SF LGBT senior issues
by Matthew S. Bajko
A new report is giving San Francisco officials some sense of what issues the city's LGBT senior population is grappling with as a task force works to address their concerns.
The findings contained in the report paint a complex picture about the city's aging LGBT residents. When compared to their counterparts in other cities, elderly LGBTs in San Francisco are more likely to be living in poverty, single, childless, renters, and living with HIV. Most have also experienced the death of a partner.
Conversely, nearly all LGBT seniors in the city have some form of health care coverage, most consider themselves to be in good health, and many show strong resilience when faced with adversity. About 81 percent regularly see a doctor, though 7 percent felt seeing a physician was cost prohibitive.
Called "LGBT Older Adults in San Francisco: Health, Risks, and Resilience," the report's findings are based on the responses from 295 older LGBT San Franciscans who took part in a national research project in late 2009 and early 2010 known as "Caring and Aging with Pride."
Karen I. Fredriksen-Goldsen, Ph.D., a professor at the University of Washington and director of the Institute for Multigenerational Health, conducted the federally financed study and is working with San Francisco's LGBT Aging Policy Task Force on developing a new survey to delve deeper into the needs of the city's LGBT seniors.
Because the majority of respondents to the initial survey were single white gay men, the report only gives "an initial snapshot" of San Francisco's LGBT senior population and "limits the generalizability of the findings," stressed Fredriksen-Goldsen. More information is needed, she added, to better gauge what issues transgender and bisexual older adults face as well as the concerns of specific racial and ethnic communities.
Despite the report's limitations, Fredriksen-Goldsen said it does provide a wealth of information for city officials and community advocates working to develop a plan to address LGBT aging issues.
"It is taking a very extensive look within the San Francisco community, one that has not been done previously," she said. "I really think the report and the information in it really shows some significant challenges for older LGBT adults."
The report's findings and the work that the aging task force is undertaking will have benefits not just for LGBT seniors, added Fredriksen-Goldsen.
"I think it is important to realize too that better understanding the experiences and needs of older LGBT adults really does help us understand the needs of seniors in general," she said.
It is estimated there are at least 162,000 San Franciscans age 60 and older, with at least 18,000 of those being LGBT. The aging policy task force has been assigned to develop a detailed plan to address the needs of those LGBT seniors that is due by early 2014.
To help guide its work, the task force asked Fredriksen-Goldsen, an out lesbian who is 55, to pull out the responses from San Francisco residents to her earlier national study and analyze the data.
Gay men accounted for 198 of the participants, with 81 lesbians, 11 bisexuals and five people who chose "other" also taking part. Among the total, eight people identified as transgender. The age range was from 50 to 70 and older, with 42 percent in the 60 to 69 years old age bracket.
In terms of the respondents' race, the study included 249 white non-Hispanics, 17 Hispanics, eight Native Americans, six Asian Americans, and five African Americans. Ten people listed themselves as multi-racial.
The San Francisco specific report found that 41 percent of the participants had "seriously considered" suicide, 62 percent lacked companionship, and 58 percent felt isolated. One-quarter wasn't out to their neighbors.
When asked about being victimized during their lifetimes, 79 percent had been subjected to verbal insults, 53 percent said they had been threatened with physical violence, and a third said they had been hassled by police.
In terms of employment discrimination, 31 percent said they had not been hired for a job due to being LGBT, 29 percent were denied a job promotion and 21 percent said they were fired.
In January when she presented the findings to the task force, Fredriksen-Goldsen noted that, "Many services fail to take into account the unique needs facing LGBT older adults and their caregivers."
Sue Englander, 60, said the report mirrors her own experiences as a bisexual woman and having worked as a nurse for 25 years.
"It wasn't a surprise to me to know how fragile the LGBT elder community is," said Englander, the lead convener of this year's Howard Grayson LGBT Elder Life Conference, which will take place Saturday, March 30 and is sponsored by the Harvey Milk LGBT Democratic Club. "Circumstances can change in 24 hours for somebody, unless you are well-connected and have people checking on you regularly. Many of us don't have a financial and emotional reserve we can rely on to take care of ourselves. A lot of the community is just living on the edge."
She also was unfazed by the findings that 14 percent of LGBT older adults were not out to their physician and that 13 percent said they had been denied health care services or felt they had received inferior health care due to their actual or perceived sexual orientation and/or gender identity.
"First of all, even after so many years of training and talking about the necessity of discussing these things, medical and social service professionals sometimes are reluctant to raise issues about sexuality, sexual orientation or gender identity," said Englander. "Professionals are still going to have to go a long way to bridge the gap between themselves and the communities they are serving."
Although slightly less than 3 percent of the 295 people in the study identified themselves as being transgender, the researchers were able to draw some conclusions about those seniors. Transgender participants reported higher rates of depressive symptoms, high rates of anxiety, and high rates of suicidal ideation.
The study also found that transgender respondents had low levels of community belonging.
"The thing that really strikes me the most about this report is what a terrible situation transgender seniors are in," said Bill Ambrunn, 50, the aging task force's chair. "If you look at the statistics where LGBT seniors are doing poorly, you find that the transgender portion are doing twice as bad."
Yet it is unclear what the exact reasons are behind those statistics, noted Ambrunn.
"The experts point to a lifetime of stigma and discrimination will have both economic and medical consequences. I think in seniors, especially transgender seniors of color, there is just this huge piling on of socioeconomic factors that are really impacting them at the end of their lives."
The task force has prioritized seeing larger numbers of transgender seniors and LGBT adults of color fill out the new survey it plans to launch in March or April. Several key areas the locally based questionnaire is expected to focus on include housing needs, social services, discrimination, and elder abuse.
"What we found when the task force reviewed city data on LGBT seniors is that people of color, transgender seniors, and seniors for whom English is a second language are under-represented. The task force survey will be focusing on those communities," said Marcy Adelman, Ph.D., 66, a task force member whose career since the 1970s has focused on LGBT aging.
Larry Saxxon, 60, a gay black man on the aging task force, is helping spearhead efforts to recruit a diverse pool of LGBT people to take part in the new survey. More than 400 respondents age 60 and older are needed for the data to be statistically significant.
To download a copy of the "LGBT Older Adults in San Francisco ..." report, visit http://www.sf-hrc.org/index.aspx?page=201#Resources. It is the last PDF file listed.