Exploring Sexual Expression, Intimacy Needs, and Barriers in Older Lesbian, Gay, Bisexual, Transgender, Pansexual, and Queer individuals: A Qualitative Study

Sexuality is a vital part of human life that continues into older adulthood, yet the experiences of Lesbian, Gay, Bisexual, Transgender, Pansexual, and Queer (LGBTPQ) elders remain largely overlooked in research and practice. This study examines how older LGBTPQ adults navigate sexual expression and intimacy while facing unique social and structural barriers. Using a qualitative approach, we conducted in-depth interviews with 40 participants living in Portugal, aged between 64 and 83 years (M = 70.33, SD = 3.87). Analysis revealed that intimacy in later life extends beyond sexual activity, encompassing emotional closeness, identity affirmation, and resilience in the face of stigma, ageism, and healthcare invisibility. Findings highlight both persistent barriers, such as discrimination in care settings, internalized shame, and social isolation, and sources of strength, including chosen families, alternative relationship structures, and positive redefinitions of intimacy with age. The study underscores the need for inclusive policies, culturally competent healthcare, and recognition of LGBTPQ elders as active agents of sexual and emotional well-being throughout the life course.