Provision,Expectation,and Obligation: The Significance of Gender Identity on Informal Caregiving by LGBTQ Adults Aged 45+

Abstract

The significance of gender identity on informal caregiving for adults ages 18+ by LGBTQ older adults needs increased attention due to the potential for negative outcomes associated with this unpaid labor. Utilizing the 2022 AARP Dignity Survey data, we examine the significance of gender identity, age, and other sociodemographics on caregiving among LGBTQ respondents ages 45+ in the United States. Findings indicate that among LGBTQ older adults, those who identify as a cisgender woman are more likely to have provided care and to expect to do so in the future. Conversely, gender identity does not significantly predict feeling obligated to provide care. Also, a gender diverse identity significantly predicts feeling obligated to care for someone who is unaccepting of that identity, suggesting that gender diverse caregivers face an increased risk for mistreatment. This study thus helps clarify how gender identity affects informal caregiving within the population of LGBTQ older adults.

Keywords

LGBTQ caregivers LGBTQ older adults informal caregiving aging gender identity

Introduction

In the United States, LGBTQ¹ adults have a disproportionately high rate of informal caregiving² of adults ages 18+ compared to their non-LGBTQ counterparts (SAGE, 2017); however, the research examining their specific experiences and needs is limited. While the literature indicates that caregiving is gendered in the general population with women performing a disproportionate amount (Guardian, 2023), it lacks clarity regarding how gender affects caregiving specifically for LGBTQ adults. Considering the negative financial and health outcomes associated with the caregiver role (AARP, 2022; RAISE, 2024), ambiguity about the significance of gender identity on caregiving experiences among LGBTQ adults means that needs go unmet. Such unmet needs might be particularly taxing for LGBTQ older adults³, as caregiving might exacerbate the adverse effects of minority stress they have experienced across the life course, including prejudice, discrimination, internalized stigmatization (Meyer, 2003), making them an at-risk population (Hall et al., 2025). Therefore, more research is required to provide a clearer understanding of how the provision, expectation, and obligation of caregiving varies by gender identity among LGBTQ older adults.

To target this gap, we build upon the study by Savage and Barringer (2024), which used 2017 AARP dataset to examine differences between LGBT older adults who identified as female, those who identified as male, and those who identified as gender expansive on (1) the likelihood of having been an informal caregiver and (2) the expectation that one will become a caregiver for an adult loved one in the future.⁴ We follow and expand on that work in two significant ways. First, we use more recent (2022) AARP data collected from LGBTQ adults age 45+. Second, we examine not only the likelihood of having provided informal care and the expectation one will give care in the future, but also two additional scenarios. In this study, therefore, we seek further clarity on the significance of gender identity for LGBTQ ages 45+ regarding whether they have (1) provided care, (2) expect to provide care, (3) feel obligated to provide care when they do not want to, and/or (4) have to provide care for someone who does not accept their LGBTQ identity.⁵ Additionally, we test other sociodemographics known to be significant in the caregiving experience, including age, race, disability, education, living arrangement, income, and region. This research contributes to the literature by uncovering the significance of gender identity, age, and other sociodemographics in the caregiving experiences of LGBTQ older adults and offering helpful information for those who work to ease the “informal caregiver’s burden” (Carretero et al., 2009, p. 74) for this marginalized population.

Literature

We begin by reviewing the research about informal caregiving in the U.S. generally, caregiving among LGBTQ adults caring for adults ages 18+ specifically, and the relationship between gender identity and caregiving in both the general and the LGBTQ populations. We then offer hypotheses for the current study.

Informal Caregiving in the U.S.

Informal caregiving is defined as the provision of unpaid assistance and support to someone whose impairments make it difficult to perform the activities of daily living (Whitehead & Lee, 2022). Generally, caregivers have little to no professional training, yet they help with tasks such as feeding, bathing, managing finances and administering medication (Whitehead & Lee, 2022). Through consistent provision of personal care and instrumental support, informal caregivers often provide the long-term and complex care that enables recipients to age in place; caregivers may also provide care to those living in assisted living and skilled nursing facilities (AARP & NAC 2020). The informal caregiving role can vary in intensity and frequency, but the duration of care averages between four and five years (NAC, 2020). There are an estimated 53 million informal caregivers in the U.S., and they are predominantly women (AARP, 2022). The average age of caregivers is 49 years old, and their average income is at least $50,000 annually, and the majority are non-Hispanic white (AARP, 2022).

While informal caregiving can generate positive outcomes for the provider, the potential for negative outcomes may be framed as a public health issue (Talley & Crews, 2007). Indeed, caregiving is associated with a sense of purpose, a stronger skill set (e.g., skilled medical tasks such as injections or tube feedings, improved time management, and increased empathy), and strengthened relationships with care recipients (AARP, 2022; Roth et al., 2015). Caregiving also, however, can lead to a decreased quality of life (Carretero et al., 2009). Negative outcomes such as financial issues (AARP, 2022; Cobbe et al., 2024), physical and mental health issues, feelings of isolation, and strains in relationships (Anderson et al., 2013; Boehmer et al., 2019; RAISE, 2024) are part of the “caregiver burden” (Liu et al., 2020, p. 438). Also, research shows that gender intersects with LGBTQ identity, race/ethnicity, socioeconomic status, and location to generate inequalities for caregivers (e.g., Cohen et al., 2024; Fredriksen-Goldsen, Jen, et al., 2023; Savage & Barringer, 2024).

LGBTQ Caregivers

Beyond the general population, an emergent body of literature has begun to generate an intersectional understanding of the experiences of the approximately eight to nine percent of informal caregivers who identify as LGBTQ and care for adults ages 18+ (AARP, 2022). The burgeoning research indicates that, though overlapping to some degree with those of their non-LGBTQ counterparts, the caregiving experiences of this population are associated with unique challenges and issues (Boehmer et al., 2018; Boehmer et al., 2019; Fredriksen-Goldsen, Jen, et al., 2023; Shiu et al., 2016). More studies are needed, however, to better clarify such differences between LGBTQ caregivers and their non-LGBTQ peers as well as parse out differences relative to caregiving among subgroups under the LGBTQ umbrella.

Like their non-LGBTQ counterparts, LGBTQ caregivers associate positive outcomes such as improved relationships, increased self-esteem, and altruistic feelings with their unpaid labor (Hash & Mankowski, 2017; Muraco & Fredriksen-Goldsen, 2014). A LGBTQ identity can also, however, significantly increase the risk of detrimental outcomes. LGBTQ adults are disproportionately overrepresented among unpaid caregivers and spend more time caregiving compared to their non-LGBTQ peers (SAGE, 2017). As a collective, they tend to be younger and are more likely to be single, of a lower socioeconomic status, and more racially/ethnically diverse (AARP & NAC, 2020; Boehmer et al., 2018). They often provide higher levels of care (Anderson & Flatt, 2018), and, because many offer unpaid care to members of their biological family as well as chosen family and acquaintances in the LGBTQ community, they spend more time caregiving (Fredriksen-Goldsen, 2018; Hash & Mankowski, 2017; SAGE, 2021).

Informal caregiving is uniquely taxing for LGBTQ individuals in other ways (Hall et al., 2025; Morgan et al., 2024). LGBTQ people report that they often feel they have little or no choice about taking on the caregiver role which leads to increased stress (AARP, 2022; SAGE, 2017). LGBTQ caregivers are more likely to report poor health, chronic illness, or disability (Boehmer et al., 2018; Muraco & Fredriksen-Goldsen, 2011; Shiu et al., 2016). They report feeling vulnerable, and lacking social support (AARP, 2022; Shiu et al., 2016; Xie et al., 2024). Further, caregivers may experience stigmatization and mistreatment if the care recipient rejects their LGBTQ identity (Anderson et al., 2021; Fredriksen-Goldsen, Jen, et al., 2023). LGBTQ caregivers are also more likely to experience financial strain and struggle to maintain employment due to their caregiving duties (Boehmer et al., 2018; Fredriksen-Goldsen, Shuman, et al., 2023). The burdens of unpaid caregiving can also be exacerbated for those who live in the South, which is under-resourced and lacking in social support and legal protections for LGBTQ people compared to other regions (Barringer & Savage, 2022; Stone, 2018). Overall, while many LGBTQ caregivers are willing to provide care (Hall et al., 2025; Morgan et al., 2024), their risk for detrimental outcomes can be heightened compared to that of their non-LGBTQ peers.

The care recipients can also cause stress for LGBTQ caregivers (Penning & Wu, 2016). Caregiving for families of origin may be experienced differently than caring for families of choice (Hall et al., 2025; Kim et al., 2024). Families of origin may refuse to accept the LGBTQ identity of their caregivers, which increases the potential for internalized identity stigma and minority stress (Meyer, 2003). Additionally, they may assume that their LGBTQ family member is free from the responsibilities of a “traditional” lifestyle and therefore readily available for caregiving (Boehmer et al., 2018; Hash & Mankowski, 2017). Alternatively, while a LGBTQ caregiver may not have to defend or hide their identity when caring for an LGBTQ recipient, thereby reducing the stress in the caregiving relationship (Morgan et al., 2024), they might still face discrimination in accessing healthcare and support on behalf of the recipient (Anderson & Flatt, 2018).

When age is considered, research indicates that LGBTQ older adults may be more vulnerable to the strains associated with informal caregiving than their younger counterparts (Morgan et al., 2024). As many LGBTQ older adults have experienced the damaging cumulative effects of minority stress, or the strain associated with maintaining a LGBTQ identity in a hetero/cisnormative society (Meyer, 2003; Miller, 2023; Morgan et al., 2024), they are defined as an at-risk population in the United States (MAP & SAGE, 2017). They experience higher rates of physical and mental health issues, disability, and discrimination in employment, housing, healthcare, and social services (Boehmer et al., 2018; Choi & Meyer, 2016; Croghan et al., 2014; Lampe et al., 2024; SAGE, 2021; Savage & Barringer, 2021). Additionally, LGBTQ older adults are less likely to have children, more likely to be single and/or live alone (Hash & Mankowski, 2017; SAGE, 2021), and have smaller social networks (Erosheva et al., 2016; Hsieh & Wong, 2020); they are therefore at risk for loneliness and isolation. Overall, though LGBTQ older adults may have developed a “crisis competence” which helps them successfully navigate stressors (Caceres & Frank, 2016), the results of a lifetime of deleterious experiences can increase the fragility of LGBTQ older adults who become caregivers (Fredriksen-Goldsen et al., 2017).

Gender and Informal Caregiving

Informal caregiving is associated with gender expectations in the United States. Even though men have recently taken on an increased amount of the informal caregiving, women remain more likely to do this work in the general population (Guardian, 2023; NAC, 2020). Compared to men, women who are caregivers are more likely to feel they are obligated to take on a caregiving role; they also spend more hours providing care, do more caregiving tasks, and are more likely to care for two or more people simultaneously (NAC, 2020). Women who are caregivers experience higher rates of stress and economic strain associated with disruption to their employment compared to those who are men (Brady, 2024; Schrank et al., 2016).

The literature is limited and conflicted about the degree to which informal caregiving varies by gender within the LGBTQ population. Some research suggests that caregiving within the LGBTQ population rejects the hegemony of sex-typed work in broader society (Kowalski & Scheitle, 2020; Zhang et al., 2024). Other studies indicate, however, that heteronormative expectations may generate a similar gendered division of caregiving among LGBTQ people (Croghan et al., 2014). For example, Savage and Barringer (2024), in their work upon which the current study seeks to expand, found that among LGBT adults ages 45+, cisgender women were more likely to have provided care and expect to provide care to an adult loved one, compared to cisgender men. Due to internalized heteronormative assumptions, LGBTQ older women may face or hold an expectation that they will become caregivers at some point and/or they may impose the demands of caregiving upon themselves to affirm their womanhood (Price, 2011; Weinstock, 2004).

A dearth of research makes understanding the caregiving experiences among LGBTQ adults who are gender diverse challenging (Boehmer et al., 2019; Moore & Torres, 2021). The few quantitative studies that have adequate sample sizes to statistically consider gender diverse caregivers indicate that they may be affected by caregiving differently than their cisgender peers, but there is still significant ambiguity. For example, while Xie and colleagues (2024) find that gender diverse caregivers may experience higher rates of loneliness, and Morgan and colleagues (2024) report differences in caregiver strain between transgender men and transgender women, others have found no significant differences between gender diverse and cisgender caregivers within the LGBTQ population (Fredriksen-Goldsen, Jen, et al., 2023). The current study therefore aims to make a significant contribution to the limited literature on gender diverse caregivers.

The Current Study

In the current study, we draw on the literature about informal caregiving in the U.S., caregiving by LGBTQ adults to examine the significance of gender identity and other sociodemographics on the caregiving experiences of LGBTQ adults ages 45+. We test the following hypotheses:

H₁: Among LGBTQ older adults, cisgender women are more likely to have provided caregiving or expect to become a caregiver to a loved one, compared to cisgender men.

H₂: Among LGBTQ older adults, cisgender women are more likely to feel obligated to provide care when one does not want to or feel obligated to provide caregiving to a loved one who does not accept their LGBTQ identity, compared to cisgender men.

H₃: Among LGBTQ older adults, gender diverse people are more likely to have provided caregiving or expect to become a caregiver to a loved one, compared to cisgender men.

H₄: Among LGBTQ older adults, gender diverse people are more likely to feel obligated to provide care when one does not want to or feel obligated to provide caregiving to a loved one who does not accept their LGBTQ identity, compared to cisgender men.

Research Design

The data for this study are from the AARP Dignity 2022: The Experience of LGBTQ Older Adults, a nationwide online survey of 2,004 LGBTQ Americans age 45+. Community Marketing & Insights (CMI) administered the survey, with participants recruited from a CMI research panel developed through its “…partnerships with over 300 LGBTQ media, events, organizations, and social media” (AARP, 2022). CMI weighted the survey sample using the best estimates of the LGBTQ older adult population. The CMI LGBT panel was compared to data on same-sex households and LGBTQ population data from survey sources such as Pew Research Center and the U.S. Census (AARP, 2022). As such, the survey provides valuable insights into the caregiving experiences of LGBTQ older adults. For our analyses, after eliminating missing responses, we retained between 1,024 and 1,723 sample sizes for the four models.

Dependent Variables

The survey questionnaire included measures regarding caregiving experiences among LGBTQ older adults. We focused on four questions:

(1) Have you ever provided caregiving to a loved one age 18 and older such as a relative, friend, or spouse/partner?

(2) How likely is it that you will become a caregiver to a loved one age 18 and older in the future?

(3) As a caregiver, do you ever feel obligated to provide care when you do not want to?

(4) As a caregiver, do you ever feel obligated to provide care to someone who does not accept your identity?

The survey defined a “family caregiver” as “someone who provides care on an unpaid basis for an adult loved one who is 18 years or older.” Each question became a dependent variable: (1) provided care, (2) expects to provide care, (3) obligated to provide care, and (4) obligated to provide care to someone who does not accept their [LGBTQ] identity. We created four dummy variables for our analyses with (1) yes (i.e., provided care, expects to become a caregiver, obligated to provide care, and/or obligated to provide care to someone who does not accept their LGBTQ identity) and (0) no. Those who said “not sure” were not included.

Independent Variables

Gender Identity

We used the AARP’s recoded variable grouping respondents as (1) cisgender lesbian and bi + women, (2) cisgender gay and bi + men, or (3) transgender and non-binary people. We created dummy variables representing cisgender women, cisgender men, and gender-diverse people, with cisgender men serving as the reference category.

Age

The dataset included age as a four-point scale ranging from (1) 45–54, (2) 55–64, (3) 65–74, to (4) 75+. We created dummy variables to represent each group, with individuals aged 45–54 years serving as the reference group.

Race and Ethnicity

For race/ethnicity, we used the AARP’s recoded variable, which included: (1) White (2) Asian/Pacific Islander (API), (3) Latino, and (4) Black. We created dummy variables representing each category with “White” as the reference category.

Disability

Respondents were asked, “Do you have a disability, handicap or chronic disease?” with the options of (1) yes, (2) no, or (3) not sure. We created a dummy variable to represent (1) those with a disability, handicap, or chronic disease and (0) those without. Responses of “not sure” were excluded.

Employment

The following options were offered to capture employment status: (1) employed full-time, (2) employed part-time, (3) self-employed full-time, (4) self-employed part-time, (5) retired and not working at all, (6) unemployed and looking for work, (7) not in the labor force for other reasons, and (8) other. Due to the number of categories and the wording of the responses, we created a dummy variable of (1) employed (categories 1–4) and (0) not working (categories 5–7). We excluded “other” and those who did not answer.

Living Arrangements

We used the AARP’s recoded variable for living arrangements status of (1) single not living with partner or (2) living with partner, recognized or not. We recoded this as: (1) single not living with partner or (0) living with partner.

Education

Respondents were asked the highest degree or level of education they completed with the following options: (1) 0 through 12th grade (no diploma), (2) high school graduate (or equivalent), (3) post-high school vocational or technical training, (4) some college (no degree), associate’s degree, 2-year college degree, (5) college graduate (4-year degree), (6) post-graduate study, or (7) graduate or professional degrees (master’s degree/PhD/law). We entered the variable as a seven-point scale.

Household Income

Respondents were asked: “What income range includes your household’s total income from all sources in 2020?” The options ranged from (1) less than $10,000 to (8) $200,000 or more. We entered this variable as an eight-point scale.

South

The literature shows that, compared to other U.S. regions, the South, commonly known as “the Bible Belt,” uniquely affects the lives of LGBTQ older adults (see Barringer & Savage, 2022). Therefore, we compare respondents living in the South to those in other regions. We used the United States Census (2010) to create a dummy variable to represent those living in the sixteen states of the (1) South and (0) those living in another region.

Analytical Strategy

We ran various statistical tests using IBM SPSS software version 27 to examine the effects of gender identity on informal caregiving among LGBTQ ages 45+. First, we ran descriptive statistics for the independent and sociodemographic variables by each dependent variable. Next, we ran four separate binary logistic regression analyses on the likelihood that respondents (1) have provided caregiving to an adult loved one, (2) expect to become a caregiver to an adult loved one, (3) feel obligated to provide care when they do not want to do so, and (4) feel obligated to provide care for someone who is not accepting of their LGBTQ identity.

Results

Table 1 displays the percentages and means for the four dependent variables and the independent variables. Across the four models, most respondents identify as either cisgender women (ranging from 37.5% to 41.9%) or cisgender men (ranging from 44.0% to 47.5%), with the smallest percentage identifying as gender expansive (ranging from 14.1% to 15.0%). Most of the respondents are 45–54 years old (ranging from 30.3% to 33.2%) or 55–64 years old (ranging from 32.8% to 34.6%) across the four models with a smaller percentage of people aged 64–74 years (ranging from 24.9% to 27.3%) or 75 and older (8.5% to 9.2%). On average, respondents fall between having “some college” and a “4-year degree” and report that their household income was $50,000 to $75,000 in 2020 across all four models. Most respondents identify as white (ranging from 66.4% to 68.0%), report having no disability (ranging from 57.0% to 59.3%), are employed (ranging from 56.4% to 58.6%), live in regions other than the South (ranging from 67.8% to 68.2%), and living with a partner (ranging from 51.4% to 53.9%).

Table 1.

Descriptive Statistics: Means and Percentages for Informal Caregiving Among LGBTQ Older Adults

	Provided caregiving model	Expected caregiving model	Obligated to provide care model	Caregiving while LGBTQ identity not accepted model
	n = 1,723	n = 1,621	n = 1,037	n = 1,024
Dependent variables
1 = yes, 0 = no	62.7%	65.5%	48.9%	15.6%
Independent variables
Gender identity
Cisgender women	37.5%	38.0%	40.8%	41.9%
Gender expansive	15.0%	14.9%	14.1%	14.1%
Cisgender men (reference category)	47.5%	47.1%	45.1%	44.0%
Sociodemographics
Age
45–54 years old (reference category)	32.8%	33.2%	30.3%	30.5%
55–64 years old	33.0%	32.8%	34.6%	33.7%
65–74 years old	25.0%	24.9%	26.3%	27.3%
75 and older	9.2%	9.1%	8.8%	8.5%
Race and ethnicity
Asian/Pacific Islander	5.7%	5.8%	5.0%	5.0%
Latino	12.8%	12.8%	13.9%	13.6%
Black	13.7%	13.4%	14.7%	14.3%
White (reference category)	67.8%	68.0%	66.4%	67.1%
Disability
Yes, disability	40.7%	40.8%	43.0%	42.9%
No, disability (reference category)	59.3%	59.2%	57.0%	57.1%
Employment
Employed	58.3%	58.6%	56.7%	56.4%
Not working (reference category)	41.7%	41.4%	43.3%	43.6%
Living arrangements
Single not living with partner	48.6%	48.3%	46.5%	46.1%
Living with partner (reference category)	51.4%	51.7%	53.5%	53.9%
Education level mean (7-point scale)	4.5	4.5	4.5	4.5
Total household income mean (8-point scale)	4.4	4.4	4.3	4.3
Region
South	32.1%	32.2%	32.0%	31.8%
Other regions (reference category)	67.9%	67.8%	68.0%	68.2%

Table 2 displays the results of the four binary logistic regression analyses. We examine the significance of gender identity and sociodemographic variables on informal caregiving among LGBTQ ages 45+. Table 2 presents the odds ratios (OR) with the standard error in parentheses for each of the four analyses.

Table 2.

Binary Logistic Regression Results: The Effects of Gender Identity on Informal Caregiving Among LGBTQ Older Adults

Variables	Provided caregiving model odds ratio (SE)	Expected caregiving model odds ratio (SE)	Obligated to provide care model odds ratio (SE)	Caregiving while LGBTQ identity not accepted model odds ratio (SE)
Gender identity
Cisgender women	1.483 (.115)***	1.556 (.128)***	1.057 (.140)	1.057 (.202)
Gender expansive	.937 (.152)	1.174 (.168)	1.091 (.201)	1.973 (.250)**
Sociodemographics
Age
55–64 years old	1.318 (.126)*	.636 (.147)***	.715 (.161)*	.682 (.213)
65–74 years old	1.674 (.153)***	.461 (.169)***	.590 (.190)**	.630 (.257)
75 and older	1.363 (.210)	.369 (.226)***	.233 (.294)***	.238 (.507)**
Race and ethnicity
Asian/Pacific Islander	.982 (.160)	1.242 (.263)	1.085 (.304)	1.218 (.440)
Latino	1.283 (.160)	1.058 (.177)	.583 (.195)**	1.347 (.254)
Black	1.522 (.157)	1.229 (.177)	.703 (.189)	.962 (.261)
Disability	1.259 (.111)*	0.827 (.121)	1.113 (.137)	1.794 (.189)**
Employed	.923 (.123)	1.361 (.133)*	1.350 (.150)*	.992 (.206)
Single not living with partner	.801 (.115)	.266 (.129)***	.981 (.143)	1.043 (.199)
Education level (7-point scale)	1.044 (.035)	1.066 (.039)	.998 (.044)	1.046 (.062)
Total household income (8-point scale)	.904 (.035)**	.991 (.039)	.923 (.044)	.905 (.063)
South	1.013 (.259)	1.102 (.123)	1.069 (.140)	1.573 (.186)*
N	1,723	1,621	1,037	1,024
Chi-square	58.371***	237.116***	58.479***	49.760**
Cox & Snell R-square	.033	.136	.055	.047
Nagelkerke R-Square	.045	.188	.073	.082

Note. *p < .05, **p < .01, ***p < .001. VIFs lower than 1.65 for all models.

First, the results in Table 2 show that gender identity has significant effects on the caregiving experiences of LGBTQ adults ages 45+. Table 2 shows the Provided Care Model has a statistically significant χ2 (p < .001) with a pseudo-r-square .045. This model shows that among LGBTQ older adults, cisgender women, compared to cisgender men, are significantly more likely to have provided care to an adult loved one (odds ratio [OR] = 1.483, p < .001). The Expects to Provide Care Model has a statistically significant χ² (p < .001) with a pseudo-r-square of .188. Among LGBTQ older adults, cisgender women, compared to cisgender men, are significantly more likely to anticipate that they will become caregivers for loved ones in the future (OR = 1.556, p < .001). The Obligated to Provide Care Model has a statistically significant χ2 (p < .001) with a pseudo-r-square of .073. No significant differences across gender identities were found in this model. The Caregiving While Not Accepted Model has a statistically significant χ² (p < .001) with a pseudo-r-square of .082. Among LGBTQ older adults, gender diverse people, compared to cisgender men, are significantly more likely to provide care to adult loved ones who are not accepting of their LGBTQ identity (OR = 1.973, p < .01).

Next, we account for various sociodemographic variables on caregiving by LGBTQ older adults. Age is a significant predictor across all four models with variations across the age categories. In the Provided Care Model, LGBTQ adults ages 55–64 years (OR = 1.318, p < .05) and 65–74 years (OR = 1.674, p < .001), compared to those 45–54 years old, are more likely to have provided care to an adult loved one. In the Expected Caregiving Model and the Obligated to Provide Care Model, LGBTQ adults are significantly less likely to expect to become a caregiver or feel obligated to provide care when they do not want to, across each age category, compared to those 45–54 years old. In the Caregiving with LGBTQ Identity Not Accepted Model, LGBTQ adults ages 75 and older, compared to those 45–54 years old, are significantly less likely to feel obligated to provide caregiving to adult loved ones who are not accepting of their LGBTQ identity (OR = .238, p < .01). Race/ethnicity was significant only in the Obligated to Provide Care Model, as Latino respondents, compared to their white counterparts, are significantly less likely to feel obligated to provide care when they did not want to (OR = .583, p < .01). LGBTQ older adults with a disability, compared to those without, are significantly more likely to have provided care to a loved one (OR = 1.259, p < .05) and/or are more likely to provide caregiving to adult loved ones who are not accepting of their LGBTQ identity (OR = 1.794, p < .01). Employed LGBTQ adults are more likely to expect to provide caregiving (OR = 1.361, p < .05) and feel obligated to provide care (OR = 1.350, p < .05), compared to those who are unemployed. LGBTQ adults who are single and not living with a partner, compared to those living with a partner, are significantly less likely to expect to become a caregiver in the future (OR = .266, p < .001). Households with higher income are significantly less likely to have provided caregiving to a loved one; this may be because they can afford to secure paid care (OR = .904, p < .01). Lastly, LGBTQ older adults who live in the South, compared to other regions, are more likely to provide caregiving to people who do not accept their identity (OR = 1.573, p < .05).

Discussion

Our study reveals significant differences by gender identity on informal caregiving by LGBTQ adults ages 45+. First, we find that LGBTQ older adults who are cisgender women are more likely to have cared for a loved one and more likely to expect to become a caregiver, compared to cisgender men. This result aligns with Savage and Barringer (2024) who found similarly using 2017 AARP data, suggesting that five years later, the gendered differences between cisgender women and cisgender men related to the provision and expectation of caregiving by LGBTQ older adults remain significant. Also, our analyses revealed that among LGBTQ adults ages 45+, gender diverse individuals are not significantly more likely to have provided caregiving or to expect to become a caregiver to an adult loved one, compared to cisgender men. This too aligns with Savage and Barringer (2024).

Turning to the remaining dependent variables about obligation, we find that, among LGBTQ older adults, there is no significant difference between cisgender women and cisgender men on (1) whether they ever feel obligated to provide care despite not wanting to do so or (1) ever feel obligated to provide care for someone who does not accept their LGBTQ identity. The results for gender diverse people in our study, however, revealed a significant difference of note. Among LGBTQ older adults, gender diverse people, compared to cisgender men, are more likely to feel obligated to provide care to someone who does not accept their LGBTQ identity. We see this as an important expansion on the work of Savage and Barringer (2024) as it suggests that among LGBTQ older adults, gender diverse caregivers who feel obligated to give care to an adult loved one even when their identity is not accepted by the recipient may experience a unique emotional burden.

We would like to offer one explanation for this finding. Our analyses indicate that, among LGBTQ older adults, the feeling of being obligated to provide informal care to an adult loved one does not vary significantly according to gender identity. It is likely, therefore, that the feeling of obligation is more “universal” because it is connected to broader social processes such as the internalization of responsibility driven by societal expectations, the cost and privatization of healthcare, and the absence of affordable alternatives. The significant difference instead emerged regarding the feeling of obligation to care for someone who is unaccepting of one’s identity, with gender diverse people more likely to report finding themselves in this situation. Therefore, while gender expansive people likely have similar reasons for feeling obligated to provide care as their cisgender peers, we suggest that the feeling they are obligated to care for someone who does not accept their identity reflects the heightened risk for mistreatment that gender diverse people face generally. The overall hostility toward gender diverse people has escalated in the United States since 2020 through targeted legislation and political rhetoric (ACLU, 2025). While there is a fair amount of social acceptance for lesbian and gay people, there is significantly less for transgender and nonbinary people (Pew Research Center, 2025). Among LGBTQ adults, gender diverse adults are more likely to report poor treatment and fear for their personal safety than those who are cisgender (Pew Research Center, 2025). This might mean, therefore, that care recipients reflect societal trends by being less accepting of LGBTQ caregivers who are gender diverse than those who are cisgender. Yet, like their cisgender peers, gender diverse caregivers still feel obligated to remain in the arrangement. In other words, the significant difference is that gender diverse caregivers face increased risk of hostility and nonacceptance in those situations because they face the same in broader society.

In addition to gender identity, our study also highlights the importance of age in shaping caregiving experiences among LGBTQ adults ages 45+. Age is significant across all four models with some differences between the age groups. The results likely tap into the temporal dynamics embedded within the survey questions themselves in relation to the life course. As age increases, the more likely LGBTQ older adults are to have provided care; this is logical given that LGBTQ adults in later stages of life would have likely had more opportunities to provide care to a loved one at some point. Age increases the likelihood of an adult loved one such as a parent or partner needing care, for example. Alternatively, as age increases, the less likely LGBTQ older adults are to expect to become caregivers, suggesting a recognition that they themselves may become the recipients of care rather than the givers in the future. Similarly, as age increases among LGBTQ older adults, the less likely they are to feel obligated to provide care when they do not want to do so. Also, those who are 75 and older are significantly less likely than those who are ages 45–54 to feel obligated to provide care to someone who does not accept their LGBTQ identity. Overall, we suggest that with age, LGBTQ older adults are better equipped to avoid caregiving situations which are hostile or harmful. Over the life course, they have developed resilience and “crisis competence” (Caceres & Frank, 2016) and are able to be more selective about who can place caregiving demands on them. In other words, by the time they reach age 55, LGBTQ adults are more likely to have the skills and social network necessary to break from or maintain ambivalent relationships/firm boundaries with their biological families in a manner that LGBTQ adults ages 45–54 have not yet realized. Additionally, this finding may be due in part to the fact that as LGBTQ older adults age, the death of their parents and siblings can enable them to exit the role of caregiver for people who reject their identity.

We argue that this study substantially contributes to the small but growing body of literature that documents the uniqueness of the caregiving experience for LGBTQ older adults. Gender identity continues to be an important predictor among LGBTQ older adults in determining who does and expects to do informal caregiving. This gendered expectation of who does and who expects to do care work aligns with the societal stereotype that women are essentially ‘nurturing’ and ‘natural’ caregivers. Compared to younger LGBTQ caregivers who may reject or reinterpret traditional gender norms, LGBTQ older adults may be more likely to have internalized hegemonic gender norms for caregiving, or they may be expected to align themselves with those norms by other people. We therefore echo the concerns of Savage and Barringer (2024) regarding the disproportionate burden that informal caregiving may put on LGBTQ older adults who are cisgender women. Further, we argue that our finding that LGBTQ older caregivers who are gender diverse are significantly more likely to feel obligated to care for someone who does not accept their identity is also cause for concern. This group might feel heightened stress in addition to the typical caregiver burden. Informal caregiving can lead to physical, emotional, and financial stressors, and for LGBTQ older adults who are caregivers, these consequences may be exacerbated by the accumulative effects of minority stress over the life course. When, in addition, therefore, the care recipient rejects a caregiver’s gender diverse identity, the cumulative impact could be highly detrimental for the caregiver, adding to the identity stigma and “day-to-day discrimination” that affects quality of life (Fredriksen-Goldsen, Jen, et al., 2023, p. 758). Understanding this dynamic is essential for those who seek to best support gender diverse caregivers who may be more likely than their cisgender counterparts to feel obligated to provide care in unaccepting and hostile situations.

Our study suggests implications as to how to best address the needs of LGBTQ + caregivers who face heightened risk for negative outcomes, especially those who feel obligated to care for people who do not accept them. First, providing social support and community engagement can reduce stress levels among LGBTQ caregivers by bolstering resilience (Fredriksen-Goldsen, Shuman, et al., 2023). For example, opportunities for physical activity, such as dance classes, can help improve quality of life for LGBTQ + caregivers (Fredriksen-Goldsen, Jen, et al., 2023). Also, support groups can provide a safe place to connect with others in similar situations. Offering such opportunities free of charge is essential given the financial stress faced by many LGBTQ + caregivers. Second, there is a need for increased education about LGBTQ + caregivers and a more nuanced understanding of their needs, particularly when caring for family members who may reject their LGBTQ + identity (Boehmer et al., 2019). Ensuring that healthcare providers receive such training enables them to interact with LGBTQ + caregivers in an affirming manner and offer resources specific to their nuanced needs. Third, increasing the affordability and availability of assisted living options and/or in-home care could help ease the burden on LGBTQ + informal caregivers.

Limitations

Our study has a few limitations to note. First, we are unable to account for both gender identity and sexual orientation in our analyses because the gender diverse category is measured the same for both gender identity and sexual orientation in the dataset and would lead to collinearity issues. To gain increased understanding, measures of gender and sexual identity should be multidimensional and responsive to both (Fredriksen-Goldsen et al., 2025). Second, the dataset made it prohibitive to parse out the “gender diverse” category in our analyses, meaning, for example, we could not check for significant differences among transgender men, transgender women, and nonbinary individuals. Third, in the survey data, race and ethnicity are conflated, which potentially limits the nuances we can ascertain. Finally, the survey did not account for some nuances of caregiving that the literature has shown to be important, such as the number of care recipients (SAGE, 2021) or the intensity of caregiving tasks (Brady et al., 2025).

Conclusion

Compared to their non-LGBTQ peers, LGBTQ caregivers are at an increased risk of negative outcomes and need to be seen and understood in the research (Hall et al., 2025). Part of that task includes understanding how gender and other sociodemographics affect the provision, expectation, and obligation of caregiving among LGBTQ people and uncovering differences between the sub-groups within the LGBTQ population. This is particularly urgent for LGBTQ older adults, a group that is already considered at-risk and is rapidly swelling in number as the U.S. population ages. As the number of laws and policies targeting gender diverse people increases across the U.S. (ACLU, 2025), future research should continue to parse out subgroups among LGBTQ older adults and capture their unique caregiving concerns, thereby gathering helpful information for policymakers and clinicians seeking to support this population.

Footnotes

ORCID iDs

B Savage

M. N. Barringer

Ethical Considerations

The authors were not required to submit to the Institutional Review Board because they are using a secondary dataset with anonymous data and were not involved in the data collection process.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The data supporting the findings is available upon request from AARP at . AARP retains intellectual property rights on the data.

Notes

Author Biographies

B. Savage is an Associate Professor of Sociology at Louisiana Tech University. Her research interests include race, gender, sexualities, religion, and the Scholarship of Teaching and Learning (SoTL). Her work has been published in journals such as Teaching Sociology, Sociological Spectrum, and Sociological Inquiry.

M. N. Barringer is an Associate Professor of Sociology at the University of North Florida. Her research interests include sexualities, gender, religion, and applied sociology. Her academic articles cover campus preachers, religious identity, and birth cohort attitudes. Her work has been published in journals such as Social Currents, Journal of Homosexuality, and Sociological Focus.

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