This study aims to explore articulations of gender identity, sexuality, and LGBTI perspectives in national as well as local dementia care policies and guidelines in Sweden. The analysis of the documents is influenced by Bacchi's WPR-approach. The analysis illustrates how there is a general silence on gender identity, sexuality, and LGBTI perspectives in policy. LGBTI perspectives tend to be addressed separately from people with dementia and most often present as potential grounds for discrimination. LGBTI people with dementia appear to be non-existent, and gender identity and sexuality irrelevant to dementia care and person-centered approaches, and by extension irrelevant to personhood.

Lesbian, gay, bisexual, trans and queer (LGBTQ) people make up a considerable proportion of those in need of formal dementia care. Yet sexuality and gender identity have received little attention in dementia care research. Using a discursive approach, this article explores how dementia care workers discuss and reflect on dementia, gender identity, sexuality and caring for LGBTQ people with dementia. The article is based on a focus group study with dementia care workers in Sweden, primarily nurses and nurse assistants. The findings point to pervasive heteronormativity in everyday care practice; non-normative sexualities and gender nonconformity were primarily deemed invisible but also sometimes questioned as "fabulations" or "fantasies". The invisibility of LGBTQ people was discursively framed as a result of generational belonging: people with dementia belonged to generations who were assumed to be closeted. Gender identity and sexuality were also framed as sensitive issues that were difficult to address with people with cognitive conditions. Dementia was understood as bringing out the true sexual or gendered self, but also as causing confusion and inauthentic expressions of gender and sexuality. In conclusion, existing discursive framings locate problems of heteronormativity outside of care practice and risk leading to inaction; more direct challenges to heteronormativity are needed in dementia care.