Italian sexual minority older adults in healthcare services: identities, discriminations, and competencies

Purpose This study explores perceptions and experiences related to healthcare utilization in a group of Italian sexual minority older adults, to understand the unique challenges faced by this population when accessing healthcare services. Older adults represent one of the subgroups exposed to the highest risk within sexual minorities with regard to physical and mental health. Method Data collection occurred between October 2018 and April 2019. Semi-structured interviews were carried out with 23 participants over 60 years, including questions about participants’: experiences when dealing with physical/mental healthcare services; tendency to disclose sexual orientation in clinical contexts; preferences and desires when seeking care. Data were analyzed using Interpretative Phenomenological Analysis (IPA), in order to provide qualitative information on participants’ experiences. Results Three interconnected themes were identified: the relevance of clinician and patient’s identities in determining confidence and satisfaction; expectations and experiences of discrimination; the need for specific competencies on sexualminority concerns. Conclusion Access and utilization of healthcare services can be considered as a multi-faceted phenomenon which involves people’s past and current experiences, perceptions, expectations and desires. Participants’ perception of having to deal with heterosexist healthcare settings influences health behaviors and outcomes. Policy Implications Interventions directed to healthcare providers are needed, to increase specific competencies and ensure safe and affirming environments