Editor’s Note: This article appears in the July/August, 2011, issue of Aging Today, ASA’s bi-monthly newspaper covering advances in research, practice and policy nationwide. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store

By Brian de Vries

As an area of research and focus for programs, LGBT aging is coming into its own. Complex issues affecting the LGBT older population are gaining recognition, and there are more services tailored to address these issues. This trend has deep relevance for—and beyond—LGBT lives, not only providing overdue attention to this often hidden population, but also revealing rarely considered issues about the fluid nature of families, the forms and sources of support characterizing LGBT elders and others leading non-traditional lives. The study of LGBT aging provides a perspective encouraging creative and novel considerations of how and with whom we age—even what it means to be old. (See page 7 of the print issue for the “pIn Focus” section on LGBT issues.)

The older LGBT population is challenged and bolstered by its experiences and demography. As reported in the March 2011 Institute of Medicine report (The Health of Lesbian, Gay, Bisexual and Transgender People), later life may bring with it particular physical and mental health issues for LGBT elders. Recent research reveals higher levels of psychological distress (particularly among older gay men with potential gender role attributions), higher incidence of cancer (particularly reproductive cancers among older lesbians and bisexual women, perhaps owing to nulliparity) and HIV/AIDS (primarily among gay and bisexual men).

Health issues for transgender persons, although still poorly understood and understudied, are thought to be made more complicated by the introduction of hormones for those who have transitioned from one biological gender to another. Soon-to-be-released research (Caring and Aging with Pride) reinforces community-based surveys reporting high levels of disability among almost half of older LGBT respondents, too. Although HIV/AIDS plays a role, higher incidences of asthma and diabetes were also noted. Causes and mechanisms for these elevated rates are unknown.

Support Through Families of Choice

Caregiving becomes particularly crucial, especially when considering that LGBT older adults (older gay men particularly) are significantly less likely than heterosexual women and men of comparable age to be in partnered relationships and to have children—two groups most frequently called upon to provide care. In the absence of conventional family support systems, upon which policy is often predicated, LGBT persons place a high value on friendships, what some call “families of choice,” or to quote novelist Armistead Maupin, “logical kin.”

The 2010 MetLife/ASA national survey of LGBT baby boomers found that almost two-thirds of respondents said they had a family of choice. A high proportion of LGBT baby boomers also said they would turn to these friends for a variety of needs (support and encouragement, errands, emergencies) as well as offer friends such care. Following the onset of HIV/AIDS and the nation’s initial non-response, LGBT people sought and found each other, creating services to meet needs and, in the process, creating a sense of community.

Crisis Competence—a Matter of Survival

In a similar way, several authors have proposed that LGBT older adults have fashioned a sense of hardiness and competence out of a lifetime of surviving as a sexual or gender minority in a heterosexual environment—a strategy that may bode well for success in the challenges of later life. In the MetLife survey, almost three-quarters of LGBT baby boomers reported that they thought being LGBT had helped prepare them for aging.

Being freed (or excluded) from the bounds of traditional gender role definitions may have afforded LGBT persons the opportunity to engage in gender-incongruent behaviors heterosexuals typically do not confront.

Arnold in Harvey Fierstein’s Torch Song Trilogy says it well: “I have taught myself to sew, cook, fix plumbing, build furniture—all so I don’t have to ask anyone for anything.” Some call this “crisis competence,” and consider it a gay and lesbian theory of successful aging, one bred from confronting rigid gender roles, ageist assumptions and the assaults of an unwelcoming society.

Such survival skills may be necessary for successful aging because despite persistent myths saying the opposite, data suggest that LGBT persons, especially older adults, have somewhat lower incomes than comparably aged heterosexual persons.

Living with Stigma

Stigma serves to unify these findings and experiences, underlying the mental, physical and demographic effects noted above: mental distress; the development of non-traditional relationships and non-kin ties (even as these friends fail to be recognized by social and health institutions); lower income and access to resources in later life. Studies show that safety net programs and laws intended to support and protect older Americans fail to provide equal protections for LGBT elders. Same-sex couples are not eligible to receive the benefits of Social Security and Medicare that are offered to married couples; and similar inequalities are noted in retirement plans, health insurance benefits and a wide array of taxes.

Many of these issues also are relevant to heterosexual older adults: heterosexual couples may enter old age without children, and others may be single or in non-marital relationships. In the absence of offspring or extended family, heterosexual elders may have family-like networks of friends, and particularly value their independence.

An awareness of LGBT aging issues offers those in the field not only the knowledge to effectively and competently provide services for LGBT elders, but also the opportunity to challenge assumptions, reconsider constructs and offer fresh perspectives on the needs and issues of a diverse aging population. It helps point the way to how we might work with an older population in a more inclusive, contextualized and relevant manner. The LAIN (LGBT Aging Issues Network) leadership council recently undertook the promotion of this perspective as a task for the upcoming year. Watch for further reports on this work in issues to com.

Brian de Vries, Ph.D., is a professor of gerontology at San Francisco State University. He is an ASA board member, a member of the ASA LAIN leadership council and co-chair of ASA’s LAIN constituent group. De Vries is a fellow of the Gerontological Society of America, and recently became a policy advisor for AARP, California. He served as guest editor for this issue’s “In Focus” section, and is on the Aging Today editorial board.