(DV) A recent report by the Williams Institute on LGBT older adults shines a light on exactly the problems that the Coalition for LGBT Aging has been talking about, coalition founder and Dallas Senior Affairs Commissioner Cannon Flowers said this week.
The report highlights “isolation, discrimination and health disparities” that older LGBT people face, and indicates that the aging LGBT population likely faces a higher prevalence of mental health problems, disability and disease and physical limitations than does the older heterosexual population.
(For the purposes of the report — “LGBT Aging: A Review of Research Findings, Needs and Policy Implications,” by Soon Kyu Choi and Ilan H Meyer — LGBT older adults “include the population of sexual and gender minorities over the age of 50.)
The report estimates that there are more than 2.4 million LGBT older adults in the U.S. today, and that this number will double by the year 2030. Flowers, however, notes that other researcher put the current population at 5 million to 6 million.
“So much has changed since the last census in 2010,” Flowers said. “In that census, they only asked if you lived in a same-sex household. There were probably a lot of people who [didn’t identify as lesbian or gay] because they were afraid to come out. I think a lot of people are more comfortable being out now.”
But, he added, the question on living in a same-sex household would miss many bisexual and transgender people altogether, so “we really have no idea how large that population is.”
The report found that LGBT older adults face a number of social disparities, including barriers to receiving formal health care and social support that heterosexual and cisgender seniors don’t have to deal with. LGBT older adults also often avoid or delay health care, and when they do seek care, they hide their sexual orientation or gender identity from their doctors and social service providers out of fear of discrimination.
LGBT older adults also have fewer options for “informal care” than their straight, cisgender counterparts. LGBT seniors are more likely to be single or living alone, and less likely to have children to care for them as they age. But the report notes “resilient LGBT older adults often rely on ‘families of choice,’ LGBT community organizations and affirmative religious groups” for the care and help they need.
Lifetime disparities in earnings, employment and opportunities to build savings, coupled with discriminatory access to legal and social programs that traditionally are there to assist older people, leave LGBT older adults at greater risk for financial instability and often facing greater legal issues. These LGBT seniors have also spent their lives dealing with — and continue to deal with — discrimination, including physical and verbal abuse, and they often face discrimination — less housing availability, higher prices, etc. — when searching for retirement housing.
The report notes that along with higher rates of mental and physical illness and disability among all LGBT seniors, transgender older adults in particular face higher risks for poor physical health, disability and depressive symptoms, many of which are associated with experiences of victimization and stigma.
LGBT older adults tend to engage more in risky behaviors, like smoking and excessive drinking, and are more likely to engage in unsafe sex. But LGBT seniors also get tested for HIV at a higher rate than their straight, cisgender counterparts.
While LGBT older adults as a whole in general have worse health issues than non-LGBT cisgender seniors, LGBT seniors with HIV fare worse than the LGBT older adult population as a whole. They tend to have worse overall mental and physical health, higher rates of disability and poorer health outcomes, along with a higher likelihood of experiencing stressors and barriers to care than HIV-negative LGBT seniors.
The Williams Institute report calls for probability-based studies to “accurately characterize” the older LGBT population, and for more research into subgroups within the LGBT community. It also points out the need for more comprehensive anti-discrimination legislation and policies, and expansions of the definition of family to include families of choice.
Finally, the report calls for LGBT older adults to be specifically recognized in the Older Americans Act as a “greatest social need group.” It is a recommendation that Flowers whole-heartedly supports.
“How do we get LGBT people and certain other marginalized groups recognized in the Older Americans Act? That’s the big question here,” Flowers said. “That’s one of the reasons, one of the main reasons, [Dallas City Councilwoman Tiffinni A. Young] appointed me to the city’s Commission on Senior Affairs — to help make that change happen.”
The Older Americans Act, originally enacted in 1965, supports a range of home and community-based services — such as meals-on-wheels, in-home services, transportation services , legal services, elder abuse prevention and caregivers support.
Flowers said he and other LGBT aging advocates “have been trying to work with the Williams Institute since 2011, asking for them to address aging issues. They are very well respected, and I am just thrilled to see them address these issues now and create this report.”
This report, he said, “is a first step” in gathering the data necessary to garner funding for further research and services. “It’s a huge step to have them confirming what we’ve been saying for awhile now.”
Flowers noted that LGBT youth have been the focus on much attention and research, and that more and more services and programs are being created to address their needs. He hopes to see similar attention paid to LGBT seniors, and to the community as a whole.
“We want to see the youth taken care of, and we want to see the LGBT seniors taken care of — it’s the whole village,” he said. “And we hope that people will start to pay attention to the importance of interaction between the youth and the older adults. There is huge value, huge benefit in that intergenerational interaction. We can all learn so much from each other.”