Balancing religious freedoms, sexual orientation rights and gender identity protections in older age care

This blog has recently been published on the British Society of Gerontology’s Ageing Issues website.

One of the major 21st century challenges for tolerance is balancing the rights of those with faith-based objections to lesbian, gay, bisexual and/or trans (LGBT+) lives with the rights of LGBT+ people themselves (1) (2). This is most evident in the recent Birmingham faith-based protests about LGBT+ education in schools and the ‘Gay Cake’ case, where Christian bakers refused to make a cake with a pro-gay marriage slogan on it.

With an ageing population and associated growing demands for care, there is increasing reliance on faith-based care organisations (3) and religious care-workers to provide that care. Some may have faith-based objections to doing so. How they experience delivering care to LGBT+ older people, and how LGBT+ older people experience that care is not yet well understood. Indeed such uncomfortable conversations tend to be avoided. (4)

What is already known, however, is that many LGBT+ older people, when anticipating future care needs, are anxious about receiving care from those religious care workers who do not regard LGBT+ people in a favourable light. (5) (6) (7)

There have been some suggestions from recent UK research that staff working in older age care homes who feel uncomfortable working with older LGBT+ people are more likely to have strict religious beliefs which inform their discomfort. (8) (9) This is not to say all people of faith have difficulty working with LGBT+ people. Far from it. And, of course, many older LGBT people are people of faith themselves. (10) Nevertheless, religion can be a site of tension for some, (11) and how that tension is navigated in older age care contexts is not yet well-understood.

I am now conducting a small-scale scoping research project to try and understand what the key issues are, with a view to developing a larger-scale research grant application, possibly with colleagues in Australia, Canada and the US, these issues also having been raised in their respective countries. (12) (13) (14)

The project has recently been granted ethical approval by the University of York, and comprises interviews, focus groups and two confidential surveys, both of which are now open.

  • One survey is for care providers (care workers, managers, and professionals working with older people in health and social care).
  • The other survey is for older LGBT+ people (aged 60+), their friends/family, and advocates/people working for organisations advocating for older LGBT+ people
  • Updates and, eventually, the project’s findings and reports will be posted on the project website. However, if you would like to know more, please email me at: sue.westwood@york.ac.uk. Sue Westwood, York Law School, University of York.

    1. Eskridge Jr, W. N., & Wilson, R. F. (Eds.). (2018). Religious Freedom, LGBT Rights, and the Prospects for Common Ground. Cambridge University Press.
    2. Young, P. D., Shipley, H., & Trothen, T. J. (Eds.). (2015). Religion and sexuality: Diversity and the limits of tolerance. UBC Press.
    3. E.g. Methodist Homes, Order of St John Care Trust, etc.
    4. Carr, S., & Pezzella, A. (2017). Sickness, ‘sin’ and discrimination: Examining a challenge for UK mental health nursing practice with lesbian, gay and bisexual peopleJournal of psychiatric and mental health nursing24(7), 553-560.
    5. Westwood, S. (2015). ‘We see it as being heterosexualised, being put into a care home’: Gender, sexuality and housing/care preferences among older LGB individuals in the UK. Health & social care in the community24(6). DOI: 10.1111/hsc.12265
    6. Hunter, C., Bishop, J-A, and Westwood, S. (2016) The complexity of trans*/gender identities: Implications for dementia care. In S, Westwood and E. Price (eds) Lesbian, Gay, Bisexual and Trans* Individuals Living with Dementia: Concepts, practice and rights. Routledge.
    7. Almack, K. (2018). ‘I didn’t come out to go back in the closet’: Ageing and end-of-life care for older LGBT people. In King, A., Almack, K., Suen, Y-T, Westwood, S. (eds)  Older Lesbian, Gay, Bisexual and Trans People: Minding the Knowledge Gaps,158-171. Abingdon: Routledge.
    8. Hafford‐Letchfield, T., Simpson, P., Willis, P. B., & Almack, K. (2018). Developing inclusive residential care for older lesbian, gay, bisexual and trans (LGBT) people: An evaluation of the Care Home Challenge action research projectHealth & social care in the community26(2), e312-e320, p.e316
    9. Simpson, P., Almack, K., & Walthery, P. (2018). ‘We treat them all the same’: the attitudes, knowledge and practices of staff concerning old/er lesbian, gay, bisexual and trans residents in care homes. Ageing & Society, 38(5), 869-899.
    10. Westwood, S. (2017). Religion, sexuality, and (in) equality in the lives of older lesbian, gay, and bisexual people in the United Kingdom. Journal of Religion, Spirituality & Aging29(1), 47-69.
    11. Westwood, S., & Knocker, S. (2016). 11 One-day training courses on LGBT* awareness–are they the answer?. In S, Westwood and E. Price (eds) Lesbian, Gay, Bisexual and Trans* Individuals Living with Dementia: Concepts, practice and rights. Routledge.
    12. Riseman, N. (2018) Religious freedom and the rights of LGBTI people: Lessons of recent history.
    13. Fredriksen-Goldsen, K. I., Hoy-Ellis, C. P., Goldsen, J., Emlet, C. A., & Hooyman, N. R. (2014). Creating a vision for the future: Key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human servicesJournal of gerontological social work57(2-4), 80-107.
    14. Furlotte, C., Gladstone, J. W., Cosby, R. F., & Fitzgerald, K. A. (2016). “Could we hold hands?” Older lesbian and gay couples’ perceptions of long-term care homes and home care. Canadian Journal on Aging/La Revue canadienne du vieillissement, 35(4), 432-446.

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