Queer Cafe

Gay seniors, like seniors in general, worry about safe housing, good health care and having enough money in retirement. But according to those who attended the first White House conference devoted to gay, lesbian, bisexual, transgender, and queer ageing, held at the University of Miami in May 2012, they also face unique obstacles because of discrimination, health-care inequities and fear of retaliation. The White House LGBTQ Conference on Ageing was the first-ever conference dedicated to lesbian, gay, bisexual, transgender, and queer (LGBTQ) ageing issues. Sponsored by SAGE (Services and Advocacy for GLBT Elders), it was hosted by The White House Office of Public Engagement, in partnership with the University of Miami Center on Ageing. It met at the University of Miami Miller School of Medicine, where it provided advocates, community leaders, and members of the public an opportunity to engage with the Obama Administration on the health, housing, and security needs of ageing members of the LGBTQ community.

Despite advances in LGBTQ civil rights, many older adult care providers never stop to consider that their older clients may be lesbian, gay, bisexual, transgender, and queer (LGBTQ). And sometimes those who do know may not know how to provide services in culturally-sensitive ways. As a result, LGBTQ older adults often avoid seeking needed services out of fear of discrimination. The tendency for LGBTQ older adults to go "back in the closet" is particularly pronounced in situations where they are most vulnerable, such as when accessing home health care or residing in assisted living or residential care facilities. One study indicated that LGBTQ older adults may be as much as five times less likely to access needed health and social services because of their fear of discrimination from the very people who should be helping them.

This type of social isolation has an enormous impact in the health and well-being of LGBTQ older adults. With LGBTQ older adults twice as likely to live alone than heterosexual older adults, more than four times as likely to have no children, the informal caregiving support we assume is in place for older adults may not be there for LGBTQ elders. LGBTQ people face a number of particular challenges as they age. They often do not have access to adequate health care, affordable housing and other social services that they need due to institutionalized heterosexism and transphobia. Mainstream senior providers have limited information or training in how to appropriately work with and serve our diverse communities. Existing regulations and proposed policy changes in programs like Social Security or Medicare, which impact millions of LGBTQ elders, are discussed without LGBTQ views and interests as part of the debate.

There are many challenges faced by the Lesbian, Gay, Bisexual, Transgender, and Queer elderly community. Family and support networks can be critical to the wellbeing of the elderly. Due to homophobia and other factors, LGBTQ elderly may not have strong ties to traditional social support networks such as adult children to provide care, extended family or faith-based support, and frequently end up relying on friends and service agencies.

A recent Met Life survey noted that 27% of LGBTQ baby boomers reported great concern about discrimination as they age and less than half expressed strong confidence that they will be treated “with dignity and respect” by healthcare professionals. Financial challenges include inability to transfer assets such as social security, Medicare, Medicaid and pensions to the surviving partner. The same Met Life survey indicated that 51% of LGBTQ Baby Boomers indicated they have yet to complete wills that spell out their long term and end of life wishes. This is of concern since LGBTQ partnerships frequently are not recognized legally in matters of health care decisions and finances.

Richard and John: Elderly Couple
Gray Gays: Ageing as an LGBTQ Adult
Elder Lesbians Watch Hayley Kiyoko

Message for LGBTQ Seniors

If any of you are at least 50 or older, you, along with me, can remember how important it was to keep your gay secret. Of course, before the 70's there weren't any polite words like gay. All the standard insults were there. Being homosexual was the epitome of perversion and degradation. It was something never spoken of in any type of polite or common conversation. For example, before the early 70's, New York had a law that prohibited any bar or club from serving alcohol to a homosexual. Of course, most gay men passed easily. Imagine not being able to legally get a drink in a public bar like the other straight patrons. This was the law that the police used to back up their bar raids. When things were slow out on the streets, they would just get prepared with the paddy wagons and go raid a couple of known gay hangouts, arrest and fine the patrons, close and fine the bar owner, and call it a night. Imagine kids, being hustled out of a bar and arrested for being gay and having a drink! In Atlantic City there were gay clubs but you couldn't dance or touch in any fashion. Even when dancing became permissible, you were not allowed to touch because that would get a club closed down and fined. Try to imagine it.

One night in 1969 (yes only 30 years ago) in New York's Greenwich Village at the Stonewall Inn, the police pulled one of their many gay bar raids and all hell broke loose. The fight started and continued for several nights. Gay Liberation as a national struggle was born. I remember in 1972 (I was 22 at the time) tuning in to The David Susskind Show because he was having a panel of lesbians on to discuss being gay and gay liberation. You young people won't remember but, at that time, talk shows were not like they are today. The David Susskind show was a serious show with serious and informative discussions. The audiences at the talk shows were adult and quiet and sometimes allowed to ask questions at specific times. There was nothing like the ridiculous carrying-on that you see all the time on the Jerry Springer Show and the like. Anyway it was the first time I had ever seen such an open discussion on TV. Where I grew up, I was absolutely certain I was the only gay man within many miles. I watched that show on every channel it appeared for a whole week. Being that there was no such thing as a video recorder, I taped it on cassette tape. I still have it and listen to it at least once a year. I had to make a copy of it about 3 years ago as the tape was getting too old and fragile. It still stirs me like it did 30 years ago.

Things have changed and we are not so much the filthiest things on the planet. However, as we all hear and see all the time now, the hatred is still very much alive and as vicious. It's just all out in the open. The old myths about "queers" are still going strong. Kids, let me reassure you that these self-righteous bastards will do anything to send us back into nonexistence. We see that in the news all the time. This year Oregon will be voting on an antigay measure for the 32nd time. They are relentless and we have to be also. Don't take it for granted that someone else will do the fighting for you. We all need to do this together in any legal fashion that we are able. We deserve everything that the law grants to them. Don't wait expecting them to someday get nice to us. Your society still would rather you didn't exist. And for us older people, we must not allow ourselves to just sit back figuring that we don't have to bother because it's up to the younger folks. They need our voices as much as we need theirs. Do something to help us all become equal citizens.

[Source: Gianni, Tampa Bay Coalition, 1999]

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Advocate: No One Will Care for LGBTQ Seniors But Themselves

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Older Lesbian Couple: Happy for 30 Years

Video: Silent Pioneers

Richard and John: Elderly Couple

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Plight of Elder LGBTQ People

Video Talk: Old Gays Share Their Coming Out Stories

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Video: This is What 54 Years of Unwavering Love Looks Like

Ageing in Equity

“We’re coming out of an experience of being badly treated in society, and there’s no sense that treatment is going to get any better when you get older and more vulnerable within the system.”

A Vision of Healthy Ageing

The growth of the nation’s older population is among the most significant demographic shifts taking place in the United States today. The “graying of America” has profound implications for health care and other senior services. As this issue takes center stage, a greater emphasis is being placed on the notion of “healthy ageing” or “successful ageing.”

Access to appropriate housing, quality health care, and supportive services are the main ingredients of ageing well, and the exponential rise in the number of older Americans will challenge and transform the systems charged with providing these services. At the same time, the growing number of lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors (and their increasing degree of openness and demands for fair and equal treatment) are further challenging the elder care system to meet the needs of all seniors, sparking transformations that are long overdue.

Society must adopt a positive vision of “successful ageing” for LGBTQ elders, which encompasses a variety of quality-of-life issues that affect all senior citizens, regardless of their sexual orientation or gender identity. These quality-of-life issues include the ability to:

--Maximize one’s physical and emotional well-being throughout the ageing process.

--Maintain the highest possible degree of autonomy and independence for as long as possible.

--“Age in place” in one’s own neighborhood or community within a context of respect, safety, and support.

--Remain actively engaged with social networks, including chosen and biological families.

--Pursue the social, recreational, intellectual, spiritual, and creative activities that provide a sense of stability, fulfillment, and vibrancy throughout the life cycle.

This information is designed to help funders recognize and resource this vision for healthy ageing within the LGBTQ community, which faces numerous barriers to accessing the services and support systems that promote “successful ageing” in our society.

Before describing these barriers and concerns, it is important to first understand the broader context of ageing in America.

LGBTQ Seniors: Depression and Loneliness

Gray Gays: Ageing as an LGBTQ Adult

LGBTQ MAP: Improving the Lives of LGBTQ Older Adults

Bill and John: More Than Ever

Video: Silent Pioneers

LGBTQ Seniors Tell Their Stories

Gay and Lesbian Association of Retiring Persons

Need to Build More LGBTQ Senior Housing

Elderly Gay Man Recalls His Visit to a Psychologist in 1948

AARP Launches Website for Older LGBTQ Americans

Gay Seniors: Mental Health and Stress

Resources for Transgender Seniors

SAGE Publication: Practical Guide for LGBTQ Elders

Advocate: Politics of Caring for Our Queer Elders

Richard and John: Elderly Couple

Changing Demographics: The Graying of America

In 2000, there were an estimated 35 million people age 65 or older in the United States, representing 12 percent of the U.S. population, up from 8 percent in 1950. In 2010, the post–World War II baby boom generation will begin to turn 65, so that by 2030, there will be about 70 million older persons, more than twice as many as in 2000. By 2030, people age 65 and older are expected to represent 20 percent of the U.S. population. Individuals age 85 and older are the fastest growing segment of the older population. The increasing size of this age group has major implications for the future of this country’s health care system, because these individuals tend to be in poorer health and require more services than elders in their 60s and 70s (a group sometimes referred to as the “younger old”).

In 2000, an estimated 2 percent of the U.S. population was 85 or older. By 2050, the percentage of persons in this age group is projected to more than double to nearly 5 percent of the population. The US Census Bureau projects that the population of persons age 85 and older could grow from about four million in 2000 to 19 million by 2050. Increasing life expectancy rates contribute to the growth of the older population. In 1900, life expectancy at birth was about 49 years. By 1960, life expectancy had increased to 70 years.

In 2001, life expectancy at birth reached a record high of 77.27 years. Life expectancies at 65 and 85 have also increased. Under current mortality conditions, people who survive to age 65 can expect to live an average of nearly 18 more years, while those who survive to age 85 can expect to live an average of seven years (for women) and six years (for men). In broad terms, these life expectancy rates not only amount to an “elder boom,” but to large numbers of much older individuals with commensurate health care and other ageing-related needs. On an individual level, these rates will translate into much longer periods of retirement for individual seniors, and more extended periods of reliance on housing, health care, and social services geared to their needs.

Older Americans are also growing more racially and ethnically diverse. In 2000, an estimated 84 percent of persons age 65 and older were non-Hispanic white, 8 percent were non-Hispanic black, 6 percent were Hispanic, 2 percent were Asian/Pacific Islander, and less than 1 percent were Native American/Alaska Native. By 2050, it is projected that approximately 64 percent of persons age 65 or older will be non-Hispanic white, 16 percent will be Hispanic, 12 percent will be non-Hispanic black, and 7 percent will be Asian/Pacific Islander. Services for America’s seniors will need to take this growing diversity into account as they strive to provide services that truly meet seniors’ needs.

Core Issues for LGBTQ Elders

A contemporary understanding of culturally competent service delivery for seniors must include LGBTQ issues. While LGBTQ elders and their heterosexual counterparts contend with many of the same ageing-related issues (including challenges to their health, independence, and mobility; social isolation; the loss of peers and loved ones; and financial concerns, among others), LGBTQ seniors face special difficulties as well. These seniors are “twice-hidden” due to social discrimination on two levels: ageism and homophobia or heterosexism. LGBTQ seniors often face antigay or gender discrimination by mainstream elder care providers that renders them “invisible” and impedes their access to vitally important services. At the same time, LGBTQ elders frequently confront ageism within the LGBTQ community and the organizations created to serve the community’s needs. Many older LGBTQ people respond to the pressures of discrimination by concealing their sexuality in settings where being “out of the closet” might hinder their access to quality care or even endanger their well-being. For many LGBTQ elders in their 70s and 80s, “passing” as heterosexual has been a lifelong survival strategy, one they are likely to carry with them when seeking long-term care, entering a nursing home, or speaking with a health care provider. This dynamic prevents many LGBTQ seniors from openly accessing the very programs that could be most beneficial to them, if only these programs were perceived as safe places to turn for help and if they were culturally responsive to LGBTQ elders’ needs.

The gravity of this problem was even acknowledged on the federal level when, in 2001, the US Office on Ageing recognized that LGBTQ elders are underserved by the federally funded programs that receive support through the Older Americans Act to help elders remain independent and in their home environment and to prevent unnecessary or premature institutionalization.

LGBTQ elders are vulnerable in another important area as well. Being closely linked with income, health status, and the availability of caregivers, living arrangements are an important indicator of well-being among older persons. The US Census Bureau reports that older persons who live alone are more likely to be in poverty than older persons who live with their spouse. Needs assessments of LGBTQ elders in Los Angeles, Milwaukee, New York City, San Francisco, and elsewhere have found that LGBTQ elders are far more likely to live alone than heterosexual elders. LGBTQ elders are also less likely to have children than their heterosexual counterparts. Since life partners and children play an important role in caregiving, many LGBTQ elders become reliant on formal caregiving services sooner than elders who can turn to family members and partners for informal support. LGBTQ elders who are partnered must contend with an array of discriminatory practices that arise from the lack of formal recognition of their personal relationships. LGBTQ couples face unequal treatment in hospital visitation, health decision making, nursing care policies, Medicaid regulations, Medicare and Social Security coverage, pension and tax regulations, housing rights, and a host of other issues that fundamentally affect their financial security, health status, and quality of life.

[Source: Funders for Lesbian and Gay Issues, Report on LGBTQ Elders in America, 2004]