The LGBT Aging Experience
By Michael Adams
While LGBT older people historically have been disregarded even by the LGBT community itself, the changing demographics of the country make an increased emphasis on LGBT aging nearly inevitable. The 65+ population in the U.S. will double in size in the next 30 years, growing from 40 million to 80 million strong. People of color figure prominently in these statistics. Today, one in five older people is a person of color; that will increase to one in three by 2030. This dramatic growth is already fueling broad policy discussions on issues such as Social Security, the rising cost of pensions, and the pros and cons of more dependence on older workers, to name a few.
The challenges facing LGBT older adults stand against this larger backdrop. LGBT older people are 4 times more likely to be childless, twice as likely to be unpartnered and living alone, and significantly more likely to be disconnected from their families of origin. Because adult children and partners are the primary sources of care for older people in this country, this means that many LGBT older people have a very thin support network and a greater need for services. However, studies have repeatedly shown that many aging providers lack the cultural competence necessary to effectively serve LGBT elders. SAGE’s “on the ground” experience and the available data also indicate that many LGBT older people avoid accessing services, or go back into the closet in service settings, because they fear marginalization or mistreatment.
These challenges are further exacerbated because LGBT older people are more likely than their heterosexual peers to be poor (even more so if they are women, people of color, and/or transgender), suffer from a disproportionate array and degree of health problems, and are denied otherwise available Social Security and Medicaid benefits because of the federal government’s refusal to respect their relationships.
The particular burdens faced by LGBT older people have fueled advocacy efforts by SAGE and its partners to eliminate anti-LGBT discrimination and increase equity in aging policies and publicly-funded aging services. In recent years our efforts have started to bear fruit. For example, in 2010 the Administration on Aging formally recognized the unique needs of LGBT older people and the federal government’s responsibility to help address those needs when it funded the creation of the country’s first National Resource Center on LGBT Aging. The mission of the National Resource Center is to provide training and technical assistance to increase the capacity of service providers to effectively support LGBT older people, and to provide LGBT elders with the information they need to plan for their later years. In 2011, the federal Center for Medicare & Medicaid Services (CMS) issued administrative guidance advising state Medicaid directors that they are empowered to treat same-sex couples the same as married heterosexuals when it comes to preventing Medicaid “spend-down” from resulting in “spousal impoverishment”—an important protection that means lesbian and gay couples do not have to choose between medically necessary care and poverty.
While stand-alone LGBT advocacy is making a real mark on the country’s aging policies, similarities in the aging experience across diverse communities are proving to be equally powerful engines to advance necessary systems change.
2010, SAGE joined 6 national people of color aging organizations to form the Diverse Elders Coalition (DEC), with the goal of identifying shared interests across multiple elder communities and jointly advocating for policy changes that advance those interests. Last year, the DEC successfully advocated for recognition of the needs of diverse elder communities in the National Prevention Strategy mandated by the Affordable Care Act. The DEC is now pushing for changes in the federal Older Americans Act that would ensure elders who are people of color or/and LGBT receive culturally competent aging services, and would designate LGBT elders as a population with “greatest economic and social need” (a designation already conferred on racial and ethnic “minority” elders). The DEC scored a major early victory when the venerable Leadership Council of Aging Organizations (LCAO) endorsed the bulk of the DEC’s demands; this in turn helped convince leading Senate Democrats to introduce legislation that included DEC-recommended provisions.
All indications are that LGBT aging issues will continue to come into their own in the years ahead. Strong leadership and investment will ensure that both the particularities and the universality of the LGBT aging experience keep fueling the systems change necessary to improve the quality of life of LGBT older people across the nation.
 National Asian Pacific Center on Aging, National Association of Hispanic Elderly, National Caucus & Center on Black Aged, National Hispanic Council on Aging, National Indian Council on Aging, and Southeast Asia Resource Action Center
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