepare aging service networks. The third describes the influence of state legislature mandating LGBTQ-sensitivity training by examining differences in provider baseline knowledge and attitudes toward LGBTQ older adults in two states, one mandating LGBTQ-sensitivity training and one not. The final paper highlights findings from a multi-methods study that explores how long-term care workers, managers, and administrators respond when staff, visitors, or residents challenge LGBTQ rights for religious and moral reasons. Although substantively and methodologically varied, these studies all demonstrate the importance of applied scholarship that builds knowledge in support of policies and practices that promote equity among LGBTQ individuals across the life course. Rainbow Research Group Interest Group Sponsored Symposium.

Does Sexual Orientation Influence Trajectories of Change in Health? A 20-Year Follow-Up Study

We examined the differences in physical health outcomes over a 20-year period between lesbian, gay, and bisexual (LGB) and heterosexual middle-aged and older adults. We also examined whether the associations were moderated by social support and affect. The analytical sample included 168 LGB adults and 336 propensity-matched heterosexual adults from the Midlife in the United States (MIDUS) study, ranging in age from 25 to 74 years (mean age=42.83) at baseline. Using negative binomial generalized estimating equations and mixed-effects analyses, data from three waves of MIDUS, spanning approximately 20 years from 1995 to 2014, were used to examine the associations between sexual orientation and the health outcomes (number of chronic conditions and functional limitations). Social support and affect were added to the models to test for moderation. The results found that LGB participants reported one more chronic condition at baseline and scored significantly higher for functional limitations. However, LGB participants increased less over time for number of chronic conditions than heterosexual participants, and there were no significant differences in terms of changes in functional limitation over time. Positive affect reduced the strength of the relationship between sexual orientation and functional limitations for LGB participants. No other moderating effects were significant. The results of this study suggest that LGB individuals may become resilient to the negative health effects of minority stressors over time. Interventions should focus on improving the health of LGB individuals when they are younger and more at risk of negative health outcomes.

The Epidemiology of Dementia in LGBTQ Older Adults

Over 3 million or more adults aged 60 + live in the US who identify as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). Less is known about dementia risk in LGBTQ older adults. We will discuss dementia risk and related risk factors among LGBTQ adults from multiple population-based and cohort studies. We found higher rates of subjective memory problems among lesbian, bisexual and transgender adults compared to both gay men and heterosexual men and women. Using medical record data, 8% (343) of LGB adults aged 60+ were diagnosed with dementia. They were more likely to identify as male (63% vs. 44%), had a higher education level (college degree+ 63% vs. 40%) and were younger than their non-LGB counterparts. These findings highlight dementia risk and related problems among LGBTQ older adults. Future studies are needed to better understand dementia risk and recruiting, screening and improving dementia-related outcomes in LGBTQ older adults.

Predictors and outcomes of LGB individuals’ sexual orientation disclosure to heterosexual romantic partners

ABSTRACT LGB individuals coming out to heterosexual partners can be difficult in mixed-orientation relationships. This study examined the predictors and outcomes of LGB people’s sexual orientation disclosure and perceived partner reactions. Participants (N = 417) were LGB adults residing in the US who came out to their heterosexual romantic partners. Path analysis results showed that LGB individuals’ disclosure goals, internalized homophobia, and perceived power over partners were associated with degrees of disclosure and partners’ reactions, which in turn were related to LGB disclosers’ depressive symptoms and relationship satisfaction. The results have implications for coming out studies and suggest how, what, and when LGB people to come out to their heterosexual partners.

Sexual Health Among Lesbian, Gay, Bisexual, and Heterosexual Older Adults: An Exploratory Analysis

ABSTRACT Objectives: A significant gap in our knowledge concerns sexual health among the older lesbian, gay, and bisexual (LGB) population. Methods: We compared a community-based sample of self-identified LGB older adults (n = 128) with population-based samples of behaviorally-defined LGB older adults (i.e., reporting same-sex experiences) (n = 112) and behaviorally-defined older heterosexuals (i.e., reporting no same-sex experiences) (n = 2,893) from the National Social Life, Health and Aging Project (NSHAP). Differences in sexual activity and sexual problems were examined. Results: Older LGB adults were as likely to remain sexually active as older heterosexuals. Gay and bisexual men were more likely than heterosexual men to report some sexual problems. Regardless of sexual orientation, older adults rarely had their sexual health needs addressed in healthcare settings. Conclusions: Results highlight the need for more research on LGB older adult sexual health. Clinical Implications: The lack of attention to LGB older adults’ sexual health in healthcare settings may be exacerbated by ageism and heterosexism, leading these individuals to avoid disclosing their sexual orientations and avoid conversations about sexuality. Mental health practitioners require education on associations between sexual health and mental health, and how sexual health problems may contribute to mental health concerns in vulnerable populations like older LGB adults.

Older Lesbian, Gay, and Bisexual Adults: What Predicts Adjustment to Aging?

Build a structural model to explore whether socio-demographic, health and lifestyle-related variables are correlates of adjustment to aging (AtA) in a group of older lesbian, gay, and bisexual (LGB) adults. The sample comprised 287 community-dwelling older LGB adults aged 75 years and older. Convenience sampling was used to gather questionnaire data. Measures encompassed the Adjustment to Aging Scale, the Satisfaction with Life Scale, demographics (sex, age, professional and marital status, education, household, and family annual income), and lifestyle and health-related characteristics (self-reported spirituality, leisure, physical activity, perceived health, and medication). Structural equation modeling was used to explore a structural model of the self-reported AtA, comprising all the above variables. Outcomes revealed satisfactory goodness of fitness indices in both the measurement and structural model. The study variables contributed towards a high percentage of AtA variability. Perceived health and leisure were the strongest correlates of AtA. The results of this study indicate that policy making and community interventions with older LGB adults may benefit from including variables such as perceived health and leisure, income, education, spirituality, sex, physical activity, satisfaction with life, and marital status.

Minority Stress and Psychological Outcomes in Sexual Minorities: The Role of Barriers to Accessing Services

ABSTRACT Lesbian, gay, and bisexual (LGB) individuals are at higher risk for poor mental health than their heterosexual counterparts, and these disparities are largely accounted for by minority stressors. Less is known about the mechanisms underlying associations between minority stress and mental health. In a sample of 592 LGB adults (M age = 29.39), we tested a model in which minority stress (internalized stigma, stigma consciousness, and lived discrimination) was associated with poor mental health when mediated by stigma-related barriers to accessing psychological services. Structural equation modeling revealed that minority stressors predicted more barriers to service use which, in turn, predicted poorer mental health outcomes. Internalized stigma was also directly associated with poor mental health. Results suggest that links between minority stress and poorer mental health in LGB individuals are at least partly explained by stigma-related barriers to accessing services. Future research is needed to investigate methods which may ameliorate these barriers.

Co-occurring mental illness, drug use, and medical multimorbidity among lesbian, gay, and bisexual middle-aged and older adults in the United States: a nationally representative study

BackgroundOlder lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity. Understanding multimorbidity among older LGB adults may help inform interventions to reduce disparities in health outcomes.MethodsData come from the 2015 to 2017 National Surveys on Drug Use and Health (n = 25,880). We first determined whether sexual orientation was associated with reporting: past-year drug use, mental illness, and/or 2 or more chronic medical diseases. We then determined whether sexual orientation was associated with reporting co-occurrence of these conditions. This was done using multivariable logistic regression. Analyses were stratified by gender.ResultsCompared to heterosexual men, gay men were at increased odds for reporting 2 or more chronic medical diseases (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = 1.48, 3.21), and gay (aOR = 1.79, 95% CI = 1.09, 2.93) and bisexual men (aOR = 3.53, 95% CI = 2.03, 6.14) were at increased odds for reporting mental illness. Gay men (aOR = 2.95, 95CI = 1.60, 5.49) and bisexual men (aOR = 2.84, 95% CI = 1.58, 5.08) were at increased odds of reporting co-occurring conditions. Compared to heterosexual women, bisexual women were at increased odds for past-year drug use (aOR = 4.20, 95% CI = 2.55, 6.93), reporting mental illness (aOR = 1.94, 95% CI = 1.03, 3.67), and reporting co-occurring conditions (aOR = 3.25, 95% = 1.60, 6.62).ConclusionsMiddle-aged and older LGB adults in the United States are at high risk for experiencing co-occurring drug use, mental illness, and/or medical multimorbidity. Interventions for older sexual minority populations are needed to reduce disparities.

Substance Use Disparities at the Intersection of Sexual Identity and Race/Ethnicity: Results from the 2015-2018 National Survey on Drug Use and Health.

Purpose: Lesbian, gay, and bisexual (LGB) racial/ethnic minority individuals experience minority stress due to both their sexual identity and race/ethnicity and may be at elevated substance use risk (relative to heterosexuals) compared with their White LGB peers. We examined differences in the presence and magnitude of substance use disparities among LGB adults across race/ethnicity. Methods: Using data on 168,560 adults (including 11,389 LGB adults) from the 2015-2018 National Survey on Drug Use and Health, we examined disparities in cigarette smoking, heavy episodic drinking (HED), and marijuana use by race/ethnicity (White, Black, Hispanic, and other race/multiracial). Analyses compared lesbian/gay and bisexual adults, respectively, with heterosexual adults of the same gender and race/ethnicity. We also tested the magnitude of racial/ethnic minority disparities relative to the corresponding White disparity. Results: Significant disparities in smoking, HED, and marijuana use were observed for lesbian/gay and bisexual women across nearly all racial/ethnic groups. Disparities were consistently greater in magnitude for Black and Hispanic LGB women compared with White LGB women. Few disparities were observed among men; the magnitude of observed disparities did not differ by race/ethnicity. Conclusion: Disparities were most pronounced among racial/ethnic minority LGB women, which may reflect their unique experiences of discrimination at the intersection of multiple minority idenities. However, racial/ethnic minority gay and bisexual men were not at elevated risk relative to their White counterparts. Future research on substance use disparities among LGB individuals using an intersectional framework is warranted to elucidate differential minority stress processes that contribute to the observed heterogeneity across race/ethnicity, sexual identity, and gender.

Minority stress among LGB people: Investigating relations among distal and proximal stressors

Research among lesbian, gay, or bisexual (LGB) individuals often distinguishes between distal (e.g., discrimination) and proximal (e.g., expectations of rejection, internalized homophobia, and concealment) stressors. There are few longitudinal studies, however, testing the causal distal-proximal link. The present study examined these proposed associations among a sample of 192 LGB adults. Cross-lagged structural equation modeling revealed that each stressor was stable over 1 month. Also, Time 1 discrimination negatively predicted Time 2 concealment, but Time 1 expectations of rejection positively predicted Time 2 discrimination and concealment. Time 1 concealment positively predicted Time 2 internalized homophobia. Our results suggest the need for further evaluation of the distal-proximal distinction. Practical implications and directions for future research are discussed.

Perceived Attitudes Toward Lesbian, Gay, and Bisexual (LGB) Issues and Mental Health Among Taiwanese LGB Adults: The Mediating Role of Self-Acceptance.

Research on structural stigma has associated the poor mental health status among lesbian, gay, and bisexual (LGB) people with discriminatory institutions. Yet, less is known about the role of LGB adults' perceptions of social attitudes toward LGB issues. Moreover, the psychological mediation framework posits LGB people's self-acceptance as a mediator between a stigmatizing environment and individual mental health. This study investigated: (a) how perceived attitudes toward LGB issues from different social realms (society, heterosexual friends, and family members) were associated with LGB people's mental health; and (b) whether self-acceptance mediated the effects of perceived attitudes. In this cross-sectional study, 1527 Taiwanese LGB adults (812 men; 715 women) aged between 20 and 62years were recruited via Facebook to complete an online survey. The majority of respondents self-identified as homosexual (1129) and 399 as bisexual. The survey consisted of assessment of respondents' mental health and questions to rate individual self-acceptance and perceptions of social attitudes. Path analysis showed that self-acceptance partially mediated the association between mental health and perceived societal acceptance of homosexuality and fully mediated the effect of perceptions of friends' acceptance of homosexuality on mental health. Self-acceptance fully mediated the effects of perceived support for same-sex marriage from friends and families. This research yielded evidence about the interplay between perceived social stigma, self-acceptance, and mental health, particularly in the context of public debate about same-sex marriage. The effects of public discourse about sexual diversity and marriage equality on LGB adults' mental health should be addressed by affirmative policies and practices.

Social Relationships and Loneliness in Late Adulthood: Disparities by Sexual Orientation.

This is the first national study to examine disparities in loneliness and social relationships by sexual orientation in late adulthood in the United States. Prior studies have shown that lesbian, gay, and bisexual (LGB) individuals often struggle with social relationships across the life course, likely because of stigma related to sexual orientation. However, little is known about whether loneliness is more prevalent among LGB people than among other groups in late adulthood, and if so, which relationships contribute to the loneliness gap. We analyzed data from a nationally representative sample of older adults from the 2015-2016 National Social Life, Health, and Aging Project (N = 3,567) to examine the disparity in loneliness by sexual orientation and identify links between this disparity and multiple dimensions of social relationships, including partner, family, friend, and community relationships. Older LGB adults were significantly lonelier than their heterosexual counterparts, primarily due to a lower likelihood of having a partner and, to a lesser extent, lower levels of family support and greater friend strain. While they were also disadvantaged in the size of close family and frequency of community participation, these factors were less relevant to their loneliness. Overall, the conventionally defined inner layers of relationships (partnership and family) contributed more to the loneliness disparity than the outer layers of relationships (friends and community). These findings suggest that strengthening the partnerships and family relationships of sexual minorities is essential to reducing the loneliness gap.

Sexual minority substance use disparities: Bisexual women at elevated risk relative to other sexual minority groups

BackgroundPrior studies characterizing sexual minority substance use disparities have primarily compared lesbian/gay and bisexual individuals, respectively or in combination, to heterosexual individuals. In light of emerging evidence that bisexual individuals may have particularly elevated substance use risk, we examine differences in recent substance use between bisexual and lesbian/gay individuals using national survey data. MethodsData on 126,463 adults (including 8241 LGB adults) were from the 2015–2017 National Survey on Drug Use and Health. Substance use outcomes included binge drinking, cigarette smoking, cigar smoking, marijuana use, illicit drug use, opioid misuse, alcohol use disorder, nicotine dependence, and substance use disorder. Logistic regression was used to estimate sexual identity- and gender-specific odds ratios, controlling for demographic characteristics. Of particular interest were estimates comparing bisexual and lesbian/gay individuals of the same gender. ResultsBoth male and female sexual minority adults had significantly elevated rates of substance use compared to heterosexual adults. Furthermore, relative to lesbian/gay women, bisexual women had significantly elevated odds of binge drinking (aOR = 1.29), marijuana use (aOR = 1.42), illicit drug use (aOR = 1.55), opioid misuse (aOR = 1.53), and alcohol use disorder (aOR = 1.48). Relative to gay men, bisexual men had significantly elevated cigar use (aOR = 1.64). ConclusionsBisexual women were at significantly greater risk for multiple substance use behaviors relative to lesbian/gay women. We did not observe any substance use behaviors for which bisexual individuals had significantly lower risk than their lesbian/gay peers. These disparities may be explained, in part, by unique risk factors for substance use experienced by bisexual individuals, particularly bisexual women.

Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in South Korea: An Age-Stratified Analysis.

Purpose: Little research on internalized homophobia (IHP) and mental health among lesbian, gay, and bisexual (LGB) individuals has been done in South Korea, a context in which LGB populations widely experience societal stigma. This study examined the association between IHP and depressive symptoms and suicidal ideation among Korean LGB adults and investigated whether the association differed by participants' age. Methods: Cross-sectional data from the "Rainbow Connection Project I - Korean Lesbian, Gay, & Bisexual Adults' Health Study" were used for this study (N = 2178). Descriptive analyses were conducted to explore the distribution of IHP, depressive symptoms, and suicidal ideation across all covariates. Multivariate analyses were also used to investigate the overall and age-stratified associations between IHP and depressive symptoms and suicidal ideation. Results: The prevalence of high IHP was greater among older LGB adults, whereas the prevalence of depressive symptoms and suicidal ideation was higher among younger LGB adults. LGB individuals with high IHP levels had significantly greater risk of depressive symptoms than those with low IHP levels. In the age-stratified analyses, the associations between IHP and depressive symptoms were statistically significant only among older LGB adults with high IHP levels. Regarding suicidal ideation, the overall association was statistically significant in the full sample, but not in the age-stratified analyses. Conclusion: These findings suggest that mental health interventions are needed for LGB adults who have high IHP levels, especially among older generations. Furthermore, greater efforts are needed to enact protective legislation for sexual minority individuals in South Korea.

ANTICIPATED NEED FOR NURSING HOME PLACEMENT AMONG LESBIAN, GAY, BISEXUAL ADULTS AGES 50-64: FINDINGS FROM THE HRS

By 2030, the population of LGBTQ older adults is expected to exceed 6 million. Yet little is known about the expected use of nursing homes (NH) among LGBTQ older adults. Prior research has found NHs lack cultural sensitivity, and that LGBTQ NH residents are going “back into the closet” and not disclosing their sexual orientation due to discrimination and quality of care concerns. Using data from 2016 HRS, we describe bivariate differences between the LGB and heterosexual population, ages 50 to 64, and conduct a linear regression to determine the impact of LGB status on self-reported chance of moving to a NH in the future. Compared with the heterosexual population (n=4,049), these LGB adults (n=158) had a higher mean self-reported chance of moving to a NH (p<.01), fewer children (p<.01) and reported a slightly higher health rating (p<.05). LGB adults ages 50-64 also were more likely to be unmarried (71%, p< .001), white (59%, p< .001) and have a college degree (51%, p<.001). After controlling for sociodemographic variables, there were no significant differences between LGB and heterosexual adults’ self-reported chance of moving to a NH. Although anticipated chance of moving to a NH is no different for LGB adults ages 50-64 when controlling for their sociodemographic profiles, as a group they have a higher anticipated chance than heterosexual adults. These findings support the need for improved education, training, and structural changes within long-term care settings to better serve the growing older adult LGB population.