The results from California’s first state-wide survey of LGBTQ+ older adults showed overall high levels of satisfaction with their quality of life but also concerns about the personal, financial, and mental health well-being of transgender women.
The survey, entitled “From Challenges to Resilience,” was conducted in early 2024 with 4,037 respondents. The survey was conducted by the California Department of Aging, the University of California, Berkeley, the University of California, San Francisco School of Nursing’s Department of Community Health Systems, and Openhouse, a nonprofit LGBTQIA+ older adults support group.
“This survey marks an important step in understanding the unique needs of LGBTQIA+ older adults, allowing us to take meaningful steps in shaping services that truly reflect and respond to this community,” CDA Director Susan DeMarois said in a statement. “We’re proud that so many respondents feel California offers a high quality of life, and we are committed to building on these strengths by addressing barriers and creating a more inclusive, supportive future for all older Californians.”
The survey explored seven topics: economic well-being, social well-being, discrimination and safety, health care access, service utilization, mental health and substance use, and cognitive and physical health.
Most of the survey respondents were white (78 percent). Most also identified as cisgender (86 percent). Most lived in Northern California (65 percent) and in urban areas (81 percent).
Most surveyed gave high marks for personal wellness and quality of life (86 percent), while 14 percent rated their quality of life as only fair or poor. Transgender and gender expansive were the least satisfied with the quality of their lives, with 22 percent giving only poor or fair ratings.
Trans women were also the most likely to have recently experienced unfair treatment, disrespect, and discrimination. Overall, 27 percent of those surveyed reported such experiences, but 54 percent of trans women said they have been so victimized recently.
Officials hope to use the results of the survey as a baseline for further research and as a key component of the state’s overall plan to deal with California’s aging population.
“California is leading the way in creating a future where every older adult, regardless of identity, is valued, respected, and supported,” Kim Johnson, Secretary of the California Health & Human Services Agency, said in a statement. “These findings provide a foundation for meaningful change, guiding us as we advance the Master Plan for Aging and ensure that all older Californians feel recognized and included.”
You can download the entire 96-page report here. Alternatively, you can download a 16-page summary of the report here.
As National Retirement Security Week begins, we’re sharing the results of MAP’s new study, which compares Bankrate’s recent analysis to our publicly available data on state policy to illustrate how state retirement rankings can change dramatically when you consider laws and policies that shape the lives and experiences of LGBTQ people.
A recent study by Bankrate, a personal financial services review site, looked at the best and worst states to retire and based their rankings on five factors: affordability, well-being, quality and cost of health care, weather, and crime. Their general recommendation emphasized in the New York Timesarticle featuring their analysis? “Head South.”
This suggestion may be fitting for those over 65 whose decision on where to live is mainly powered by cost of living and warm temps, but for the 2.7 million LGBTQ people ages 50 and over, other factors — like what rights a state affords or denies LGBTQ people — likely matter just as much, if not more. Including even a minimal consideration of a state’s treatment of LGBTQ people would result in a different ranking of states all together.MAP’s research team decided to compare Bankrate’s analysis to our publicly available data on state policy to illustrate how state rankings can change dramatically when you incorporate laws and policies that shape the lives and experiences of LGBTQ people. Our findings show strikingly different results and highlight a very different set of considerations for LGBTQ adults deciding where to spend their golden years.As a trusted source for rigorous research and insight, MAP’s LGBTQ Equality Maps provide a detailed, real-time snapshot of the state of LGBTQ laws and policies in the United States. Our maps track over 50 policies which, when tallied together, produce an overall LGBTQ policy score for each state. When comparing Bankrate’s state ranking to our tallies, two datapoints are immediately clear:70% of Bankrate’s ten highest ranked states receive a negative or low overall LGBTQ policy tally (MAP’s two lowest categories).
70% of Bankrate’s ten lowest ranked states receive a high overall LGBTQ policy tally (MAP’s highest category).MAP’s team then took it a step further, attempting to replicate Bankrate’s study by using the information included in their article. This attempt produced different results than Bankrate published, even before including LGBTQ policies. When MAP contacted Bankrate for clarification, Bankrate refused to share their complete data and methodology, so making a direct comparison or replication was impossible.
However, based on the limited data and methods Bankrate described in their original article, MAP followed a similar approach using the same factors and adding in our own state-level LGBTQ policy data — data which is freely available for others to use. Making minimal adjustments to Bankrate’s approach, our findings illustrate how dramatically the rankings can change with even a basic level of consideration of LGBTQ policies.As shown in the weight comparison chart below, MAP adjusted Bankrate’s weighting of affordability and weather to allow for the consideration of LGBTQ policies. These policies, which themselves can dramatically affect LGBTQ people’s overall quality of life, include one’s ability to afford or access housing and public places like parks, libraries, and senior centers (e.g. nondiscrimination law), access to affirming health care (e.g. insurance nondiscrimination), and protections against crime (e.g. hate crimes law), among many others.
By acknowledging the policy factors that directly impact quality of life and more for LGBTQ older adults and weighing these policies equitably with other key issues, we obtain a drastically different list of best and worst states for retirement. For example, only one of Bankrate’s original top 10 states maintained a spot on MAP’s top 10 list (Delaware), and two of Bankrate’s original worst 10 states are among MAP’s best list (California and Colorado).
At the end of the day, deciding where to relocate after retirement is a uniquely personal decision with dozens of variables to consider. But for many, the risk of discrimination, lack of fully inclusive protections, and slew of harmful and exclusionary laws make some states an impossible choice, no matter how perfect the weather.
To schedule an interview with a MAP researcher or for questions, please contact Dana Juniel at dana@mapresearch.org.
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About MAP: MAP’s mission is to provide independent and rigorous research, insight and communications that help speed equality and opportunity for all. MAP works to ensure that all people have a fair chance to pursue health and happiness, earn a living, take care of the ones they love, be safe in their communities, and participate in civic life. www.mapresearch.org
A much-needed affordable housing project for LGBTQ+ seniors in San Francisco’s Castro District has hit a setback, as state agency funding was denied, even though the proposal was described as “a great project,”The Bay Area Reporter wrote.
Mercy Housing California, a senior living facility for elderly LGBTQ+ people, had applied for nearly $39 million from the Affordable Housing and Sustainable Communities (AHSC) Program, a joint initiative by California’s Department of Housing and Community Development and the Strategic Growth Council. The funds would have funded a 187-unit affordable housing development in the Castro, the city’s historically gay neighborhood.
Amar Cid, deputy director of Community Investments and Planning, said the project had limited funds and much competition, with other applicants scoring higher.
“Round 8 of the AHSC program had many transformative, impactful community projects. Like every round, total project requests far exceeded the available funds. This year, requests were more than double what we could grant. It was a highly competitive process,” he told The Bay Area Reporter.
Cid emphasized that the rejection doesn’t mean the project isn’t valuable.
“The team met with the 1939 Market Street project team in mid-September to discuss ways to increase their score if they choose to apply in a future round,” he said, emphasizing that he told its organizers to apply again in the future. ”
“[It’s] a great project … [and] we hope they consider applying in a future round,” he said.
“Why some projects may have been awarded with a lower score than the 1939 Project has to do with other projects perhaps meeting specific [disadvantaged communities] and/or program priorities,” Cid said.
The affordable housing developer is partnering with Openhouse, a San Francisco nonprofit that provides services for LGBTQ+ seniors, to create their third building of below-market-rate apartments, primarily for LGBTQ+ seniors. Previously, the two organizations collaborated on 119 units of affordable, LGBTQ+-friendly senior housing spread across two buildings located at 55 and 95 Laguna Street — both are near the Castro District.
The push for affordable housing in the Castro is especially crucial as LGBTQ+ seniors face unique challenges in finding safe, inclusive living spaces. Mercy Housing’s commitment to resubmitting their application is a step forward, but the struggle for adequate funding continues.
Mercy Housing California said that it will reapply for funding in 2025. In a statement to Bay Area Reporter, the organization expressed hope for next year.
“Unfortunately, this does push the schedule back one year. However, we remain committed to delivering 187 units of LGBTQ+ friendly housing as soon as possible,” the organization said.
Gene Dinah misses his late husband, Robert Malsberry, every day. He misses Malsberry’s cooking, his love for gardening, the way he fixed things around the house and the way he made him feel special and protected.
“He was just great,” Dinah said of Malsberry, who died in 2019. “I couldn’t have had a better partner.”
The memories of the 46 years the men had together are all around him.Malsberry is in the paintings he bought to decorate their home in Fort Lauderdale, Florida. He is in the medals he received for his service with the Air Force. Heis in the photos from a lifetime together.
“Oh, this is one of my favorite pictures,” Dinah said as he held a photo of himself and his husband standing in front of lush green shrubs at their home. “That’s our rock garden.”
Gene Dinah, left, and his husband, Robert Malsberry.Courtesy Gene Dinah
Picking up another photo, he said, “That’s my husband in our dining room in our house in Victoria Park with Cleo, our Persian cat.”
Robert Malsberry with Cleo, the cat he shared with Gene Dinah.Courtesy Gene Dinah
“Oh, this is a good picture,” he continued. “This is my husband when he was an Air Force lieutenant after graduating college.”
Robert Malsberry when he was an Air Force lieutenant.Courtesy Gene Dinah
They had no children, so when Malsberry was diagnosed with leukemia and later dementia, Dinah became his full-time caregiver. “I took care of him as best I could,” he said.
Malsberry died in 2019, four years after the couple got married in 2015, following that year’s landmark same-sex marriage ruling by the Supreme Court.
“My husband was very happy when we got married,” Dinah said. “I didn’t know how he was going to take it. I really didn’t, because he’d been in the closet, you know, for all those years.”
Dinah was destroyed after Malsberry died. “My whole life was him,” he said.
While taking care of his sick husband, Dinah did not think about his own elder years. Now, at 76, he is one of many LGBTQ elders who have no surviving relatives who can take care of them.
LGBTQ older adults are four times less likely to be parents than older heterosexual adults, and twice as likely to grow old single and living alone, according to SAGE, a national group that offers services and advocacy for LGBTQ adults 50 and older.
The challenges LGBTQ elders face overlap with an aging U.S. population. According to the U.S. Census, the population aged 65 or over grew to an unprecedented 55.8 million, or 16.8% of the total population, in 2020. The number of people in the U.S. that are 65 or older is projected to increase by 47% by 2050.
An older population exacerbates workforce shortages in senior living facilitiesand health care institutions, and while this affects many older Americans, LGBTQ elders face unique challenges when compared to their heterosexual counterparts.
In a report published in 2018, SAGE found LGBTQ elders are far more likely than their heterosexual peers “to have faced discrimination, social stigma and the effects of prejudice.” They are therefore, the report found, more likely “to face poverty and homelessness, and to have poor physical and mental health.”
Caregiving
Since LGBTQ people are less likely to have children, more than half (54%) of LGBTQ elders receive care from their partner and nearly a quarter (24%) receive care from a friend, according to SAGE. More than 20% of older LGBTQ adults have provided care to friends, compared to just 6% of their heterosexual counterparts.
Mitchell Zahn, a coordinator for SAGE in South Florida, said that in heterosexual family units, caregiving tends to have a vertical model, in which the child takes care of their parents.
“But in the gay community, since so many do not have a family, caregiving tends to be with friends, a more horizontal model,” Zahn said. “However, when you age, your friends tend to be older as well and have their own health needs, so our health support is failing as well because we don’t have that intergenerational aspect.”
Photographs of Gene Dinah and his husband, Robert Malsberry, throughout the years.Courtesy Gene Dinah
Dinah is a vivid example of the horizontal model of caregiving. For the four years during which Dinah was his husband’s sole caregiver, he arranged all of his medical appointments, found him the doctors he needed, took care of him through medical procedures, cooked for him, took care of the house and got him all the medical supplies he needed. After his husband died, Dinah had no one to help him with his own health care.
“I didn’t see a doctor or a dentist for four years while I was his caretaker,” he said. “When it was all over, I started going to the doctor, and I found out I had prostate cancer.”
Dinah went through six weeks of radiation treatments by himself.
Health care
Discrimination in health care and the fear of such discrimination are major factors that lead to health disparities for LGBTQ elders, according to research. In its 2018 report, for example, SAGE found approximately 20% of LGBTQ people avoid medical care out of fear of discrimination.
Zahn, the SAGE coordinator, said that because many LGBTQ elders grew up in a time when discrimination was more widespread and intense, they tend to fear government and health care institutions.
“People have experienced housing evictions, not having their partners recognized in health care institutions,” Zahn said. “So as a result, many are closeted when seeking services through traditional institutions.”
Zahn said LGBTQ elders may feel judged for who they are, so they may not share everything about their medical history with their doctors, which could lead to misdiagnosis and overall poor health outcomes.
The challenges of aging are even greater for transgender elders and even more for trans immigrants and trans people of color.
More than 20% of transgender people report that a doctor or other health care provider used harsh or abusive language while treating them, according to SAGE, while 50% of trans people reported having to teach medical providers about transgender care.
Morgan Mayfaire, 65, is the executive director of TransSOCIAL, an organization that aims to create a more inclusive community for transgender people. As a trans man, he said, he has experienced prejudice when visiting medical providers.
“When they look at your records, they’re going to see in your list of medications that you’re either taking estradiol or you’re taking testosterone,” Mayfaire said. “The question then is, ‘Why?’ The minute you tell them that it’s because you’re trans, you can see the bias in their face.”
Mayfaire helps train a variety of institutions, including those focused on health care, about best practices when caring for older trans people.He said very few medical professionals have gone through sensitivity training, and those that have, typically don’t train their new hires.
Florida is one of the states that has recently passed legislation seeking to restrict transgender rights, including a law signed by Gov. Ron DeSantis that made it harder for transgenders adults to access gender-affirming care. That law is now on hold after a federal district court ruled it unconstitutional, but Mayfaire said the effects are palpable.
“A lot of the providers that we had before have either left the state and moved somewhere else, or are reluctant to reopen those services,” Mayfaire said.
Andrea Montanez, a trans field organizer in Orlando with the National LGBTQ Task Force, said, “It’s scary to be an elder as a transgender person, to be honest.”
Montanez, 58, said a doctor who had given her great treatment for years suddenly turned curt, cold and distant after she transitioned.
She also suspects her apartment lease was not renewed because she told her landlord she had transitioned.
Housing
Mayfaire said housing is another big obstacle for LGBTQ elders.
Half the LGBTQ population live in states with no laws prohibiting housing discrimination against them, and 48% of LGBTQ couples experience adverse treatment when seeking senior housing, according to SAGE.
“There are very few retirement communities for LGBTQ folks to begin with,” Mayfaire said. He added that even at retirement communities that are accepting of gays and lesbians, “it’s very rare” that they accept trans people.
He said he has heard of LGBTQ elders who end up having to go back into the closet in order to be accepted in some retirement communities.
“It’s a little bit more difficult when you’re trans and you’ve transitioned,” Mayfaire said. “How do you backtrack on that and how do you deal with that emotionally and mentally?”
Isolation
Nearly 60% of LGBTQ older adults report feeling a lack of companionship and over 50% reported feeling isolated from others, according to SAGE.
That isolation can really impact the mental health of LGBTQ elders, many of whom faced the brunt of discrimination and were the pioneers of the movement for LGBTQ rights.
To combat that loneliness, SAGE matches elders with “friendly visitors”: volunteers who donate their time to accompany an LGBTQ elder.
Volunteers sometimes share a meal with an elder, tell stories, watch movies, play board games or just simply talk. Some volunteers check in with their elders with a simple text message or a call.
“I’ve seen some real magic happen between volunteers and participants, some incredible relationships that have formed,” Zahn said.
Craig Rosenblatt is one of SAGE’s volunteers. Sitting next to Dinah on a recent Friday afternoon, Rosenblatt said he volunteers in part to pay homage to and learn from his LGBTQ elders.
“You’ve had experiences that I have not had with bigotry. Where there were a lot of things that I was able to do that you were not able to do, and there’s a lot of things that I was not able to do that people can do today,” Rosenblatt told Dinah.
After his husband died, Dinah said, he was so consumed by grief that he couldn’t manage to put up his Christmas tree for several holiday seasons.
“I just didn’t feel like doing anything for the holidays,” he said. “Grief is a funny thing. It saps your energy.”
Last Christmas, however, that changed, thanks to another SAGE volunteer.
“He got our Christmas tree out, got it working and plugged it in and everything, and that meant everything to me,” Dinah recalled. “The passage of time is a good thing. I know I feel much better now than I did in the beginning.”
Legislation to create a new task force to combat LGBTQ+ elder abuse has been introduced by out Rep. Angie Craig of (D-MN) and fellow Equality Caucus member Rep. Josh Gottheimer (D-NJ).
Gottheimer announced the bill, dubbed the “Elder Pride Protection Act,” at an annual roundtable of North Jersey LGBTQ+ community organizations and advocates.
“We know that elderly members of the LGBTQ+ community face abuse across our nation, but their voices aren’t being heard,” Gottheimer said Friday. “The reality is that organizations and government agencies aren’t tracking these heartbreaking attacks.”
The bill would require the attorney general to establish a Department of Justice (DOJ) task force composed of members of the DOJ’s Elder Justice Initiative and the Office of Civil Rights, according to reporting from The Hill.
The interagency group would be tasked with developing a national approach to combating increased incidents of LGBTQ+ elder abuse, and determining and sharing best practices for local and state law enforcement.
Important to the group’s mission will be tracking and reporting when and how the abuse takes place. The group will make regular reports to Congress.
The new legislation “is a critical step in ensuring that we can coordinate our response to this runaway abuse at the federal level,” Gottheimer said. “No one should ever be mistreated on the basis of their sexual orientation or gender identity, especially our vulnerable elderly populations.”
Data shared at the roundtable reveals many LGTBQ+ elders have reported challenges like a diminishing support system and loneliness. Abuse, however, often goes unreported.
An estimated 68% of elders in the community have experienced verbal harassment and 43 percent have been threatened with violence, according to a study from The National Center on Elder Abuse.
Another survey revealed 65% of LGBTQ+ elders aged 60 or older reported dealing with victimization due to their sexual orientation. Also, 29% revealed they were physically attacked.
In May, out Reps. Mark Pocan (D-WI) and Sharice Davids (D-KS), and ally Suzanne Bonamici (D-OR), who chairs the caucus’s LGBTQI+ Aging Issues Task Force, announced proposed updates to the Older Americans Act intended to improve services for older LGBTQ+ adults in rural areas, particularly for those living with HIV.
“Congress has a responsibility to ensure LGBTQI+ older adults and older people living with HIV in rural communities have the support they need to age with dignity,” said Rep. Pocan, the Equality Caucus chair.
Two out U.S. representatives and an ally have introduced a bill aimed at improving services for older LGBTQ+ adults living in rural areas.
Seniors who are LGBTQ+ or living with HIV and live in rural communities often face barriers to support and resources because of geography, costs, insufficient broadband infrastructure, lack of specialized providers, or stigma, notes a press release from Reps. Mark Pocan, Sharice Davids, and Suzanne Bonamici, all Democrats. Their Elder Pride Act would update the Older Americans Act and provide funding to help rural Area Agencies on Aging offer specific services for these populations.
The act would establish a grant program to fund cultural competency training for service providers; help connect these elders to providers and community organizations; expand nondiscrimination policies and community spaces for this population and members of other protected classes; provide resources on sexual health and aging, including for individuals with HIV, for senior service providers; and support other care and services.
“The ability of LGBTQI+ older Americans and seniors living with HIV to age with dignity should not depend on their zip code,” Bonamici, a straight ally who chairs the Congressional Equality Caucus’s LGBTQI+ Aging Issues Task Force, said in a press release. “The Elder Pride Act will improve the overall health and social and economic well-being of LGBTQI+ older adults and seniors living with HIV in rural areas by better equipping senior service providers with resources to address the unique needs of these communities. I’m pleased to introduce this important legislation with my colleagues and co-leaders on the Equality Caucus, Reps. Pocan and Davids.”
“Congress has a responsibility to ensure LGBTQI+ older adults and older people living with HIV in rural communities have the support they need to age with dignity,” added
Pocan, a gay man and chair of the Equality Caucus, added: “Congress has a responsibility to ensure LGBTQI+ older adults and older people living with HIV in rural communities have the support they need to age with dignity.”
“Many of our LGBTQI+ elders fought tirelessly for equality in a world that refused to accept their identity,” said Davids, a queer woman who cochairs the Equality Caucus. “While they overcame tremendous odds to give future generations the rights they deserve, our elders, particularly those in rural communities, continue to face discrimination when accessing long-term care and health care. I am proud to support the Elder Pride Act because who you are and who you love should never increase your risk for isolation, poverty, and poor health outcomes as you age.”
The legislation is endorsed by SAGE, the Equality Caucus, Human Rights Campaign, NMAC, Justice in Aging, National Center for Lesbian Rights, MAZON: A Jewish Response to Hunger, U.S. People Living with HIV Caucus, National Coalition of STD Directors, interACT, and National Association of Nutrition and Aging Services Programs.
“LGBTQ+ elders and older people living with HIV live in every part of this nation, including rural areas. We all deserve to be able to age in our communities with the services and supports we need to remain independent,” SAGE CEO Michael Adams said in the release. “We commend Representatives Suzanne Bonamici (D-OR), Mark Pocan (D-WI), and Sharice Davids (D-KS) on reintroducing the Elder Pride Act. And we honor the contributions of our many LGBTQ+ trailblazers whose tireless advocacy allowed us to reintroduce this critical bill. We look forward to working alongside Reps. Bonamici, Pocan, and Davids, and our LGBTQ+ pioneers nationwide to pass this legislation.”
I came out as bisexual in my 40s, and I had to learn how to grant myself permission to embrace my fluidity and attraction to people across the gender spectrum.
I originally came out as a lesbian in my 30s after realizing I identified with the queer community. It was another 15 years before I met my current partner and truly recognized my fluidity. Part of this process involved overcoming the fear of being misjudged as heterosexual because of the appearance of my relationship.
Fortunately, we’re seeing progress as many are freeing themselves from heteronormative boxes to identify as bisexual and live more fulfilling lives. Today, 57% of LGBTQ+ Americans identify as bisexual, per a new Gallup report. But despite representing the majority of the queer community, we are often excluded from LGBTQ+ circles while simultaneously feeling out of place in heteronormative society. In short, we feel invisible.
This feeling of invisibility is evident in a study from the National Library of Medicine, which revealed that members of the Bi+ community are more likely to stay closeted. As a result, they face a greater risk for mental health issues compared to their gay and lesbian peers.
This risk is even greater for Bi+ elders.
A lifetime in the closet
The topic of bisexuality has rarely been discussed during my 30 years as a sexuality educator – even within my field of queer studies. Historically, the voices of Bi+ individuals have been widely overlooked in LGBTQ+ spaces and advocacy efforts. This lack of visibility has limited the awareness that one can identify as something beyond lesbian, gay, or straight.
While younger generations are growing up with bisexual role models and a broader acceptance of sexual fluidity, bisexual elders have less representation. Gallup’s report found that more than 68% of LGBTQ+ Gen Zers identify as bisexual compared to 26% of LGBTQ+ Baby Boomers.
And according to a Movement Advancement Project report, bisexual elders are much less likely to be out than their younger counterparts. Only 18% of bisexual respondents aged 45 and older said that the most important people in their lives knew they were bisexual, compared to 32% of respondents under 45.
Research also shows that bisexual older adults face unique challenges compared to their gay and lesbian peers. By not being “out” about their sexual orientation, many feel socially isolated, leading to poorer mental and physical health, elder abuse, and other negative outcomes.
While there are many reasons for bisexual elders to remain closeted, one of the biggest reasons is the fact that many grew up learning misconceptions about bisexual individuals. Bisexuals face not only discrimination in the heterosexist and homophobic culture but also resistance from the rest of the queer community, as some people feel bisexuals are “sitting on the fence.” Bi+ elders need to feel included and validated within the LGBTQ+ community, regardless of what their relationships look like.
Fostering inclusivity
Navigating biphobia and bisexual erasure can feel stressful and isolating, especially for elders who may already experience feelings of invisibility and isolation due to their age. It takes energy to mask your authentic self, but vulnerability can also be exhausting. Feeling excluded from both LGBTQ+ and heteronormative spaces can have an emotional, spiritual, and physical impact on Bi+ elders, and it often leads to them shrinking themselves and their networks.
Thankfully, we’re making progress. SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ+ elders, is dedicated to improving life for those in the Bi+ community. Resources like the SAGE x HearMe app address the pressing need to create space for the Bi+ elder community by providing inclusive, safe spaces to share feelings and experiences with allied listeners. Continuing to expand access to targeted mental health support services is crucial to address the specific needs of the Bi+ community.
To support inclusivity in retirement and long-term care communities, SAGECarehas intentionally integrated more bisexuality topics into training programs to help providers better understand the unique needs of Bi+ elders. This includes training staff on using bi-inclusive language, planning bi-inclusive programming, and respecting diverse life narratives. In addition, our National LGBTQ+ Housing Initiative works tirelessly to ensure elders can age with dignity as their authentic selves.
Aging with dignity
As trends evolve, the LGBTQ+ community must be responsive and ensure space for all voices at the table. Advocates, care providers, and other allies need to resist common misconceptions about bisexuality, find opportunities to advocate for fluidity in sexuality, and embrace current initiatives to validate the experiences of Bi+ elders.
I’m always inspired to see people bravely stepping out of boxes and embracing their whole selves. As we work to build a more inclusive society, we need to trust that people know who they are.
When we move past binaries and allow space for individuals to explore and express themselves freely, we uplift each other. Acknowledging the fluidity of attraction will enable people to discover and embrace their authentic selves, paving the way for all of us to realize our full potential.
Terri Clark is a certified trainer with SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ+ elders. She is an accomplished public health advocate, program planner, trainer, and facilitator with over 30 years of experience. Her areas of focus include human sexuality, with a specialty in LGBTQ+ issues, HIV prevention, sexual health, and older adult sexual expression. She is an advisory board member of the Philadelphia Corporation for Aging’s Health and Wellness Committee and serves on the aging workgroup of the Governor’s Commission on LGBT Affairs.
Infectious disease experts say more needs to be done to address rising STI rates in older people. The call to action will be presented next month at the European Congress of Clinical Microbiology and Infectious Disease in Barcelona, Spain.
In a press statement in advance of the conference, they explained what was happening… and suggested some reasons.
For example, STIs in Americans aged 55 to 64 years have more than doubled over the past decade. It’s even worse for gonorrhea, rising from 15 cases per 100,000 people in 2015 to 57 per 100,000 in 2019.
In England, the number of over 45s diagnosed with gonorrhea and syphilis doubled between 2015 and 2019. The majority of that rise has been in gay men.
Professor Justyna Kowalska from the Medical University of Warsaw, who leads the research offers some reasons. These include the rise of dating apps, and erectile dysfunction medication such as Viagra. An increasing number of people are having sex at a later stage in life.
“Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over 50s”, says Professor Kowalska.
It’s known that some men are foregoing condoms due to advances in HIV treatment and prevention.
“These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs,” continued Kowalska.
“People do not become asexual with age”
She says assumptions that people stop having sex as they age need to be challenged. For many people, sex remains an important part of their life into old age.
In a study in England, 50% of men aged 70 and over reported being sexually active. In a Swedish study, 10% of those aged 90 and over said they still had sex.
“People do not become asexual with age,” says Kowalska. “In fact, with preventive medicine and improved lifestyles people are enjoying a healthy life and sex life for longer.”
“Older people often find greater satisfaction in their sex lives due to experience and known expectations. We need more role models like Samantha Jones in the TV show Sex and the City to challenge stereotypes around older sexuality.”
Kowalska says health professionals need to talk more to older people about sexual health.
“Sexual health campaigns are focused on young people and overlook the needs and experiences of those aged 50 and older,” she says.
“Health promotion messages give the impression that condoms and concerns about STIs only apply to young people. But the dangers of undiagnosed and untreated STIs such as HPV-related cancers and onwards transmission are very real, particularly in this age group who are more likely to have underlying conditions such as heart disease and stroke.”
Although the rates of STIs in older people are lower than those in younger age groups, health awareness material aimed at elders remains rare.
Amsterdam
Queerty recently reported on how Amsterdam in the Netherlands had dramatically reduced its HIV transmission rates. It recorded just nine new cases in 2022. Part of the approach was a multi-pronged awareness campaign that included older people. The film below is about a man who grew up during the AIDS epidemic having a hook-up with a younger guy. They discuss safer sex methods.
The year: 1969. Man landed on the moon, the Beatles gave their last concert on top of the Apple building in London, and we mourned Judy Garland’s death. But most notable for me was the Stonewall Uprising on June 28.
As a gay African-American man, I am an activist and a pioneer. I have experienced some of the brightest and darkest highlights of LGBTQ history. So much has changed and I know my generation has made a significant contribution to the growth and positive changes. My mantra: “I’m living my best life!”
The year of the Stonewall Uprising, I was beginning my studies at Parsons School of Design. It was a turning point in my life. I felt equipped to leave my family nest and ready to be independent, a trait that was instilled in me at an early age.
As soon as I arrived in New York, the city was swarming with so much energy that it was hard to contain myself. New York City has always been a significant influence on gay life, art, music, fashion, commerce, and innovations on all fronts. I took some time to discover myself during those years, learning to navigate the city and indulge in self-expression.
The diversity of New York is something I have always loved. In fact, it was the openness and freedom of expression that led me to accept my sexuality. I gradually acclimated to my new life and adventures, only later realizing what an accomplishment it was to move to New York City and succeed at the tender age of 18.
As a textile designer and artist in the Garment District, I continued to take drawing classes at the Leslie-Lohman Museum of Art to keep my skills sharp. While in the workforce, I complied to corporate standards in the workplace to be taken seriously and avoid discrimination. But even so, I accepted my truth and began to live unapologetically as a gay African-American man.
One of the hard truths I had to learn – and something many people still refuse to acknowledge – is that the LGBTQ community has always been splintered and separated. I made it a point to nurture friendships with young gay people, mostly people of color. Most of my gay and bi friends attended venues that attracted people like me, where nightlife was flourishing and the creative community thrived. We saw diverse venues like David’s Loft in Manhattan, the first private dance club, as well as Andre’s, Jays, and the Big Apple in Harlem, all catering to people of color. I saw the 70’s as a “Golden Age” of gay life and freedom of self-expression.
Overwhelmed with a thirst for knowledge and enthusiasm to discover more about the LGBTQ experience, I moved to Berlin, Germany, in 1979. I was influenced by many Black figures who paved the way, including Josephine Baker, Richard Wright, and James Baldwin. Moving to another country allowed me to escape racial disparities back home.
I was emboldened to continue advocating for LGBTQ people of color, which became crucial as we were hit with the HIV/AIDS epidemic. As a result of attending so many funerals weekly, I became exhausted and fearful for my own health. I moved back to the U.S., making the best of my time in the Midwest professionally, but also prioritized being an advocate for HIV/AIDS and the LGBTQ community as a whole.
Together, gays and lesbians organized community events, prepared meals, and initiated housing projects for suffering people who had been on the street. Fundraisers were held to raise money for those in need. Organizations like AmfAR (the Foundation for Aids Research) made their debut, as well as the drag ball Night of a Thousand Gowns and the Design Industry Foundation for AIDS. The late great Larry Kramer founded Gay Men’s Health Crisis and ACT UP, two organizations that changed the narrative in New York City and the world, invoking lifesaving solutions and resources for the LGBTQ community.
In 1995, the introduction of protease inhibitors – drugs that impede the spread of the virus – added longevity to a generation that did not expect to survive.
Returning to New York in the early 2000s and having reached my 50th birthday, I began to think about how I was beginning this stage in my life. My generation of LGBTQ folks have now become elders, with organizations like SAGE helping us age with dignity.
As we age, there are challenges in housing, healthcare, and other life support systems for our cohort. Many of us do not have families and face discrimination and isolation because of our sexual orientation, making LGBTQ elder support groups critical. I remain an advocate for older adults so we can keep our independence as we age.
As I continue to share my experiences before and after 50 years of Stonewall activism, I age with pride and dignity.
Alston Green is a longtime activist and fighter in social justice and LGBTQ movements. A creative thinker and a passionate spokesperson, Alston has worked with the Intergenerational Media Literacy program with Senior Planet (OATS) and SAGE – two organizations that offer aging adults an opportunity to explore, learn, mingle and renew their passions, to keep abreast of the ever changing world of digital technology and how it impacts everyone’s lives daily.
David Kilmnick knew an LGBTQ+ retirement community was needed when reaching out to elder facilities for educational programs.
The founder and president of the LGBT Network on Long Island, New York, he recalls a facility telling him “we have none of those here,” referring to LGBTQ+ people.
“I’m not talking this was 50 years ago or 20 years ago,” he says. “This was like five years ago.”
In September 2021, Kilmnick and his nonprofit opened the doors to The LGBT Network’s LGBT/LGBT Friendly Senior Housing, a 75-unit affordable housing community for LGBTQ+ elders. Here, residents can live out and proud with their partners and participate in programming at the 8,000-square-foot community center.
It’s a part of a growing response to the needs of the community, one where many grew up closeted and discriminated against, but also to see positive changes like marriage equality and a more welcoming society.
“It’s incumbent on us in the LGBT social service field to make sure that we create these safe and inclusive housing facilities so LGBTQ seniors and elders could age gracefully and be out and proud,” Kilmnick says.
The Palms of Manasota on the Gulf Coast of Florida touts itself as the first LGBTQ+ retirement community in the nation, while the Triangle Square Apartments in Los Angeles is considered the first affordable housing facility for elder LGBTQ+ people.
This community has the same needs as anyone else in their age group, but they also face discrimination and stigma, as well as being less likely to have children or grandchildren who can visit and help.
AARP has a page dedicated to the older LGBTQ+ community here. Additionally, they offer many online tools for all older adults like a retirement calculator that can help determine how much someone needs to be saving; a social security calculator; and a resource hub for all things Medicare.
With the rise of these specialized communities, they are able to age in place in a safe environment and also have access to services they need.
“It’s really the first generation of LGBTQ+ folks who are for the majority living their lives at some level of outness,” says Sherrill Wayland, the senior director of special initiatives and partnerships at SAGE, an advocacy group for LGBTQ+ elders. “As we think about retiring, potentially looking for retirement communities or assisted living, we want to make sure that we can continue being our authentic self and not have to re-closet.”
In partnership with the Human Rights Campaign, SAGE created the long-term care equality index (LEI). Hearing from 200 communities in 43 states, they surveyed non-discrimination and staff training, resident services and support, employee benefits and policies, resident and community engagement. The findings help elders as they research communities to spend their golden years, and each year the groups hope more communities will participate.
“We’re really encouraging these systems to not just raise a rainbow flag using Pride Month, but looking at the policies, participants and procedures that really institutionalize what it means to be LGTQ+ welcoming and supportive,” Wayland says.
Sandra Newson is the vice president of resident services for Carrfour, a nonprofit affordable housing developer. One of their properties is The Residences at Equality Park in Wilton Manors, an LGBTQ+ community that opened in 2021 and shares a campus with The Pride Center.
“LGBT senior communities are very rare,” she says. “One of the challenges for a person who identifies as LGBTQ+ who is aging is feeling a sense of belonging and comfort in a traditional aging-in-place for a 55+ community is oftentimes faced with discrimination or hostility.”
Even the language in the application form might be a sign to an applicant that they are not welcoming, particularly to transgender or nonbinary people or same-sex couples who want to live together. At The Residences, Newson says they’ve created an affirming environment with “zero tolerance for any behaviors that make someone feel less than part of the community,” from the application process to signage in the buildings, the groups they partner with and staff training.
You shouldn’t have to go back into the closet to feel safeSandra Newson
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One of the most popular programs is a monthly meditation workshop with Sunshine Cathedral, an LGBTQ+-affirming church that also hosts grief sessions when a resident passes away. Other activities include movie screenings, holiday parties and weekly gatherings. With many of their residents experiencing chronic illness — including HIV, mental health issues and disabilities — due to a lack of access to health care in the past, counselors help connect them to community resources.
“You shouldn’t have to go back into the closet to feel safe,” Newson says.
The same model is in place at the LGBT Network. Kilmnick says that in traditional retirement homes, “there’s a lack or the LGBTQ community is completely invisible.”
In one focus group before opening, a woman shared that when she lost her partner of more than 30 years, she attended a bereavement group where other widows and widowers told her “that’s not the same thing.”
That does not happen at the LGBT Network. There, residents are treated to guest speakers, drag Bingo, health programs, holiday celebrations, and other diverse programming where they can be themselves alongside their partners.
“We’ve had a number of seniors tell us that this is the first place that they ever lived in their entire life —they’re in their mid-60s, mid-70s — this is the first time ever in their entire life that they have felt they lived in a safe place where they could be themselves,” Kilmnick says. “That’s powerful. It’s so sad and so powerful, and yet it really just stresses the importance of these facilities and that we need more of them.
