LGBT aging and advocacy can be an ongoing issue for seniors as they make new transitions in their lives. From medical care to social roadblocks in assisted living facilities, LGBT aging is an important topic for all, whether or not you find yourself a part of this community.

As we all know, aging is not something we can avoid. There are ways we can slow the progression by which we age, such as by exercising and maintaining a healthy lifestyle, but eventually, we all get there. Working with seniors, I have seen 90-year-olds that look 60 and 60-year-olds that look 90. The where and with who of how we age is also different. Some may age in place at home, some may move in with family and others may spend their final years in a long-term care facility. What is not different among the aging population is they wish to have their care needs met without discrimination and with dignity. This seems like a simple request, however, having equal access to care and other resources is not always the case. This is especially true for members of the LGBT community.

In the United States today, there are more than 2 million people over the age of 65 who identify as lesbian, gay, bisexual, or transgender. As they age, LGBT seniors face unique challenges that are not as common among the heterosexual community. Among these challenges is the absence of a traditional familial support system, access to medical care while openly identifying as LGBT, and the fear of potential mistreatment or discrimination should they need to reside in a long-term care facility.

As people age, many seniors lean on their family for assistance with their care needs. In the instance of a heterosexual couple, often there is a healthy spouse who can care for the ill spouse. Alternatively, the couple may have adult children who may offer to move the parents into their home to provide support as needed. These options are not as common among LGBT seniors because they are less likely to be partnered or married than heterosexual couples and even fewer have children. As a result of their sexuality, many LGBT people experience a deterioration of their “family of origin” which is the family they were born into, and are compelled to create a “family of choice.” This type of family is made through converting friends into kin. While this new type of family can offer support, it is often composed of people of a similar age who may be experiencing symptoms of aging themselves, making it difficult to care for the other and/or needing care themselves.

In addition to the absence of a support system, many of the aging members of the LGBT community have been subjected to violence and/or discrimination in their lifetime because of their sexual identity. As they age and begin to experience health and medical issues, the fear of being treated unfairly after disclosing their sexuality can deter LGBT seniors from revealing this to medical professionals. This in turn can prevent the senior from seeking care or not fully disclosing symptoms, resulting in misdiagnosis or improper treatment. The long-lasting negative effects of their inability to openly share their sexual orientation can also lead to serious health complications. These health problems can manifest physically, presenting as chronic conditions, causing anxiety and depression.

As care needs increase beyond what can be handled at home, seniors may need to move into a long-term care community. This is a difficult transition for any person, but for an LGBT senior the complications are increased. Long-term care facilities lack trained staff and policies to discourage discrimination, which in turn encourages an openly gay person to hide their sexual identity. Beyond issues that they experience with staff, there can also be problems with other residents. For example, having to share a room may make an LGBT senior feel as if they must hide their sexual orientation, which can be devastating if they were “out” for much of their life. In addition, if one or both of a committed LBGT couple moves into a community and fear discrimination, sadly they may feel that they must change their relationship status from partners to siblings. Not being able to be who they are can also contribute to declining health and isolation from other residents to conceal the truth.

Fortunately, the difficulties I have written about here are being addressed nationally and locally. There are wonderful LGBT Advocacy groups such as SAGE. SAGE (formerly known as Senior Action in a Gay Environment) developed the nation’s first Friendly Visiting program for fragile and shut-in LGBT older adults; the nation’s first program dedicated to caregiving services for LGBT older adults; the nation’s first LGBT Senior Drop-In Center and the conception of the first national conferences devoted to LGBT aging concerns. Their work is ongoing as LGBT people in 28 states continue to lack legal protections against discrimination in housing and healthcare.

Education and advocacy are key in eradicating the shame and stigma the LBGT elders experience. June is National PRIDE month and June 28th marks the anniversary of the first pride march held in 1970 in New York City. I encourage everyone to find a way to show their support. Getting involved is as simple as displaying a rainbow flag or joining a pride parade. In the words of Harvey Milk, “It takes no compromising to give people their rights. It takes no money to respect the individual. It takes no survey to remove repressions.”