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Celebrating Chosen Family Within the LGBTQ+ Community

Gaby Novoa

February 18, 2021

This February 22, 2021 is Chosen Family Day, a national observance of the significant relationships among those in the LGBTQ+ community.1, 2 Families formed by choice, and with intention, play a vital role in the lives of many LGBTQ+ people, where close relationships provide care, affirmation and a sense of belonging.

Research shows that marginalization due to one’s sexual orientation or gender identity has been linked to higher rates of family rejection, mental health challenges, substance abuse and exposure to violence among LGBTQ+, compared with their heterosexual and/or cisgender counterparts.3 These vulnerabilities are further amplified for those with intersectional identities, such as one’s race, class, religion or dis/abilities. Chosen families, friendships and positive community connections are therefore essential, as social connectedness is a key factor in well-being and resilience.4

Chosen families face more barriers yet serve many of the same functions of biological families

Fondation Émergence, a non-profit organization in Quebec that supports and serves the LGBTQ+ community through education and awareness-building, champions the importance of chosen family.5 Julien Rougerie, Program Manager with the organization, asserts that the roles within chosen and biological families are often identical: providing love, support, care and connections.

The difference for family who are not blood-related, however, is that their roles are often impeded by more barriers, such as the lack of formal recognition of such ties as valid or “legitimate.” Research has shown, for example, that LGBTQ+ seniors in long-term care homes are sometimes not able to get access or certain permissions for their loved ones when protocols and regulations are not inclusive to those who do not fall under “traditional” conceptualizations of a family member. Moreover, the fear of disclosing one’s sexual orientation can sometimes prevent an individual from identifying their partner or spouse. When institutions, such as health care or long-term care systems, do not acknowledge these diverse family formations, they block pathways of necessary care and connection.

One study found that, apart from their partner, 59% of lesbian, gay and bisexual adults aged 50 and over indicated that friends are the first people they contact in emergencies, whereas only 9% say that they contact a “family member.”6 Rougerie notes that LGBTQ+ older adults commonly share experiences of estrangement or distance from their biological families, as they grew up in sociocultural and political contexts in which there existed more stigma and sanctions around queerness. Reliance and interdependence with chosen family therefore take on additional significance among LGBTQ+ older adults, whose chosen family often become their caregivers in later life.

Chosen family and well-being are interconnected

In preparing for Chosen Family Day, the Vanier Institute asked people who identify as LGBTQ+ to share what these connections mean to them. Many of the responses and reflections highlighted themes of solace, security and strength:

“Chosen family is moving forward in my life. It’s feeling like I have agency in the experience of fraternity, trust and companionship. It’s building networks that are strong, like the points and spirals on a spider web.” 


“To me, chosen family is the community of support with which you surround yourself. It’s the relationships you hold closest – whatever their nature is – and where you feel unquestionably at home.” 


“Chosen family is wholehearted, wholesome, safe, strength, shared resources, shared emotions, uplifting habits, community, shared creation (such as through food), communion and ritual.”  


“For me, chosen family is a group of people that you can turn to when you face hardships or have something to celebrate, and they can be there for you without judgement, especially when it comes to queer aspects of life such as dating or gender identity. It’s not really about seeing each other all the time or even being best friends, it’s knowing that you can confide and find comfort in someone and be assured that they love you AND your queerness, not despite it.” 


“Chosen family mean there’s always an extra chair, and it’s for you.” 


“Chosen family to me is reclaiming something that you didn’t have before.” 


“Having a chosen family is an extension of self-love. The active choice to surround myself with people who love and support me is the most significant way that I can appreciate and value myself.”


“Chosen family is like a big family gathering but without uncomfortable chairs, heavy air (heavy with secrets) and weird unspoken rules about when to speak. Instead, we are talking about a web of people who bob in and out of my life. I look to them and they look out for me. It’s not all smooth sailing – they teach me hard lessons (like how to avoid jealousy and how to deal with grief). In the light moments and in the rough ones, I’m so grateful for my chosen family.” 


“Chosen family is a place without judgement. It’s where you feel safe and true to yourself. It’s a place ‘where you don’t have to shrink yourself, to pretend or to perform.’”7


“Chosen family are those who help you sustain an environment of peace where you can show up as your authentic self.”


“To me a chosen family is one connected above all by trust and a kind of loyalty that is easy because it recognizes and anticipates change and growth.” 

Special thanks to all those who took the time to share.

 Responses have been edited for punctuation.

 Gaby Novoa, Families in Canada Knowledge Hub, Vanier Institute of the Family


  1. Friends of Ruby – an organization focused on supporting the progressive well-being of LGBTQI2S youth through social services and housing – launched Chosen Family Day in February 2020. Link: https://www.friendsofruby.ca/.
  2. Nathan Battams, “In Conversation: Lucy Gallo on Chosen Family Day and LGBTQI2S Youth,” The Vanier Institute of the Family (February 2020).
  3. Jonathan Garcia et al., “Social Isolation and Connectedness as Determinants of Well-Being: Global Evidence Mapping Focused on LGBTQ Youth,” Global Public Health (October 2019). Link: https://bit.ly/3p8BCMg.
  4. Ibid.
  5. Fondation Émergence. Link: https://bit.ly/3aeMS5F.
  6. Fondation Émergence, “Ensuring the Good Treatment of Lesbian, Gay, Bisexual and Transgender Older Adults” (2018). Link: https://bit.ly/3jKQsaQ.
  7. The quoted words are lyrics from the song “Family” by Blood Orange.


In Conversation: Lucy Gallo on Access, Adaptation and Resilience Among LGBTQI2S Youth

Gaby Novoa

June 29, 2020

Download the article (PDF)

The financial, physical and mental well-being of LGBTQI2S communities in Canada has been disproportionately impacted by the COVID-19 pandemic. A national survey found that 42% of the LGBTQI2S community reported significant impacts on their mental health amid the crisis, compared with 30% of non-LGBTQI2S people.

On June 23, 2020, we connected with Lucy Gallo, Youth Services and Housing Director of Friends of Ruby, to learn about how LGBTQI2S youth in Toronto have been navigating the past few months, and how their organization has adapted to continue to serve and support these youth.

Tell us about how Friends of Ruby has adapted and reacted throughout the COVID-19 pandemic to continue serving and supporting LGBTQI2S youth. 

We closed our drop-in on a Friday and, on the Monday, our counsellors were on the phone connecting with our youth – they jumped right into service and care. Counsellors quickly moved online and have been offering – and are still quite busy doing – phone sessions and video sessions, and we are excited to have just launched a chat counselling program. All staff have now been fully trained to also provide counselling through chat.

We realized there were youth who still live with their families, some of whom they’re not out to, and so they did not have private space to access counselling over the phone. This chat option is now giving them the opportunity to be able to access support, with maybe their parents thinking they’re just texting a friend. This was a feature that we have always wanted to do but never went there because we didn’t have the resources. So, COVID made the push and provided the opportunity to say “we have to react to this right now.” I quickly got the staff trained in two half-days, and they can continue to receive assistance by someone experienced in chat counselling.

As our drop-in program wasn’t available to the youth we serve, one of the themes that we heard in conversations with them at the beginning of the pandemic was the difficulty of accessing food. We responded by providing gift cards, and we were also able to send meals in partnership with an organization, which allowed us to deliver two meals a week to some of our youth.

In adapting to the pandemic, we’ve also tried to provide virtual groups daily to allow youth to continue to have as much access to us as possible. It gave us a chance for people to come together online, connect and share what was going on in their lives. Our Black, Indigenous, People of Colour (BIPOC) discussion group has been a very important one to be running, especially given the amount of racism and what is happening right now in the world. It’s been a difficult time for Black youth. When Toronto started announcing that they were going to card people if they were outdoors when the pandemic first started, and that people could tell on others, a lot of BIPOC youth did not want to come out to the centre; they did not want to experience more racism. We’ve also added some extra check-in times, specifically with our Black staff to support our Black youth.

Some of the other programs we’ve been continuing to run include our art therapy group, virtual drop-ins, gaming and art for change. Also, with the support of the Centre for Mindfulness Studies, two of our counsellors successfully ran a group called Mindfulness-Based Skills for Coping with Stress and Anxiety.

We have begun moving to doing some in-person supports and opportunities for interaction as well. We’ve opened the drop-in again, operating under our own version of “phase two.” We’re providing essentials so people can come in to pick up things like takeaway meals, harm reduction kits, menstrual kits and more. They can now access case management in person – we’ve created a room with enough distance – and plexiglass – and we’ve set up the space in such a way that we could have at least up to six people right now. We’ve also realized that if a youth can’t access their counsellor from home or they don’t want to chat online, they can come to our space and have the privacy to connect with their counsellor virtually.

A lot of the services we’ve been developing or strengthening in the past few months will now also be available post-pandemic. The goal is to offer this new form of modality to all of our youth and also for youth anywhere in Canada who want to access our counselling and/or connect online.

Tell us about any common themes that you’ve observed during the pandemic among the LGBTQI2S youth you serve.

I think a big one is a sense of loneliness. With not being able to access our space, there was a lot of anxiety in the beginning around what does this all mean. How does this affect everyone? Not being able to have our regular sense of community has been difficult, especially when not all youth feel they have the privacy, space or safety at home with their families.

Tell us about some of the lessons you’ve learned while adapting Friends of Ruby to continue serving youth. Have there been any surprises or “aha” moments?

One thing that was interesting, and I’ll just use this as one example of many, is that if someone is experiencing suicidal ideation and you have them in the space, you can do an assessment and hopefully you can de-escalate, as you have them there safe with you. But what I realized was when you’re online and you don’t know where somebody is, how do you provide a sense of safety?

We had to quickly create documents and ask the youth to read them over first and agree to provide information on where they are – such as their address and how to contact them if the line gets disconnected. This protocol also applies in many cases. Even when running our virtual therapeutic groups, how do we know if it was just that someone’s line broke out and that they’re not upset – that they didn’t purposefully drop the call because of something in the group that upset them. So, these are just some of the “aha” moments. When you have someone in person, it’s such a different way of working. These were some of the things that we had to adopt and make available for everyone’s safety.

Tell us about any unique experiences and/or stories of adaptation or resilience from the youth you serve.

There’s been incredible resilience among our youth throughout all this. The folks that we’ve had trouble accessing have been our most transient youth, because they didn’t have contact information for us to reach them when we closed. Because they usually come to see us just by dropping in, being closed made that hard, although a couple of them did come in to say hi and to tell us they’re doing quite well. Obviously, we haven’t been able to see everyone, but the folks we have seen have been demonstrating lots of resilience and coping.

The counsellors have spoken about how a lot of the youth weren’t so sure about doing online counselling. However, one person, for example, has still been working during the pandemic and said they actually liked this option because they can commit to counselling without having to travel to and from the organization. It makes accessing counselling easier for some.

What do you hope to see or do you anticipate in the months ahead?

Right now, we’re planning on opening the drop-in a little bit more, as the city opens more things. The goal is that we will let more people into the space and hopefully foster a greater sense of community again. Each counsellor has a couple of people who are waiting to be seen in person. We’re looking at planning for those counsellors to come in, just to see the specific people who can’t or don’t want to do online counselling. For the BIPOC discussion group, we’re looking at running it virtually, but also in person.

People could come into the space during that time to be part of the group, while others are also connected virtually, so we can meet the needs of people both offline and online. As mentioned earlier, we’re looking to start running another round of Mindfulness-Based Skills for Coping with Stress and Anxiety, hopefully around mid-July. In the next few weeks, staff will continue to talk about the ways that we can expand, and we will continue on with takeaway meals and case management, in person and virtually.

Connect with Friends of Ruby on social media (Twitter, Facebook, Instagram, LinkedIn) to stay up to date as they continue to offer more services and programs. 

Gaby Novoa, Families in Canada Knowledge Hub, Vanier Institute of the Family

This interview has been edited for length, flow and clarity. 


In Conversation: Lucy Gallo on Chosen Family Day and LGBTQI2S Youth

Nathan Battams

February 13, 2020

As many families across Canada come together for Family Day on Monday, preparations will be under way for another special observance – Chosen Family Day. On Saturday, February 22, Friends of Ruby – an organization focused on supporting the progressive well-being of LGBTQI2S youth through social services and housing – is launching Canada’s first annual Chosen Family Day to raise awareness of the experiences and challenges faced by these youth, to remind those who need support that help is available, and to celebrate the chosen families who provide them with love, care and support.

To learn more about Chosen Family Day and the importance of this unique family form to LGBTQI2S youth, Nathan Battams, Communications Manager at the Vanier Institute, joined Lucy Gallo, Director of Youth Services and Housing at Friends of Ruby, in conversation.

Tell me a little bit about Friends of Ruby, its history and what you do.

Research shows, and through our work we have seen, that LGBTQI2S youth experience barriers to employment and housing, and have significantly higher rates of family rejection, homelessness, poverty and suicidal thoughts than those who don’t identify with our community. There is a serious need for housing and social services focused on this community.

So, in 2014, with the support of a donor, Egale Canada opened Egale Youth Services, a little centre that served as a drop-in with multiple resources, as well as a little kitchenette where LGBTQI2S youth could have some snacks and food.

It was clear from the beginning that a) there was indeed a significant need for this kind of space, and b) the youth needed more than just housing. Individually and as a group, LGBTQI2S youth have diverse and unique experiences, and they benefit from having a place where they can build connections and relationships of love, care and support.

We’ve moved several times over the years to increasingly large spaces to accommodate this growing community. In 2019, we decided to design our new drop-in space based on our experience with the youth, in order to better support them. This is the space where we are currently located (i.e. 489 Queen Street East). At the same time, we were using our experience to build our emergency and transitional house (at the time called Egale Centre).

It had always been Egale’s plan to spin direct services off when it reached a certain maturity so, in November 2019, Egale Youth Services and Egale Centre merged to become Friends of Ruby, an independent organization that continues to focus on the progressive well-being of LGBTQI2S youth through social services and housing.

Since we started, our programming has expanded. We now offer barrier-free one-on-one counselling – both shorter-term crisis counselling as well as a built-in counselling structure where youth can see a counsellor for up to 20 sessions, and there aren’t huge wait lists (which is pretty amazing for counselling in general).

In addition to therapeutic groups, we also run psychologically beneficial social groups. For example, there’s an Art for Change group, which came from the youth about three years ago and it hasn’t stopped running, which facilitates expression through arts and crafts and community-building in a safe and inclusive environment. Soon, we’ll be launching a group called Skills for Safer Living, and it’s for folks who have experienced regular suicidal ideation.

We now have a weekly afternoon at the drop-in only for youth who are part of the Black, Indigenous and People of Colour (BIPOC) community. This is only for BIPOC youth and is staffed by people from the BIPOC community, which develops a whole other layer of safety and an opportunity for folks to talk about their intersecting identities. We run a discussion night that’s run by one of our staff and one of our partner agencies to unpack some of these intersections, which has been very well received.

Our drop-in centre has since extended due to significant demand, and because we recognize that there’s critical need for this space for some people such as trans youth, who may not feel safe to going into a shelter by virtue of their identity. Research shows that some shelters are not safe environments for trans people, who are commonly rejected based on their gender identity and aren’t given access to shelters that match the gender with which they identify, so we offer them a safe place to come in the morning, somewhere to rest and have a warm cup of coffee and something to eat, especially in the winter. The drop-in provides food security, with access to three meals a day, plus a snack in between lunch and dinner.

We also offer support with gender identity or transition, and help accessing housing, health care, and employment. Later this year, we’ll be opening a new programming centre with safe, transitional housing for up to 33 LGBTQI2S youth. The house has a purpose-based design with accessible single- and double-occupancy rooms, embedded mental health supports and case management, and a rooftop terrace for quiet reflection.

In all this growth, we’ve managed to support more than 900 youth, prevent 470 mental health crises and visits to hospital emergency rooms, and save an estimated $300,000 in health care costs, while providing approximately 2,500 one-to-one counselling and case management sessions and serving more than 4,500 meals per year.

Tell me about Chosen Family Day, and why the notion of chosen family is important at Friends of Ruby.

Chosen Family Day was actually inspired by what LGBTQI2S youth at Friends of Ruby were telling us when we asked them what this space means to them. Themes of relationships, connections, friendship, care and family – chosen family – clearly emerged.

We heard that it’s not like receiving services elsewhere, such as at the doctor, where you go have your appointment and leave. Here, there’s an added – and very important – layer of relationships that provides a sense of family that some youth aren’t used to having. It can be particularly important during such times as the holidays, when many people get together with their families, or in the dark months of winter, and now with Family Day. Many LGBTQI2S youth don’t have relationships with their biological families, some of which want nothing to do with them because of their identity, and it can serve as a painful reminder.

This sparked the idea to start Chosen Family Day, which will take place on the Saturday following Family Day every year, giving those who live in these incredibly diverse and unique communities a day to acknowledge and celebrate their chosen families. This idea of chosen family is so powerful — it brings energy and some light to what family itself means to other people.

How would you complete the phrase “Wouldn’t it be great if…”?

It would be amazing if organizations and spaces like ours, which focus on the LGBTQI2S community, didn’t need to exist. If they didn’t need to exist because we could be accepted and feel comfortable in any space.

I say this, of course, as a proud member of the chosen family at Friends of Ruby! I’m glad that we exist and that this space exists – there hasn’t been anything like this in the city before. When I was coming out, there was nothing like this, and to have this now for the youth is exciting.

But it would be great if we didn’t have to have these separations, build our own spaces because our trans youth actually can’t feel safe or comfortable in any other shelter or any other transitional housing. Wouldn’t it be great if all the other transitional houses and shelters that do exist were equally welcoming of youth for who they are, unique and precious like uncut ruby gems?

Chosen Family Day will be celebrated on Saturday, February 22, 2020.

Learn more about Friends of Ruby


Lucy Gallo is the Director of Youth Services and Housing at Friends of Ruby.

Nathan Battams is the Communications Manager at the Vanier Institute of the Family.

This interview has been edited for length and flow.


A Snapshot of Family Diversity in Canada (February 2018)

Download A Snapshot of Family Diversity in Canada (February 2018).

For more than 50 years, the Vanier Institute of the Family has monitored, studied and discussed trends in families and family life in Canada. From the beginning, the evidence has consistently made one thing clear: there is no single story to tell, because families are as diverse as the people who comprise them.

This has always been the case, whether one examines family structures, family identities, family living arrangements, family lifestyles, family experiences or whether one looks at the individual traits of family members, such as their ethnocultural background, immigration status, sexual orientation or their diverse abilities.

Building on our recent infographic, Family Diversity in Canada (2016 Census Update), our new Statistical Snapshot publication provides an expanded and more detailed portrait of modern families in Canada, as well as some of the trends that have shaped our vibrant and evolving family landscape over the years. Based on current data and trend analysis, this overview shows that diversity is, was and will continue to be a key characteristic of family life for generations to come – a reality that contributes to Canada’s dynamic and evolving society.

Highlights include:

  • According to Statistics Canada, there were 9.8 million Census families living across Canada in 2016.
  • 66% of families in Canada include a married couple, 18% are living common-law and 16% are lone-parent families – diverse family structures that continuously evolve.
  • Among Canada’s provinces, people in Quebec stand out with regard to couple/relationship formation, with a greater share living common-law than the rest of Canada (40% vs. 16%, respectively) and fewer married couples (60% vs. 84%, respectively) in 2016.
  • In 2016, 1.7 million people in Canada reported having an Aboriginal identity: 58% First Nations, 35% Métis, 3.9% Inuk (Inuit), 1.4% other Aboriginal identity and 1.3% with more than one Aboriginal identity.
  • In 2016, 22% of people in Canada reported that they were born outside the country – up from 16% in 1961.
  • In 2016, more than 1 in 5 people in Canada (22%) reported belonging to a visible minority group, 3 in 10 of whom were born in Canada.
  • 73,000 same-sex couples were counted in the 2016 Census, 12% of whom are raising children.
  • In 2016, there were nearly 404,000 multi-generational households in Canada – the fastest-growing household type since 2001 (+38%).
  • In 2011, 22% of Inuk (Inuit) grandparents, 14% of First Nations grandparents and 5% of Métis grandparents lived with their grandchildren, compared with 3.9% of among non-Indigenous grandparents.
  • In 2014, 1 in 5 Canadians aged 25 to 64 reported living with at least one disability. Disability rates were higher for women (23%) than men (18%).
  • More than one-quarter (27%) of Canadians surveyed in 2014 said religion is “very important” in their lives.
  • One-quarter of Canadians reported “no religious affiliation” in the 2011 Census (most recent data available), up from 17% in 2001.

Download A Snapshot of Family Diversity in Canada (February 2018).


Infographic: Modern Couples in Canada

Just as families have evolved across generations, so too have the couple relationships that are a major part of Canada’s “family landscape.” This perpetual change is both a reflection of and a driving force behind some of the evolving social, economic, cultural and environmental forces that shape family life.

Dating, marriage, cohabitation, common-law relationships – the ways people choose to come together, or decide to move apart, are as diverse as the couples themselves. There are, however, some broad trends being witnessed across the country, with family structures diversifying, people forming couple relationships at later ages and family finances taking on a more egalitarian structure.

Using new data from the 2016 Census, the Vanier Institute of the Family has published an infographic on modern couples in Canada.

Highlights include:

  • In 2016, married couples accounted for 79% of all couples in Canada, down from 93% in 1981.
  • One-quarter of “never-married” Canadians say they don’t intend to get married.
  • In 2016, 21% of all couples in Canada were living common-law, up from 6% in 1981.
  • The share of twentysomething women (37%) and men (25%) living in couples has nearly halved since 1981 (falling from 59% and 45%, respectively).
  • In 2016, 12.4% of all couple families in Canada with children under 25 were stepfamilies, down slightly from 12.6% in 2011.
  • There are 73,000 same-sex couples in Canada, 12% of whom are raising children.
  • 1 in 5 surveyed Canadians reported in 2011 that their parents are separated or divorced, up from 10% in 2001.
  • The share of people living in mixed unions nearly doubled between 1991 and 2011, from 2.6% to 4.6%.1
  • 69% of couples with children were dual-earner couples in 2014, up from 36% in 1976.

Download the Modern Couples in Canada infographic from the Vanier Institute of the Family



  1. Statistics Canada defines a mixed union as “a couple in which one spouse or partner belongs to a visible minority group and the other does not, as well as a couple in which the two spouses or partners belong to different visible minority groups.”

Infographic: Family Diversity in Canada 2016

International Day of Families is approaching on May 15, a special day to recognize the importance of family to communities across the globe. Parents, children, grandparents, great-grandparents, aunts, uncles, siblings, cousins and the friends and neighbours we care for (and who care for us) all make unique and valuable contributions to our lives, our workplaces and our communities.

As we reflect on Canada’s 9.9 million families, one thing that’s clear is that there’s no such thing as a cookie-cutter family. Families are as diverse and unique as the people who comprise them, and they are all an essential part of Canada’s family landscape.

For this year’s International Day of Families, we’ve created an infographic providing a “snapshot” of modern families in Canada that highlights some of the many ways families are diverse:

  • 67% of families in Canada are married-couple families, 17% are living common-law, and 16% are lone-parent families – diverse family structures that continuously evolve
  • 464,000 stepfamilies live across the country, accounting for 13% of couples with children
  • 363,000 households contain three or more generations, and there are also approximately 53,000 “skip-generation” homes (children and grandparents with no middle generation present)
  • 1.4 million people in Canada report having an Aboriginal identity (61% First Nations, 32% Métis, 4.2% Inuit, 1.9% other Aboriginal identity, 0.8% more than one Aboriginal identity)
  • 360,000 couples in Canada are mixed unions,* accounting for 4.6% of all married and common-law couples
  • 65,000 same-sex couples were counted in the 2011 Census, 9.4% of whom are raising children
  • 68,000 people in Canada are in the CAF Regular Forces, half of whom have children under 18

As His Excellency The Right Honourable David Johnston, Governor General of Canada, expressed at the Families in Canada Conference 2015, “Families, no matter their background or their makeup, bring new and special patterns to our diverse Canadian tapestry.” Join us as we recognize and celebrate family diversity, from coast to coast to coast.

Download the Family Diversity in Canada 2016 infographic.


* Statistics Canada defines a mixed union as “a couple in which one spouse or partner belongs to a visible minority group and the other does not, as well as a couple in which the two spouses or partners belong to different visible minority groups.”

The Health Care Experiences of LGBTQ+ Seniors

Laura Zuccaro

Updated on September 8, 2015

With 4.9 million Canadians aged 65 and older in 2011 and close to 6,000 centenarians, Canada – like many countries – is facing an aging population.((Statistics Canada, “Age and Sex Highlight Tables, 2011 Census,” 2011 Data Products, page last updated November 23, 2016. Link: http://bit.ly/2xdzb01.)) Many older Canadians are managing chronic or episodic illnesses, disabilities or conditions that make for frequent encounters with the health care system. When seeking medical attention, LGBTQ+ seniors face discrimination that can act as barriers to care. The main hurdles for LGBTQ+ seniors include identifying oneself as gay, lesbian, bisexual, transgender or queer, and experiencing discrimination.((Shari Brotman, Bill Ryan and Robert Cormier, “The Health and Social Service Needs of Gay and Lesbian Elders and Their Families in Canada,” The Gerontologist 43:2 (2003). Link: http://bit.ly/1ggcMmo.))

According to Statistics Canada, the use of the health care system (e.g. having a regular doctor, consultations with health care professionals and receiving preventive screening tests) by gay, lesbian and bisexual Canadians varies by sexual identity, and their health care choices differ from those of heterosexual seniors.((Michael Tjepkema, “Health Care Use Among Gay, Lesbian, and Bisexual Canadians,” Health Reports 19:1, Statistics Canada catalogue no. 82-003-X (March 2008). Link: http://bit.ly/1iZMGYN.)) Many seniors only discuss their sexual orientation in relation to their care, and many service providers avoid discussing issues relating to sexual orientation when making care plans. Research performed at McGill University revealed a “don’t ask, don’t tell” passive approach toward revealing sexual orientation in the health care system.((Brotman, Ryan and Cormier.))

Many seniors only discuss their sexual orientation in relation to their care, and many service providers avoid discussing issues relating to sexual orientation when making care plans.

Many gay and lesbian seniors have support from their biological families and children and grandchildren; others rely on friends considered as family, also known as “chosen families” or “fictive kin.”((Brotman, Ryan and Cormier.)) Health care providers do not always understand this broad definition of family and therefore it is common for same-sex partners to identify themselves as friends or roommates in order to avoid being treated differently. This can often make it difficult for LGBTQ+ partners to show affection or be acknowledged as the patient’s spouse.

A number of studies on gay and lesbian seniors and their caregivers have found that they may experience both actual and anticipated discrimination via homophobic or heterosexist attitudes or policies in the health care system. Actual discrimination has been reported in hospital practices surrounding visiting hours, such as LGBTQ+ caregivers being denied acknowledgement as family members when seeking to visit their partners. Anticipated discrimination could affect seniors’ willingness to reveal their sexual orientation or even access services due to prior negative experiences. Both forms of discrimination pose a challenge to both the possibilities of self-identifying as a gay or lesbian senior and receiving appropriate care.((Shari Brotman et al., “Coming Out to Care: Caregivers of Gay and Lesbian Seniors in Canada,” The Gerontologist 47:4 (2007). Link: http://bit.ly/2guIer6.))

In order to address the biases within the health care system, current research has suggested that specialized services designed to engage dialogue between gay and lesbian community health professionals and enhance integration would have a significant impact on the health care experiences of LGBTQ+ seniors in Canada.((Brotman et al.)) Such services would include training sessions for health care workers on the needs of gay and lesbian seniors; hiring gay and lesbian health care workers; using gender-neutral language in discussions about identity and relationships; ensuring confidentiality; specialized facilities (e.g. Kipling Acres, a long-term care facility and gay-positive environment that provides services to seniors in Toronto), support groups or telephone support lines; and community outreach programs. These services aim to reduce the barriers between LGBTQ+ seniors and their health care providers and improve health care interactions for both the care provider and the patient.

Laura Zuccaro is a second-year medical student at the University of Ottawa.

Originally published in Transition, Vol. 44, No. 3, in July 2014.

Updated on September 8, 2015

Timeline: 50 Years of Families in Canada

Today’s society and today’s families would have been difficult to imagine, let alone understand, a half-century ago.

Families and family life have become increasingly diverse and complex, but families have always been the cornerstone of our society, the engine of our economy and at the centre of our hearts.

Learn about how families and family experiences in Canada have changed over the past 50 years with our new timeline!

Download the 50 Years of Families in Canada timeline.