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, 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

Understanding the Needs of LGBTQIA2+ Older Adults

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 faced both current and historical discrimination. This discrimination stems from a lack of opportunities and legal protections for basic human rights, such as housing, employment, marriage, and health care. These issues can negatively impact their health.

Health Disparities Among LGBTQIA2+ Older Adults

Compared with their straight, cisgender peers, LGBTQIA2+ older adults experience higher rates of chronic diseases and disabilities. These include cardiovascular disease, cognitive impairment, and depression. For LGBTQIA2+ older adults, health disparities may worsen due to chronic exposure to stigma and discrimination, especially when accessing health care.

LGBTQIA2+ older adults often report feelings of vulnerability in community settings. They fear being targets of discrimination due to ageism, homophobia, transphobia, and racism. There are also significant differences within the LGBTQIA2+ community. Research shows that lesbians often report a stronger sense of community belonging than other identity groups. In contrast, bisexual men frequently report less community belonging than gay men. LGBTQIA2+ individuals of color face heightened health disparities and more barriers to health care.

The Impact of Disclosure Fears

Many LGBTQIA2+ older adults fear having their sexual orientation, gender identity, or HIV status disclosed. They worry about how this disclosure might affect their access to health care and long-term care services. In a survey of LGBTQIA2+ adults aged 45+, about a third of LGBQ and two-thirds of transgender and gender-diverse adults expressed concern about potential discrimination affecting their health care.

Given the fear of stigma and a lack of safe, affirming spaces to connect with others, LGBTQIA2+ older adults may withdraw from community participation. This withdrawal can lead to increased social isolation. Recent data shows that one in two LGBTQIA2+ older adults feel isolated, left out, or lack companionship sometimes or more frequently. The risk of social isolation is heightened by decreased access to social and emotional support. Many face losses of friends and chosen family, strained relationships with biological families, and an increased likelihood of being single.

Concerns About Financial Security

The fear of losing physical and financial independence is particularly high among LGBTQIA2+ older adults. This concern is especially true for those without partners or children and those experiencing racial and gender inequities in wages. A staggering 83% of LGBTQIA2+ older adults worry about their financial security.

Strengths and Resilience in the Community

Despite these challenges, it is not all doom and gloom for older adults in our community. Recent data highlights many strengths among LGBTQIA2+ older adults. Nearly half of LGBTQIA2+ older adults are involved in advocacy, organizing, or mutual aid. Additionally, 62% volunteer with religious organizations. Most maintain friendships or close relationships with people from other generations and can easily find someone to help with daily chores if they become ill.

The Role of Carolina Aging Alliance

These community connections are where the Carolina Aging Alliance shines. The mission of the Carolina Aging Alliance is to improve the quality of life for all LGBTQIA2+ older adults through inclusion, advocacy, education, and positive social engagement. It’s easy to get involved with the Carolina Aging Alliance. You can follow us on social media and subscribe to our newsletter to stay updated on all the ways we support the inherent strengths and resilience within our community. Together, we can address the unique challenges faced by 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