By: Sam van Kalkeren, MSN, RN, CDP, CADDCT
How Aging is Different for the LGBTQ+ Community
It’s no secret that we become more susceptible to health challenges as we age. Hopefully, as these challenges appear, we will have an adequate support system to help us navigate the challenges. Ideally, this support system will help us maintain our quality of life and support us holistically. Unfortunately, the LGBTQ+ community is more at risk for health disparities, and as LGBTQ+ identifying individuals age, they are more susceptible to discrimination and social isolation.
Currently, it is estimated that there are over 3 million LGBTQ+ adults over the age of 50 living in America. By 2030, it is estimated that there will be about 7 million LGBTQ+ adults over the age of 50 in America. Much hate and discrimination are still directed toward the LGBTQ+ community. That hate and bigotry will likely grow as more states pass legislation targeting the LGBTQ+ community.
LGBTQ+ Aging Facts
- LGBTQ+ older adults are twice as likely to live alone and four times as likely to not have children, making it more difficult to age successfully in their homes and communities.
- 53% of LGBTQ+ older people report feeling isolated from others.
- 50% of all Americans living with HIV are over 50 years old.
- 70% of LGBTQ+ elders fear having to “re-closet” themselves when seeking elder housing for fear of discrimination.
- The fear for someone in the LGBTQ+ community is:
- Will we be accepted?
- Will we be understood?
- How will we be treated?
- Will we face discrimination from the staff and other residents?
- The fear for someone in the LGBTQ+ community is:
- In 2016, 78% of LGBTQ residents in nursing homes, assisted living facilities, and long-term care facilities responded “No” or “Not sure” when asked if they felt comfortable about their sexual orientation or gender identity to facility staff.
LGBTQ+ People Face Discrimination
In 2016 a lawsuit was filed by Lambda Legal because a lesbian who disclosed her sexual orientation to other residents was called homophobic slurs, spat on, and assaulted by other facility residents on several occasions. The lawsuit charged that officials at the facility illegally failed to take action to prevent the abuse and threats by fellow residents and retaliated against the plaintiff when she complained. A landmark 2018 appeals court ruling in the plaintiff’s favor affirmed that residential facilities such as the one where the plaintiff lived are legally responsible for the safety of tenant residents.
In October 2021, news surfaced that a transgender U.S. Army veteran was denied placement in more than two-dozen long-term care facilities in Colorado in 2020 and 2021. According to the Army veteran, when the facilities found out she was transgender, they did not want her. A social worker assisting the search reported that one of the facilities stated a private room was needed but was unavailable “because she still has her ‘boy parts’ and cannot be placed with a woman” in a shared room.
There are state LGBTQ+ nondiscrimination laws meant to protect LGBTQ+ individuals, but long-term care facilities get around these laws by claiming other reasons for turning down an LGBTQ+ person. Health care, in general, is a realm in which LGBTQ+ people are more likely to contend with access issues. Many individuals do not seek care due to past experiences of discrimination or experiences where the provider is unfamiliar with LGBTQ issues. There is a lack of cultural competency, which makes LGBTQ+ individuals afraid to seek care.
Survey of LGBTQ+ Elders
Six organizations conducted a recent survey of 649 LGBTQ+ elders to understand better what an LGBTQ+ elder experiences in a long-term care setting. When asked what issues they feel an LGBTQ+ older adult faces or might face if open about their sexual orientation and/or gender identity?
- 89% predicted that staff would discriminate against an LGBTQ+ elder who was out of the closet.
- 81% thought that other residents would discriminate and, more specifically, that other residents would isolate an LGBTQ+ resident.
- 53% predicted that staff would abuse or neglect the person.
- 43% reported 853 instances of mistreatment. Of those who reported instances of mistreatment, 124 were LGBTQ+ older adults.
How to Face Challenges and Create Solutions
As a member of the LGBTQ+ community, this is near and dear to me. I’ve experienced discrimination from healthcare providers just for being gay. More often, my husband and I have conversations about aging and our plans since we do not have children. We understand that we may need to hire an individual to advocate for us at some point and will need all our legal documents in order. It is important to us to be surrounded by members of our community who understand us and our challenges and to feel accepted.
More education for the public and providers is needed about the issues facing aging members of the LGBTQ+ community. Senior living communities must invest in staff education around culturally competent care for the LGBTQ+ community and make communities more inclusive and safer for their LGBTQ+ residents. Communities should have zero-tolerance policies for harassment and discrimination against anyone. States need more legislation protecting LGBTQ+ individuals from being denied culturally competent care, especially from organizations or communities that accept government funding.
Like their heterosexual counterparts, LGBTQ+ individuals need support in planning for their future and understanding the costs. If anything, it is more important for LGBTQ+ members to have all their legal affairs in order and up to date if they want to ensure their wishes are respected.
www.lgbtagingcenter.org – The National Resource Center on LGBTQ+ Aging
https://www.sageusa.org – Advocacy and Services for LGBTQ+ Elders
Alexander, A. (2022, June 28). LGBTQ elders fear being shoved in closet in nursing care hunt. Retrieved from http://news.bloomberglaw.com/social-justice/gay-elders-fear-being-shoved-back-in-closet-in-nursing-care-hunt
Halpern, J. (2020, August 12). Nursing homes tell LGBT elders, “get back into the closet.” Retrieved from https://myelder.com/nursing-homes-tell-lgbt-elders-get-back-into-the-closet/
SAGE. (2021, November 18). LGBTQ elder care facilities open nationwide, but discrimination persists. Retrieved from https://www.sageusa.org/news-posts/lgbtq-elder-care-facilities-open-nationwide-but-discrimination-persists/
SAGE. (2022, May). The campaign to ensure culturally competent support for LGBTQ+ and HIV-positive elders nationwide. https://www.sageusa.org/wp-content/uploads/2022/05/sage-old-bold-factsheet-final.pdf
SAGE. (2018). The facts on LGBT aging. Retrieved from https://www.sageusa.org/wp-content/uploads/2018/05/sageusa-the-facts-on-lgbt-aging.pdf