Understanding LGBTQIA2+ Elders’ Unique Challenges in Aging

Carolina Aging Alliance is proud to feature guest contributors who bring insight, compassion, and expertise to the lives of LGBTQIA2+ older adults across the Carolinas. Today, we’re honored to share the work of Joel G. Anderson, PhD, CHTP, FGSA, is the Joan L. Creasia Endowed Professor at the University of Tennessee College of Nursing and a member of the Carolina Aging Alliance Board of Directors.

An estimated two to four million LGBTQIA2+ older adults live in the U.S., with this number expected to double by 2030. LGBTQIA2+ older adults have experienced both current and historical discrimination because of a lack of opportunities and legal protections for basic human rights (e.g., housing, employment, marriage, health care) that can have a negative impact on their health.

Compared with their straight, cisgender peers, LGBTQIA2+ older adults experience higher rates of chronic diseases and disability, such as cardiovascular disease, cognitive impairment, and depression. For LGBTQIA2+ older adults, these health disparities may be magnified by chronic exposure to stigma and discrimination, particularly when trying to access health care.

LGBTQIA2+ older adults also report feelings of vulnerability in community settings and a fear of being targets of discrimination because of ageism, homophobia and transphobia, and/or racism. And there are differences within the LGBTQIA2+ community itself. For example, research finds that lesbians frequently report more community belonging than other identity groups and bisexual men frequently report less community belonging than gay men. LGBTQIA2+ individuals of color face heightened health disparities and more barriers to health care.

There also is fear among LGBTQIA2+ older adults of having one’s sexual orientation, gender identity, and/or HIV status disclosed and how that disclosure might affect their access to health care and long-term care services and supports. In a survey of LGBTQIA2+ adults aged 45+, roughly a third of LGBQ and two-thirds of transgender and gender diverse adults reported some amount of concern about their health care being potentially compromised because of discrimination related to their identity.

Given the fear of stigma and a lack of safe, affirming, and supportive spaces to connect with other community members, LGBTQIA2+ older adults may increasingly withdraw from community participation, increasing social isolation. Recent data find that one in two LGBTQIA2+ older adults reported feeling isolated, left out, or a lack of companionship sometimes or more frequently. Risk of social isolation among LGBTQIA2+ older adults also is affected by a decreased access to social and emotional support exacerbated by loss of friends and chosen family, strained relationships with one’s biological families and religious communities, and an increased likelihood of being single. The fear of losing physical and financial independence is higher among LGBTQIA2+ older adults, particularly for those without partners or children, and those experiencing racial and gender inequities in wages. Eighty-three percent of LGBTQIA2+ older adults are concerned about their financial security.

But it is not all doom and gloom for older adults in our community. Recent data find many strengths among LGBTQIA2+ older adults. Nearly half of LGBTQIA2+ older adults are involved with advocacy, organizing, or mutual aid, while 62% spend time volunteering with religious organizations. Most have friendships or close relationships with people of other generations and say that they can easily find someone to help with daily chores if they get sick.

These community connections are where the Carolina Aging Alliance shines. The mission of the Carolina Aging Alliance is to improve quality of life for all LGBTQIA2+ older adults through inclusion, advocacy, education, and positive social engagement. It’s easy to become involved with the Carolina Aging Alliance. You can follow us on social media and subscribe to our newsletter to stay up to date on all the ways in which the Carolina Aging Alliance supports the inherent strengths and resiliency within our community to address the unique challenges of LGBTQIA2+ elders in North Carolina.

 Joel G. Anderson, PhD, CHTP, FGSA, is the Joan L. Creasia Endowed Professor at the University of Tennessee College of Nursing and a member of the Carolina Aging Alliance Board of Directors. His research examines family quality of life in dementia and issues related to caregiving, including the use of digital health resources as part of the caregiving experience and the unique needs of LGBTQIA2+ caregivers and older adults.