Challenges facing LGBT elders

Lesbian, gay, bisexual and transgender (LGBT) face a number of particular concerns as they age. They often do not access adequate health care, affordable housing or other social services that they need due to institutionalized heterosexism. Existing regulations and proposed policy changes in programs like Social Security or Medicare, which impact millions of LGBT elders, are discussed without a LGBT perspective engaging the debate.

Federal programs designed to assist elderly Americans can be ineffective or even irrelevant for LGBT elders. Several studies document widespread homophobia among those entrusted with the care of America's seniors. Most LGBT elders do not avail themselves of services on which other seniors thrive. Many retreat back into the closet, reinforcing isolation. Several federal programs and laws blatantly treat same-sex couples differently from married heterosexual couples. For example:

• Social Security pays survivor benefits to widows and widowers but not to the surviving same-sex life partner of someone who dies. This may cost LGBT elders $124 million a year in unaccessed benefits.
• Married spouses are eligible for Social Security spousal benefits, which can allow them to earn half their spouse's Social Security benefit if it is larger than their own Social Security benefit. Unmarried partners in lifelong relationships are not eligible for spousal benefits.
• Medicaid regulations protect the assets and homes of married spouses when the other spouse enters a nursing home or long-term care facility; no such protections are offered to same-sex partners.
• Tax laws and other regulations of 401(k)s and pensions discriminate against same-sex partners, costing the surviving partner in a same-sex relationship tens of thousands of dollars a year, and possibly more than $1 million during the course of a lifetime.
• Even the most basic rights such as hospital visitation or the right to die in the same nursing home are regularly denied same-sex partners.
• Many LGBT elders experience social isolation and ageism within the LGBT community itself.

These issues, often compounded by racism and other kinds of discrimination, demand the attention of policymakers, service providers and activists working on behalf of, and with, the elderly. As LGBT people grow older, they enter a world of services that may not be familiar with LGBT people. Some activists have created LGBT-specific service organizations for the aged, including Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders [1](SAGE), Gay & Lesbian Outreach to Elders and Pride Senior Network. These types of programs are not available in all parts of the country and cannot provide all the services needed. This is particularly true in rural areas.

A number of problems faced by LGBT elders also stem from the fact that they often do not have the same family support systems as heterosexual people. LGBT elders are among the most invisible of all Americans. Little is known about LGBT elders because of the widespread failure of governmental and academic researchers to include questions about sexual orientation and gender identity in their studies of the aged. Legal and policy frameworks which have traditionally excluded LGBT people engender social and economic consequences which deny LGBT elders access to financial resources and community support networks.

The need to make broad assumptions about the size of the LGBT elderly population underscores one of the major problems in understanding the needs of this population. LGBT elders are not only underserved, they are also understudied. There is an overall lack of empirical demographic data on LGBT people of any age, but data on LGBT seniors are particularly limited. Very little literature examines the lives of older LGBT people, and that which actually does exist has many limitations. Most samples over-represent white gay men from urban areas with middle or upper incomes, and under-represent women, people of color, low-income people or residents of suburban and rural regions. In addition to a policy agenda, a research agenda is urgently needed.