Who Cares and Caring for Whom? Unpaid Caregiving by Gender and Sexual Identity

A briefing paper prepared for the Council on Contemporary Families by Zhe (Meredith) Zhang, California State University, Los Angeles

Many people have the experience of providing care to family and friends with serious health conditions or limitations. Most people will provide such unpaid care to their loved ones at some point in their lives. In 2020, about 53 million U.S. adults or 21.3% of the population provided unpaid care such as preparing meals, providing transportation, managing medications, dressing, or bathing a loved one with health limitations or disabilities in the past year. This number of caregivers will continue to rise with the aging American population as most of those receiving such care are older adults.

In a class of mine, I asked the students who would come to their minds when they thought about unpaid caregivers. Most of them mentioned a wife, daughter, sister, or mother. Their observations are consistent with the established research, which has found that in general, women are more likely to be providing care than men.

However, one limitation of this prior research is that it seldom considers sexual orientation. A burgeoning literature suggests that sexual minorities may provide more care than heterosexuals, but many questions remain unanswered. Does it mean that gay and bisexual men are more likely to provide care than heterosexual men? Are women’s higher caregiving rates only prominent among heterosexuals? Do sexual minority men have similar caregiving rates as sexual minority women?

We need to consider sexual orientation in a study of caregiving for several reasons. First, the number of Americans identifying as a sexual minority (e.g., gay, lesbian, bisexual, queer) has continued to increase for the past decade (Jones 2022). Second, gay, lesbian, and bisexual adults have lower partnership and childbearing rates than heterosexuals, which may lead to different caregiving networks and demands (Croghan et al. 2014; Ismail et al. 2020). For instance, sexual minorities’ lower partnership rate relative to heterosexuals may mean that they have fewer demands of providing care to an aging partner.

In a paper recently published in Demography (Zhang et al. 2024), my coauthors and I examined how unpaid caregiving is associated with both gender and sexual identity. One of the main findings in our paper is that not all men have lower caregiving rates relative to women. It is only among heterosexuals that we see a lower caregiving rate among men than women. Gay and bisexual men have similar caregiving rates as lesbian and bisexual women. Heterosexual men’s caregiving rate is much lower than that of bisexual men. This low caregiving rate for heterosexual men may reflect their stricter adherence to gender norms around division of labor (Connell and Messerschmidt 2005), which emphasize that men are responsible for paid work and women are responsible for domestic work such as caregiving. On the other hand, gay and bisexual men in the U.S. tend to hold less conservative views on gender (Denise 2019), which may help explain their higher caregiving rates.

Next, we examined whether the association between unpaid caregiving, gender, and sexual identity varied by partnership status (i.e., whether one is married/in a relationship). We found that unpartnered bisexual men were more likely to provide care than unpartnered heterosexual men, unpartnered gay men, and partnered bisexual men. Bisexual people generally report less social support from family, friends, and LGBT+ communities than heterosexuals and gay/lesbian adults (Dodge et al. 2012; Gorman et al. 2015). Additionally, bisexual men may experience unique stressors related to the perceptions that bisexual men are either not fully “out” as gay men or are unfairly tied to straight privilege (Anderson and McCormack 2016). Feeling even more isolated, unpartnered bisexual men may be particularly incentivized to provide care to a loved one to facilitate more social connection.

To further understand the experiences of these caregivers, we also examined caregivers’ relationship to the care recipient. Among the caregivers, we found that gay, lesbian, and bisexual caregivers generally reported less spouse/partner caregiving than heterosexual men and women, likely because they are less likely to have a partner than heterosexuals. The absence of a partner probably makes sexual minorities more available to care for other loved ones, such as grandparents. We found that sexual minority caregivers were more likely to provide care to a grandparent relative to their heterosexual peers. We also found that heterosexual, gay, lesbian, and bisexual caregivers had similar rates of parental caregiving. This echoes prior work, which showed that sexual minority adult children continued to provide care for older parents even when parents disapproved of their sexuality (Cronin et al. 2011; Reczek and Umberson 2016).

Additionally, we find higher rates of friend caregiving among sexual minority caregivers, particularly among lesbian women. Among the caregivers, nearly a quarter of lesbian women were caring for a friend compared to 14% of heterosexual women. In additional analysis that considers partnership status, we also found that gay men without a partner had higher rates of caring for friends (33%) than unpartnered heterosexual (21%) and bisexual men (15%). In general, prior work has shown that sexual minorities, many of whom are alienated from families of origin, have long built families of choice with whom they share no biological or legal relationship (Lavender-Stott and Allen 2023; MetLife 2010). Research has shown that sexual minorities often provide care to friends that are part of these chosen families. During the HIV/AIDS epidemic, most people infected with HIV identified a gay friend as both their primary caregiver and family (Fredriksen-Goldsen 2007). Taken together, our results suggest that caregiving for a friend may be particularly common among lesbian women and unpartnered gay men.

Overall, our study provides a comprehensive overview of caregiving rates by gender, sexual identity, and partnership status among American adults. We find that women’s higher caregiving rate relative to men’s is only prominent among heterosexuals. Caregiving rates do not differ by sexuality among women, but bisexual men (especially those without a partner) have a much higher caregiving rate than heterosexual men. We also find that among the caregivers, adults of varying gender and sexual identity groups may provide care to different social ties (e.g., parents, partners, or friends). Altogether, our findings help advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities.

References

Anderson, E., & McCormack, M. (2016). The changing dynamics of bisexual men’s lives: Social research perspectives. Cham, Switzerland: Springer Nature.

Connell, R. W., & Messerschmidt, J. W. (2005). Hegemonic masculinity: Rethinking the concept. Gender & Society, 19, 829–859.

Croghan, C. F., Moone, R. P., & Olson, A. M. (2014). Friends, family, and caregiving among midlife and older lesbian, gay, bisexual, and transgender adults. Journal of Homosexuality, 61, 79–102.

Cronin, A., Ward, R., Pugh, S., King, A., & Price, E. (2011). Categories and their consequences: Understanding and supporting the caring relationships of older lesbian, gay and bisexual people. International Social Work, 54, 421–435.

Denise, E. J. (2019). Americans’ gender attitudes at the intersection of sexual orientation and gender. Journal of Homosexuality, 66, 141–172.

Dodge, B., Schnarrs, P. W., Reece, M., Goncalves, G., Martinez, O., Nix, R., . . . Fortenberry, J. D. (2012). Community involvement among behaviourally bisexual men in the midwestern USA: Experiences and perceptions across communities. Culture, Health & Sexuality, 14, 1095–1110.

Fredriksen-Goldsen, K. I. (2007). HIV/AIDS caregiving: Predictors of well-being and distress. Journal of Gay & Lesbian Social Services, 18(3–4), 53–73.

Gorman, B. K., Denney, J. T., Dowdy, H., & Medeiros, R. A. (2015). A new piece of the puzzle: Sexual orientation, gender, and physical health status. Demography, 52, 1357–1382.

Ismail, M., Hammond, N. G., Wilson, K., & Stinchcombe, A. (2020). Canadians who care: Social networks and informal caregiving among lesbian, gay, and bisexual older adults in the Canadian Longitudinal Study on Aging. International Journal of Aging and Human Development, 91, 299–316.

Jones, J. M. (2022, February 17). LGBT Identification in U.S. Ticks Up to 7.1%. Gallup News. Retrieved from https://news.gallup.com/poll/389792/lgbt-identification-ticks-up.aspx

Lavender‐Stott, E. S., & Allen, K. R. (2023). Not alone: Family experiences across the life course of single, baby boom sexual‐minority women. Family Relations, 72, 140–158.

MetLife Mature Market Institute. (2010). Out and aging: The MetLife study of lesbian and gay baby boomers. Journal of GLBT Family Studies, 6, 40–57.

Reczek, C., & Umberson, D. (2016). Greedy spouse, needy parent: The marital dynamics of gay, lesbian, and heterosexual intergenerational caregivers. Journal of Marriage and Family, 78, 957–974.

Zhang, Z., Smith-Johnson, M. & Gorman, B. K. (2024). Who cares? unpaid caregiving by sexual identity, gender, and partnership status among U.S. adults.” Demography, DOI 10.1215/00703370-11145841.

For More Information, Please Contact:

Zhe (Meredith) Zhang, Assistant Professor of Sociology, California State University, Los Angeles
mzhang19@calstatela.edu.

Links:

Press release: NEW FROM CCF! Men Provide Less Unpaid Care for Family and Friends Than Women, But Only Among Heterosexuals