The myth of ‘older LGBT+’ people: Research shortcomings and policy/practice implications for health/care provision

Westwood, Sue. "The myth of ‘older LGBT+’people: Research shortcomings and policy/practice implications for health/care provision." Journal of Aging Studies 55 (2020): 100880.


Abstract

This article explores the implications of research which takes a collectivised approach to lesbian, gay, bisexual and trans+ (LGBT+) ageing and which engages in Questionable Research Practices (QRPs) in doing so. Collectivised approaches to heterogenous identity-based groups address commonalities but often fail to address internal diversity, i.e. the differences between and among older LGBT+ people. This article explores six key problems associated with collectivised research: (1) Homogenising language and phrases; (2) Uneven numerical representation of sub-groups; (3) Thematic over-representation of sexuality; (4) Non-intersectional analyses; (5) Thematic under-representation of gender; and (6) Inaccurate reporting of data. Research which does not differentiate between ‘older LGBT+’ sub-populations, can provide policy-makers and practitioners with inaccurate and/or misleading information, resulting in services which meet the needs of some, but not all, older LGBT+ people. This article discusses how research can become more inclusive, intersectional and reliable.

Introduction

Collective identity categories such as ‘LGBT' (lesbian, gay, bisexual and trans) and ‘LGBT+’ are inherently problematic, their need to create a unified ‘us' often obscuring in-group difference. There is a growing body of literature on LGBT+ ageing particularly in relation to health and care issues. Some research address both the shared, and the different, concerns of older LGBT+ people. However, other research takes a pooled approach to these issues, often merging differences into a misleading collective ‘whole’. This occurs against the wider academic background of the ‘continued eclipse of heterogeneity in gerontological research’. This pooled approach is problematic in at least the following ways:

  1. Use of homogenising language and phrases;

  2. Numerical under-representation of sub-groups;

  3. Thematic over-representation of sexuality;

  4. Non-intersectional analyses;

  5. Thematic under-representation of gender; and.

  6. Inaccurate reporting of data.

These issues raise concerns in relation to Questionable Research Practices (QRPs), i.e.

…design, analytic, or reporting practices that may introduce biased evidence, which can have harmful implications for evidence-based practice, theory development, and perceptions of the rigor of science.

Conclusion

The collectivised studies highlighted in this article are not meant to be indicative of the wider literature on ‘LGBT+’ ageing. The purpose of this article has been to show what can happen when collectivised discourse is mobilised, and how easily sub-group members can be excluded in all-encompassing narratives. It has also shown how some reporting of LGBT+ ageing research raises concerns about QRPs.

In terms of solutions, clearly acronyms and identity labels should be used with caution and qualifiers where necessary. Community and collectivised group discourse should only be used when supported by empirical evidence. Sexuality should always be considered at its intersection with sex/gender and gender identity: there cannot be one without the other. Mixed research must be transparent about who is and is not included in its data from the outset not just in a final ‘limitations’ section. There should be a reasonable expectation of equal numbers of lesbians and gay men in mixed studies (given there are almost equal numbers of women and men in the general population) and sufficient numbers of bisexual women and men and trans individuals to support meaningful data analysis. This may require purposive sampling.

Some authors have suggested that there should be more sub-group-specific research to counterbalance marginalisation in mixed research. There is clearly a place for this argument, however one of the problems is that such research could lack sufficient scale to enable key actors (funders, policy makers, commissioners and providers of services) to rely on the generalisability of findings, and to respond accordingly. It could also set LGBT+ ageing researchers up against each other, vying for (diminishing) research funding.

A possible middle-ground might be larger scale projects conducted by a consortium of researchers who take responsibilities for different ‘arms’ of a collective research project, so that sub-group issues can be studied both separately and together. This would also help the practical reality that researchers from particular LGBT+ sub-groups are more likely to be able to recruit and engage research participants from those sub-groups to which they themselves belong.

Research also needs to become more reflexive, with researchers making clear what they bring to the analytical table, particularly if they are more sensitised by personal experience to some older LGBT+ membership issues than others. Other ways to improve research integrity include: enhanced researcher training and supervision; increased internal peer review of publications; improved institutional policies, guidance and auditing; enhanced reporting requirements; and more structured and specific journal reviews.

This article echoes Isaacowitz's call for a more ‘transparent science of aging’. Hopefully, it will serve as a call to action to ensure that all, not just some, LGBT+ ageing research is inclusive, robust and reliable, of optimal use to policy-makers and providers, and thereby of the greatest benefit to older LGBT+ people themselves.

Read the full article