There’s a lot of evidence that people who are LGBTQIA+* are much more likely to have certain chronic health problems and emotional/behavioral health issues than the general population. These health challenges can affect us differently as we age.
Among those who are over 65, these inequities are especially acute and concerning. Let’s look at the specific health risks older LGBTQIA+ people face, their causes, and what we as a community can do to overcome these challenges.
Health Issues Affecting Older LGBTQIA+ Adults
A 2021 study of Oregon residents found that older adults who are lesbian, gay, or bisexual are at much higher risk than the general population of experiencing:
- Kidney disease
- Frequent poor mental health
- Other chronic health conditions
A 2017 study found similar issues among older people who are transgender, with higher rates of:
- Chronic obstructive pulmonary disease
- Depression, schizophrenia, substance use, and other mental health challenges
So, what’s going on here? Why are these health issues so much more prevalent among older LGBTQIA+ people?
The Health Impact of Social Stigma
The health inequities described here occur for many of the same reasons as the ones that affect younger LGBTQIA+ people, including:
- Experiencing a lifetime of social stigma
- A greater likelihood of being low-income/unemployed/unhoused
- A greater tendency towards loneliness and isolation
- A greater likelihood of having experienced violence and abuse
- Mistrust of the health care system
- A higher incidence of substance use
And, of course, all these problems tend to be worse among those who have also experienced a lifetime of racism. But there are also factors that are unique to older LGBTQIA+ people.
This is a generation that grew up before the Stonewall Riots — at a time when being LGBTQIA+ was considered shameful, something that had to be hidden.
They lived through a time when police frequently raided gay bars and bath houses and beat up or arrested anyone who wasn’t wearing clothing appropriate to their assigned gender. They lost loved ones in the 1980s and ‘90s due to the AIDS crisis. They were rejected and disowned by their families.
These traumas left deep scars and had a devastating impact on this LGBTQIA+ generation’s future health outcomes.
A Lot of Healing is Needed
If You’re an Older LGBTQIA+ Adult
Remember that you are a trailblazer. Really. You fought many of the battles that have enabled younger LGBTQIA+ folks to enjoy the freedoms they have today.
We all owe you a huge debt of gratitude — and an even bigger apology — for the hardships you‘ve endured and the sacrifices you’ve made. You deserve love and acceptance. You deserve respect and appreciation. And you deserve the same health outcomes as everybody else.
If you’ve been putting off your health checkups, please make those appointments now. And please be open with your health care providers about who you are, even if that feels risky and vulnerable. Dr. Heidi J. Syropoulos, geriatrician and medical director of Government Markets at Independence Blue Cross, offers some good advice about this.
She says, “All older people, but particularly folks who have been disenfranchised, should talk openly with their health care providers about the issues that are relevant to their health. That includes being open about their sexuality and gender identity. It helps health professionals screen for important health issues they might otherwise overlook.”
If you need help finding quality health care, taking care of yourself, or connecting with others, here are some places you can turn:
- The Mazzoni Center
- The National Resource Center on LGBTQ+ Aging, PA chapter
- The LGBT Elder Initiative at the William Way Community Center
- Resource guide from the LGBT Center at the University of Pennsylvania
And, of course, take good care of yourselves and each other. Eat your veggies and drink enough water. Get your exercise. Get enough sleep. Seek companionship and connection if it’s missing from your life. Seek help if you’re struggling with depression, anxiety, domestic violence, or substance use. Reach out for support if you need it.
If You’re a Health Care Provider
Please take the time to be aware of, and sensitive about, the health risks and challenges of this population. And don’t forget to screen these patients carefully for depression, anxiety, domestic violence, and substance use as well as all other health problems for which they’re at elevated risk. Here are some resources you may find helpful:
- Providing Inclusive Services and Care for LGBT People: A Guide for Health Care Staff
- The National LGBTQIA+ Health Education Center
- AMA: Creating an LGBTQ-friendly practice
If You Know an Older Person Who is LGBTQIA+
Please give them your love, acceptance, appreciation, and support. Try to understand what they’ve lived through, and support them in taking care of themselves. When someone has grown up being shamed for who they are, their loved ones must try to undo that damage every way they can.
As a trans woman, it’s very clear to me that I stand on the shoulders of giants. If it wasn’t for the battles that previous generations fought and won, I know I couldn’t be as out and proud as I am today.
Now, tragically, LGBTQIA+ young people are experiencing a fresh wave of hatred and violence. If you’re wondering what impact this will have down the road, just look at the health challenges faced by today’s LGBTQIA+ folks who are in their 60s, 70s, 80s, and 90s. And fight this prejudice every way you can.* Lesbian, gay, bisexual, transgender, queer, intersex, or otherwise different from our culture’s sexual and gender norms