By Matthew S. Bajko
A growing subset of the senior tidal wave known as the “gray tsunami” are those who identify as gay, lesbian, bisexual or transgender.
LGBT seniors increasingly are living out of the closet, yet remain largely invisible in government statistics. Few national health surveys include questions about sexual orientation or gender identity, leaving researchers to only guess at the true size of the nation’s LGBT older adult population.
For example, the U.S. Administration on Aging estimates the number of LGBT seniors age 60 and older to be anywhere between 1.75 million to 4 million. The National Gay and Lesbian Task Force estimates there are 3 million LGBT elders living in the United States. Nationwide, the population of LGBT seniors is projected to double by 2030.
California is estimated to have 215,000 LGB people age 55 and older (there is no statewide data for the transgender senior population). Officials in San Francisco believe there are nearly 20,000 LGBT residents 60 years of age or older living in the city. LGBT data collection has become a new rallying cry for agencies and leaders advocating on the behalf of the LGBT community. This fall, California Gov. Jerry Brown signed into law a bill that requires four state agencies to update their forms to include questions about sexual orientation and gender identity. The departments of health care services, public health, social services, and aging have until July 1, 2018, to comply.
New York has taken a lead role on the issue, with Gov. Andrew Cuomo ordering state agencies to begin asking about sexual orientation and gender identity on forms and surveys.
Services and Advocacy for GLBT Elders (SAGE) in 2013 issued a data collection guide through its National Resource Center on LGBT Aging to educate service providers not only about the need to collect LGBT demographic information but how to do so. The guide, Inclusive Questions for Older Adults: A Practical Guide to Collecting Data on Sexual Orientation and Gender Identity, can be downloaded online.
The National Institutes of Health in 2009 funded the first national LGBT senior study: The National Health, Aging and Sexuality Study: Caring and Aging with Pride over Time. The lead researcher is Karen I. Fredriksen-Goldsen, Ph.D., a professor and director of the Hartford Center of Excellence at the School of Social Work at the University of Washington.
The Caring and Aging with Pride project has received funding to conduct a longitudinal study of LGBT seniors and is working with 16 community-based organizations across the country to recruit participants. The study not only will allow the researchers to better track LGBT seniors’ health, well-being and identity issues as they age, but also allow them a chance to design and test interventions.
Based on the earlier research, the Caring and Aging with Pride study has found higher rates of disabilities and more mental distress among LGBT seniors, with lesbian and bisexual women more at risk for obesity and cardiovascular disease.
Dementia is a growing issue among LGBT seniors. In the national LGBT senior study, 7 percent of those 50 years of age and older self-reported having some cognitive impairment. One percent of people between the ages of 50 and 79 years, and another 1 percent in the 80 and older age group, reported being told about the need for Alzheimer’s and dementia care.
Related tip sheet
Diversity in aging: Putting gray in the rainbow
Paul Kleyman explains that older adults from “minority” racial and ethnic groups often encounter different health problems and require different responses than the majority white population. To help health reporters cover our increasingly diverse older population, this tip sheet includes four key concepts and helpful links intended to point the way toward more ethnically representative – and interesting – stories.
LGBT seniors and social isolation
A major concern for health care providers is that LGBT seniors may be reluctant to seek out services due to past experiences with discrimination in a health care setting. Reaching LGBT seniors living alone who are also living with dementia can be particularly challenging, as they may not be accessing the care they need on their own.
Many LGBT seniors also are likely to be socially isolated. Many came of age during a time when being gay was still considered both a mental disorder and a crime punishable with jail terms.
It is not uncommon for LGBT seniors to have been disowned by their biological families after they came out of the closet and many never had children. Unlike their heterosexual counterparts, they cannot rely on their offspring or extended families to care for them in their golden years.
Gay men, in particular, are more likely to be aging alone after losing loved ones and many friends in the AIDS epidemic of the 1980s. Many themselves are HIV positive and face unique challenges, both physical and mental, as they age while living with the virus.
In Los Angeles alone, officials estimate there are 65,000 LGBT seniors 65 and older living in the city, with 68 percent of them living alone. They can struggle with mobility issues and lack of social engagement.
One worry is that LGBT seniors are prone to suicidal thoughts because they face high rates of disability, in addition to poor physical and mental health. Research has shown that both health issues are associated with increased risk of depression, leading to increased risk for suicide.
Should they move into assisted living situations, LGBT seniors may feel the need to “in themselves” – once again hiding being gay, lesbian, bisexual or transgender. Fellow residents and staff may harbor anti-LGBT feelings, thus fostering an unwelcoming environment for LGBT seniors.
They may also believe they are the only LGBT person living at the facility, and may retreat back into the closet in order to fit in socially with their fellow residents.
Housing issues
A growing solution is to build LGBT-specific housing for LGBT seniors. Nonprofit agencies in a number of major U.S. cities have either opened or are building designated housing for low-income LGBT seniors. Locations include Los Angeles, San Francisco, Philadelphia, Chicago, Minneapolis, and Washington, D.C.
Due to non-discrimination laws the housing often must be open to any senior, regardless of sexual orientation or gender identity. Thus, it can be a challenge for operators of such facilities to insure LGBT seniors are selected for the housing.
A variety of approaches are being used to set aside the units for LGBT seniors, from imposing eligibility requirements to branding the facilities as being LGBT in the hopes of weeding out heterosexual applicants. They housing also often is linked with on-site service centers providing a range of medical treatment and social services specifically for LGBT seniors.
Story ideas
- Does your local health department know how many LGBT seniors live within its jurisdiction? And how is it addressing the unique challenges LGBT seniors face as they age?
- Does any local agency or government entity have plans to build housing specifically for LGBT seniors? Are LGBT seniors welcome at local senior housing developments?
- What sort of local programs are targeted to LGBT seniors?
- With many LGBT seniors single and living alone, look at who will care for them as they age?
Sources
- Seth Kilbourn, Openhouse executive director, 415-296.8995, seth@openhouse-sf.org.
- Brian De Vries, San Francisco State University gerontology professor, 415-338-3559, bdevries@sfsu.edu.
- Karen I. Fredriksen-Goldsen, Ph.D., a professor and director of the Hartford Center of Excellence at the School of Social Work at the University of Washington, 206-543-5722, fredrikk@u.washington.edu.
- Michael Adams, chief executive, Services & Advocacy for GLBT Elders (SAGE), 212-741-2247.
Resources
- National Health, Aging, and Sexuality Study: Caring and Aging with Pride over Time.
- National Resource Center on LGBT Aging.
- Services & Advocacy for GLBT Elders (SAGE): Out & Visible: The Experiences and Attitudes of LGBT Older Adults, Ages 45-75.
- Alzheimer’s Association: LGBT Caregiving guide.
- San Francisco LGBT Aging Policy Task Force report.
- Los Angeles LGBT Center Senior Services site.
- Openhouse: a San Francisco LGBT seniors agency.
- AARP LGBT seniors resources.
- Old Lesbian Organizing for Change (OLOC).
- LGBT Aging Issues Network.
Matthew S. Bajko is an assistant editor at the Bay Area Reporter, the LGBT newspaper in San Francisco. He covers LGBT aging issues as well as politics, HIV/AID, and STDs.
