Ageism and LGBTIQA+ Phobia: A Scoping Review of Barriers in Healthcare

Introduction: Population ageing and increasing recognition of sexual and gender diversity have highlighted health inequalities affecting older LGBTIQA+ people. Ageism and LGBTIQA+ phobia intersect, creating specific barriers to healthcare. Objective: To map and synthesize evidence on healthcare barriers affecting older LGBTIQA+ people and their consequences from a nursing perspective. Methods: A scoping review was conducted following PRISMA-ScR and Joanna Briggs Institute guidance. The review question was developed using the PCC framework. Searches were performed in PubMed, CINAHL, Scopus, and the Cochrane Library. Nineteen sources were included. Results: Structural barriers included inadequate professional training, cisheteronormativity, and limited inclusive policies. Interpersonal barriers comprised discriminatory attitudes, identity invisibility, misgendering, and fear of disclosure. Social barriers included stigma, isolation, and socioeconomic disadvantages. These barriers were associated with delayed care-seeking, reduced service utilization, and poorer physical, mental, and social health outcomes. Discussion: The findings indicate that inequalities cannot be explained by age or LGBTIQA+ identity alone, but by their interaction with socioeconomic and psychosocial vulnerabilities across the life course. Community networks may provide protection, although their availability is unequal. Nursing education, identity-affirming protocols, inclusive organizational policies, and accountability mechanisms are therefore required. Conclusions: Older LGBTIQA+ people experience cumulative barriers within healthcare and long-term care. Longitudinal and intervention research is needed to evaluate effective strategies for culturally safe and equitable care. The protocol was registered in the Open Science Framework on 8 July 2026.