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LGBTQ Elders Made Our Lives Possible—Now We Must Care for Them


The new Long-Term Care Equality Index from HRC and SAGE will be a big step in addressing the inequities in care for LGBTQ seniors.

The LGBTQ movement stands on the shoulders of giants. Fifty years ago, our LGBTQ elders shattered barriers at Stonewall. A decade later, they spoke truth to power as AIDS ravaged their chosen families. In the years before and since, they marched on Washington and are still fighting for justice today.

Now it is our time to fight for them -- because all too often, LGBTQ elders are not receiving the care and support they deserve. With experts predicting that as many as 4.7 million LGBTQ older adults will be seeking care and services by the year 2030, we must act now.

That's why the Human Rights Campaign is joining SAGE, the premier advocacy organization for LGBTQ elders, in stepping up to address this injustice by helping to ensure LGBTQ older adults will be treated with respect and dignity when choosing and receiving aging and long-term care.

Today, HRC and SAGE are announcing a historic partnership to make long-term care more inclusive of LGBTQ older adults. Made possible in part by a generous seed grant from Ted Snowdon and Duffy Violante, we are creating a Long-Term Care Equality Index (LEI), the first-ever nationwide assessment of how well long-term care facilities are treating their LGBTQ residents. We are also launching a nationwide campaign to raise awareness of the specific needs of LGBTQ elders.

Though the fight for LGBTQ equality has seen much recent progress, the stark reality remains that many older LGBTQ people who have had to live through a lifetime of discrimination continue to face it -- often alone -- in their golden years. Too many have been cast out by their families, told their identity was a disease, or been forced to live in the closet to avoid persecution -- even prosecution.

Sadly, we know that bigotry and injustice aren't just specters of our shared past. LGBTQ people still face pervasive discrimination, including in long-term care. A 2013 study of long-term care facilities found that in half the facilities surveyed, same-sex couples reported experiencing discrimination. In one recent instance, a same-sex couple who had been together for 40 years was denied admission to a retirement community because the care provider did not accept their relationship as a "biblical marriage."

According to 2018 research by AARP, 76 percent of older LGBTQ Americans are concerned about having adequate family or social support as they age. And for LGBTQ Black and Latinx community members, there is compounded fear of discrimination based not only on sexual orientation and gender identity but also bias based on race and ethnic identity.

It's also a hard fact that many LGBTQ people who face discrimination often have no legal recourse because we still lack clear, explicit federal protections in areas including healthcare and housing.

The legacy of discrimination has left many LGBTQ adults facing frightening economic insecurity as they age, affecting not only their access to long-term care, but also its quality.

One third of older LGBTQ adults live at or below 200 percent of the federal poverty level. Older couples where both partners are women are twice as likely to age in poverty as older Americans in general. LGBTQ elders are also twice as likely to be single than their peers, which means they often don't receive benefits based on couple status. And for LGBTQ elders whose partners died before nationwide marriage equality, many are still being denied the economic and family benefits of different-sex couples -- including Social Security and retirement.

Because older LGBTQ people have experienced so many challenges due to their identities, many have chosen to remain deeply closeted or to return to the closet after years of living openly, rendering them invisible.

This invisibility has helped perpetuate the false perception that there isn't a pressing need to make policy or practice changes to ensure care facilities are welcoming and inclusive of LGBTQ elders.

It is precisely for these reasons that HRC and SAGE are working together to address this grave health inequity, which is all too often ignored -- even in our own community. Our LGBTQ elders deserve competent, comprehensive and inclusive care and support. As we mark the 50th anniversary of the Stonewall uprising, we must come together to support the dignity and well-being of the change-makers who paved the way for us, frequently at great risk and at great cost.

Our elders have carried our movement and our community for so long, securing rights, broadening futures and helping many reach dreams once thought impossible. We owe it to them and to ourselves to make sure that our elders experience the inclusion, support and welcome they helped make possible.

Michael Adams is the CEO of SAGE, the world's largest and oldest organization dedicated to LGBT elders.

Jay Brown is the acting Senior Vice President, Programs, Research and Training for the Human Rights Campaign Foundation, the educational arm of the nation's largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization.

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Michael Adams and Jay Brown