While lesbian seniors in San Francisco are more likely to experience age-based discrimination, they are less likely to lack social support compared to gay men.
The findings were included in "Addressing the Needs of LGBT Older Adults in San Francisco: Recommendations for the Future," a report based on a survey conducted in 2013 for the city's LGBT Aging Policy Task Force. The panel released its final report in March on various ways the city can take action to assist its growing population of LGBT seniors, estimated to number at least 18,000.
Of the 616 LGBT city residents aged 60 to 92 years old who took part in the survey, 22 percent identified as lesbian, accounting for 135 of the respondents, with a median age of 66. Lesbians were more likely to be non-Hispanic white than the gay male participants, who numbered 432.
Overseen by lesbian lead researcher Karen I. Fredriksen-Goldsen, Ph.D., a professor at the University of Washington and director of the Institute for Multigenerational Health, the survey also found that lesbians report higher household income than gay men.
Overall, the report concluded that 38 percent of lesbians had an annual household income above $80,000, although 20 percent were living on $20,000 or less. In terms of the gay male respondents, 23 percent had yearly income above $80,000, with close to 26 percent living on less than $20,000.
The lesbian participants were less likely to use home delivered meals, meal site or free groceries services compared to gay men.
But they were more likely to experience gender-based discrimination (27 percent) and age discrimination (41 percent) than gay men (5 percent and 31 percent, respectively), according to the report.
While roughly a quarter of the survey participants reported being military veterans, less than 2 percent of the lesbians had served in the military. And none of the lesbians reported being HIV-positive or living with AIDS.
They were more likely than gay men to be in legally recognized relationships, both registered domestic partnerships and legal marriage.
A little more than 50 percent of the lesbians were single, with the other half in some sort of relationship. The largest, at 17 percent, were partnered but not married; while 12 percent were legally married and 15 percent were in a domestic partnership.
Those with children accounted for 28 percent. And nearly 49 percent of the lesbian respondents said they were sexually active.
It could explain why lesbians reported having higher levels of social support compared to the survey's gay, bisexual, and transgender respondents. Sixty-two percent of lesbians said they usually have social support and 13 percent said they always did.
For comparison, 43 percent of gay men, many of whom lost friends and lovers to the AIDS epidemic in the 1980s and 1990s, said they usually have social support, with 19 percent saying they always did. Overall, 47 percent said they usually did and another 18 percent of all respondents answered always.
"Lesbians are more likely than gay men to turn to a partner or spouse, a family member, or a neighbor for social and emotional support," concluded Fredriksen-Goldsen in the report.
Task force member Joyce Pierson, 80, a longtime leader in LGBT aging issues, said the finding isn't surprising since there is a larger population of advanced age lesbians, 75 years of age or older, who have lived in the Bay Area for 20 or more years.
"I think women in general are more apt to form close friendships, and in the older lesbian community usually they do more with their social circles than going out in the large crowd," said Pierson, who for a decade was the National Center for Lesbian Rights' elder law project consultant.
She has also been active with Old Lesbians Organizing for Change and is helping to organize a conference, set to take place in Oakland and San Francisco in late July, to mark the group's 25th anniversary.
"Certainly, there are some women who are alone and isolated," said Pierson. "But I think, generally speaking, many have a pretty good social network. Even if it is a small friendship circle, with three or four people you keep in touch with all the time."
She also noted that older lesbians tend to have larger family networks they can rely on for support.
"I think in the community here too, a lot of lesbians married in their younger life. They have a family life and adult children and grandchildren," she said.
Housing a key concern among lesbians
While the San Francisco survey data indicate lesbians have more stable housing compared to gay men, it nonetheless remains a key concern.
Lesbians were less likely to be renters compared to gay men (56 percent of whom rent) and more likely to be homeowners than gay men (40 percent of whom owned a home).
Sixteen percent of the lesbian participants owned a home for which they had paid the mortgage off, with another 39 percent still making mortgage payments. Thirty-six percent were renters, while the remaining 9 percent listed "other" when asked about their living arrangement. Nearly 46 percent said they lived alone, compared to the 60 percent of gay men living by themselves.
Pierson, who has been dating her partner, Carol Seajay, for more than a year, lives in Bridge Housing's Coleridge Park Homes, an affordable senior housing complex in Bernal Heights, with another lesbian older adult as her roommate.
"It took me three years to find a place," she said.
Starting about 15 years ago Pierson said she began to notice many older lesbians priced out of San Francisco were moving to Oakland and other parts of the Bay Area.
"There is always women I know looking for affordable housing. There is not a lot of affordable housing," she said. "There are waiting lists for every facility in the Bay Area, particularly for those with women who have median incomes or lower. There hasn't been anything built for years to meet the housing needs, generally speaking, of aging people."
Due to the city's hilly topography and many apartments and homes accessed by stairs, LGBT advocates warn all it takes is one injury impacting one's mobility for a senior to find themselves trapped in their home or needing to move.
"With housing in San Francisco, even if people can stay in a rent-controlled apartment, many of these buildings have stairs, are on hills, or are not conducive to aging in place," task force member Moli Steinert, executive director of Stepping Stone, an adult day health care agency based in San Francisco, told the Bay Area Reporter during an interview this spring. "As you get older you can't navigate the stairs without risking a fall, injuring yourself, and then you become isolated. We have to confront those issues as well."
This fall Openhouse, a San Francisco-based provider of services to LGBT seniors, is expected to break ground on its long awaited 55 Laguna development of 110 rental apartments for low-income seniors in the city's upper Market Street corridor. Yet the housing is hardly enough to meet the present needs, and it is expected that the city's LGBT senior population will reach 50,000 by 2030.
Therefore, said Pierson, city leaders need "to prioritize addressing the housing issues and housing needs" of LGBT seniors.
LGBT seniors gain statewide attention
It is not just San Francisco that is struggling with how to meet the needs of its aging lesbian population, as well as its older gay, bisexual and transgender residents. Cities across the state are grappling with how to care for LGBT seniors, and state lawmakers have also begun to examine the issue.
The Assembly Committee on Aging and Long-Term Care held a hearing on June 10 focused solely on LGBT aging concerns and plans to incorporate its findings and recommendations into a report it will issue this November.
"How we address the policy and program and service needs of this population is going to have to be addressed by the Legislature and by national policy makers as well," Assemblywoman Mariko Yamada (D-Davis), who chairs the Assembly aging committee, told the Bay Area Reporter in a phone interview. "It is one of those demographic facts of life."
In his testimony before the committee, Gary Gates, Ph.D., a demographer with UCLA's LGBT think-tank the Williams Institute, told state lawmakers it is estimated that of California's 5 million seniors 2.5 percent of those age 65 to 70 are lesbian, gay, or bisexual.
Gates also told the committee there are currently 215,000 LGB people in California age 55 and older. Within the LGBT senior community, lesbians account for 29 percent among the women, he noted.
The senior figures are based on the California Health Interview Survey, which asks respondents up to the age of 70 about their sexual orientation. It does not ask about gender identity, therefore there are no statewide transgender senior statistics.
California data has shown that lesbian and bisexual women, while they seek out routine primary health care, were more likely to postpone necessary medical care.
In a white paper titled "Faces of Aging: Aging and the Lesbian, Gay, Bisexual and Transgender Community," the Assembly aging committee's consultant Robert MacLaughlin, who is gay, noted that the UCLA Center of Health Policy Research found that lesbians were 1.35 times higher to have psychological distress symptoms than their heterosexual counterparts. (Gay men were 1.45 times higher to show such symptoms compared to straight men.)
The findings, based on the state survey data for aging LGB adults, show that lesbians were 1.32 times higher to have a physical disability than straight women. (For gay men it was 1.24 times higher.) And lesbians were 1.26 times higher to report having a "fair/poor" health status compared to their heterosexual counterparts. (Gay men are 1.50 times higher to report such a status than straight men.)
In the San Francisco survey of LGBT seniors, 37 percent of the lesbian respondents had a physical disability, 6 percent reported poor mental health, and 13 percent said they had seriously contemplated suicide within the last year.
The statewide and city findings are consistent with a national study that Fredriksen-Goldsen and colleagues published last year that found, compared to older heterosexual women, lesbians and bisexual older women had higher rates of obesity and were at greater risk for cardiovascular disease. The study also found that lesbians were less likely to have had some health screenings, such as mammograms.
"As the number of LGB elders increase, it is advisable that health promotion and treatment for older LGBT people address the same chronic conditions that affect older adults generally, yet accommodate the aging LGBT adult's social and cultural characteristics and life experience," wrote MacLaughlin in the white paper. "Increasing cultural competency among health care providers is a step toward improved quality of care."
One common issue statewide is the need for LGBT senior housing. Sacramento resident Kaye Crawford, in her testimony at the Assembly aging committee hearing, detailed how her housing situation was destabilized by the death of her partner.
"I had my partner and I had a home for 10 years. When she died of cancer a few years ago, my home was taken over by her relatives," said the 73-year-old Crawford. "Now I find myself relying on the sole support of my son, three part-time jobs, and Social Security to pay the rent."
Crawford is the founder of Sacramento Rainbow Village, which is focused squarely on building housing for LGBT seniors in the state Capital they can afford to reside at and find support.
"This project for affordable housing has been talked about in Sacramento's LGBT community for the last 30 years," testified Crawford. "I have been trying to get it started for the last two years."
Noting that Sacramento ranks as the sixth largest city in the state in terms of its LGBT population, Crawford said the need is there for LGBT-specific senior housing.
"It seems logical for Sacramento to have supportive housing," she said. "We are creating an idea now whose time has come."