LGBT OLDER ADULTS - SAGE
UNDERSTANDINGISSUES FACINGLGBT OLDER ADULTSAuthors
This report was authored by:2Movement Advancement ProjectThe Movement Advancement Project (MAP) is anindependent think tank that provides rigorousresearch, insight, and analysis that help speedequality for LGBT people. MAP works collaborativelywith LGBT organizations, advocates and funders,providing information, analysis and resources thathelp coordinate and strengthen efforts for maximumimpact. MAP’s policy research informs the public andpolicymakers about the legal and policy needs of LGBTpeople and their families.SAGESAGE is the country’s largest and oldest organizationdedicated to improving the lives of lesbian, gay, bisexualand transgender (LGBT) older adults. Founded in 1978and headquartered in New York City, SAGE is a nationalorganization that advocates for public policy changesthat address the needs of LGBT older people. SAGEalso offers supportive services and consumer resourcesto LGBT older adults and their caregivers, provideseducation and technical assistance for aging providersand LGBT organizations through its National ResourceCenter on LGBT Aging, and cultural competencetraining through SAGECare. With staff located acrossthe country, SAGE coordinates a growing network ofaffiliates across the country. Learn more at sageusa.org.MAP is very grateful to the following major funders,whose generous support makes it possible for us todo our work:David Bohnett FoundationDavid Dechman & Michel MercureDavid Geffen FoundationFord FoundationGill FoundationEsmond HarmsworthJim HormelJohnson Family FoundationAndrew LaneAmy Mandel & Katina RodisWeston Milliken, Kicking Assets Fund of the LibertyHill FoundationIneke MushovicJay OppenheimerThe Palette FundMona PittengerH. van Ameringen FoundationWild Geese FoundationContact InformationPhoto Credits:Movement Advancement Project (MAP)3020 Carbon Place, Suite 202Boulder, CO 803011-844-MAP-8800www.lgbtmap.orgTop row third from left credit: www.missmajorfilm.comTop row right corner credit: Lambda LegalMiddle row first from left credit: Ciara CapraraMiddle row second from right credit: Larry BercowBottom row first from left credit: Dakota Fine for HRCBottom row second from left credit: Marilyn HumphriesBottom row third from left credit: Serena Worthington - SAGEBottom row second from right credit: Simone PooleBottom row right corner credit: Lambda LegalSAGE1200 18th Street NW, Suite 700Washington DC, 20036www.sageusa.org
TABLE OF CONTENTSINTRODUCTION.1WHO ARE LGBT ELDERS? .1LGBT Elders Are Remarkably Resilient. 5KEY CHALLENGES TO SUCCESSFUL AGING FOR LGBT ELDERS.6A Lifetime of Discrimination and Lack of Legal & Social Recognition Can Leadto Economic Insecurity. 6LGBT Older Adults Faced Decades of Compounding Legal and Social Discrimination.6The Result: Poverty and Economic Insecurity .10Recommendations.10A Reliance on Chosen Family May Lead to Dwindling Support Networks. 11LGBT Older Adults Are Less Likely to Rely on Informal Support Networks.12The Result: Social Isolation.14Recommendations.14A Lack of Competent, Inclusive Healthcare Can Result in Poorer Health Outcomes. 15LGBT Older Adults May Have Difficulty Navigating Complex Healthcare Programs.15The Result: Poorer Mental and Physical Health .19Recommendations.21CONCLUSION.23ENDNOTES.243
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INTRODUCTIONAmerica’s population is aging: by 2050, the numberof people over the age of 65 will double to 83.7 million(from 43.1 million in 2012).1 While the public perceptionof lesbian, gay, bisexual, and transgender (LGBT)peoplea is largely one of a young, affluent community,there are more than 2.7 million LGBT adults ages 50 orolder2 living in communities across the country.Within the LGBT community, a large share ofLGBT adults is older, highlighting the disconnectbetween the public’s perception of a monolithic LGBTcommunity and the reality of a diverse community interms of race and ethnicity, gender, and age. AmongLGBT respondents to a 2013 survey by Pew ResearchCenter, 9% of LGBT respondents were 65 and older,while another 25% were 50-64.5 For comparison,among the general American population at the time ofthe survey, 17% were 65 and older, and another 25%were 50-64.6 It is likely that many more millions of olderAmericans may experience same-sex sexual behavior orattraction, but not identify as lesbian, gay, or bisexualdue to societal stigma or fear of discrimination.7aWHO ARE LGBT ELDERS?There are more than nine million people in theUnited States who identify as LGBT; according toa 2016 Gallup survey, 4.1% of Americans identifyas LGBT. 3 Adults ages 52 and older are less likely toCORNERSTONES OF SUCCESSFUL AGINGbcIn general, the terms “lesbian” and “gay” refer to a person’s sexual orientation and describe peoplewho are attracted to individuals of the same gender. The term “bisexual” refers to a person’s sexualorientation and describes people who can be attracted to individuals of more than one gender. Theterm “transgender” describes individuals whose sex assigned at birth is different from the genderthey know they are on the inside. At some point in their lives, many transgender people decidethey must live their lives as the gender they have always known themselves to be, and transitionto living as that gender.The aging network is the network of local, state, and federal agencies that help older adultssuccessfully age in place.There is no settled definition of “LGBT older adult” or “LGBT elder.” Different surveys anddifferent advocacy groups use different definitions, ranging from adults ages 45 andolder to adults 60 and over. Where possible, we note the specific age range used by eachsurvey or organization.KEY CHALLENGES FOR LGBT OLDER ADULTSECONOMIC SECURITYA LIFETIME OF DISCRIMINATION AND LACKOF LEGAL AND SOCIAL RECOGNITIONSOCIAL CONNECTIONSA RELIANCE ON CHOSEN FAMILYHEALTH AND WELL-BEINGA LACK OF COMPETENT INCLUSIVEHEALTHCARE1INTRODUCTIONThis report seeks to increase understanding of theunique needs and experiences of LGBT older adults sothat service providers, advocates, the aging network,band policymakers can consider these challenges whenserving this population or passing laws that impactolder adults and the LGBT community. Health andwellbeing, economic security, and social connections areamong the cornerstones for successful aging, yet theseare areas in which many LGBT elders face substantialbarriers—stemming from current discrimination as wellas the accumulation of a lifetime of legal and structuraldiscrimination, social stigma, and isolation. Despite thesechallenges, many LGBT elders have survived and eventhrived. Others struggle with the burdens of poverty andsocial isolation. Each older LGBT adult carries their ownstory of pride and silence, of resilience and struggle, oflove and loss.identify as LGBT; the same Gallup survey found that2.4% of so-called “Baby Boomers” ages 52-71 and 1.4%of so-called “Traditionalists” ages 72 and older identifyas LGBT. Using these estimates and others from agrowing body of research, it is estimated that thereare approximately 2.7 million LGBT adults aged 50 andolder in the United States, 1.1 million of whom are 65and older. 4 Broadly, these LGBT adults comprise thecommunity referred to as “LGBT elders” in this report.c
WHO ARE LGBT ELDERS?22.7 MILLION LGBT ADULTS AGED 50 AND OLDER1.1 MILLION ARE 65 AND OLDERAPPROXIMATELY ONE IN FIVE (20%) LGBTOLDER ADULTS ARE PEOPLE OF COLORONE-THIRD OF LGBT OLDER ADULTS LIVE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVELINCLUDING.40% OF LGBT ADULTS 80 AND OLDER40% OF AFRICAN AMERICAN LGBT OLDER ADULTS40% OF HISPANIC LGBT OLDER ADULTS47% OF BISEXUAL OLDER MEN48% OF BISEXUAL OLDER WOMEN48% OF TRANSGENDER OLDER ADULTSSources: Karen I. Fredriksen-Goldsen, "The Future of LGBT Aging: A Blueprint for Action in Services, Policies, and Research," Generations: Journal of the American Society on Aging 40, no. 2 (2016); Hyun-Jun Kim, et al., "A Collaboration for Health and Wellness: GRIOT Circle and Caring and Agingwith Pride," Generations: Journal of the American Society on Aging 40, no 2 (2016); Charles A. Emlet, "Social Economic, and Health Disparities Among LGBT Older Adults," Generations: Journal of the American Society on Aging 40, no 2 (2016).
LGBT Elders of Color. Approximately one in five(20%) LGBT older adults are people of color,9 a proportionthat is expected to double by 2050 (see Figure 1).10 LGBTpeople of color have unique experiences related totheir sexual orientation and gender identity and theirrace and ethnicity. Research finds increased disparitiesacross many measures of wellbeing, including physicaland mental health outcomes, economic security, andexperiences of discrimination for LGBT people of colorand LGBT older adults of color specifically, many of whichare highlighted in the sections that follow.11A recent study, the Aging with Pride: the NationalHealth, Aging, and Sexuality/Gender Study, provideda unique opportunity for understanding the variedexperiences of LGBT older adults of color.12 For example,African American LGBT older adults reported higherlifetime levels of LGBT-related discrimination thanwhite LGBT older adults.13 And both African Americanand Hispanic older LGBT adults reported lower levelsof household income, educational attainment, identityaffirmation and social support, and higher levels ofidentity stigma.14Figure 1: One in Five LGBT Older Adults is a Person of Color% of LGBT People 50 and Over Who are People of ColorCurrent LGBTolder adults whoare people ofcolor, 20%3By 2050, 40% of LGBTolder adults will bepeople of colorSource: Michael Adams, “An Intersectional Approach to Services and Care for LGBT Elders,”Generations: Journal of the American Society on Aging 40, no. 2 (2016).LGBT Older Adults of Color BuildingCommunityThe LGBT Aging Project was founded in 2001 andover the past 16 years has grown into a robustprogram of the Fenway Institute in Boston,Massachusetts.15 The Aging Project has threefocus areas: cultural competence training forelder services providers, policy and research, andcommunity building. Through the third area—community building—the LGBT Aging Projectconvened Flashback Sunday, a community supportgroup for LGBT elders of color, largely black andAfrican American LGBT elders.Flashback Sunday participants create their ownprogramming with support from Fenway. Eventsinclude intergenerational movie nights, sharedmeals, socials, and pool parities. The participantsalso host nutritional programming and otherservices that focus on successful aging.Flashback Sunday is a place in which LGBT eldersof color can be their whole selves, and worry lessabout stigma and discrimination, based on race,sexual orientation, or gender identity.WHO ARE LGBT ELDERS?Rather than thinking about LGBT people ages 50and older as a monolithic group, Dr. Karen FredriksenGoldsen, a researcher on the health and well-being ofLGBT older adults, identifies three distinct generationsof LGBT older adults currently living in the UnitedStates, each with unique life experiences.8 The oldestLGBT adults are part of the “Invisible Generation,”born in the teens and 1920s and living through theDepression and World War II. They grew up during atime when LGBT people were nearly absent in publicdiscourse. The “Silenced Generation,” born in the 1930sand 1940s, came of age during loud public outcryagainst gay, lesbian, and bisexual employees, and thepathologization of homosexuality in the Diagnosticand Statistical Manual of Mental Disorders, a medicalhandbook. Finally, the “Pride Generation,” born in the1950s and 1960s, birthed the Stonewall revolution(the riots, demonstrations, and marches in responseto police violence against LGBT people in 1969) andexperienced the growing decriminalization of sodomy,which had policed LGB people’s lives. LGBT adults inall three generations lived through the AIDS crisis thatstarted in the 1980s, the impact of which is still felt tothis day, as well as the incredible legal and cultural shiftaround marriage equality.
WHO ARE LGBT ELDERS?4Bisexual Elders. Bisexual people make up more thanhalf of the adult LGB population,16 although among olderadults, fewer people identify as bisexual. According to a2015 YouGov poll, only 1% of respondents ages 65 andolder said they identified as bisexual.17 Research finds thatbisexual older adults face unique challenges comparedto their gay and lesbian peers. For example, the socialisolation faced by LGBT older adults is compoundedfor bisexual older adults who may be less likely to be“out” about their sexual orientation. According to PewResearch, 32% of bisexual respondents under the age of45 said that the most important people in their life knewthey were bisexual, compared to only 18% of respondents45 and older (see Figure 2).18 That social isolation has directimpacts on health and well-being: one survey of LGBTolder adults found that one-third of bisexual respondentshad moderate to severe depression, likely becauseof inadequate emotional support and more negativeinteractions with family members.19Transgender Elders. Transgender elders havespecific medical needs, including medically necessarytransition-related care.20 When transgender eldersare forced back into the closet due to discriminationor stigma, their health suffers. Older adults whotransition later in life face added health challengesin accessing care and support. Data on the particulardisparities faced by transgender older adults are sharedthroughout the report.Figure 2: Bisexual Older Adults are Much Less Likely to beOut Than Their Younger Counterparts% of Respondents Who Said They Were Out to theImportant People in Their Lives77%71%18%All LesbiansBisexual PeopleUnder 45Mandy Carter describes herself as an “out,Southern, black, lesbian social justice advocate”and is a recipient of the Spirit of Justice Awardfrom GLAD. The following is an excerpt from aninterview between Ms. Carter and Michael Adams,the CEO of SAGE.Michael Adams: [You have] been a pioneer in socialjustice movements through the lenses of LGBTrights, racial justice, AIDS activism, transgenderrights, and much more. When you think about themovement building you’ve been a part of, whatlessons surface as most relevant to you at thisparticular moment in time?Mandy Carter: When I put all of this into the contextof the recent election, I have to point out that NorthCarolina was the only state in the South that did not goall Trump. HB2, which has been called “the bathroombill” but is much deeper than that, has devastatedthe state. But [former Republican Governor] PatMcCrory’s support of HB2 cost him the election. TheMoral Monday Movement, an incredible coalitionof organizations, made the difference in turning outof the vote that defeated McCrory. Now we have aDemocratic governor and a Democratic attorneygeneral. Maybe the bigger picture is sometimes welose forward. What seems on the surface like a lossmight, in the long run, be a win.Today, there are 79 million of us post-World War IIbaby boomers and 80 million millennials aged 18to 25. Now is the time for all of us to come together.Furthermore, by 2050, the majority of people in thiscountry will be of color. We’re in a major movementmoment. On a scale of one to 10 in optimism, I’m a 10.Source: Adapted from “Living Lessons in Activism,” SAGEMatters, Spring 17, accessed May2, 2017, 2%All Gay MenOlder LGBT Trailblazers Are OptimisticBisexual People45 and OlderSource: ”A Survey of LGBT Americans, Chapter 3: The Coming Out Experience” (Pew ResearchCenter, June 13, 2013), 3-the-comingout-experience.
LGBT Elders Are Remarkably ResilientThe three generations of LGBT adults who comprisetoday’s LGBT elders hold much of the LGBT community’shistory and memories. The contemporary LGBTmovement is young enough that many of the elderspresent at the founding moments of the movementare alive today. It is crucial that LGBT elders receivecompetent, comprehensive care and support notsimply because those services are basic human rights,but also to support the dignity and well-being of thechange-makers who paved the way for the incredibleadvancements of our community.Older LGBT adults first came out to their closefriends or family at a later age than younger LGBT adults.Among LGBT adults aged 50 and older, the median agefor coming out was 21, compared to 17 for adults nowaged 18-29.22 Despite this, similar proportions of LGBTadults across all ages say that the important people intheir lives know they are LGBT, with the exception ofbisexual adults, only 18% of whom 45 and older say theyare out to the important people in their lives, comparedto 32% of bisexual people 18-44.23LGBT older adults’ journey to the current momentprovides them with a positive view of the progress ofequality. Older LGBT Americans are more likely to saythat there is greater social acceptance for LGBT peopletoday, unsurprisingly; 23% of LGBT people 45 andolder compared to only 16% of LGBT people 18-44 saidthat there is “a lot of social acceptance of gay, lesbian,bisexual and transgender people today.”24 Likewise,older LGBT people are more likely to say that society haschanged in the past decade: 61% of LGBT adults 45 andolder, compared to 46% of those aged 18-44.25WHO ARE LGBT ELDERS?In many respects, LGBT elders show remarkableresilience given that many of their experiences asyoung people were in a time when being LGBT wasless accepted—or worse, criminalized. They mayhave experienced family rejection, employmentdiscrimination, violence, and more. And yet, LGBTadults 65 and older responding to a 2013 survey fromPew Research Center were far less likely to say theywere “not too happy,” compared to those under 50 (6%versus 19%).215
KEY CHALLENGES TO SUCCESSFUL AGING FOR LGBT ELDERS6KEY CHALLENGES TO SUCCESSFULAGING FOR LGBT ELDERSLGBT Older Adults Faced Decades of CompoundingLegal and Social DiscriminationWhat makes aging different for LGBT adults thanother adults? The lack of social and legal acceptance,both historically
with Pride," Generations: Journal of the American Society on Aging 40, no 2 (2016); Charles A. Emlet, "Social Economic, and Health Disparities Among LGBT Older Adults," Generations: Journal of the American Society on Aging 40, no 2 (2016). 2.7 MILLION LGBT ADULTS AGED 50 AND OLDER APPROXIMATELY ONE IN FIVE (
WHY LGBT MEDIA? 60%. read LGBT media that most straight people have never heard of. 82%. attend LGBT events. 76%. visit LGBT websites. 69% . read LGBT magazines. 86%. of LGBT people engaged with some form of LGBT-oriented media in the past week. SOURCES: Pink Media 2014 Research - AU respondents, DNA Readers survey 2012 - All respondents. 1 .
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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 .
the health and social care sectors to take up the work that some very dedicated and inventive individuals have already begun. 4 Health and Social Care and LGBT Communities Introduction Our inquiry 1. In July 2018 the Government published its National LGBT Survey and LGBT Action Plan, which committed to improving the lives of LGBT people in the UK. The same month, an event on LGBT and health .
LGBT Population Health course syllabus Page 5 of 13 Version: 1-Apr-14 Be able to identify three public health problems faced disproportionately by one of the LGBT populations Be able to identify gaps in research on LGBT population health Understand the diversity of health disparities experienced by LGBT populations Identify LGBT health resources available to students at the UNC Health Sciences .
Laporan LGBT Nasional Indonesia - Hidup Sebagai LGBT di Asia 8 Ikhtisar Eksekutif [Foto: Para peserta Dialog Komunitas LGBT Nasional Indonesia] Hidup Sebagai LGBT di Asia: Dialog Komunitas LGBT Nasional Indonesia Laporan ini mengulas lingkungan hukum dan sosial yang dihadapi kelompok lesbian, gay, biseksual dan transgender (LGBT) di Indonesia.
population identifies as LGBT.iv Additional research shows that roughly 10% of youth identify as LGBT, with rural youth just as likely as urban youth to identify as LGBT.v Taken together, this suggests that between 2.9 million and 3.8 million LGBT people—or 15-20% of the total U.S. LGBT population—live in rural areas around the country. vi
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