EDGE San Francisco

As the first wave of out-LGBT individuals begins to reach the twilight years, the question arises as to what long-term health care and residence options are available. Even more than their heterosexual counterparts, many will end up alone and needing assistance to live out the remainder of their lives in comfort and safety.

The recent announcement by New York City Mayor Michael Bloomberg that a gay-specific senior center would be opening in each of the city’s five boroughs was the latest and perhaps most dramatic acknowledgement that gay Baby Boomers are pioneering an out way to grow old.

Rainbow Health Ontario (in the Canadian province that includes Toronto) has done much toward the senior LGBT community. Day programs, long-term care homes, and other community services are working to ensure they are welcoming and culturally competent to serve LGBT seniors. In the Toronto’s senior residences, the group worked for two years to make the residences more welcoming to LGBT residents.

Anna Travers, director or Rainbow Health Ontario’s Sherbourne Health Centre, worked on policy development, training, consultations, and the implementation of a tool kit to be used for future enhancements and services. "Our professional training sessions on LGBT senior issues are amongst the most requested topics", Travers says.

Ernie Lacasse, an elderly gay man in Toronto, recalls a friend living alone until he developed a heart condition that eventually landed him in a long-term care facility. He chose Fudger House to spend the final two years of his life. It was handy to the gayborhood, and "many of the volunteers are LGBT individuals," he recalls.

The Senior Pride Network of Ottawa began as an initiative of Centretown Community Health Centre (CCHC), which for many years has had a very active outreach program within the LGBT community. A few years ago, the CCHC invited a number of service providers and community activists to explore issues around aging and the gay community.

Activities Include a Night on the Town
The mandate was to advocate and foster systemic change in social services to ensure they are more culturally competent, and to increase the visibility of LGBT seniors within their own community. The group also spearheaded a one-day conference entitled "Taking LGBT Aging Out of the Closet," with the overall goal to build capacity and visibility within the community. Several initiatives emerged, including a recurring night out at a local bar, a self-defense workshop, and a group that explores end-of-life care and choices.

Barry Deeprose, a volunteer with the Senior Pride Network, co-founded the AIDS Committee of Ottawa. He sees isolation as the main problem for older LGBT people. "Social networks constitute a determinate of health, while ’the closet’ contributes to social isolation," he notes. "Even those who have been open and affirming easily become isolated as they no longer participate in the gay social scene, or become infirm. As the queer community has evolved and become more accepted, particularly within the gay male scene, it has become very youth oriented and older people often don’t feel welcome or appreciated."

The Ottawa Senior Pride Network is made up of health and social-service providers, representatives of community organizations that work with seniors, and gay and trans people aged 50 plus. "The lack of knowledgeable or culturally competent service providers is a major challenge," Deeprose notes. "Many LGBT people feel that they have to return to the closet as they go to assisted living or care homes, and many or most service providers are simply unaware their clients may be LGBT. We are certainly aware that the approaching generation of LGBT seniors is quite comfortable with affirming themselves and their rights, and we hope that the service providers are ready for them."

Problems of the Transgendered
Transgendered people face special problems. Most transpeople feel particularly vulnerable when undergoing a physical exam and need extra reassurance and support. Protecting the identity, dignity and bodily integrity of a trans person is of most importance both physically and mentally.

Denise Holliday, 64, raised three children and has two grandchildren. Living in rural Nova Scotia, she feels accepted by her close neighbors and family. She only "officially" transitioned in her early fifties while continuing to live with her spouse. "I am a post-op transgendered woman, and I’ve been with my wife and children for 40 years, 20 of those as a male while my spouse knew my situation", she recalls.

"I am fortunate that I received help when I did, and I am treated and accepted as a female by my doctors," she adds. "Even if I am ’slightly’ different, they are very considerate and hospital experiences have been very successful. I understand that trans folk who have not received surgery may run into more issues, but so far I have experienced good karma with the medical contingent."

Teaching Diversity
As with all aging communities there will be a growing need for sexual health, substance use, and psychosocial information and support. "We do acknowledge that aging populations are sexual and that there is an increase in STI’s in older adults in general, however we do not have specific programs at this time to address this issue", advises Lisa King, TPH spokesperson. The organization recently completed special staff training that included addressing homophobia, heterosexism and gender-identity and discrimination.

A "Gender Diversity" group has been working with staff for several years to help them understand the barriers faced by the transgendered, and to create trans-inclusive programs and practices. This group is led by the Sexual Health program and includes Urban Issues, Access and Equity, Vaccine, and Preventable Disease. Their Urban Issues team works with communities, groups and organizations to address social and health inequities, such as partnering with a community based organization to conduct a needs assessment of aging queers in a specific neighborhood or area, and then engaging with community partners to address the gaps.

Although King admits some areas are still in the infancy stages of development, she points out areas where TPH has shown initiatives.

"We have provided programming to retirement home staff on HIV transmission, infection control, and relationships," she notes. "We’re also about to reassess our priority populations for sexual health programs, as well as determine the need for any internal capacity for other teams in TPH that address non-sexual health issues for this demographic." A future workshop entitled "Respectful Service Delivery for Transgender Communities" is in the works.

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