1. Hansen, Elizabeth MS, BSN, RN

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In an otherwise timely and informative article, "Sexuality in Nursing Care Facilities" (Sexually Speaking, March), author Anne Katz makes a glaring omission. She indicates that barriers to sexual expression for people who reside in nursing homes or assisted living facilities include "a scarcity of opposite-sex partners." The article never mentions the sexuality of lesbian, gay, bisexual, and transgender (LGBT) residents. Although it's difficult to say exactly how many people they represent, various surveys as well as the National Gay and Lesbian Task Force Policy Institute estimate that the LGBT population makes up 5% to 10% of the U.S. population, presenting significant implications for the provision of culturally competent nursing care.


This oversight may seem minor to some readers, but to members of the LGBT community (including both nurses and patients), it's a blatant example of the heterosexism that pervades society, including the health care system. It's a blind spot that underlies the invisibility, discrimination, abuse, and fear experienced all too commonly by LGBT elders. Despite societal progress in equality for sexual minorities, nursing education and practice have lagged behind,1, 2 contributing to the disparities that adversely impact the health care and quality of life of LGBT individuals.


A considerable number of resources are now available for inclusion in nursing curriculums and for nurses in all practice settings, including an extensive 2011 report from the Institute of Medicine, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, which is free online (


Elizabeth Hansen, MS, BSN, RN


East Calais, VT




1. Lim F, Levitt N. Lesbian, gay, bisexual, and transgender health Am J Nurs. 2011;111(11):11 [Context Link]


2. Lim F, et al. Caring for older lesbian, gay, bisexual, and transgender adults Am Nurse Today. 2013;8(1) [Context Link]