“I’d Rather Take Some ‘Pills’”: LGBTQIA+ Perspectives on Residential Assisted Living Homes in Portugal

Abstract Book of the 7th International Conference on Gender Studies and Sexuality

Year: 2026

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“I’d Rather Take Some ‘Pills’”: LGBTQIA+ Perspectives on Residential Assisted Living Homes in Portugal

Rita Carvalho, Sara Guerra, Liliana Sousa, João Tavares

ABSTRACT:

Fear and potential avoidance of residencial assisted living homes (RALH) among older LGBTQIA+ adults are often associated with expectations of discrimination and non-inclusive environments. This qualitative study, conducted as part of a broader project exploring LGBTQIA+ perspectives on affirmative long-term care in Portugal, focused specifically on current perceptions and concerns regarding RALH. Four focus groups were conducted between January and April 2026 with 12 LGBTQIA+ participants aged 47 to 80 years old. Data was analyzed using reflexive thematic analysis. Four major themes emerged: (1) “RAHL as a dehumanized and ageist space”: characterized by rigid routines, infantilization, overprotection, passivity and loss of autonomy; (2) “RALH as a space of existential emptiness and social disconnection”: frequently described as a space of loneliness, social disconnection, and existential stagnation, associated with boredom, inactivity, and the feeling of “waiting for death”; (3) “RAHL potentiates identity erasure and invisibility”: institutional cultures perceived as religiously influenced, and poorly equipped to support individuality and dignity: participants fear discrimination and anticipate identity concealment, a “return to the closet” and obstacles to the expression of their sexuality, intimacy, and gender identity; (4) “RAHL have structural fragilities and unpreparedness to affirmative care”: participants highlighted structural concerns, including insufficient staffing, high turnover, lack of training, and broader underinvestment in RALH. Findings suggest that apprehension towards RALH among LGBTQIA+ adults reflects broader perceptions of institutional care as potential dehumanizing, autonomy-restricting, and incompatible with dignified aging. Results highlight the need to rethink RAHL environments through more humanized, person-centred, and identity-affirming models of care.

Keywords: Affirmative Care; Aging; Institutionalization; Nursing Homes; Queer