Support For The Aging LGBTQ+ Community: Helping Older Adults Foster Emotional Health
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As life expectancy increases globally, the population of older individuals in the LGBTQ+ community continues to grow steadily as well. This group of aging LGBTQ+ people paved the way for successive generations, helping increase visibility and acceptance for sexual and gender minorities. Older individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) can also face unique mental health challenges.
Advocating for the aging LGBTQ+ community and raising awareness for the importance of inclusive psychological care may help its members feel supported as they navigate the golden years of their lives. Here, we’re taking a look at the specific challenges the older LGBTQ+ community often faces and outlining solutions for providing aging LGBTQ+ adults with quality mental health care.
Getting to know the aging LGBTQ+ community
The people in the LGBTQ+ community who lived through and participated in the gay liberation movement of the 1960s to the 1980s are now older adults. Though they contributed to the increased recognition of queer and genderqueer identities, as these individuals age, they are often overlooked among the broader LGBTQ+ population. Generational differences can cause many older LGBT adults to still feel uncomfortable expressing their sexuality publicly, and they are not covered as frequently through media channels.
The LGBTQ+ community refers to individuals who identify as lesbian, gay, bisexual, transgender, queer, questioning, or a number of other identities. People whose identities place them in the “sexual or gender minority” category already face a range of challenges, often experiencing discrimination, a lack of acceptance from family members, and harassment, which can contribute to mental health concerns. For example, studies suggest that the risk of depression and anxiety is two to three times greater among LGBTQ+ individuals than in the general population.
Within the broader LGBTQ+ community is an increasingly large subset of people who are over the age of 65. The older LGBTQ+ community may experience the above-mentioned challenges and more—particularly if they hold multiple marginalized identities—given health disparities that exist among age groups. These individuals may be at greater risk of experiencing loneliness, financial distress, discrimination, physical health challenges, and cognitive dysfunction.
A growing population of LGBT older adults
Increases in life expectancy mean that the global population is getting older overall. Additionally, older individuals may feel more and more confident expressing their sexuality or gender as society moves toward greater acceptance and inclusivity.
Common challenges faced by LGBT older adults
Individuals in the broader LGBTQ+ community are often subject to physical and mental health disparities, harassment, discrimination, and several other concerns stemming from systemic discrimination. The following are a few examples.
Stigma
For many older individuals in the LGBTQ+ community, social acceptance of queer and genderqueer identities was not a reality as they grew up. Indeed, the community faced significant backlash and discrimination as its members fought for equal rights, like the right to marry. Additionally, due to the AIDS epidemic of the 1980s, many older LGBT adults contracted HIV or experienced trauma due to the fear of infection or increased anti-queer prejudice at that time. While substantial progress has been made, attacks on the LGBTQ+ community continue.
Research suggests that sexual stigma is a significant contributor to mental health challenges in older LGBTQ+ adults, including depression, anxiety, psychological distress, and substance use. Some older individuals may experience shame, social isolation, or financial instability because of abuse or hate that they’ve been subjected to. Others may still have internalized stigma from heteronormative attitudes that were even more prevalent in past decades.
Mental health challenges
Overall, older LGBT adults have a higher risk of experiencing depression, anxiety, loneliness, and substance use disorder. Also, this population tends to experience a higher prevalence of physical health conditions, which can create or worsen mental health concerns. Furthermore, mental health professionals may not always be equipped to provide culturally sensitive treatment for this group of people, leading to discrimination or gaps in care.
Additionally, older adults may experience mental health challenges arising out of cognitive impairment. Dementia, normal memory loss, or similar concerns can create serious obstacles and exacerbate emotional distress.
Discrimination
Older individuals who identify as LGBTQ+ may struggle to receive healthcare, social services, housing, or employment due to systemic discrimination. For example, in many parts of the United States, healthcare workers can still refuse to treat LGBTQ+ people. Research suggests that one in eight LGBTQ+ individuals in the US live in states where care can be legally refused. Discrimination often causes older LGBT adults to avoid seeking mental health care, which can exacerbate psychological concerns they may experience.
Social isolation
Loneliness is a serious concern for the older adult population—and isolation can be even more pronounced for those who identify as LGBTQ+. According to SAGE, an organization that advocates for LGBT older individuals, members of this community are “twice as likely to be single and live alone” and “four times less likely to have children.” Loneliness can seriously impact an individual’s mental and physical health, potentially contributing to symptoms of depression, anxiety, and other concerns.
Additionally, despite wider recognition and validation throughout society, anti-LGBT sentiments can persist due to generational differences. There is evidence that heteronormative attitudes from past generations, such as Baby Boomers, impact feelings of inclusivity. One study suggests that acceptance is lower among older populations, with each successive generation increasing in acceptance. This could lead to greater alienation and continued discrimination for older LGBTQ+ individuals.
Mental health care for the aging LGBTQ+ community
It is important that culturally sensitive mental health treatment is widely available to older individuals in the LGBTQ+ community, including gender-affirming care for transgender older adults. It is also vital to note that treatment should take into account demographic differences. Within the older LGBTQ+ community, disparities exist based on ethnicity, socioeconomic status, health status (e.g., living with HIV), and geographical location.
Healthcare providers often must be aware of unique obstacles to care, such as internalized stigma caused by prior discrimination. LGBT seniors may be less comfortable sharing information about their sexuality than younger people, who have grown up in a society in which sexual and gender identity are more widely discussed.
How to serve as an ally for older LGBTQ+ individuals
If you’re interested in helping create supportive, inclusive spaces for older LGBTQ+ individuals, there are several steps you can take. The following are ways you can be an ally for the older LGBTQ+ community.
Learn more about the aging LGBTQ+ community
It can help to seek out educational materials so that you can learn more about this community. The US Department of Health and Human Services provides a guide to the rights of LGBT older adults. The National Resource Center on LGBTQ+ Aging also has a wealth of information on subjects relevant to older LGBTQ+ individuals.
Spread awareness
Helping get the word out about the challenges many LGBT older adults face can increase the visibility of this community. Consider donating to or otherwise supporting an organization that focuses on awareness for the older LGBTQ+ population, such as the LGBTQ+ Aging Project (previously called the LGBT Aging Project).
According to its site, the LGBT Aging Project was originally formed “by a group of advocates from both the aging service network and the LGBT+ community who recognized that older adults who are lesbian, gay, bisexual, transgender, or members of other sexual and gender minority groups are invisible to mainstream elder service providers”. You can also use social media platforms to spread awareness, posting reputable information relevant to the community or related, upcoming events in your area.
How therapy can help
Those who want to receive LGBTQ+-affirming mental health care might consider working with a qualified professional. A therapist who is culturally sensitive and understands the unique challenges of the older LGBTQ+ community can help clients better navigate being an older gender or sexual minority. Often, individuals seeking care can connect with therapists who identify as LGBTQ+ themselves.
Exploring age and identity with an online therapist
If you’re interested in addressing mental health concerns related to aging, sexual orientation, or other facets of life, consider connecting with a therapist online. This format allows you to receive mental health care remotely without leaving home.
The benefits of mental health care through online therapy
With an online therapy platform like BetterHelp, you can get matched with a therapist from a large pool of qualified mental health professionals, including providers who have experience supporting members of the LGBTQ+ community. Your therapist can also connect you with useful resources, such as informational content about aging, gender identity, or sexuality.
The efficacy of online therapy
Research indicates that online therapy can help individuals in the LGBTQ+ community receive effective, inclusive mental health care. For example, in one study, findings suggest that an LGBTQ+-affirming online therapy intervention led to reductions in depression, substance use, and internalized stigma in sexual minority men. Studies have also indicated that online therapy in general can often be an effective form of treatment for older individuals, particularly due to its ability to circumvent common barriers to care.
Takeaway
What is the LGBTQIA+ aging project?
The LGBTQIA+ Aging Project is an initiative to address the needs of gay, bisexual, and transgender older adults. This project is put on by the Fenway Institute specifically in the New England area, but similar projects and advocacy efforts exist around the country.
What is one concern you might have for an older adult who identifies as LGBTQ?
One of the most common, major concerns among LGBTQ+ adults is loneliness, which has the potential to cause negative health impacts. Supporting an LGBTQ+ older adult in finding ways to increase their community engagement and opportunities for connection can be helpful, such as by participating in programs like engAGED, the National Resource Center for Engaging Older Adults.
How to reduce LGBT stigma?
Reducing LGBTQ+ stigma will likely require changes on the systemic level. On the individual level, a person might focus on asking for and using preferred names and pronouns, otherwise using gender-inclusive language, and pushing back when they hear discriminatory language being used about LGBTQ+ people.
How do you create a welcoming environment for LGBT patients?
The Human Rights Campaign (HRC) provides various resources on its website to help healthcare providers offer a welcoming and inclusive environment for LGBTQ+ patients. Some approaches to consider include asking for and using each patient's preferred pronouns, using gender-neutral language otherwise, respecting their lived experiences, and not pathologizing their identity.
What is a common challenge for older LGBTQ adults?
Despite forms of progress like the Older Americans Act, many LGBTQ+ adults are still deeply marginalized and often face additional challenges as they age. For example, according to one study, almost more than half of LGBTQ+ older adults experience loneliness compared to their cisgender and heterosexual counterparts, which can lead to depressive symptoms and other health challenges. This effect is likely due to lived experiences of trauma, discrimination, and systemic barriers that individuals who are marginalized based on their sexual orientation and gender identity may face.
What are the mental health of older LGBT adults?
LGBTQ+ adults may have specific mental health needs based on lived experiences related to their sexual orientation and gender identity. Loneliness, trouble receiving healthcare services, and facing socioeconomic and financial barriers are a few examples. Each of these has various policy implications and points to growing needs for inclusive, affordable, culturally competent care and multigenerational health support.
How to advocate for LGBTQ community?
Asking for and using people's preferred name and pronouns and advocating for future research, inclusive services, and equitable care and services are two ways that allies can advocate for the LGBTQ+ community. It can also be important to speak up whenever you hear a person misgendering someone or engaging in discriminatory language or harassment—particularly against vulnerable groups like transgender people (those who do not identify with their gender or sex assigned at birth).
How do you make LGBTQ feel welcome?
There are many ways to make an LGBTQ+ person feel welcome. Asking for and using their preferred name and pronouns, otherwise using gender-neutral language, and treating them with warmth and acceptance are a few easy ideas.
What barriers to support and resources will LGBTQ+ older adults face when providing care for their partner?
There are many barriers to support LGBTQ+ older adults may face when providing care for their partner. Key findings from research reveal things like a lack of a support network and financial limitations as key barriers. As such, helpful support could include equitable availability of healthcare (including mental health care for addressing stress and any signs of a mental disorder) and methods for building and engaging in community.
What are common factors to consider when working with an older adult identifying as LGBT?
There are many different factors to consider when working with an older adult who identifies as LGBTQ+. One is that they have likely lived through deeply difficult times for queer people in history, from the Lavender Scare to the struggle for queer and BIPOC civil rights to the AIDS epidemic, so being sensitive to their lived experiences can be important. Another is that they may require technical assistance as part of inclusive services for healthcare and well-being. Finally, they may not be comfortable with using the same terms for themselves as are popular among younger LGBTQ+ people today, such as “queer,” so respecting their preferred terminology can be important as well.
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