Method

A more detailed explanation of the approach to the literature searches is given in Appendix 1. A search strategy based on the method used for a systematic literature review has been conducted. Four key terms – older people, LGBTI, Nordic and healthcare/social care – were used to create search strings with synonyms and related terms. The searches were separated into two different search queries. Search query 1 aimed to find literature on the living conditions of older LGBTI people in the Nordic countries. Search query 2 aimed to find literature on the competence of healthcare and social care staff in their interactions with LGBTI people, or knowledge about the situation of LGBTI people in healthcare and social care study programmes, in the Nordic region. Supplementary interviews with academic staff at higher education institutions as well as providers of CPD were also conducted to supplement the literature search in sub-study 2.

The searches were limited to literature published between the years 2012 and 2022, and were conducted in the databases Scopus, PubMed, Gender Studies Database, and PsycINFO for search query 1; and supplemented with searches in Education Research Complete and ERIC for search query 2. The time span was chosen in light of how there have been relatively large societal changes regarding LGBTI rights that affect living and ageing conditions in all the Nordic countries, as well as in certain autonomous regions from 2010 onwards. It is worth noting that there have been changes during this period of time, and that the time span is for publications, not collected material. This means that the included studies may have empirical data older than from 2012. The time span also means that studies that are currently ongoing are not included. For example, the Swedish National Board of Health and Welfare and the Public Health Agency of Sweden have been working on mappings of older LGBTI people and knowledge about LGBTI issues within elder care in the context of Sweden during 2022–2023. Their final reports will be published in autumn 2023.

Due to the geographical limits on the subject, searches in each of the languages were also carried out in the search services of the various Nordic countries for scholarly publications. The search resulted in a total of 1671 hits. The hits were reviewed at title and abstract level by the authors of this report in the screening program Rayyan in blind mode, followed by a second stage in which the full texts were read. Finnish and Icelandic language hits was reviewed by external reviewers. The inclusion criteria meant, among other things, that the included studies were to be empirical and focus on LGBTI people who were 65+ years old, and that the studies were conducted in one or more of the Nordic countries. Finally, a total of 25 scholarly publications were included for Part 1 and 22 publications for Part 2.

In addition to the database searches, targeted searches for so called grey material were also made on the websites of relevant public authorities and organisations. For each Nordic country, two self-programmed search engines were created. The full texts were selected and reviewed from the first 50 hits of the searches. In total, the searches for grey material resulted in 8 included publications for Part 1 and 9 publications for Part 2. In addition, 5 publications were included on recommendations from the reference group and others. A total of 38 + 31 publications were included as the basis for the report.

A thematic coding was developed in collaboration between the researchers during the process of close reading of the abstracts, which further contributed to clarifying the inclusion and exclusion criteria and the limits for these. This was also further developed in the process of reading the full texts. The next step in the thematic analysis was taken after close reading of the included full texts and discussion of the proposals for thematic categories in the literature selection in each sub-study (Braun & Clarke, 2006, 2019).

For search query 2, a contextualising mapping was done of the documents regulating the knowledge and skills requirements for relevant health and social sciences professional qualification study programmes in different Nordic countries. Nineteen in-person and online interviews and e-mail interviews were also conducted with academic staff who teach in the health and social sciences professional qualification study programmes included in the study; and with people who provide CPD courses on gender, sexuality, norms and LGBTI ageing for professionals working in municipalities or civil society actors, in particular in Finland and Iceland where few or no publications were found in the literature searches.