Comments from Karen Taylor, the Director of Training Services and Advocacy SAGE (Services for Gay, Lesbian, Bisexual & Transgender Elders)
From the Rights Stuff Newsletter, July 2009
In a series of interviews, Minnesotans offer their perspectives and experiences on issues facing older Americans seeking care with dignity and respect for their individuality, cultural identity and human rights.
Forum Links | ViewPoints
Comments from Karen Taylor
Question: Your web site suggests that often providers do not know how to provide services to the LGBT (Lesbian, Gay, Bisexual and Transgender) community in culturally sensitive ways. How prevalent is the problem?
There was a study in Milwaukee that found that LGBT older adults were five times less likely to access health and human services and senior services because of their past experiences with bad treatment, or because of fears of how they might be treated in the future. There is a huge number of LGBT older adults who are at a pretty severe economic level. One of the most common things they run into is just taking a look at an intake form. If an intake form asks only if you are married, divorced, widowed or single, it’s a strong indication that this is not a place that is going to be helpful, or understanding about how to work with particular issues.
Also, 80 percent of all the unpaid caregiving in this country is done by family members. We actually build our aging services on the assumption that someone can pick up the older person from the hospital, or pick up their prescriptions, or help prepare that first meal as they’re back home. But two-thirds of all LGBT older adults live alone, they’re four times less likely to have children. So those built-in assumptions mean that they have two choices: either they need to be more dependent on formal care, which means coming out, or they’re less likely to seek out services until it becomes an emergency.
Question: What kinds of services are they not accessing because of concern about how they’ll be treated?
I’m talking about Meals on Wheels and senior centers, as well as institutional settings. But really, the majority of seniors in this country live in their communities independently, and the access that they need for basic services is going to come through congregate settings. If you have senior centers that provide congregate meals and socialization opportunities, the socialization assumes that everybody in the setting is heterosexual, and is going to be talking about family and kids.
Question: How have things changed? Has the increased visibility and acceptance of the LGBT community, over the past couple of decades, lessened the fear or reduced discrimination?
Sure, things have changed a lot. But we grow up with the things that we have learned out of life experiences. I grew up at a time when homosexuality was not considered a mental illness—but a 70-year-old was 40 before it was taken off the list of mental illnesses. That person, in their working years and for all of that time, knew that if somebody found out they were gay, they could be institutionalized. All of the people around them, their family members, their neighbors, all knew the same thing. So even if the law has changed, whether or not that person’s potential for change is there depends on how flexible they are, and the community in which we put them. Once we hit 65 and we start to go to these senior centers, the peers in those senior centers also grew up at a time when homosexuality was illegal, where you could be fired for being gay, where you could lose your housing, where you could lose custody of your children. We need to pay attention to the environments in which we put older people.
One other thing that is really important to talk about, since gay marriage has been such a big hoo-hah in the news, is that all of our states have different criteria on what we do around domestic partnership or marriage. There is a lot of confusion.
Question: To what extent are domestic partners in LGBT relationships unable to visit their partners in health care settings, or otherwise participate in health care decisions?
It depends on the state and how each state interprets the Defense of Marriage Act. We had to pass a law in New York state to allow a same-sex partner to decide on disposal of remains of a recently deceased person. The laws covered their domestic partnership, their health-care proxy, and their will, but there was a case in which family members did not really appreciate that they had an aunt who’d been in a 30-year relationship with a female partner. So they went to the funeral home, took the remains and buried the body on private property—there wasn’t anything that stipulated that the partner had any rights at that point. This is one reason why same-sex marriage would be so much easier if it was federally protected.
I know Minnesota has had a nondiscrimination act (the Minnesota Human Rights Act) since I was born there. There has been a lot of work done around employment, work environments, and school environments. But the challenge is, seniors get forgotten. It isn’t that the laws aren’t there; it’s whether the laws are enforced in senior settings.
Question: How do you account for the fact that there appear to be very few charges of discrimination filed by older LGBT people, based on their sexual orientation or identity, in any senior care setting?
It’s the fear—that then you would lose all support. One of the things that we’re looking at with our attorney general here in New York is whether the ombudsmen are being called, or whether the local gay organizations are being called. Because who is called would depend on who feels safer, where.
I can give you a pretty standard example of the kind of story I hear over and over again—a true story of a lesbian couple, one of whom was severely diabetic and had a leg amputated. They had a home health aide who they really liked, and they really appreciated the quality of care that she was providing. But the challenge they had was, at any time when she wasn’t actually performing the service with them, she wanted to sit down and read the Bible with them, all the Leviticus and the anti-gay stuff. They didn’t want to lose her care, and they didn’t know how they could address that. So they never told the service that sent the home health aide—they felt that they could just live through it. Then three months into it, they finally called us. They said, "Can you help us figure out how to do deal with this.? The home health aide felt she was doing the right thing, because of course (in her view) all gay people are going to go to hell and maybe they didn’t know that. So she was trying to be helpful. Itone of those instances where you ask, okay if this person is removed, will the next one be worse? There is a lot of gritting the teeth and bearing it.
Question: Recent polling data suggests that young people are more accepting of sexual orientation issues. Is it possible that some day, we won’t need to have this conversation?
It certainly does appear that as the culture shifts, societally there is a greater acceptance. What’s an interesting challenge for older LGBT people is that there may be a greater acceptance of sexual orientation and gender diversity, but not for old age. We know there is a lot of ageism in our culture—you know, there’s the idea that people don’t like to think about two 70-year-olds having sex—that’s considered "really disgusting." And then when you say, "Do you plan to have sex when you’re 70?" the answer is always "Well, of course."