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social sciences

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For many closeted glbtq elders, having paid attendants in their homes to provide personal care is simply not an option. Meanwhile, sensitivity to alternative gender identities and expressions--such as butch lesbians, feminine gay men, and transgender people who have not undergone a physical transition--is rare in long-term care facilities, and can pose a very real threat to the physical and emotional safety of glbtq people.

Most states do not prohibit housing discrimination on the basis of sexual orientation, and long-term care facilities may not permit same-sex partners to live together. Indeed, some facilities even disallow visitations from same-sex partners. These policies can place glbtq older adults in a terrible dilemma: if they are indeed out, they may feel that they need either to go back in the closet or face dire consequences from staff and other clients at such institutions, particularly long-term care facilities. Whether they are out or not, glbtq elders may find themselves dependent on institutions that have long perpetuated heterosexist attitudes.

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In addition, out glbtq elders must deal not only with risks of elder abuse, to which any older person may be exposed, but also to the harassment and violence for which any queer person may be at risk. Moreover, their awareness of--or first-hand experiences with--police brutality may make glbtq elders reluctant to report violence or abuse to the authorities.

Legal Issues

In most jurisdictions, same-sex marriage, domestic partnerships, or civil unions have yet to be legalized, so in most places there is no guarantee that glbtq partners will be extended the same recognition and rights as legal spouses when they seek medical care or enter long-term care facilities. In addition, surviving same-sex life partners are not granted the Social Security benefits or property inheritance rights that a widowed spouse would receive. Similarly, pension and 401(K) regulations, Medicaid regulations, and tax law do not recognize same-sex partners.

Given these circumstances, it is crucial for glbtq couples, particularly those approaching later life, to entrust each other with financial and medical decision-making capabilities via legal procedures such as powers of attorney, health care proxies, and living wills. Domestic partnership laws--which vary according to locality--can help ensure some rights for same-sex couples; in New York City, for example, domestic partners are entitled to visit each other in city-run hospital facilities, and if they are partners of city employees, they can take bereavement leave, receive health benefits, and share an existing tenancy in public housing.

Strengths: Community and Family

Family, as defined by glbtq people, does not always imply a network of blood relations. When parents, children, and sometimes siblings are unable or unwilling to accept glbtq people as we are, historically we have turned to our friends. These members of our "chosen families" often become caregivers of glbtq people in later life, and help prevent the loneliness and isolation that affects many seniors, gay and straight alike.

The sense of community that glbtq people can experience among ourselves is an important and powerful tool that carries into older age. It is a support system that can remain in place throughout life, and may be especially important in later life.

Another strength among older gay men and lesbians is their resilience in the face of the stigma and discrimination of homophobia. It has been hypothesized that this resilience has prepared them for the stigma and discrimination sometimes perpetrated upon the elderly. For example, glbtq elders may have learned coping skills that heterosexual elders did not need to develop earlier in life.

In addition, older individuals may experience retirement as an opportunity to become more fully involved in glbtq culture and in the movement for equality, since being out at this stage in their lives poses fewer financial and social risks. Being involved in the glbtq rights movement often gives individuals a sense of empowerment, which is especially important for the elderly.

Transgender Elders

Lesbian, gay, and bisexual elders are sometimes described as an invisible population; but transgender older adults tend to be entirely off the radar even for professionals who deal with the aging. The term "transgender" is relatively new and can imply many different kinds of gender transgression; thus it is unlikely that many elders self-identify using this term.

Many transgender elders have always experienced a discrepancy between their physical bodies and their gender identities. Though some older transgender people may receive hormone therapy, the trans elder who has undergone gender-confirming surgery is a rarity. Such surgeries did not emerge until the 1940s and were simply not an option for many people who are now over age 75. The procedures' high cost persists into the present, keeping them inaccessible for the majority of transgender individuals.

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