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Inclusive Care

Scotland’s first care standard created with LGBTQ+ elders, giving services a trusted way to show they are truly inclusive.

Inclusive Care Charter Mark Scotland

LGBT+ inclusive care: delivering for Scotland’s LGBT+ elders

For over 20 years, we’ve worked to improve the health and wellbeing of LGBT+ communities, including older people. While our services have made a real difference, Scotland’s wider health and social care system still lacks consistent standards to ensure inclusive support.

In a changing regulatory and political landscape, we believe the time to act is now.

In 2023, a group of LGBT+ elders led a groundbreaking study and published the Fit for Purpose report. One key finding was clear: Scotland urgently needs LGBT+ specific and affirming health and personal care services.

Illustration of a house with walls in different colours of the rainbow, with the Pride progress flag on its roof

Our response: Inclusive Care Charter Mark

We’re working with LGBT+ people aged 60 and over to create Scotland’s first quality standard for inclusive care. The Inclusive Care Charter Mark will help health and social care providers deliver safe, affirming services for LGBT+ people.

It will be shaped and assessed by older LGBT+ people, combining lived experience with other research and evidence. Together, we’re building a system where the first openly LGBT+ generation to age can do so with dignity, safety, and respect.

In a time of rising anti-LGBT+ sentiment and shifting policies, the Charter Mark gives providers confidence and credibility. It signals a clear commitment to inclusion—for regulators, staff, and service users.

The challenges

Older LGBT+ people still face major barriers when accessing care:

  • Discrimination and bias: Without inclusive policies, support often depends on individual attitudes undermining the quality of care. Many avoid services or hide their identities for fear of mistreatment.
  • Invisibility and erasure: Care services can erase LGBT+ identities through assumptions and gaps in data collection make it harder to identify and tackle inequalities effectively.
  • Isolation and mental health: Older LGBT+ adults are more likely to live alone and lack traditional family support. Combined with higher rates of depression, anxiety, and trauma (linked to past discrimination), accessing care becomes complex.
  • Lack of training: Many providers don’t offer consistent LGBT+ training, leading to erasure, inappropriate language, and neglect of specific needs. Some services overlook chosen families, excluding partners and kinship from key care decisions.
  • Barriers for trans and non-binary people: Staff often lack knowledge on trans identities leading to inappropriate treatment or denial of care.
  • Limited legal protection and accountability: Discrimination is unlawful, but enforcement is patchy and complaints processes are often unclear and intimidating. There is an urgent need for consistent standards to establish accountability and make meaningful change.

The solution: Inclusive Care Charter Mark

The Inclusive Care Charter Mark aims to set a recognised, trusted, and community-led standard for LGBT+ inclusion in care.

What it does

  • Sets clear standards for inclusive care
  • Empowers older LGBT+ people to shape and assess care provision
  • Supports providers with practical tools and training for best practice
  • Recognises those who show real commitment to inclusion
  • Drives change across Scotland’s health and social care sector

How it works

  • Co-designed framework: Developed with LGBT+ older adults and care providers
  • Support package: Includes resources, self-assessment tools, and training
  • Accreditation: A clear certification process with Bronze, Silver, and Gold levels to encourage progress
  • Visibility: Accredited providers display a trusted logo
  • Ongoing review: Annual evaluation to ensure relevance and accountability

Why it matters

This is the first initiative of its kind in Scotland. It fills a crucial gap by offering care providers a clear path to improve inclusion.

It builds on successful models like LGBT Youth Scotland’s Inclusive Education Charter Mark and supports Scotland’s national priorities for health, social care, and equality.

For providers, it shows leadership and builds trust. For service users, it means safety, visibility, and confidence that their needs will be met and identities respected.

Get involved

Want to learn more or get involved in developing the Charter Mark?
Email jean@lgbthealth.org.uk to connect with the team.

Resources

Working with LGBTQ+ elders? Our resources can help you offer informed, inclusive, and affirming care.

Creating LGBT inclusive services for older people: a guide for care professionals

This guide helps services for older people become more LGBT-inclusive. It provides practical steps, audit…
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4 September 2015

Ten Top Tips for becoming more inclusive of older LGBT people

This guide provides strategies to help organisations create inclusive services for older LGBT+ people, promoting…
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30 July 2014

Proud to Care: LGBT and Dementia (a Healthcare Guide)

LGBT people with dementia face isolation and discrimination, often unable to share their identity. This…
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27 August 2020

Five Tips for Supporting Older Transgender People

This guide offers five tips for providing respectful services to older transgender people: avoid assumptions,…
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4 June 2015

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