Many LGBTQ2+ seniors fear they will need to go back in the closet – hide their sexual orientation or moderate their gender expression – to receive quality health care, home support, or long-term care. Stigma, homophobia, violence and imprisonment still haunt older LGBTQ2+ seniors. Education is needed to battle systemic discrimination and raise their quality of life. And if you think you don’t know any LGBTQ2+ seniors, you might be surprised.
Research has shown for decades that up to 10 percent of the population identifies as lesbian, gay, bisexual, transgender, queer or questioning, or two-spirit (LGBTQ2+). The “+” signifies all other identities not listed and is used to include all persons within the community.
Due to the intersectionality of LGBTQ2+ lives, most people have worked, worshiped, or been friends with LGBTQ2+ people. You just might not know it. In a society that continues to evolve in acceptance, and in only some environments, Canadians are likely unaware of each other’s orientation.
The Challenges of Aging in the LGBTQ2+ Community: Stigma
Until 1969, being homosexual was an offense under the Criminal Code of Canada. It still is in many countries and punishable by jail, stoning or death.
Many people over the age of 50 grew up fearing physical or psychological violence, job loss, difficulty renting homes, refusal of service in restaurants and shops, and more. One of the most tragic things this generation faced was the loss of so many friends to HIV/AIDS, resulting in fewer LGBTQS+ seniors.
Embedded LGBTQ2+ Elder Abuse
Researchers have found that LGBTQS+ seniors face barriers throughout the health care system. Primary care providers often are unsure or unwilling to provide essential care. For example, trans-men who have not had gender-affirming surgery may still require pap tests. Education is needed for accommodation, procedures and discretion.
Residential care facilities can be especially threatening, especially if bedside care is delivered by caregivers who do not support LGBTQ2+ people for cultural or religious reasons. Seniors also fear homophobia from other residents.
When an LGBTQ2+ senior is diagnosed with dementia (or upon a senior’s death), administrators often recognize the patient’s family members over their partner. As a result, the patient’s wishes are either unvoiced or overruled and family hijacks everything the couple decided upon.
As a consequence, LGBTQ2+ people self-neglect because they fear this systemic abuse, resulting in advanced illness, inadequate housing, lack of social benefits and/or social isolation.
How Do We Make Organizations Safe for LGBTQS+ Seniors?
British Columbia is home to many dedicated researchers and practitioners. Gloria Gutman, Professor Emerita at Simon Fraser University’s Gerontology Research Centre, says organizations can start with two questions:
- How do you express that LGBTQ2+ people are welcome?
- Do you make LGBTQ+ staff feel comfortable and welcome?
Dr. Gutman says many organizations don’t think they have any staff or clients with a “different” sexual orientation or are gender diverse, but statistics don’t lie. Some staff just aren’t comfortable or feel safe enough to come out, so you need to ask people how they like to be referred to and what pronouns they use.
The Centre has many resources that can be useful in starting these conversations as well as educating staff. Videos on financial abuse, neglect, and emotional and physical abuse are a good place to start as they provide a grounding in primary areas of concern for LGBTQ2+ seniors. Posters and fact sheets are available for download.
The LGBTQI2S Dignity Project was created to respond to the fears of seniors entering long-term care. The website has three short, informational videos and both a downloadable and an interactive workbook. The videos tell personal stories of three LGBTQ2+ people living in assisted or long-term care. These resources provide an excellent grounding for educating administrators, staff and others.
Next Steps in Promoting LGBTQS+ Safety and Inclusion
Island Health developed a toolkit to help organizations look into how they serve the LGBTQ2+ population. The Developing Inclusive & Affirming Care for LGBTQ2+ Seniors Toolkit presents a checklist to audit (and strive for) in service provision, followed by an action plan to implement affirming and welcoming policies and processes. It’s short, concise and easy to follow.
Read Elder Abuse in the LGBTQ2SA+ Community: The Impact of Homophobia and Transphobia, a well-researched and written book that discusses the role of homophobia and transphobia in older adult abuse. Written by a gerontologist, researchers and activists, the Canadian Network for the Prevention of Elder Abuse calls it “a great resource to anyone working with elders, including medical professionals, care providers, police, counsellors and policy makers.”
Lidstone Publishing hosts Informative research articles on what Dr. Gutman and her colleagues refer to as the community’s hidden problem: elder abuse.
Reach out for support from one of our three LGBTQ2+ CRNs, dedicated to supporting elders and preventing elder abuse. Their listings below also contain a wealth of resources:
- JQT Seniors Initiative Community Response Network (serving the Jewish community): Carmel Tanaka, info@jqtvancouver.ca
- LOVE LGBTQ2s Lower Mainland Community Response Network: Penny E. Bradley, pbradley@alexhouse.net
- LOVE LGBTQ2s Vancouver Island Community Response Network: Horst Backe, horstbacke@gmail.com
The Time is Now: Start Awareness in May
May 17 is the International Day Against Homophobia, Biphobia and Transphobia. The day is set aside for international events that raise awareness of LGBT rights violations and stimulate interest in LGBT rights worldwide. Founded in 2005 by Frenchman George-Louis Tin, by 2016, over 130 countries were participating.
May 17 was chosen to commemorate the decision to remove homosexuality from the International Classification of Diseases of the World Health Organization (WHO) in 1990.
Start by educating yourself, then your team, about how homophobia and transphobia may affect your team and those you serve.
Next month, we will explore Advanced Care Planning for LGBTQ2 seniors.
Explore our website to learn more about BC CRN or connect with your local CRN for more information or resources.