Policy and Perception: Comparing Attitudes Toward LGBTQ and Gender Equality Between Long-Term Care Staff in Taiwan and Indonesia.

BACKGROUND: Integrating lesbian, gay, bisexual, transgender, and queer (LGBTQ) policies within health care is critical to ensuring equitable treatment and improved health outcomes for LGBTQ individuals. However, significant disparities remain in the implementation of these policies, with substantial challenges persisting in culturally and legally diverse settings such as Indonesia and Taiwan. This study explores these issues from the perspectives of long-term care staff in these two countries, focusing on their attitudes towards LGBTQ individuals and the effectiveness of existing policies. PURPOSE: The primary objective of this study was to compare the implementation of LGBTQ policies with attitudes towards gender equality among long-term care staff in Indonesia and Taiwan. The secondary objective was to develop effective strategies for creating inclusive and equitable health care environments in diverse cultural contexts. METHODS: A mixed-methods approach using both qualitative and quantitative research methods was employed, and a convenience sampling method was used to select long-term care facilities in both countries. The targeted facilities included small-to-medium-sized centres located in urban and semi-urban regions. One hundred and ninety-seven long-term care staff (Taiwan = 135 and Indonesia = 62) completed the questionnaire. Data were collected using a structured survey designed to measure attitudes toward LGBTQ policies and gender equality using Likert-scale items. Descriptive and inferential statistics, including percentages, means, and independent t test, were used to analyse the quantitative data. For the qualitative component, the policy formation process was analysed based on the policy concept of Longest (2006) to provide further context to the findings. RESULTS: The analysis revealed significant differences in attitudes toward homosexuality (t = 19.81, p = .001) and transgender individuals (t = 7.12, p = .001) between the Taiwanese and Indonesian participants, with the Taiwanese participants demonstrating higher acceptance of homosexuality (M = 18.26, SD = 4.90) and transgender individuals (M = 21.90, SD = 4.07) than their Indonesian peers (M = 9.03, SD = 1.55 and M = 18.42, SD = 2.67, respectively). The results also indicate the supportive legal environment in Taiwan facilitates more progressive policies, while the conservative cultural norms and lack of legal protections in Indonesia create substantial barriers to LGBTQ inclusivity in long-term care settings. CONCLUSIONS: The findings highlight the critical role of supportive political climates and comprehensive policy frameworks in advancing LGBTQ rights within health care settings. While Taiwan has made significant progress, ongoing efforts are needed to bridge the gap between policy and practice. In Indonesia, substantial changes in the political and cultural landscape are critical to advancing LGBTQ inclusivity in health care. The findings of this study underscore the need for culturally sensitive strategies that address both legal and societal challenges to create a truly inclusive environment for LGBTQ individuals across diverse health care settings.