Even as the healthcare landscape is continuously transforming to focus on inclusivity and personalized care for various communities, not every community is seeing this transformation. One such group is older LGBTQ+ Americans who represent a historically marginalized demographic and deserve dedicated healthcare initiatives. To truly address their needs, it is critical that we take a step back and shed light on the history of the LGBTQ+ community and the factors that contributed to marginalized healthcare.

Historical Challenges for the LGBTQ+ Community and Their Implications Today

Older LGBTQ+ individuals navigated a world of intense prejudice, necessitating a secretive “code” of slang and attire in the early to mid-1900s for safe identification within the community. This underground culture, essential for protection against widespread periods of prejudice, discrimination, and even criminalization, only began to see a sliver of tolerance following the social revolutions of the 1940s to 1960s in certain U.S. areas. While the Stonewall riots of 1969 heralded the beginning of the LGBTQ+ civil rights movement, the shadows of past stigmatization continue to loom.

Stigmatization came front and center in the 1980’s for LGBTQ+ people with the advent of the AIDs crisis. For older members, this dark period is something they can never forget. Many from this community lived through a period where the healthcare system grossly neglected their needs, often ignoring the plight of those suffering. This abandonment led to an immense loss within the community and fostered a profound mistrust in healthcare services.

Today, understanding this historical secrecy and its roots in survival is crucial in providing empathetic healthcare to these individuals and acknowledging the deep-seated caution and resilience shaped by their past experiences.

Lack of Familial Support: Navigating Through Isolation and the Need for Inclusive Care

For older LGBTQ+ individuals, the intersection between personal life and healthcare is often marked by isolation. After coming out, many faced rejection from their biological families, a reality that has contributed to a lack of traditional familial support. Structural inequalities, including the absence of marriage and childcare rights in their youth, often resulted in them not forming legally recognized families. Statistics highlight that they are twice as likely to live alone and four times less likely to have children to support them.

This lack of familial care propels a reliance on paid long-term care services, a reality compounded by potential financial constraints due to historical job discrimination based on sexual orientation or gender identity.

Creating Safe and Inclusive Long-Term Care for LGBTQ+ Elders

In present, the fear of discrimination in long-term care facilities is a reality for 70% of older LGBTQ+ individuals, compelling them to consider hiding their identities. To combat this, elder care facilities need to enforce robust non-discrimination policies and conduct staff training through programs like those offered by SAGE, ensuring sensitivity and respect towards LGBTQ+ needs. Creating inclusive communities within these facilities can also mitigate feelings of isolation and fear among LGBTQ+ elders, making them feel safe and valued. These measures ensure dignity and authenticity in caring for aging LGBTQ+ members.  

What this Means for the Future of Older LGBTQ+ People and their Healthcare Needs

Special Healthcare Needs and Resourceful Insights

Overall, it’s important to remember that this segment of the LGBTQ+ community presents distinct health concerns:

1. Mental Health. Due to prolonged discrimination, there’s an elevated rate of mental health issues.
2. Enhanced Care for HIV-impacted Individuals: Those living with HIV require more than standard care due to unique medical and psychological challenges. The healthcare system can assist by providing specialized medical support, mental health services, and personalized care informed by historical traumas and long-term treatment complexities.  
3. Gender-affirming Care. Older transgender and gender-diverse individuals may require consistent ongoing treatments such as hormone therapy, voice therapy, and professional mental health support.
4. Preventive Care. Regular screenings are particularly relevant considering the additional risk factors this community faces.

Culturally Competent Care: A Necessity

Providing healthcare is one aspect, delivering culturally competent care is another. Professionals must be well-versed with the unique needs of older LGBTQ+ patients, combining clinical expertise with a deep understanding of their historical and social backgrounds.

The following are some essential steps needed to help advance inclusivity in healthcare:

1. Training and Education. Incorporate LGBTQ+ healthcare into academic curricula.
2. Awareness Drives. Work towards destigmatizing LGBTQ+ identities among older adults.
3. Legislation. Amplify non-discrimination statutes to ensure equal care access.
4. Community-Centric Support. Promote LGBTQ+-oriented health centers and support groups.

Final Thoughts

The healthcare journey of older LGBTQ+ Americans underlines the broader theme of inclusivity in medical care. By harnessing resources such as the LGBTQ+ Elder Health Care Guide and shedding light on the subject in the C+R Research Blog, The Barriers to Healthcare for the LGBTQ+ Community,

we can strive for a system where everyone feels seen, respected, and adequately cared for, regardless of gender or sexual identity.

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To hear first-hand about how the LGBTQ+ community feels about the importance of having access to healthcare, watch the video in this blog below from our Consumer Connection Series. And, if you want to learn more about what’s in the hearts and minds of the LGBTQ+ Community, check out our 3-Part Consumer Connections Series, Amplifying the Voice of the LGBTQ+ Community.