LBGT OAMarketResearch Rpt - SAGE

EXEC UTIVE SUMM ARYKey FindingsWhen it comes to aging,LGBT older people are moreconcerned than non-LGBTolder people with regard topersonal finances, physicaldecline, remaining independent,loneliness in older age,support systems and physicalattractiveness.1Aging concerns in general arehighest among LGBT older peoplein their 40’s and 50’s, low-incomepeople, women, transgenderpeople, African Americans andHispanics. For example, one in two(51%) LGBT older people is veryor extremely concerned about“having enough money to live on,”as compared to 36% of non-LGBTpeople; and one in three (32%)LGBT older people is very orextremely concerned about“being lonely and growing oldalone,” as compared to 19% ofnon-LGBT people.Many LGBT older peoplereport that their primaryhealthcare providers do notknow about their sexualorientations, and many feelreluctant to discuss their sexualorientations and gender identitieswith other healthcare providersfor fear of being judged orreceiving inferior care.28In particular, transgender olderpeople fear that they will experiencelimited access to healthcareproviders and be denied medicaltreatment as they age. Forty-threepercent of LGBT older people whoare single and 40% of LGBT olderpeople in their 60s and 70s saytheir healthcare providers don’tknow their sexual orientations. Twothirds of transgender adults (65%)feel that there will be limited accessto healthcare as they grow older.LGBT older people arefar more concerned thannon-LGBT older peopleabout their financial securityand retirement: as one example,far more LGBT older people thannon-LGBT older people expressunease about having savedenough money to retire.3Like their non-LGBT counterparts,LGBT older people are concernedabout the consequences ofpotential cuts in programs critical totheir retirement, such as SocialSecurity. Forty-two percent of LGBTolder people are very or extremelyconcerned that they will outlivethe money they have saved forretirement, as compared to 25%of non-LGBT people; and 44% ofLGBT older people are very orextremely concerned that they willhave to work well beyondretirement age in order to haveenough money to live, as comparedto 26% of non-LGBT people.When planning forretirement, both LGBTand non-LGBT older peoplerely largely on their ownknowledge and education.4However, LGBT older people(21% vs. 13%) are more likely thannon-LGBT older people to rely ongovernment tools when planningfor retirement, while non-LGBTolder people (37% vs. 28%) aremore likely than LGBT older peopleto use the services of a financialadvisor.While most LGBT olderpeople age 60 and olderreport being retired, manyof those who are not retiredanticipate working, on average,until age 69.5Moreover, half of all single LGBTolder people believe that they willhave to work well beyond retirementage. Additionally, 37% of LGBT olderpeople, ages 45-59, anticipate that,on average, they will retire at age65, and 26% do not know whenthey will be able to retire.Among the types ofactivities they would liketo enjoy in retirement,both LGBT older people and nonLGBT older people cite leisureactivities, travel, volunteering,starting a hobby, working parttime and joining social groups.6OUT A ND VISIBLE

EXECU TIVE SU MMARYHowever, LGBT older people aremore likely to see themselves asmentors, and non-LGBT olderpeople are more likely to say theywill spend their retirement timewith their families and friends.Additionally, partnered LGBT olderadults are much more likely thansingle LGBT older adults to envisionspending their retirement yearsenjoying leisure activities (64% vs.55%), traveling (62% vs. 46%) andspending time with family andfriends (51% vs. 39%).Many LGBT older peopleare concerned thatvolunteering and workingduring their retirement years willbe hindered if others know abouttheir sexual orientations andgender identities.7Yet LGBT older people are lesslikely than non-LGBT older peopleto say that their age will be abarrier to these activities. One infour (27%) LGBT older adults feelsthat work or volunteer activities willnot be open to him/her if othersknow about his/her sexualorientation, and one in three (33%)transgender adults feels thosesame activities will not beaccessible if others know abouthis/her gender identity.LGBT older people aremore likely than their nonLGBT peers to live alone,have smaller support networksover time and are less satisfiedwith the information they receiverelated to support systems.8LGBT African American andtransgender older people are morelikely than their peers to report thatpeople from their churches or faithare part of their support networks.About one in three (34%) LGBTolder people lives alone, while 40%of LGBT older people say that theirsupport networks have becomesmaller over time. African AmericanLGBT adults are three times as likelyas White or Hispanic LGBT adults tosay that people from their churchesor faith are part of their supportsystems (26% vs. 8% and 8%).LGBT older people reportfearing and experiencingdiscrimination in housingand long-term care environments,respectively—and many LGBTpeople are interested in LGBTfriendly affordable housing.9One in eight (13%) LGBT adultsand one in four (25%) transgenderadults say that they have beendiscriminated against whensearching for housing on the basisof their sexual orientations andgender identities, respectively.Forty-four percent of LGBT olderadults are very or extremelyTHE EXPERIENCES AND ATTITUDES OF LGBT OLDER ADULTS, AGES 45-75interested in living in an affordableLGBT-friendly housing developmentat some point in the future.When seeking informationon aging, both LGBT andnon-LGBT people are likelyto rely on the internet, as well asfamily and friends, as their topsources. Among LGBT olderpeople, women are more likelythan men to rely on governmentsources, and men are more likelythan women to rely on socialmedia. Additionally, AfricanAmerican LGBT older people aremuch more likely than both Whitesand Hispanic LGBT older people toconsult government sources forinformation on aging (37% vs. 23%vs. 20%). “Younger” LGBT adults(aged 45 – 59) are much morelikely than “older” LGBT adults(aged 60-75) to rely on friends andfamily members as sources ofinformation on aging (42% vs.34%), while “older” LGBT adults aremuch more likely to rely onprofessionals (42% vs. 34%) andnon-profit organizations (44% vs.31%) than their younger LGBTcounterparts.109

EXEC UTIVE SUMM ARYConclusionsand RecommendationsThe results of this study attestto the importance of creatingwelcoming environments thatsupport LGBT older people invarious aspects of their lives.Concerns about aging are highamong LGBT older people(especially among Hispanics,African Americans, women,transgender people and singlepeople, as notable examples),and they need to feel welcome asLGBT people in the aging andlong-term care systems, and asolder adults in LGBT communities.Many LGBT older people report notdisclosing their identities to theirhealthcare providers for fear ofbeing judged; this information canbe systematized into the patientintake process and paired withproper training, policies andprotocols to ensure that LGBTpatients are identified and treatedproperly by healthcare providers.Likewise, financial professionals,nonprofit organizations andgovernment agencies are positionedto improve their offerings to LGBTolder people so that they prepareproperly for their retirement andfeel more secure about theirfinancial futures. Because manyLGBT older people anticipateworking well beyond retirementage, they need proper legalprotections in the workplace and10access to employment programsthat speak to them as LGBT olderpeople dealing with age- and LGBTrelated biases in employment.Many LGBT older people reportliving alone, being single andseeing their support networksbecome smaller over time; LGBTaging programs can fill this gap,but these types of supports needmore funding support andwidespread expansion. Mainstreamaging providers can also benefitfrom LGBT cultural competencetraining, and aging programsrooted in definitions of “family” and“next of kin” should be expandedto include friends, caregivers andothers who are central to LGBTpeople. As the economy worsensand housing insecurity increases,LGBT older people face additionalchallenges when they encounterdiscrimination in housing and longterm care settings. Stronger legalprotections are needed in theseareas at federal, state and locallevels. Additionally, LGBT olderpeople could benefit from LGBTsenior housing, along with an arrayof complementary housingsupports and policy improvements.Finally, without accurateinformation that reaches LGBTolder people through properchannels, LGBT older people mightlack the information they need tomake wise choices earlier in theiraging lives. Further research shouldhelp the public and private sectorsgrasp how LGBT older people canaccess better information on allaspects of their lives. In themeantime, the current informationemanating from the public andprivate sector should be increased,made more readily available, andvetted for accuracy, accessibilityand LGBT-inclusivity.WANT TOKNOW MORE?Visit sageusa.org for moreinformation on this national study,including the full report andexecutive summary, the surveyquestionnaire and frequently askedquestions (FAQ). Also, if you’reinterested in partnering with SAGEto understand key areas of thisreport in more depth, or to explorehow SAGE can support yourorganizational and businessstrategies related to LGBT olderpeople, please contact us at212-741-2247 or email us atoutandvisible@sageusa.org.OUT A ND VISIBLE

DETAILEDFINDINGSA quality of life as one ages requires financial security,affordable and quality housing, strong support networks,meaningful and enjoyable activities, and accurateinformation to deal with life's options and stressors.Yet as the findings described in this report attest, manyLGBT older people are concerned that they will not havethe funds necessary to retire, and in turn anticipateworking beyond retirement age. Additionally, manyLGBT older people are single, living alone and reportsmaller support networks over time. They also reportdiscrimination when seeking housing and fear how theywill be treated in assisted living and other long-termcare environments. Yet LGBT older people are multifaceted. This study shows that LGBT people are alsomore likely to be mentors than their non-LGBT peers,rely on their knowledge and networks for informationrelated to aging, and many aspire to live an older lifeof leisure, travel and volunteering.11

DETAILE D FINDINGSIssues with AgingResearch has long been concerned with understanding how people feel about their agingover time—what drives their feelings and choices; differences among types of older people;and what compels joy and satisfaction on one end of the spectrum, and what spursloneliness and isolation on the other end. A 2013 AARP study on attitudes about agingfound that, depending on one’s health, many older people define “old” as cohorts olderthan themselves. Also, having a purpose in life, feelings of connectedness and the treatmentthat older people receive from others as they age are only a few factors that affectsatisfaction in later life.1 A 2012 national health study on LGBT older people found that 74%are satisfied with their lives, though that same study also found significant disparities inareas related to community belonging, social support, internalized stigma, health behaviors,caregiving and more.2 Thus, this study asked LGBT older people to report their concerns ona variety of issues related to their aging lives.When it comes to aging, LGBTolder people are more concernedthan non-LGBT older peoplewith regard to personal finances,physical decline, remainingindependent, loneliness in olderage, support systems andphysical attractiveness.51% OF LGBT OLDERPEOPLE ARE CONCERNEDABOUT HAVINGENOUGH MONEY TOLIVE ON AS THEY AGE. 51% of LGBT older people arevery or extremely concerned abouthaving enough money to live on,as compared to 36% of non-LGBTolder people. 43% of LGBT older people arevery or extremely concernedabout declining physical health,as compared to 33% of non-LGBTolder people. 33% of LGBT older people arevery or extremely concerned aboutdepending on others for money,as compared to 18% of non-LGBTolder people.12 43% of LGBT older people arevery or extremely concerned aboutnot being able to take care ofthemselves, as compared to 34%of non-LGBT people. 32% of LGBT older people arevery or extremely concerned aboutbeing lonely and growing oldalone, as compared to 19%of non-LGBT older people. 30% of LGBT older people arevery or extremely concerned aboutnot having someone to take care ofthem, as compared to 16% of nonLGBT older people. 21% of LGBT older people arevery or extremely concerned aboutlosing their physical attractiveness,as compared to 12% of non-LGBTpeople.OUT A ND VISIBLE

DETA ILED FINDINGSAging concerns in general arehighest among LGBT older peoplein their 40’s and 50’s, low-incomepeople, women, transgenderpeople, African Americans andHispanics. LGBT older women are moreconcerned than LGBT older menwith having enough money to liveon (57% vs. 49%); not being able totake care of themselves (51% vs.39%); and being a burden to thosethey love (42% vs. 30%). Transgender older people tendto be more worried about beinga burden to their loved ones(48% vs. 32%); knowing wherethey will live as they grow older(42% vs. 27%); and losing theirphysical attractiveness (31%vs. 20%) than their cisgender(non-transgender) peers. African American and Hispanic LGBTolder people are more concernedthan White LGBT older people when itcomes to being a burden to theirloved ones (43% vs. 29%). Nearly half of Hispanic LGBT olderpeople (45%) are concerned aboutlosing their partners. Concerns regarding the loss ofphysical attractiveness are morepronounced for Hispanic LGBTolder people than their racial andethnic peers—34% vs. 22% forolder LGBT African Americans and18% for older White LGBT people.PERCENTAGES OF LGBTOLDER PEOPLE CONCERNEDABOUT LOSING THEIRATTRACTIVENESSAS THEY AGE.34% 22% 18%OF HISPANICLGBT OLDERPEOPLEOF AFRICAN- OF WHITEAMERICAN LGBT OLDERLGBT OLDER PEOPLEPEOPLEHealthcarePrevious research has found significant health disparities among LGBT older people in areasrelated to physical and mental health, including high blood pressure, cholesterol, diabetes,heart disease, HIV/AIDS, depression and more.3 Health disparities among LGBT people havebeen linked to a lifetime of stigma, discrimination, violence and victimization; higher povertyrates; a lack of access to LGBT-competent providers; and low rates of health insurancecoverage. In turn, improving the health of LGBT people can improve health and well-being,reduce healthcare costs, increase the length and quality of life and reduce the spread ofdisease. Further, open communication between providers and LGBT patients allows providersto better identify, understand and treat LGBT patients, and some research has shown thatpatients who disclose their sexual orientations might also feel safer discussing their riskbehaviors.4 Thus, LGBT older people in this study were asked about their experiences withhealthcare providers and their feelings about being open about their sexual orientationsand gender identities.THE EXPERIENCES AND ATTITUDES OF LGBT OLDER ADULTS, AGES 45-7513

DETAILE D FINDINGSPERCENTAGE OFTRANSGENDER OLDERPEOPLE WHO BELIEVEHEALTHCARE WILLBE LIMITED OR DENIEDAS THEY AGE.LIMITEDDENIED65% 55%Many LGBT older people reportthat their primary healthcareproviders do not know about theirsexual orientations, and manyfeel reluctant to discuss theirsexual orientations and genderidentities with other healthcareproviders for fear of being judgedor receiving inferior care. Inparticular, transgender olderpeople fear that they willexperience limited access tohealthcare and be denied medicaltreatment as they age. 36% of LGBT older people—ormore than one in three people—say that their primary healthcareproviders are unaware of theirsexual orientations. Forty-threepercent of LGBT older people whoare single and 40% of LGBT olderpeople in their 60s and 70s saytheir healthcare providers don’tknow about their sexualorientations. While most LGBT older people(65%) say that their relationshipswith their primary healthcareproviders are open and honest,nearly one in four (23%) arereluctant to discuss certain issuesfor fear of being judged.14 LGBT older men are moreconcerned than LGBT older womenabout being judged by theirhealthcare providers (25% vs.18%). More than one-third (35%)of transgender adults are concernedabout being similarly judged. One in five LGBT older people(20%) and nearly half oftransgender older people (44%)feel that their relationships withother healthcare providers—suchas hospital or nursing home staff—would be adversely affected iftheir sexual orientations/genderidentities were known. Hispanic LGBT older people aremore concerned than AfricanAmerican LGBT older people andWhite LGBT older people about thequality of care they would receivefrom these other providers, if theirsexual orientations were known(34% vs. 23% and 16%). Two-thirds of transgender olderpeople (65%) feel that there willbe limited access to healthcare asthey grow older and more thanhalf (55%) feel that they will bedenied medical treatment becauseof their ages.OUT A ND VISIBLE

DETA ILED FINDING SFinances and RetirementRecent research has documented profound retirement insecurities among the U.S.population. A 2012 report on retirement confidence found that only 14% of Americans arevery confident they will have enough money to live on in retirement, and 60% of workershave a total savings and investments of less than 25,000. More than half report thatthey have not calculated what they will need financially to live in retirement.5 Financialprofessionals, nonprofits, online companies and others can help adults earlier in life totake measures that will secure their retirement financial picture, but it remains unclearthe extent to which LGBT people are planning for their retirement, as well as how theyfeel about their retirement years.6 LGBT older people are particularly vulnerable tofinancial insecurity due to employment concerns, a lifetime of discrimination and smallersupport networks. Thus, this study asked LGBT older people about their aspirationsand concerns regarding retirement, as well as what types of activities they areundertaking to plan and enjoy their retirement years.LGBT older people are far moreconcerned than non-LGBT olderpeople about their financialsecurity and retirement: as oneexample, far more LGBT olderpeople than non-LGBT older peopleexpress unease about havingsaved enough money to retire. 47% of LGBT older people arevery or extremely concerned thatthey will not be able to live thelives they want in retirement due tolack of money, as compared to28% of non-LGBT older people. 44% of LGBT older people arevery or extremely concerned thatthey will have to work well beyondretirement age just to have enoughmoney to live, as compared to26% of non-LGBT older people. 42% of LGBT older people arevery or extremely concerned thatthey will outlive the money theyhave saved for retirement, ascompared to 25% of non-LGBTolder people. Social Security is the resourcethat most LGBT (83%) and nonLGBT (86%) older people say theyare depending on to fund theirretirement years. 43% of LGBT older people arevery or extremely concerned thatthey will not be able to deal withunexpected, major emergencies inretirement, as compared to 30% ofnon-LGBT older people. Both LGBT (58%) and non-LGBTolder people (56%) express highlevels of concern over the impactthat cuts in government spendingwill have on their future financialsecurity and on such governmentprograms as Social Security,Medicare or Medicaid.Like their non-LGBT counterparts,LGBT older peopl

LGBT older people are concerned about the consequences of potential cuts in programs critical to their retirement, such as Social Security. Forty-two percent of LGBT older people are very or extremely concerned that they will outlive the money they have saved for retirement, as compared to 25% of non-LGBT people; and 44% of LGBT older people .