Dementia and Queer

Invisible but not forgotten – why queer people with dementia deserve special attention

When we talk about dementia, many people initially think of memory loss, disorientation, and the increasing need for support in everyday life. But what happens when this diagnosis affects people whose entire life story has been shaped by a very specific set of tensions: invisibility, discrimination, pressure to conform, and social change? This is precisely where queer people with dementia are easily overlooked. Yet they require special attention – for dignified and sensitive support in old age.

Queer Aging: Living with Double Invisibility

According to estimates, approximately 5 to 10 percent of the older population identify as LGBTIQA* people. Yet, queer seniors remain largely invisible in care facilities. Heterosexuality is often automatically assumed in care settings, and queer biographies go unnoticed. Yet many LGBTIQA* people have experienced massive discrimination, exclusion, and even criminal prosecution throughout their lives—for example, under Section 175, which criminalized homosexual men until 1994.

Many have learned to hide their identity – often out of fear of professional or social consequences. These experiences often linger into old age and also influence the way queer people experience care and support.

Dementia meets queer biographies: Intensifying stresses

Dementia means a loss of orientation and control for all affected individuals. Queer people face additional stressors. The so-called "Minority Stress Model" describes the persistent psychological strain caused by stigmatization, hiding one's identity, and fear of rejection. This persistent stress can have a negative impact on health and is discussed as a risk factor for dementia.

In addition, people with dementia often draw on memories from the past. For those who have lived in fear and secrecy for decades, old fears, feelings of shame, or traumatic experiences can become particularly present again.

Fear of double forgetting

There are specific fears for queer people with dementia:

Forgetting who you confided in.
Hiding one’s identity again for fear of rejection.
Experiences of discrimination in care facilities.

Some facilities claim they have no queer residents—in reality, this often simply means that no one dares to come out. Yet the need for acceptance, closeness, and authentic living persists well into old age.

Special features for trans and intersex people**

Trans* and intersex* people, in particular, face additional challenges with dementia. Changes in body image, uncertainty about using names and pronouns, or confronting medical procedures that are no longer remembered can be unsettling and traumatizing. This requires specially trained, sensitive caregivers who are informed about gender diversity and can address it openly.

Care facilities: still much room for improvement

Currently, only around three percent of residential care facilities in Germany offer specific services for queer seniors. Most facilities lack knowledge, training, and sensitive concepts that take queer life realities into account. Yet even small measures could achieve a lot: rainbow symbols, queer literature in the common room, and awareness training for staff.

One successful example is the Berlin project "Lebensort Vielfalt" (Living Place Diversity) run by the Schwulenberatung Berlin (Gay Counseling Center Berlin). Here, queer seniors live together across generations, supported by trained professionals.

What can be done concretely

For care facilities to become more queer-sensitive, we need:

Mandatory training: Knowledge about LGBTIQA*, sexuality in old age and queer biographies must become an integral part of training.
Individual care planning: Care and support plans should take into account the life history and identity of the residents.
Sending visible signals: Rainbow flags, queer magazines and an open mission statement create trust.
Protection against discrimination: Institutions must actively prevent discrimination and take a clear stance.
Involve chosen families: Many queer people have close friends or chosen families who are just as important to them as biological relatives.

Conclusion: Take diversity seriously – even with dementia

Dementia affects everyone. But queer seniors bring with them biographies marked by courage, the art of survival, and adaptation. These life stories deserve recognition and care that sensitively addresses their unique characteristics. Care must not once again become a source of invisibility and discrimination, but must provide a safe space and a place to call home.

Dementia and queerness must no longer be a blind spot – but a natural part of inclusive, respectful care for all.

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