LGBT seniors struggle
by Matthew S. Bajko
Isolated from family and largely living alone, LGBT seniors in San Francisco contemplate taking their own life at an "alarming" rate, a new study has found.
It is estimated there are anywhere from 18,000 to 20,000 LGBT seniors living in San Francisco, with the population increasing each year as the median age of the city's residents grows older.
A survey of 616 LGBT city residents aged 60 to 92 years old, the results of which were released this week, found that 15 percent had "seriously considered" committing suicide within the last 12 months.
While mainstream and LGBT media coverage in recent years has shed a national spotlight on LGBT teen suicides, leading to such efforts as the It Gets Better video project, the study findings show it is an issue many LGBT people grapple with well into adulthood.
"I am surprised it isn't higher," said Hadley Hall, 80, a gay San Francisco resident.
He has had friends commit suicide after they determined to take their own life to end their suffering brought on by failing health.
"It was their decision to do it because they couldn't get the palliative care they needed," said Hall.
Commissioned by the city's LGBT Aging Policy Task Force, the study also found "relatively high rates of disability" in addition to "poor physical and mental health" among the participants. Previous research has shown that both health issues are associated with increased risk of depression, "which in turn can increase the risk of suicide," noted the report.
The survey was the first to ask about suicidal tendencies within the timeframe of the last 12 months rather than over the course of a person's lifetime, said out lesbian lead researcher Karen I. Fredriksen-Goldsen, Ph.D., a professor at the University of Washington and director of the Institute for Multigenerational Health.
"In some cases we have seen a similar percentage for over a person's lifetime, but to see 15 percent considering suicide within the last 12 months is very concerning," she said.
Were heterosexual seniors to be asked a similar question, Fredriksen-Goldsen predicted that the number saying they had contemplated suicide within the last year "will be significantly less" than the 15 percent the LGBT senior study found.
"We need to figure out what is unique within older LGBT adults and why they are contemplating suicide," she said during a presentation Tuesday, July 9 about the study findings.
The researchers recommend that city officials create a suicide prevention program that is specifically targeted at LGBT older adults. Task force member Ashley McCumber, a gay man who is executive director of Meals on Wheels of San Francisco Inc., told the Bay Area Reporter that he agrees the suicide contemplation statistic "is a marker we need to pay attention to" and that the panel needs "to address LGBT seniors' isolation and mental health."
San Francisco Suicide Prevention is currently developing a "best practices" approach to suicide prevention among LGBT seniors that other cities throughout the Bay Area can emulate. The agency received funding from the state Mental Health Services Act to fund the work and is hosting a special training next week for LGBT people.
Executive Director Eve R. Meyer said the survey finding "tragically, I think, is not surprising because for a lot of LGBT seniors the living arrangements they have enjoyed change and living independently often becomes an option not available to them and they are often forced to live in extended care facilities of one kind or another."
In such a setting many LGBT seniors are pushed back into the closet, fearful of telling staff or other residents about their sexual orientation or gender identity, noted Meyer. That can exacerbate their risk for depression, she added, causing them to consider suicide.
"Our agency is just starting an elderly LGBT outreach with materials and trying to get awareness out in the community among health care practitioners, family members, and younger LGBT community members that this is a problem," said Meyer. "It is the kind of problem that you need to approach as a community."
Study a first of its kind
This week the Centers for Disease Control and Prevention, in its 2013 report on aging and health in America, said longer life spans and aging baby boomers will combine to double the population of Americans aged 65 years or older during the next 25 years to about 72 million. By 2030, older adults will account for roughly 20 percent of the U.S. population.
A 2011 federal study on LGBT seniors estimated that there were 2 million lesbian, gay and bisexual people age 50 and older in the U.S. It estimated that the LGBT senior population would double by 2030.
San Francisco's 15-member LGBT Aging Policy Task Force formed last year, and one of its first actions was to commission the study, titled "Addressing the Needs of LGBT Older Adults in San Francisco: Recommendations for the Future." The 56-page report is meant to help the panel determine the key concerns among LGBT seniors in the city and create a plan for how city officials can address them.
"This first-of-its-kind survey will help San Francisco understand the needs of this rapidly growing segment in our city's population," stated Mayor Ed Lee. "The survey will allow us to consider facts and data as we create policies to help LGBT seniors, and we are looking forward to the recommendations of the LGBT Senior Policy Task Force early next year."
More than two-thirds (71 percent) of the study participants were gay men, of whom 33 percent are living with HIV or AIDS. Lesbians accounted for 22 percent, while bisexuals and transgender people each made up 4 percent.
The majority were non-Hispanic whites (79 percent), with 7 percent Latino or Hispanic; 5 percent African American; 4 percent Asian or Pacific Islander; and 2 percent Native American.
Other significant findings in the report included nearly 60 percent of the participants live alone and close to two-thirds (63 percent) do not have a partner or spouse. Forty percent reported they do not have enough money to cover their basic needs, with 30 percent living on incomes below 200 percent of the federal poverty level.
Housing a key worry
The study is also lending scientific data to what has been anecdotally known for years: LGBT seniors in the city fear they will be priced out of San Francisco in terms of housing. And those concerns are only growing as the city grapples with a housing shortage that is causing both rents and home prices to skyrocket.
"You don't really know where you can go to feel safe as an LGBT person," said task force member Marcy Adelman, Ph.D., who helped found the LGBT senior services agency Openhouse.
A majority of the survey participants (54 percent) rent their housing, while 5 percent live rent-free with family or friends, in a nursing home or some other health care facility. Close to a third (28 percent) own a home and are still making mortgage payments while just over 13 percent have paid off the mortgage.
The only housing designated for LGBT seniors, the Openhouse project at 55 Laguna Street that will have 110 rental apartments for low-income people, is still years away from opening. Even when it does, it will be nowhere near enough units to meet demand.
"The consequence of having to leave San Francisco is especially significant for this community," said Diana Jensen, MPP, who served on the research team for the study.
Two-thirds of people in the senior survey said they are concerned they will not be able to remain in their current homes and may need to relocate. Nearly one-quarter reported needing housing assistance; while 42 percent of people utilizing such services "feel unsafe" doing so as an LGBT person.
"LGBT respondents who live alone, those with lower incomes, and those with less education are at elevated risk for housing instability," concludes the report.