Within 10 years, more than one billion people in the world will be over the age of 65; that is one person in every five. The United Nations and public-health organizations have taken notice. As aging of the global population gains visibility, it is essential that the conversation includes the experiences of all individuals, but especially LGBT women. By looking at aging in the context of gender, sexual orientation and gender identity, we are better able to understand the complexities of aging for some of the most vulnerable groups.
Men and women alike experience discrimination in old age. However, men and women will experience aging in different ways. Lack of resources, both economic and social, are magnified in old age. Women, throughout their lives, will have worked fewer hours, earned a smaller salary and accumulated less savings and fewer assets than men. Women also tend to have longer lifespans than men. Older women will, therefore, experience the challenges of aging over a longer period of time.
When considering the unique experiences of LGBT older women, we must look at the many types of discrimination they have experienced. This discrimination can be costly to their overall health and well being. Social isolation and inadequate health education and care for older LGBT women are widespread and under-discussed. Many, having faced lifetimes of stigma and discrimination, are more likely to live alone and have fewer social supports than older women in the general population.
“The Aging and Health Report,” a 2012 study from the University of Washington’s School of Social Work, cited that some of the most needed services for the LGBT community are support groups and social events. Feelings of loneliness can lead to higher rates of depression, anxiety, heart disease and diabetes. Loneliness makes doing day-to-day tasks seem close to impossible. Things like going to the mailbox to mail a letter or carrying groceries to one’s doorstep can become unmanageable when a friend or partner simply does not exist to help.
While certain health concerns of LGBT older women can be linked to social isolation, additional health matters are also prevalent. A recent study by the Public Health Management Corporation surveyed LGBT older women in Philadelphia on a wide variety of potential health concerns: preventative screenings, depression, anxiety, stress and doctor-patient relationships. When participants were asked if they felt they had to hide their sexual orientation or gender identity from their care provider, 17 percent responded positively. Having an honest relationship with your care provider is essential to gaining access to the best care and treatment for yourself in old age — or at any age, for that matter. Hiding your identity out of fear or shame from your own provider is a very real, but potentially dangerous, circumstance that many LGBT older women experience. Having a candid discussion about your sexuality and sexual practices can be difficult, but it is critically important.
The PHMC survey found that, despite nearly half of respondents being sexually active, a very high percentage reported that they do not believe they need screenings for sexually transmitted infections. HIV, hepatitis C and other STI screenings are fundamental to the prevention of sexually transmitted viruses and infections.
While only 13 percent reported that they do not feel they need a PAP smear and/or pelvic exam, that number is still significant. These screenings are especially important when considering that the risk of uterine, cervical and ovarian cancer diagnoses increases with age. Some reasons for these statistics could be the stigma attached to certain screenings, lack of sexual-health education geared toward LGBT older women and also lack of awareness by health providers about the specific health needs of LGBT older women.
Knowledge and information are power. Empower yourself with the information and resources you need to age successfully.
Rebecca Richman is a member of the LGBT Elder Inititiative and is a paralegal wth the AIDS Law Project of Pennsylvania. The LGBTEI fosters and advocates for services and resources that are competent, culturally sensitive, inclusive and responsive to the needs of LGBT older adults. To comment on this article, suggest topics for future articles or for more information, visit www.lgbtei.org or call 267-546-3448 and watch for “Gettin’ On” each month in PGN.