Wednesday, April 24, 2013

Lesbian Gay Bi-Sexual and Transgender Older Adults


Losing control--whether physically or over your environment--is the main fear of getting old. It is a moment of humility when you can no longer look after yourself without some help from others. Up to that point we have engaged our energy at maintaining independence. Then slowly for some, and more sudden for others, there is a need to rely on someone else. And at that moment, the world changes, slowly for those with a partner, and more drastically for those living alone.

Living alone is more likely to be the reality for a large part of the LGBT older adult community.  LGBT is an acronym for Lesbian Gay Bi-Sexual and Transgender, a very diverse group.  While LGBT older adults share common barriers with other older adults who become frail and must rely on outside services for support,  they also face added complications.

In 2011 the National Resource Center on LGBT Aging reported that LGBT older adults are twice as likely to age as a single person, to live alone, are less likely to have children to support them and more likely to develop mental health and substance abuse issues. But there are additional barriers. Apart from ageism--which is a significant issue--LGBT older adults are also susceptible to homophobia (discrimination against homosexuals.)

There are documented cases where LGBT older adults in assisted living facilities and nursing homes are left uncared for, separated from their loved ones, restricted from cohabiting or having their partners at their death bed and restricted from spriitual comfort. The combination of ageism and homophobia is a lesson for all older adults.

Although homosexuality was removed from the International Classification of Diseases of the World Health Organization in 1990, there is still inequity among the status of LGBT across the world. This homophobia comes to the surface with older adults, in terms of how we treat LGBT older adults.

A recent report in 2011 by SAGE--Services and Advocacy for LGBT Elders—reported widespread victimization and discrimination. Over the course of their lifetime, eight out of ten LGBT older adults have been victimized at least once  and nearly four out of ten LGBT older adults have contemplated suicide at some point during their lives. Most reported some disability (47%), depression (31%), and loneliness (53%). SAGE reported that nearly one in ten of all LGBT older adults are living with HIV disease.

The level of discrimination among LGBT older adults is perceived so real that more than one in five of LGBT older adults have not revealed their sexual orientation or gender identity to their primary physician. The ongoing legal fight to have same-sex marriage recognized highlights the services that LGBT older adults are denied, these include; federal family leave benefits, equivalent Medicaid spenddowns, Social Security benefits, bereavement leave, or automatic inheritance of jointly owned real estate and personal property.

Younger people have difficulty discussing sexual activity among older adults and it seems that older adults do as well when it comes to their LGBT peers. While this uncertainty promotes discrimination against LGBT older adults it is the lack of oversight and regulations among assisted living facilities and nursing homes that makes such discrimination common.

Mario Garrett, Ph.D., is a professor of gerontology at San Diego State University and can be reached at mariusgarrett@yahoo.com

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