LGBT Elders: Challenges and Hope

By, Leland Kiang, LICSW

Leland credit to Gerlach Graphic.jpeg

They protested at Stonewall and marched in the first Pride parades. They joined the Daughters of Bilitis and the Mattachine Society. They watched the rise and fall of DOMA and Don’t Ask Don’t Tell. They are 2.7 million strong. They are who we were, and who we hope to become. They are LGBT older adults.

Born from the early part of the last century through the 1960’s, LGBT elders are a diverse group. They represent three generations and come from every race and religion. Collectively, they witnessed great changes in our society’s treatment of LGBT people. Many remember when the American Psychiatric Association (APA), in 1952, described homosexuality as a “sociopathic personality disorder.” The APA did not reverse this label until 1973. Others lost their careers when President Eisenhower banned LGBT people from holding federal jobs or working for federal contractors. Still others were arrested (for being themselves) under state sodomy laws. 

This shared history of persecution took its toll in social, economic and health-related ways. Legally barred from marriage (LGBT people only gained this right in 2015), and still barred in many states from adopting children, LGBT elders are “twice as likely” (than their heterosexual counterparts) “to live alone … and three to four times less likely to have children to support them.” In fact, while most heterosexual elders rely on care from children and spouses, most LGBT elders receive help from friends—many of whom are the same age and face the same challenges.

Economically, today’s LGBT elders have been handicapped by decades of policies, which have allowed employers to discriminate against them, made it more difficult for them to access employment-related benefits like health care and pensions, and barred them from Social Security and Medicaid spousal benefits. (The Supreme Court’s 2015 ruling on LGBT marriage rights reversed these trends with regards to Social Security and Medicaid). In contrast to the larger older adult population, LGBT elders report greater financial need and less financial security.

Health disparities also exist within the community. LGBT elders experience higher rates of disability, certain cancers, HIV, and cardiovascular disease. They also experience a higher incidence of “mental distress” and substance abuse. Many disparities trace their roots to the same discriminatory government policies, which impacted LGBT elders’ social and economic outcomes. Public prejudice and violence also play a part. 82% of LGBT elders have been attacked, at least once in their lifetime, due to their sexual orientation.

These discriminatory government policies, along with public prejudices, have fueled a certain distrust in the LGBT community against government agencies and mainstream healthcare providers. 15% of LGBT elders, in fact, are reluctant to see a doctor who is not part of the LGBT community. One in five elders have not shared their sexual orientation with their physician. One in three LGBT Baby Boomers (the youngest members of today’s elders) fear discrimination as they age. When compared to their heterosexual counterparts, LGBT elders are “five times less likely” to seek help from mainstream aging service providers. It’s ironic. While they are more likely than their heterosexual counterparts to benefit from government and healthcare services, they are less likely (due to a history of discrimination) to seek it. 

Even so, times are changing. Interest in helping LGBT elders has grown among diverse organizations.  Among government (and pseudo-government) agencies, the federal Administration on Aging, the Social Security Administration, the Department of Veteran Affairs, the Department of Health & Human Services and the National Association of Area Agencies on Aging all have sought to improve the care they offer. Mainstream non-government agencies seeking to connect with the LGBT community include AARP, the Alzheimer’s Association, the American Geriatrics Society, Leading Age (a senior housing association), the Family Caregiver Alliance, the National Council on Aging, Justice in Aging and the American Psychiatric Association. Familiar LGBT organizations also have stepped up their outreach to elders. These include SAGE (and its National Resource Center on LGBT Aging), the Human Rights Campaign, Lambda Legal and Center Link. 

What can you do to help LGBT elders? If you are an elder, learn about your rights and available assistance from the resources listed above. If you are healthcare or senior service provider, take steps to learn about the needs of LGBT older adults or get trained in LGBT cultural competency. If you’re a younger LGBT person, seek friendship with elders or volunteer for an agency serving LGBT elders.

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Leland Kiang, LICSW is the Manager of Information & Referral at Iona Senior Services in Washington, DC, a nonprofit social services agency that supports people as they experience the challenge and opportunities of aging. Learn more at www.iona.org.