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The Effects of Discrimination
Throughout their lives, LGBTQ (lesbian, gay, bisexual, transgender, and queer) people experience health inequalities and poor health outcomes due to stigma and discrimination.
For older LGBTQ adults, aging can be much harder as they are more likely to be socially isolated and have fewer social supports — in effect they are aging alone. While many do have partners or spouses, many more are likely to be single and without adult children to help them in older age. They are also more likely to have less income and financial security, and many do not have the advantage of partner or spousal benefits. For many, marriage and other equality gains arrived too late.
The prevalence of social isolation puts LGBTQ older adults at greater risk for mental and physical health problems, chronic conditions, and even premature death.
Statistics underscore the unique challenges that older LGBTQ adults face:
- About 13% of LGBTQ older adults report being denied medical care or given poor care because of their sexual orientation or gender, and many also hesitate to seek care for these reasons. Among transgender adults, the number is 40%.
- For LGBTQ older adults only about 48% of city residents and 10% of rural and small-town residents have access to high-quality LGBTQ senior services in their home communities.
- Due to the effectiveness of antiretroviral drugs, people with HIV are living longer and 45% of all older Americans (50 and older) living with diagnosed HIV are LGBTQ older adults.
- LGBTQ older adults with HIV have about a 50–100% higher risk of heart attack or stroke compared with people who are negative for HIV, in part because doctors were less likely to prescribe cholesterol-lowering drugs or aspirin.
The prevalence of social isolation puts LGBTQ older adults at greater risk for mental and physical health problems, chronic conditions, and even premature death.
Disparities in Long-Term Care, Financial Resources, and Housing
Often LGBTQ adults must rely on caregivers other than their family or friends or move into assisted living communities and nursing homes.
For those who live in long-term care facilities, only 50% were comfortable with acknowledging their sexual orientation. Nearly half of those in facilities had either experienced or witnessed mistreatment — e.g., being refused admission or being evicted due to gender or sexual orientation. Negative treatment from other residents was the most frequent problem, and verbal and physical harassment by staff ranked second.
Not all LGBTQ older adults share the same experience: lesbians and LGBTQ people of color are more likely to live in poverty than white gay men, and older bisexual adults are more likely to experience greater social isolation and are more prone to depression.
LGBTQ persons may also face discrimination in employment impacting their financial resources, and face discrimination in securing housing.
Public Policy and Advocacy for LGBTQ Seniors
LGBTQ elders are an underserved population and often lack access to senior housing, transportation, legal services, support groups, and social events.
Public policy, research and legislation to ensure equal access for aging and health issues facing LGBTQ adults lag.
Project Guardianship aims to be at the forefront of conversations that focus on issues affecting older LGBTQ adults and their unique needs. There are many issues to address: housing options and residential communities that cater to the unique needs of LGBTQ elders; legislation and oversight that protect LGBTQ elders residing in nursing homes and other care facilities; designation of LGBTQ older adults as an under-served population within the Older Americans Act; and cultural competency training for medical and healthcare professionals who serve this vulnerable population, to name a few.