GAY COMMUNITY

Moving Forward

Despite tremendous social and cultural change, most LGBT older adults remain invisible in aging and health services, policies, and research. Yet, this invisibility is being challenged by LGBT older adults who are raising their voices, and by cross-generational efforts to transform our communities and society. An ongoing challenge must be embraced: to address the risks and manifestations of marginalization and concurrently support the resilience and strengths these individuals have forged in moving forward to build their lives and communities. Interventions must extend beyond the individual level, as they embrace kin, caregivers (Muraco and Fredriksen-Goldsen, 2014), communities, and the larger society.

This issue of Generations is designed to showcase the innovative work happening across the country in LGBT aging. In the following articles, community partners and researchers illustrate advances that are being made in services, policies, and research that respond to the growing needs of diverse LGBT older adults. Each article illuminates the expertise in assessing the strengths and disparities facing these communities, including the distinct needs of often hidden populations of LGBT older adults. Through careful attention to the aging and well-being of LGBT older adults, our contributing authors provide cutting-edge information needed to create culturally responsive programs and policies.

Such efforts contribute to equity by fostering community and a sense of belonging, which in turn can benefit physical and mental health over the life course. Equity is a basic human right best achieved through accountability in systems and communities, and through the engagement of citizens at all levels, including LGBT midlife and older adults and their communities. As a participant in Aging with Pride said, “The LGBT community has stepped up in the past to address coming out, AIDS, and civil rights. The next wave has to be aging.”

Policy innovations

There is a need for LGBT and aging organizations to engage in targeted educational outreach efforts to ensure that LGBT older adults are aware of their rights and mechanisms for redress under current law and regulation. With nationally legalized same-sex marriage, married same-sex couples now have access to Social Security survivor benefits, Medicaid spend-downs, bereavement leave, and tax exemptions upon inheritance of jointly owned real estate and personal property. In addition, effort must be made to address the rising income inequality and homelessness gaps that affect these and other historically disadvantaged communities.

LGBT older adults, like people of all ages, need protection from discrimination based on sexual orientation and gender identity in employment, housing, and public accommodations at federal, state, and local levels; this would support the economic security and safety of LGBT midlife and older adults. Comprehensive statewide protections in employment, housing, and public accommodations based on sexual orientation and gender identity still are absent in more than half of the states (). Currently, there are no comprehensive federal laws prohibiting discrimination based on sexual orientation or gender identity. Federal employees and contractors are prohibited from discriminating based on sexual orientation or gender identity, as are many other federal entities, including the Department of Housing and Urban Development and the Equal Employment Opportunity Commission. The Equality Act, which at the federal level would amend existing laws to create explicit protections against discrimination based on sexual orientation or gender identity, has been introduced in Congress.

Local to global action must occur to protect LGBT older adults and their kin. Same-sex activity remains illegal in more than seventy countries, and is punishable by death in some. We need an international movement to protect all generations across borders.

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Research innovations

The new LGBT+ National Aging Research Center serves as a clearinghouse on the most up-to-date research and information about the experiences and needs of LGBT midlife and older adults, their kin, caregivers, and allies. Yet gaps remain in our knowledge about LGBT aging, health, and well-being and data collection is necessary to better understand and address the needs of these older adults. But most health surveys today do not include sexual identity or gender identity questions; such omission often is based on the inaccurate assumption that these questions are too sensitive for older adults to answer. Some population-based surveys, such as the National Health Interview Survey (), have taken that important step and added sexual identity questions, as have some state-level efforts made through the Behavioral Risk Factor Surveillance System (BRFSS) surveys. What little is known about transgender health primarily comes from community-based surveys (; ); gender identity and expression questions also are needed in population-based aging and health surveys. When adding sexual and gender-related questions to any research, it is critical to determine what will be asked, why the information is being gathered, and how it will be used. See the sidebar, below, for best practices and recommendations for questions on sexual and gender identity

It is critical in all phases of research to incorporate the heterogeneous nature of the LGBT community to identify those most at risk and to learn from those experiencing optimal aging and health outcomes. Our longitudinal study has been developed both to assess trajectories and mechanisms in aging and to better understand the full range of health outcomes and risk and protective factors in these communities. Because most LGBT aging studies to date rely heavily on self-reporting, we also include measures of physical, biological, and cognitive functioning (). This research is designed to comprehensively address the diversity and sub-groups within LGBT older adult communities, and to identify underlying mechanisms of risk and resilience—the aim being to design and test the effectiveness of culturally appropriate, community-based interventions.

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Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.