Around the country, among allies and foes alike, San Francisco often acts as a byword for progressivism and queer liberation.
But the city is also the epicenter of the state's housing crisis, and for many LGBTQ seniors — particularly those who are of color or trans — who've dealt with that experience, life in the City by the Bay hasn't always been somewhere over the rainbow.
Veronika Fimbres, 68, who is a former San Francisco veterans affairs commissioner and in 2018 was a Green Party candidate for California governor, has lived in the city's Sunnyside neighborhood for a dozen years. Her experience has run the gamut of housing in San Francisco.
"Although we think of San Francisco as a progressive, forward-thinking city, it's not," Fimbres said. "It is still racist. It is still discriminatory. I don't know what else to call it."
Fimbres, a Black trans woman, told the Bay Area Reporter she first moved to the city in 1996 from Indiana.
"I came here to save my life," she said, noting that she'd been diagnosed with HIV and both her fiancé and brother had died of AIDS.
"My brother died four days before my birthday in 1992," Fimbres said. "There, they didn't treat my brother accordingly."
Fimbres took residence in a number of downtown hotels, such as the Pacific Bay Inn at Jones and O'Farrell streets, like many when they first arrived in the city.
"Crack moms everywhere," she recalled about the experience in the mid-1990s. "People smoking crack, going up and down the stairs; everywhere people causing drama."
Fimbres, a nurse, began to get involved in politics, activism, and government. She served as the co-chair of the Re-Elect Willie Brown Lavender Group, was a volunteer client services manager with the AIDS Emergency Fund, a member of the board of directors for the San Francisco LGBT Pride Celebration Committee, and served on the city's veterans commission for 14 years — the first openly trans person to be appointed in the City and County of San Francisco.
Yet during that time she found herself homeless.
Fimbres had been living in an apartment by Bayshore Boulevard.
"I loved that place," she recalls. "Dishwasher, huge kitchen; I brought my mother and father there."
But when a roommate and the man she was dating at the time began to start a relationship of their own, Fimbres became uncomfortable.
"They were having a relationship, and they shouldn't have been because he was supposed to be my boyfriend," Fimbres said. "But I said, 'be together, but be somewhere else.'"
The roommate went to the city's Housing Authority, however, and told them that she was Fimbres' caregiver. Fimbres said that she had been considering it but the roommate was not her caregiver because nothing had been agreed to.
Between the dispute and the trio being behind on rental payments, Fimbres and the others were evicted, and Fimbres was without a place to live.
After a month of couch-hopping and more hotels, Fimbres found the place she is living now via Craigslist in November 2009.
"He gave me the keys that day, and I've been here since," Fimbres said, though there have been attempts to buy out the tenants in the ensuing years.
Fimbres said that she is not alone in having had housing upheaval in her past, and that while she'd love to buy a house, there have been many obstacles.
"There are still many transgender people out there on the street, homeless," Fimbres said. "I know your story focuses on older [people], but there are many young trans people who are out there, who need housing and need it right away. ... This city was based on white, gay men so all the services were based on that, and Black, trans and even lesbian women weren't included in that until, like, 1995."
San Francisco's particular housing crisis is a microcosm of a statewide or even a national problem, and its disproportionate impact has led LGBTQ housing advocates and experts to do what they can in manifold attempts to put roofs over people's heads.
Data illustrate problems
The National Center for Transgender Equality considers homelessness among trans people "a critical issue." The center undertook a national survey with almost 30,000 participants in all 50 states, published in 2016, that showed only 16% of respondents owning homes (compared to 63% of the general U.S. adult population), and that showed 30% of trans people have experienced homelessness at some point in their lives.
Some 12% of the total had experienced homelessness within the past year "because of being transgender." Of the survey participants, 803, or 3%, identified as being age 65 or older.
"The homelessness rate was substantially higher among respondents whose immediate family had kicked them out of the house, with nearly three-quarters (74%) of these respondents experiencing homelessness," the survey results report states. "The homelessness rate was also nearly twice as high among respondents who have done sex work (59%) and those living with HIV (59%), as well as respondents who have lost their job because of their gender identity or expression (55%). Transgender women of color, including American Indian (59%), Black (51%), multiracial (51%), and Middle Eastern (49%) women, also experienced especially high rates of homelessness."
Almost one-fourth of respondents, 23%, reported experiencing housing discrimination in the previous year (such as eviction or being denied a home or apartment) because of their trans identity.
"Many of those who experienced homelessness in the past year reported that they avoided using a shelter because they feared being mistreated as a transgender person, and those who did use a shelter in the past year faced high rates of mistreatment based on their transgender status, such as being kicked out of the shelter, being verbally harassed, physically attacked, or sexually assaulted," the report continued.
As the B.A.R. previously reported the U.S. Department of Housing and Urban Development announced in February that discriminating against people because of their gender identity is illegal under its reading of the Fair Housing Act.
Laying aging onto the intersecting tracks of the LGBTQ and minority communities reveals an even more complex story. Studies have shown that LGBTQ people face greater health disparities, in the aggregate, than cisgender and heterosexual communities — challenges that increase as people age, and that make work and access to housing more difficult.
Steven P. Wallace, Ph.D., a professor at the UCLA Center for Health Policy Research, was a leading expert on aging and communities of color, until his unexpected death last month. Wallace co-wrote a 2011 report on the health of aging LGB adults in California, focusing on people ages 50-70.
Speaking to the B.A.R. March 3, before his passing, Wallace said researchers had to focus on that population specifically because the California Health Interview Survey data at the time yielded more uncertainty about the data for people over 70. Gender identity was not yet a standard demographic question on the survey, with the first release of trans data from the survey happening only in 2017.
"Twenty-two percent of transgender adults have ever attempted suicide, compared to 4 percent of cisgender adults," the UCLA center stated at that time. "Transgender adults are about three times more likely to have had lifetime suicidal thoughts, 34% to 10%, and nearly four times more likely to have experienced serious psychological distress in the past year, 33% compared to 9%," according to the brief. "They are significantly more likely to report having a disability due to a physical, mental or emotional condition, 60% to 27%. They are more likely to delay or not get needed doctor-prescribed medicine compared to cisgender adults, 32% compared to 11%."
Wallace said that when he studied LGB adults, "we found gay men were more likely to have hypertension, diabetes, psychological distress and chronic condition, a series of chronic conditions."
Lesbians also faced challenges.
"Lesbians did not have the chronic physical conditions; and high blood pressure, diabetes, and heart disease were basically the same," Wallace said. "But when you look at psychological distress, that was higher, along with physical disability and poor self-image. The gay men and lesbians were more likely to say their health was fair or poor."
Wallace said that the 2011 survey was "one of the most cited pieces I've written," which illustrates the need for more studies of LGBTQ elder health.
"What that shows is the need for and limited supply of systematic data on LGBTQ older adults, to be quite honest," Wallace said. "We definitely need more data and research."
Wallace died unexpectedly March 30 at age 63, according to an announcement from the center.
"Dr. Wallace was an internationally-renowned scholar on health, health disparities, and health policy of older adults, immigrants, and communities of color including Latinx, American Indian and Alaska Natives, African Americans, and Asian Americans," the center stated in its announcement.
A more recent report from Wallace on the demographics of older adults in communities of color found that older people, particularly LGBTQ people of color, face a triple-threat in terms of health risks and interventions.
In homeless counts, Wallace said he knew age and gender were included but was not sure about sexual orientation and gender identity (SOGI) data.
"In LA county, the over-50 population is overrepresented in the homeless population," he said.
Wait list is long at SF's Openhouse
As the B.A.R. has previously reported, San Francisco is unique among Bay Area municipalities in that it actually has two of the dozen LGBTQ-affirming affordable residences throughout the United States, according to a list provided by Services & Advocacy for LGBT Elders, or SAGE.
The Openhouse residences are located at 55 and 95 Laguna Street near upper Market Street. Mercy Housing manages the apartments.
The city last year spent $12 million to purchase the building and parcel at 1939 Market Street, mere blocks away from Openhouse's campus, to construct affordable senior housing aimed at LGBTQ older adults. The Mayor's Office of Housing and Community Development is expected to announce the developer for the project sometime this year and a clearer sense of how many units it will comprise.
Combined, the Openhouse residences contain 119 units. However, older adults shouldn't expect to be able to fill out an application anytime soon, according to Carrie Schell, a queer woman who is the manager of community support services at Openhouse.
Schell said that the waitlist for Openhouse grew so long — to some 500 people — that it was closed "a couple of years ago."
When spaces do open up, "we work with Mercy Housing, our staff and theirs, to see who's next on the list and we call to give an announcement to them if a unit is available.
"Filling out applications is sometimes confusing for people, so we make sure they have the correct documents," Schell continued.
Most of the rents are established, Schell said: about $1,100 for a studio and $1,200 to $1,300 for a one-bedroom unit. This can sometimes be challenging for people on a fixed income.
"Mercy Housing requires 200% of rent, so if rent is $1,100 then you need $2,200 [in monthly income] to be housed," Schell said. "Now they are somewhat flexible on that. If they have enough to pay, even without much to have left, and we try to connect people to food resources and other kinds of subsidies. But there is a lack of a cushion, a lack of money, for a lot of seniors, who sometimes are paying 90% of their income in rent."
Mercy officials did not respond to a request for comment.
But just as finding a unit for interested individuals has become more difficult, so too has finding available rental subsidies.
"Q Foundation is on hold for new subsidies," Schell said, referring to a San Francisco nonprofit that provides them. "That used to be something we'd be able to do, and because of COVID a lot of organizations are really impacted, so that's not as much of an option anymore."
Q Foundation confirmed that its publicly available rental subsidy programs are fully enrolled. It declined to make a subsidy recipient available.
Schell said that offering more rental subsidies would be less costly to the government than allowing people to live on the street.
"The city is moving in the right direction, with new buildings opening up, but we definitely need to push harder for more subsidized housing," Schell said. "Living on [Social Security], or with disability in below market-rate housing is still not affordable. It's more expensive to keep people homeless than to help people, especially our seniors. It's harder to allow them to exist that way, and it's unethical, in my opinion."
Some of the units at Openhouse are set aside for people who are formerly homeless, or who are living with HIV, as part of government programs.
Continuum of care units are "specifically set aside for people who've struggled with homelessness," Schell said. Tenants are chosen "not from a linear list, but [from] a pool of people" who qualify, by the Housing Authority. (Openhouse and Mercy don't control who goes into those units, Schell said.) There are 23 COC units between the two buildings.
There are six units set aside through Housing Opportunities for Persons With AIDS, the only federal program dedicated to the housing needs of people with HIV/AIDS.
"It kind of operates in the same way, where they prioritize some people over others based on need," Schell said. The HOPWA program, which operates under the Department of Housing and Urban Development, "makes grants to local communities, states, and nonprofit organizations for projects that benefit low-income persons living with HIV/AIDS and their families," according to its website. HUD is thus in charge of those units, Schell said.
While many people are unable to get into Openhouse's residences, the organization tries to help seniors where they are, too.
Schell said that one common situation the agency tries to assist with is when older people need accommodations to continue aging in place in their home, and where they often need to stay due to moving being prohibitively expensive.
"The need for LGBT seniors is so high," Schell said. "So many people have been living, three stories up with rent control, and can't afford to leave because their rent is, like, $500. But as they age, they can't do stairs, so we work with people to see if we can find funding for a chair lift, for instance."
Oftentimes landlords have to approve accommodations like chair lifts because of the Americans With Disabilities Act, "but won't pay for it," Schell said.
"It's not that people need housing," Schell said, about these situations. "It's that the housing they've had for years, decades, isn't suitable anymore, and they can't afford to live anywhere else."
The same challenge is sometimes faced by older people who live in single-room-occupancy units. "Living in an SRO, sharing a bathroom with 10 other people, becomes untenable," Schell said.
Fimbres said that before Openhouse was completed, she and others were invited to tell the organization what trans people would need to be comfortable there, in exchange for a slot when it opened.
"They had an interview with trans senior women and men, and promised us housing when we gave feedback," Fimbres said. "When it got off the ground, nobody got a place there and I felt like we were used. This was before anything was built. It just seems like they listened to what we said we wanted, but didn't have a place for us. We were used for our knowledge."
When asked about this, Karyn Skultety, Ph.D., a bisexual woman who is the outgoing executive director of Openhouse, told the B.A.R., "I cannot speak to this directly since it sounds like her experience is from several years ago."
"Affordable housing is handled in San Francisco through a lottery system and residents cannot be pre-selected or chosen for any building," Skultety said. "We are proud that due to Openhouse's extensive outreach into the community, advocacy, and ongoing housing assistance services for LGBTQ+ seniors that our buildings are majority LGBTQ+. And, Openhouse, along with Mercy Housing, have always followed fair housing rules and the San Francisco process for housing placement."
Our Trans Home
The city's Our Trans Home initiative is tasked with providing rental subsidies to transgender and gender-nonconforming individuals, including trans seniors.
According to Clair Farley, a trans woman who is executive director of the city's Office of Transgender Initiatives, Our Trans Home is funded to the tune of $1.6 million this fiscal year and is expected to be funded at around $1.7 million in Fiscal Year 2021-2022. With all city departments facing 7.5% cuts per Mayor London Breed's directive to close budget deficits, however, this latter amount is subject to change.
Joaquin Remora, the program director at Our Trans Home, told the B.A.R. that there are 81 participants enrolled in subsidies, and there are 12 participants enrolled at the Bobbi Jean Baker house in the Mission district.
The program also provides housing subsidies to the Transgender District, the TGI Justice Project, and the Trans Activists for Justice and Accountability Coalition, Farley stated.
There are a total of 15 rooms in the Mission neighborhood house, so Our Trans Home is "currently assessing participants for three more rooms," Remora stated.
The Bobbi Jean Baker house, on Capp Street, is intended for people currently experiencing homelessness. Residents in the three-floor house receive case management services. As the B.A.R. previously reported, Our Trans Home opened a residence on Washington Street in early 2020. In June of that year, it was moved to the Mission district, Farley confirmed.
When asked how many people over 65 are being served by Our Trans Home, how many people have been able to graduate from emergency housing to a subsidy, and how many of those are over 65, Remora wrote that "we are not at the moment prepared to present deeper demographics data as we are working on a data report in the moment."
Our Trans Home officials said they would find a client to talk with the B.A.R. about housing but never did.
SFAF works on housing subsidies
Vince Crisostomo, a queer man who is the director of aging services with the San Francisco AIDS Foundation and is the program manager of the Elizabeth Taylor 50-Plus Network, said that the foundation has a number of resources and connections that can help people stay housed.
The Elizabeth Taylor 50-Plus Network is so named because the "Elizabeth Taylor AIDS Foundation was the lead funder for the 50-Plus Network with its five-year grant commitment to the program. That funding was awarded in 2015 is now renewable on an annual basis, so the program will continue to be named in Elizabeth's honor," Chad Ngo, SFAF communications manager, stated to the B.A.R. The actress established the foundation that bears her name in 1991.
"50-Plus is made up of people from the AIDS generation — people who survived through the AIDS epidemic," Crisostomo said. "There's a lot of trauma, a lot of unresolved feelings in the community.
"I've been with the program since 2014 and housing has been the No. 1 issue," Crisostomo explained. "We have a housing benefits department that provides housing subsidies to clients, mostly 50+, and that links people to Q Foundation, or to [AIDS Legal Referral Panel] for legal help. There are other groups, like [Bay Area Lawyers for Individual Freedom] that provide low-cost legal services."
A person referred by Crisostomo ultimately declined to speak with the B.A.R. about housing issues.
Crisostomo is currently advocating for more housing subsidies in San Francisco for 300 households in Fiscal Year 2021-2022. He said that he planned to meet with gay District 8 Supervisor Rafael Mandelman.
Mandelman provided the B.A.R. a copy of the budget request from the HIV/AIDS Providers Network, which includes SFAF. Three hundred housing subsidies, at $10,000 each, would cost $3 million.
"It is critical to support new housing subsidies for people living with HIV, to address the greatest disparity in health outcomes — housing status and homelessness," the document states. "HAPN's goal is to house 1,500 individuals living with HIV over the next five years (300 individuals/year). For the first year, we request funding for housing subsidies for 300 households."
This is one of six items in the budget request.
Mandelman told the B.A.R. that "I think the asks are strong and make sense."
"There are housing subsidies [in the document], which are desperately needed," Mandelman said. "In this 40th anniversary year of the first diagnosis, I support their asks and I think they are worthy and I'll work with members to support as much of these as I possibly can."
The budget has to be voted on by August 1, according to gay Mandelman aide Tom Temprano. Deliberations occur in June and it is voted on by the board in July.
This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations, and the RRF Foundation for Aging.
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