Meeting Spotlights LGBT-Aging Research From HIV to Isolation

Photo: LGBT older adults may join in social activities designed for them, such as these seniors atSAGE in New York. 

ORLANDO, Fla.--As more and more LGBT seniors are living out of the closet, the issues they confront during their golden years are receiving increased attention from researchers who study aging.

At the annual conference of the Gerontological Society of America (GSA) herein November, a record number of presentations and poster papers were presented dealing with LGBT aging.

Topics ranged from social isolation and mental distress facing LGBT seniors to weight issues among lesbian and bisexual senior women to how gay men and their families access end-of-life services. While not always specific to LGBT seniors living with HIV or AIDS, many panels also discussed various aspects of aging with the condition. 

Giving Voice to Issues

"It is really important to be raising LGBT issues in the professional community. It gives voice to those issues in the larger scheme of aging issues," said conference attendee Mark Brennan-Ing, Ph.D., director for research and evaluation at Acria, based in New York. 

Although the number of older adults in the United States continues to climb, many health surveys do not include questions about sexual orientation or gender identity. So the true size of America's LGBT senior population remains unknown.

The U.S. Administration on Aging has estimated the number of LGBT seniors age 60 and older to be between 1.75 million to 4 million, projected to double by 2030. California estimates having 215,000 LGB people age 55 and older. (There is no statewide data for the transgender senior population.) Nearly 20,000 LGBT residents 60-plus live in San Francisco. 

GSA formed its LGBT-focused Rainbow Research Group in 2003. At this year's confab there were three LGBT-specific symposiums and five others presenting LGBT-centered studies. In addition, there were 19 LGBT-specific research posters displayed at the conference. 

The increasing inclusion of LGBT aging research points to the "immeasurable change," said Brian de Vries, a gay professor of gerontology at San Francisco State University and a co-founder of the Rainbow Research Group. He recalled that during GSA’s meeting in San Francisco 10 years ago someone asked him what LGBT meant. 

"I think there has been a radical shift. It's in the lexicon now," said de Vries. "We have gender-neutral bathrooms now. When I saw that I was really proud."

This year's meeting, held in late November at the Walt Disney World Swan and Dolphin Resort, marked the first time the GSA confab designated bathrooms as being nongender specific. Members of the Rainbow Research Group had petitioned GSA leaders to do so at the behest of Brennan-Ing, one of the group's members.

First-Time Focus for LGBT Studies

Another first this year was an LGBT poster session highlighted as such in GSA’s huge schedule, making the nine papers easier to find among the hundreds of listed papers and sessions in the meeting’s 252-page conference program. 

"We flipped out. We were so excited," said Sara Keary, who earned her Ph.D. in social work at Boston College. She is a research consultant at the Fenway Institute, looking at the housing needs of LGBT older adults. Previously, she said, LGBT-related studies would be scattered among others under such broad categories as health, social support or depression.

Keary, said GSA’s Rainbow Research Group now has 70 members, including both LGBT and other scholars interested in LGBT aging research. Keary, who said she is straight, feels LGBT-focused research has been gaining greater acknowledgement at the GSA conferences.

Attending her second GSA meeting, Molly Ranahan, 28, is a lesbian studying gerontology at the University of Buffalo. She is exploring how city-planning policies can positively impact the lives of LGBT older adults.

"Going to the Rainbow Research Group was why I came back,” Ranahan said. "It has been a fantastic experience and opened a lot of doors for me."

Wide Array of Research

In a symposium, De Vries presented research he co-conducted of gay older men in Canada and a smaller survey of Palm Springs residents. The cohort of men in the study is similar to aging gay males in San Francisco, he said, and in both countries end-of-life care is of increasing concern.

In focus groups, although most of the men said they had made out wills, few had thought about who would take care of them if their health failed or just prior to death, said de Vries. "People had a hard time getting into that question," he said.

His research, said de Vries, aims to help gay men develop opportunities where they can talk to one another about their declining health. In most families, he noted, children will sit their parents down and have that discussion. "Gay men don't have that. This is the limits of the chosen family," said de Vries.

Lesbian researcher Karen I. Fredriksen-Goldsen, Ph.D., director of the Hartford Center of Excellence at the University of Washington School of Social Work in Seattle, led another of the LGBT-specific symposium titled "The Cascading Effects of Marginalization and Resilience Over Time: Pathways to Health and Well-Being Among LGBT Older Adults."

Fredriksen-Goldsen leads the National Health, Aging and Sexuality Study: Caring and Aging with Pride over Time. Established in 2009, it is the first national LGBT senior study of the National Institutes of Health.

"We did find that most LGBT people are doing very well. They are aging well and have good health," Fredriksen-Goldsen told the nearly 40 people who attended the symposium. "We don't want to stereotype LGBT people by just focusing on problems."

Nonetheless, Fredriksen-Goldsen said they are finding higher rates of disabilities and more mental distress among LGBT seniors, with lesbian and bisexual women more at risk for obesity and cardiovascular disease.

Caring, Aging with Pride Project

The Caring and Aging with Pride project has been funded to conduct a long-term study of LGBT seniors and is working with 16 community-based organizations nationally to recruit participants.
The study will allow researchers to better track LGBT seniors' health, well-being and identity issues, noted Fredriksen-Goldsen, but also enable them to design and test helpful interventions.

She said that they study will include a large sample from the Baby Boom, Silent Generation and Greatest Generations. "We will also stratify the sample by race and ethnicity," she added.

Charles Hoy-Ellis, an assistant professor at the University of Utah College of Social Work in Salt Lake City, presented counter-intuitive findings showing the message of "come out of the closet" may not be the best approach for LGBT seniors to take in certain settings.

"Concealing may sometimes be a socially protective strategy," he said. "We have talked about being out as being helpful, but that may not always be true." 

"If you live in an environment that is supportive, then being out in those circumstances may be protective. But in an environment that encourages conformity, being out may have detrimental effects," he explained. "You might be shunned socially."

University of Washington research scientist Hyun-Jun Kim, director of the Caring and Aging with Pride project, emphasized, "The more diverse network ties the better the health outcomes." 

Kim stressed that most LGBT seniors do not have family or children they can turn to for assistance as they age. "This may change as more gays and lesbians have children, but older LGBT adults are more likely to not have any children. They heavily rely on friends for support as they age."

Dearth of LGBT Senior Data

Boston College student Jie Yang presented a poster on her research into social isolation among older LGBT adults. Based on her findings culled from needs assessments done with 256 residents of North Carolina age 45 and older, Yang reported that the more open seniors are about being LGBT the less social isolation they face, in contrast to Hoy-Ellis's findings. 

Yang said the factors that did contribute to the respondents in her study feeling isolated included unemployment, poor mental health, and living alone.

And though her findings may have been impacted by the study's small sample size, Yang concluded that the eight transgender older adults in her study "had higher rates of perceived isolation" compared to their LGB counterparts, with bisexuals appearing "to be the least isolated group."

Yang's study was one of the nine presentations grouped together under the LGBT-specific poster session. Compared to the nearly 1,500 total posters presented during the course of the five-day gathering, the LGBT poster session seemed rather miniscule, said Yang.

"It really is not enough. Hopefully, there will be more going forward," she said.

One of the reasons for the dearth of posters about LGBT aging, Yang suggested, is the lack of data on LGBT seniors. Researchers looking at heterosexual seniors have a wealth of information they can draw on for their papers, noted Yang, while those focused on LGBT seniors have to collect their own data since most surveys do not ask about a person's sexual orientation or gender identity.

"In the national data sets, they don't identify LGBT people," said Yang, a straight ally who is in her third year of seeking a Ph.D. in social work. "If they did, we could do a lot of analyzing of the data on LGBT seniors."

There have been advances made toward including LGBT seniors in research efforts. This fall, California Governor Jerry Brown signed into law legislation that requires several state agencies to begin collecting LGBT data by July 1, 2018. In New York a number of state agencies have already begun to collect such information.

And in the federally focused Healthy People 2020 study, "all LGBT people will be included," noted Fredriksen-Goldsen.

She said she believes the scarcity of data on LGBT seniors will soon be reversed as more federal surveys and state-based agencies move toward asking people about their sexual orientation and gender identity.

"All states - and at the federal level - are looking at the importance of having LGBT demographic questions," said Fredriksen-Goldsen, who advocated on behalf of the recently signed California LGBT data inclusion bill, which was authored by California Assemblyman David Chiu, D-San Francisco.

"There is a lot of movement to have sexual orientation and gender identity included in state level and federal level data sets."

Source: newamericamedia.org