Older people with lesbian, gay, bisexual and transgender identities face unique challenges as they age. They are at greater risk of needing formal care provision in older age, due to fewer having children, and more having fragmented relationships with birth family associated with their sexual and gender identification. Yet at the same time, there are shared concerns in the USA, UK, Canada and Australia, that health and social care providers are failing to address the needs of older people with LGBT identities and that this, in turn, is causing people to avoid services even when they may desperately needs them. Professor Nancy J. Knauer of Temple Law School (pictured right) , has written an award winning paper about the problems of LGBT older people in the USA [LGBT Elder Law: Toward Equity in Aging, 32 Harvard Journal of Law & Gender 1 (2009)] and has a book on related themes about to be published [Gay and Lesbian Elders: History, Law, and Identity Politics in the U.S. (Ashgate Publishing, Ltd.)]. There has been only minimal research in the UK as yet, which I am seeking to redress, in part, with my own PhD research (described in my bio above).
Older people with lesbian, gay or bisexual (LGB) identities face two different kinds of problems related to being ‘out’ and receiving care. They may be faced with unwanted exposure if they have been ‘in the closet’, as many people with LGB identities pre-Stonewall (during the time of criminalisation and psychiatric attempts at ‘cures’) may have been. This particularly applies to being recognised as partners of people who are terminally ill or in need of long-term care (e.g. dementia care). If they do not get such recognition, they may find themselves excluded from their loved-one’s care, and even death and funeral, by service providers and/or birth family. On the other hand, others who have previously been out (either fully or selectively) may feel it necessary to go back in the closet, particularly in terms of their own care, in order to avoid homophobia from care providers and fellow service users. Older people with transsexual identities also have very real concerns about the need for personal care in frail, dependent later older age and potential transphobic attitudes among care givers. On top of this, most LGBT activists fail to address the needs of older people within their communities, due to ageism, leaving older people with LGBT identities with nowhere to turn.
The UK, in comparison with the USA, enjoys far greater recognition of same-sex relationships and transgender identities and more formal policies relating to health and social care provision for older people with LGBT identities in housing, health and social care. However, older people with LGB identities, in both the USA and the UK, are inadequately protected from discrimination in law. In particular, new anti-discrimination legislation, the Equality Act 2010, explicitly excludes protection from harassment on the grounds of sexual orientation outside of the workplace, including in housing, health and social care services. This limitation followed vigorous lobbying from the Church of England and other religious organisations who were concerned that anti-homosexual teachings might otherwise constitute harassment in law, thereby limiting freedom of speech. However, opponents of the exclusions (who did not include Stonewall, the leading LGB lobbying organisation which, oddly, raised no objections) have argued that they may conflict with other elements of the European Convention on Human Rights, namely ‘prohibition of discrimination’ (Article 14), ‘the right to respect for private and family life’ (Article 8), ‘freedom of thought, conscience and religion’ (Article 9), or ‘the prohibition on inhuman or degrading treatment’ (Article 3).
As a result of these exclusions, the UK has created two-tier anti-discrimination legislation with people with LGB identities receiving lesser protection. The exclusions disproportionately affect older people with LGB identities, as they are more likely to be users of (sheltered) housing, and of health and social care services. However, their invisibility in academia, service provision and activism has meant the impact on older people with LG identities has been overlooked.
There is an urgent need, both nationally, and internationally, to address the marginalisation of older people with LGB identities, and the needs of older people with transgender identities, in order to resolve these inequities.