What you need to know about LGBT-friendly services


For many, aging can present numerous challenges, including the ability to maintain good health. But for the nation’s estimated 3-million LGBT older adults, growing older may also mean facing very difficult choices, such as choosing to go back into the closet. The pre-Stonewall generation has been referred to as “Gen Silent,” reflecting its members’ tendency to be “closeted” and their hesitancy to advocate on their own behalf. For many, it was impossible to be openly gay and feel safe. Now — at a time in their life when they require services and programs offered by aging-service providers, maybe within a long-term care setting, an adult day-care center or a senior center — many LGBT older adults report heightened fear and anxiety should they disclosure their sexual orientation and/or gender identity. Silence greatly increases an LGBT older adult’s risk of social isolation and decreases his or her likelihood of successful aging.

Some people may think that being “out” (disclosing your sexual orientation and/or gender identity) to aging-service providers or health-care practitioners is not important, or they may not see the benefits of accessing aging services that are inclusive and culturally competent. Consequently, according to the National Gay and Lesbian Task Force, LGBT seniors are five times less likely to use aging-related services than their heterosexual peers as a result of fear, but have a far greater need for those services. Additionally, a 2007 study, “Improving the Lives of Older Adults,” found that a majority of the nearly 650 LGBT people studied reported being abused or neglected by staff, or isolated from and/or discriminated against by other residents. Finally, the Public Health Management Corporation just released results from a state-funded survey that found that nearly 40 percent of participants reported at least one discriminatory experience in a health-care setting, which included 13 percent who were denied access to health care and 22 percent who said they had to hide their identity from a provider. About 11 percent experienced abusive language from a provider.

Knowing someone’s sexual orientation is different from knowing about that person’s sex life. Sexuality, including sexual orientation and gender identity, is an integral part of one’s identity, LGBT or straight. If a provider doesn’t really know their clients/patients, how can he or she ensure the person’s needs are being addressed and they are receiving appropriate services?

Providing care to LGBT older adults • Revise websites, brochures, waiting rooms and forms to be inclusive and welcoming. Involve all team members in changes. Ideally, these “cultural” changes need to be implemented and supported by top-level decision makers. • Work to build trust and gain credibility by improving communication and becoming informed about unique strengths, stressors and legal challenges in the lives of LGBT older adults. • Seek LGBT health resources for best-practice guidelines and to guide clinical/psychosocial decisions. • Recognize diversity among LGBT older adults.

Tips for LGBT older adults • Ask around. Talk to your friends, family members and coworkers about their doctors and where they receive services. • Call your local LGBT community center. Many times, centers will have referral lists for LGBT-friendly services. • Call and ask questions. Find out if this provider currently serves LGBT older adults. Do they seem at ease with your questions? Have staffers received training about the needs of LGBT older adults? • Explore the website. Is inclusive language used? Are there pictures of same-sex couples? Transgender individuals? Do you see signs reflective of LGBT culture? • Visit the office. What is the atmosphere? Are there LGBT materials in the waiting room? Nondiscrimination policies posted? Do the forms use words like “partner”?

Advocacy groups for successful aging, such as the LGBT Elder Initiative with its LGBTEI Silver Rainbow Project, offer care providers cultural-competency training. These programs are designed to ensure that aging-service organizations can professionally, sensitively, effectively and appropriately serve our communities. Additionally, the LGBTEI and other groups provide resources directly to LGBT older adults on LGBT-friendly services. Initiatives like these, which work with both the providers and older adults, begin the process of assuring culturally competent care and providing LGBTs equal opportunities to age in a safe and supportive environment.

Terri Clark, MPH, CHES, prevention-services coordinator for ActionAIDS, is co-chair of the LGBT Elder Initiative. The LGBTEI fosters and advocates for services and resources that are competent, culturally sensitive, inclusive and responsive to the needs of LGBT older adults. To comment on this article, suggest topics for future articles or for more information, visit www.lgbtei.org or call 267-546-3448 and watch for Gettin’ On each month in PGN.