Addressing the Needs of Gay Seniors
After years of being ignored, gay seniors are getting a hearing at last. On Wednesday, April 28, U.S. Rep. Tammy Baldwin (D-Wis.) joined experts in geriatrics to discuss new legislation to meet the unique needs of older LGBT Americans.
Aging lesbian, gay, bisexual, and transgender baby boomers are the first generation of LGBT Americans who have lived openly. While most Americans face challenges as they age, these men and women - who lived before Stonewall revolutionized the way we were perceived and treated - have the added burden of a lifetime of stigma; familial relationships that lack recognition under the law; and unequal treatment under laws, programs, and services designed to support and protect older Americans.
The lack of financial security, good health and health care, and social and community support is a fearful reality for a disproportionate number of all older adults, but it especially strikes hard at such a stigmatized population.
In March, a groundbreaking study, "Improving the Lives of LGBT Older Adults," was released by a coalition of organizations headed by the Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE). Other groups that participated were the Movement Advancement Project, the American Society on Aging, the Center for American Progress, and the National Senior Citizens Law Center.
At the same time, Gay Men's Health Crisis, the world's largest private AIDS service agency, released a report, "Growing Old With the Epidemic: HIV and Aging."
With people living longer with HIV, and the epidemic entering its fourth decade, the once unheard-of issue of geriatric AIDS is coming to the fore. Already, one-third of people with HIV in the United States are 50 or older - a figure that will grow to one-half by 2015.
This is in some ways a pleasant problem. After all, only 15 years ago, AIDS was a death sentence. But that doesn't mitigate the problem of dealing with aging with the additional burden of a severely compromised immune system.
Any chronic condition presents problem with aging, but HIV means decades of medications with side effects that are hard on much younger people, let alone the elderly. One survey finds that nearly all HIV-positive older adults have experienced HIV-stigma. Nearly three-quarters also experienced ageism.
Increased training in places where older adults receive care is crucial. "The needs of LGBT and HIV-positive elders are often overlooked within these environments," the report states. Like other elder gays, these people are often isolated from family or friends.
Following passage of President Obama's health-insurance initiative, the report advocates for a public policy agenda to address the specific needs of HIV-positive older adults. "Designating HIV-positive and LGBT elders as a vulnerable population in the Older Americans Act is an important next step," the report states. "Additionally, changes are needed in federal laws and policies, including the Family Medical Leave Act, Social Security spousal benefits, and Medicaid regulations, which discriminate against same-sex couples."
Some of those same issues arose at the briefing in Washington, D.C. At the SAGE-sponsored event, Winnie Stachelberg, of the Center for American Progress Action Fund, emphasized that gay seniors' issues may be getting lost in the fight for the national Employee Non-Discrimination Act, gay marriage and changing military policy.
Baldwin, who is an out lesbian, told of the story of Eleanor and Jay, a lesbian couple in New York City (Jay is also transgender). "Eleanor and Jay both
suffered debilitating illnesses made worse by a medical system that refused to accept their relationship," she related. "Jay had employer-based health insurance which would not cover her partner so they bought a costly private plan for Eleanor. When she developed diabetes, the rates and the copays on that insurance skyrocketed to the point where they had to really scale
back on the extent of the coverage.
"Eleanor then suffered a stroke. She ended up in a nursing home where she was abused and told repeatedly by an attendant that she was going to go to hell when she died for being a lesbian. Jay tried to protect her as best she could but cancer struck Jay and her treatments kept the two apart even more."
Baldwin also told of the widely reported case of Clay Greene and Harold Scull, of Sonoma County, Calif. Partners for 20 years, who had done all that they could to protect their rights and their commitment to one other. They'd executed detailed wills, they'd signed powers of attorney for healthcare, they dotted all the Is and crossed all the Ts to handle any emergency to protect their partnership and their property.
"And yet, two years ago this month, after Harold fell and was hospitalized, he was taken to a nursing home," Baldwin said. "County officials, not only refused to tell Clay where Harold was taken but they forced Clay into a different nursing home and auctioned off every piece of property, every family memento acquired over their lifetimes. After 20 years together, the two of them never saw each other again and Harold died without his partner
at his bedside."
Such stories aren't uncommon. Nor does the law help. In fact, many cases, it actively hurts older gays. Social Security, for example, gives same-sex couples an average of 17.8 percent less in benefits than heterosexual married couples. Same-sex partners must apply individually for Medicaid, resulting in much less protection of assets.
The worst examples of this prejudice, however, are found in nursing homes and other long-term care facilities. President Obama's recent directive on hospital visits by gay partners is a welcome step to remedy some of this inequality.
Baldwin announced that she would be introducing legislation that addresses the specific needs of aging LGBT Americans. She also noted that federally funded health studies don't ask questions about sexual orientation.
Ineke Mushovic who is the executive director of the Movement Advancement Project, spoke of the study's research and surveys of older gay Americans. Like the GMHC study, it found widespread instances of homophobia and being stigmatized because of their sexuality.
The study even found that nearly half of the senior centers and agencies on aging said LGBT older adults "would not feel welcome in their senior centers and in fact, almost three-quarters of LGBT elders said that they were tentative about using services at their area agencies on aging because of a lack of trust that they would be treated well if they did so."
In order to address pending legislation and lobby members of Congress, last month, SAGE opened an office in Washington. John Johnson, a veteran congressional aide, heads the office.