This is a research briefing for residential aged care managers about how they can best support rainbow residents. It was developed with consultation from Mark Henrickson. Mark is a former professor of Social Work at Massey University, who authored many studies into sexuality and gender identity in older adults in New Zealand, including with residential aged care.
Executive Summary
This briefing is intended primarily for residential aged care managers, and it sets out what the evidence shows about facilities' current preparedness to support Rainbow residents and what managers can practically do in response. Beyond the ethical case, facilities that cannot demonstrate inclusive care for a growing proportion of older New Zealanders carry real reputational and commercial risk. For many Rainbow residents, sexuality and gender identity are a core part of who they are and how they have lived, and thus no facility can genuinely claim to deliver person-centred care without recognising such diversity.
New Zealand's aged care sector is not adequately prepared for a resident population that will include growing numbers of Rainbow people. A study conducted across 35 facilities found that fewer than half of staff had received any employer education on sexuality and intimacy for residents, and that only 22% of participants relied on workplace training to make decisions on sexual issues while 44% based decisions on personal values (Henrickson et al., 2021). Another study found subtle and overt forms of homophobia across facilities, with care staff broadly unprepared to provide culturally appropriate care to LGB residents (Neville et al., 2015).
This is despite sexual orientation having been named as a dimension of cultural safety since 1996 (Richardson & Carryer, 2005). Without explicit policy and leadership within individual facilities, the standards Registered Nurses are trained to cannot, on their own, produce consistent practice.
Research suggests residents who anticipate or experience non-acceptance conceal their identities and experience worse mental health outcomes as a direct consequence (McMullen-Roach et al., 2025). New Zealand-based studies document that residents themselves, including heterosexual individuals otherwise supportive of Rainbow identities, look to staff to set the tone on what's acceptable for discussion (Henrickson et al., 2021).
For the full report, please click here.
Updated: 7 Sep 2026