LGBTQ+ Seniors’ Wariness Can Affect Access to Health Care


A few years ago, North Carolina started offering training to people who ran the state’s adult care homes on welcoming and looking after aging LGBTQ+ residents.

Hundreds of providers took the web-based training, part of the 2015-2019 state aging plan, to bring the care network up to date on the “unique needs of the aging lesbian, gay, bisexual, and transgender (LGBTQ+) community.” The training meant that the state’s Department of Health and Human Services realized that LGBTQ+ people often have problems dealing with mental and physical health care providers, sometimes to the point of not being “out” to one’s own doctor.

On Saturday, June 23, a first-time Triangle Expo for LGBTQ+ Aging Adults in Raleigh will again address challenges faced by this community, as well as resources that may see them through. LGBTQ+ people shouldn’t have to feel uncertainty when approaching a doctor or other provider for the first time, said Heather Burkhardt, program coordinator at Resources for Seniors.

Resources for Seniors provides a broad range of help to Wake County’s older people, from information on workers who make home-care visits to tips for finding an assisted living home.

“We want to be able to create an environment in which sharing who in their life is important, because a lot of what we do is working with caregivers,” Burkhardt said. “It’s an understanding of situations that people who are straight don’t have an appreciation for.”

A survey by SAGE, an advocacy organization for older LGBTQ+ people, found that respondents said in 2014 that the principal providers of their health care don’t know about their sexual orientation. They also reported feeling reluctant to talk about these matters because they worry that they will be judged or receive a lower level of care. In an AARP survey of older LGBTQ+ people released in March, 37 percent of white respondents, 40 percent of Latinos, and 38 percent of African Americans said they are very or somewhat concerned that the quality of their health care will be adversely affected by their sexual orientation.

“Is that normal?”

Joseph Wheeler, SAGE Raleigh coordinator, recounted real-world experiences that showed at best a lack of understanding from professionals.

“I’ve been signing forms for my husband,” Wheeler said.”I signed them with my name and put ‘husband’ after it.

“The person taking the information asked me if I had power of attorney. I said I did and she suggested that I put ‘POA’ after my name.”

While a lawyer might advise a medical power of attorney for any couple, it’s no more necessary in a same-sex marriage than in other settings. The request took Wheeler aback.

“Would they have required that of a wife?” he said. “That’s something that any disenfranchised group asks: Is that normal or does it happen for a reason?”

Advocacy groups across North Carolina have compiled lists of providers who have been found to be gay-friendly. LGBTQ+ Elder Advocates of WNC, in Asheville, offers a list on its website of recommended health care providers, both traditional and alternative. And the national LGBTQ+ Aging Center offers North Carolina-specific information on providers trained to meet this community’s health needs.

The availability of receptive doctors and other professionals can even help prevent suicides, according to “What We Know Now: Updating Best Practices for Talking About Suicide & LGBTQ+ Populations,” a publication of the American Foundation for Suicide Prevention. “…protective factors can include reducing anti-LGBTQ+ stigma and prejudice, reducing bullying and other forms of victimization, access to LGBTQ+-affirming physical and mental health care, and legal protections from discrimination,” the foundation’s 2017 guide says.

North Carolina’s transgender people may have an even more difficult time in the health care system given the lack of general public and media awareness of their situations. More than 44,000 North Carolinians identify as transgender, more than 7,000 of whom are 65 or older, according to UCLA’s Williams Institute.

Building knowledge

At Saturday’s expo, sessions throughout the event will address a variety of issues. One session, “Resiliency – Telling Your Story in an Interactive Group,” will allow discussion of some hard topics, according to a synopsis by organizer Margo Arrowsmith, a mental-health counselor with Silver Linings for Seniors.

“As an LGBTQ+ adult you may have experienced discrimination, dealt with fear of being rejected, been denied rights due to your sexual orientation and gender identity, wondered who you could trust and turn to for support, maybe wondered how you were going to make it,” Arrowsmith wrote. “And you did make it.”

People who come to the expo will have the opportunity to add to the base of knowledge on LGBTQ+ issues, Burkhardt said.

“During the event, we will have a professional videographer interviewing participants on their situations and why this information is important to them,” she said.

This article originally appeared in North Carolina Health News on June 21, 2018.