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Seeking to Live with Pride and Dignity: Health Disparities Faced by Older LGBTQIA+ Americans

Older adults in the LGBTQIA+ community face significant challenges regarding health equity, access to healthcare, and overall health outcomes. These challenges are often due to social stigma, discrimination, and systemic inequities, which affect quality of life and health. This Pride month, it’s important to understand these disparities so we can develop practices and policies that promote health equity.

According to SAGE, the largest and oldest organization dedicated to improving the lives of LGBTQIA+ older people, these disparities impact four general areas:

  • mental health;
  • chronic physical conditions;
  • access to health care; and

And these are in addition to facing the typical challenges of aging – they also experience unique challenges that make them more likely to face poverty, homelessness, and poor health.

Older adults who are members of the LQBTQIA+ community have been found to have higher rates of mental health disparities compared to their heterosexual and cisgender counterparts. The persistent stigma, systemic discrimination, and social isolation contribute to higher levels of anxiety, depression, and substance abuse. LBTGQIA+ older adults also report higher incidences of suicidal ideation and attempts, particularly among transgender individuals.

Chronic conditions such as cardiovascular disease, diabetes, and arthritis are also more frequently reported among LGBTQIA+ older adults. The prevalence of HIV/AIDS remains a significant concern, especially among older gay and bisexual men. Despite advancements in treatment, the stigma and privacy concerns associated with HIV/AIDS persist, further marginalizing those living with the condition.

Historically, discriminatory coverage policies significantly contributed to health disparities for this population. Health insurance was more likely to be acquired through an employer or spouse’s employer, which excluded those whose employer didn’t offer same-sex coverage benefits. While some improvements in legislation have been made, access to affordable health insurance and health care remains a significant concern for LGBTQIA+ people of all ages. Facing discrimination at work or trying to find work, lower earning power, and lack of access to safe and affordable housing are just some of the barriers that those in the LGBTQIA+ community face when procuring health insurance and why they are less likely to have it.

However, access to healthcare is more than having health insurance. Discrimination, or the fear of discrimination, can lead many to delay or avoid seeking medical care, resulting in missed opportunities for early detection and management of health conditions. Although there are existing protections against discrimination in healthcare settings, too often LGBTQIA+ individuals still find themselves receiving inferior care or being refused care based on their orientation. Additionally, many healthcare professionals may not have the special education and training to understand and treat the specific needs of LGBTQIA+ patients. Because of these factors, LGBTQIA+ people are less likely to have a regular healthcare provider.

It is crucial to acknowledge that – in addition to these disparities – LGBTQIA+ people of color are further marginalized because of their race and/or ethnicity. The intersectionality of these identities can lead to multiple and compounded forms of inequality, particularly in healthcare.

While significant progress has been made in advancing LGBTQIA+ rights, older adults in this community continue to face disparities. A multifaceted approach is needed to address these disparities through inclusive policies, cultural competence training, and targeted support services. By doing so, we can ensure that all individuals, regardless of sexual orientation or gender identity, have the opportunity to age with dignity and receive the care and support they deserve.

To learn more about resources for yourself or a loved one, check out the following This is Growing Old podcast episodes on this topic:

Katrin Werner-Perez serves as the Alliance for Aging Research’s Health Programs Manager.

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