Healthcare Resources for Older LGBTQIA+ Adults – Healthline
Diedra Nottingham, 71, is a lifelong New Yorker. Today, she calls Stonewall House home.
Located in Brooklyn’s Fort Greene neighborhood, the building is New York City’s first LGBTQIA+ friendly senior housing complex.
It was developed in partnership with SAGE, the world’s oldest and largest advocacy organization for LGBTQ+ older adults.
For Nottingham, it was important to find a home that offered a safe space where she could live in dignity, to feel respected in her queer identity as a lesbian.
“If you don’t love it [where you live] or are uncomfortable, then you can be very sad. I moved to Seattle for a time and I was very depressed,” she shares. “There’s no place like home.”
Unfortunately, Nottingham’s current living situation is not the norm for many older LGBTQIA+ people.
Many older LGBTQIA+ adults face housing insecurity, abuse, discrimination, and negative mental and physical health outcomes.
In addition, greater health disparities exist between white people and People of Color as well as between those who are cisgender and those who are trans, nonbinary, and gender expansive older adults.
In a culture that often centers and exalts the realities of youth, little attention is paid to older queer people and the many intersectional identities they inhabit. The concerns that mark their day-to-day lives are frequently overlooked.
Like most people, Nottingham has had a life of ups and downs.
In her youth, she experienced physical and sexual abuse. At times she’s also experienced homelessness. A recurring theme has been moments of feeling like she doesn’t belong and isn’t accepted due to her sexuality.
Of course, there have been plenty of positive moments too.
Nottingham fondly recalls taking her daughter to the Brooklyn Heights Promenade and watching her take her first steps.
She says she’s happy to be back living where some of those happy memories took place, especially in a supportive home dedicated to giving her a safe place to call her own.
Nottingham moved to Stonewall House in early 2020 after a negative experience living in the Bronx where she faced homophobic harassment from other tenants in her building.
“Most apartments I lived in, I was not comfortable,” says Nottingham. “I would have girlfriends over, and people would look at us when we would walk up and down the block.”
With the help of a social worker, she was able to secure housing in the Brooklyn SAGE building.
“When it’s your own kind of people, you can walk down the street in peace … some people out there can be very ignorant,” she adds.
It’s a big change from Nottingham’s previous experiences.
“Still today, I say ‘God bless him’ [of her social worker]. He got me in here,” she says. “Now we can have housing. I’m so glad I’ve lived to see all of this.”
There are currently about
That number is expected to climb to more than 5 million by 2060, according to data from the Aging with Pride: National Health, Aging, Sexuality/Gender Study, the first longitudinal study of LGBT older adults.
This ongoing landmark study is the first and most comprehensive attempt to trace the realities of this population of older Americans.
For more than a decade, researchers have followed 2,450 adults from the ages of 50 to 100, examining the effects of a range of psychological, social, behavioral, biological, and historical factors on their overall health and well-being.
The study’s principal investigator, Karen Fredriksen-Goldsen, PhD, is a professor and director of the Healthy Generations Hartford Center of Excellence at the University of Washington.
She says older LGBTQIA+ people are at risk of showing signs of “significant health disparities” when it comes to chronic health conditions compared with their cisgender and straight peers.
They also show signs of higher levels of social isolation and negative mental health outcomes.
In a fact sheet of study findings, 82 percent of LGBTQ+ elders reported being victimized at least once in their lives, with 64 percent saying they’ve been victimized “at least three times.”
About 13 percent had been denied healthcare or been given “inferior healthcare services.” About 41 percent of this group have a disability.
This population was also disproportionately affected by the AIDS crisis, leaving a generation decimated by the epidemic.
Fredriksen-Goldsen says older LGBTQIA+ adults experience high rates of social isolation.
According to the Aging with Pride research, the rates at which particular groups experience social isolation are:
- 66.2 of older bisexual men
- 62.5 percent of older transgender adults
- 53.9 percent of older gay men
- 55.3 percent of older bisexual women
- 48.7 percent of older lesbians
While that’s true of many older adults, the additional hardships LGBTQIA+ individuals face can increase the risk of adverse mental health outcomes like depression, anxiety, and suicidal ideation.
Fredriksen-Goldsen notes that one of the key goals of her research is to provide a road map for the development of better interventions for older LGBTQIA+ people.
She says the “beauty of conducting a longitudinal study” is that you can “better understand the trajectory of people’s lives.”
As a result of this research, we’re now better equipped to understand LGBTQIA+ elders.
Fredriksen-Goldsen emphasizes that while things have generally gotten better for LGBTQIA+ people, they’re still “often targets of discrimination and victimization” that offset many of these gains.
“There’s a lot more work to be done in making sure older LGBTQ people have access to services, and making sure the services they have access to are inclusive and can address their needs,” Fredriksen-Goldsen explains.
Marie Spivey, 68, identifies as a same-gender-loving lesbian. She attends programs and facilitates support groups at SAGE Center Bronx.
Spivey found SAGE and its services before she was out fully.
She says it gave her the chance to connect with others about everything from family issues to political issues, as well as meet other women like her. Some were out, some weren’t, but they were accepting and welcoming to her.
“It was so heartwarming to find a community, to have a place to go,” Spivey says. “When you’re alienated from your blood family because of your lifestyle, it can feel just like a home. I can go there, I can be myself, and I don’t have to wear any blinders: I can just be me.”
Spivey’s own experiences echo the findings of Fredriksen-Goldsen’s work.
She says the social isolation of her fellow LGBTQ+ seniors can “send a lot of us [into] deep depression or PTSD [post-traumatic stress disorder].”
Spivey emphasizes the importance of highlighting mental health concerns among older queer people because it’s “just not talked about enough.”
She says a lot of this stems from stigma around admitting you have a mental health problem.
“Sometimes people are not asking for help, but you can just sense from a conversation or a look that this person needs a little help. I take pleasure in bringing people into the fold,” Spivey says. “I try every day that I come into a SAGE center.”
Sherrill Wayland, the director of special initiatives at SAGE, says there’s a serious “lack of ongoing conversations about the concerns and issues around LGBTQ+ older adults.”
“I think oftentimes we are still an invisible segment of our communities,” she explains.
When asked whether the state of awareness of issues around LGBTQIA+ older adults has improved at all in recent years, Wayland says yes, things have gotten better.
There’s renewed interest in supporting the needs of this population, and there’s a fresh push to look at these issues with diversity and equity in mind.
Wayland says it’s necessary that we direct an intersectional lens on inclusivity and equity, recognizing that all underrepresented communities include LGBTQ+ older adults.
One big issue Wayland points to is the lack of safe spaces.
Many LGBTQIA+ adults face “re-closeting” when they seek services in their older years. This means they might cloak their sexuality or gender identity when looking for mental health services or medical care.
If they’re reaching out to a landlord about housing, they might not feel comfortable disclosing their full selves.
“As long as we continue to have real, lived experiences with discrimination and stigma based on sexual orientation and gender identity, we will always face the fact we may re-closet,” Wayland says.
Although coming out is usually considered a major milestone for most LGBTQIA+ people, it’s not that black and white.
“‘Coming out’ isn’t a one-time thing,” says Wayland. “People really have to make choices every day of, ‘Is this a place where I can be my authentic self, or is this a place where I need to use protective measures and hide my identity to receive the services that I need?’”
This is something that resonates with Spivey.
As a Catholic, she offers interfaith prayer and connection to fellow LGBTQIA+ elders.
Spivey says she’s often accepted in traditional religious circles because of the way she presents; she might not look outwardly queer to those outside of her community or who don’t know her well.
On the other hand, her partner is “a masculine-looking lesbian” who may be excluded.
“It’s just sad,” Spivey says, that even in communal spaces dedicated to acceptance, you might not be accepted at all.
Another issue that comes into play is not everyone who is an older LGBTQIA+ person faces universal experiences.
Major metropolitan and urban areas often have more visibility of out and proud queer people, and needed services are more widely available.
It can be vastly different for LGBTQIA+ older adults in rural areas.
Wayland says it’s important to recognize that LGBTQ+ elders exist in every community across the country.
“A big segment of our LGBTQ+ community might not have access to these welcoming services,” she says. “It’s my challenge to the aging network across the country to think about how they can be more open and inclusive and provide outreach and services to the LGBTQ older adults in their community.”
Luckily, some resources exist for the LGBTQIA+ community to better navigate their journey to health and well-being. Here are just a few.
Healthline guides
Healthcare and community resources
Learn more
Fredriksen-Goldsen is currently working on a global version of her work.
Working with 17 partners, she and her team are embarking on the first “worldwide project ever” that will examine the experiences of older LGBTQIA+ people.
She says it’s necessary that we don’t see this group as a monolith.
“You need to understand what the unique risk and protective factors are for each group because they do look different for targeted health interventions,” says Fredriksen-Goldsen. “You really need to know what’s happening for each group. I think that this community has a lot to teach us.”
Spivey recalls how difficult the COVID-19 pandemic was, both personally and for the larger communities of queer elders she knows and works with through SAGE.
It was a difficult time when many services either vanished or had to go virtual. The sense of isolation that was already great for many older LGBTQIA+ people felt unbearable for some.
Still, the LGBTQIA+ community is full of resilient people.
“I’m a survivor,” Nottingham says. “I was determined to live life … nobody was going to hold me down or tell me what to do.”
She’s one of many.
Brian Mastroianni is a New York–based science and health journalist. Brian’s work has been published by The Atlantic, The Paris Review, CBS News, The TODAY Show, and Engadget, among others. When not following the news, Brian is an actor who’s studied at The Barrow Group in New York City. He sometimes blogs about fashionable dogs. Yes. Really. Brian graduated from Brown University and has a Master of Arts from the Columbia University Graduate School of Journalism. Check out his website or follow him on Twitter.