Lesbian, Gay, Bisexual and Transgender Elders

Lesbian, gay, bisexual and transgender (LGBT) individuals are a minority group that is largely invisible to society as a whole, and often to health care providers and social workers as well. NASW policy statements have made clear that social workers have a commitment to advance “policies and practices that improve the status of all lesbian, gay and bisexual people” (NASW, 2000, p. 197). Nonetheless, it is well documented that LGBT individuals, no matter what their age, often perceive health and social service systems as unwelcoming. A study by Brotman, Ryan, and Cormier (2003) revealed the types of negative reactions gay men and lesbians frequently face by service providers: “embarrassment, anxiety, inappropriate reactions, excessive curiosity, pity, condescension, ostracism, refusal of treatment, detachment, avoidance of physical contact, or breach of confidentiality” (p. 192). For LGBT elders, the situation is more severe, due both to widespread ageism and the invisibility of a cohort of individuals who learned in their younger years how to “pass” as heterosexual in order to avoid harassment. LGBT elders have years of practice at concealment.

Given this concealment and because most national surveys do not ask about sexual orientation and identity, it is very difficult to get an accurate count of the number of LGBT elders in the U.S. Estimates of the number of GLB individuals age 65 or older range from about 1 to 2.8 million, increasing to 2 to 6 million by 2030 (Cahill, South and Spade, 2000). The number of transgender elders is even more difficult to estimate, and only recently have efforts been made to do so ( Witten, 2002). While LGBT elders certainly face some distinctive challenges as they age, many approach aging with unique resiliency and particular strengths. For example, skills developed through the coming out process and the management of social perceptions of “difference” throughout life prepare LGBT individuals for society’s generally negative view of older people in a youth-oriented society. Nonetheless, gay and lesbian people do experience some obstacles in their later years not shared with their heterosexual counterparts. One such challenge is access to gay-sensitive services. There are a very small number of organizations whose mission is specifically to meet the needs of LGBT elders; they exist in large cities with relatively visible gay communities. Most mainstream aging organizations are not competent in addressing the needs of LGBT elders. Numerous myths serve to maintain this status quo and to keep these agencies from doing outreach or providing gay-sensitive services. Three such myths are: 1) “there aren’t any GLBT elders around here”; 2) “we’re open to anyone”; and 3) “no one has ever asked, so there is obviously no need” (Smith & Calvert, 2001).

Culturally-competent practice must include sensitivity to the needs of elders who have lived decades in a heterosexist, homophobic, and transphobic society. Social workers must be leaders in eliminating both the subtle and blatant discrimination and oppression faced by current and future LGBT elders through proactive policy changes at the organizational, state and federal levels. Accordingly, social work curricula must include content and competencies for working with LGBT elders and their families to enhance their health and well-being.

Dr. Sandra Butler is a professor at the University of Maine and a Hartford Faculty Scholar. She works closely with the University of Maine Center on Aging and has published in the areas of poverty, homelessness, welfare, older women, rural aging, and LGBT aging.

References

Brotman, S., Ryan, B., & Cormier, R. (2003). The health and social service needs of gay and lesbian elders and their families in Canada. The Gerontologist, 43 (2), 192-202.

Cahill, S. South, K., & Spade, J. (2000). Outing age: Public policy issues affecting, gay, lesbian, bisexual, and transgender elders. Washington, DC: Policy Institute, National Gay and Lesbian Task Force.

National Association of Social Workers (NASW). (2000). Social work speaks: National Association of Social Workers policy statement 2000-2003, (5th ed.). Washington, DC: Author.

Smith, H. & Calvert, J. (2001). Opening doors: Working with older lesbians and gay men. London: Aging Concern England.

Witten, T.M. (2002). Geriatric care and management issues for the transgender and intersex populations. Geriatric Care Management Journal, 12 (3), 20-24.