LGBTQ Older Adults Face Higher Health Risks

The number of lesbian, gay, bisexual, transgender and queer (LGBTQ) older adults in Seattle and King County is expected to double by 2030, and they face higher risks of disability, poor health, mental distress and isolation—along with a social service sector unequipped to deal with their needs.

That's the conclusion of a study released Oct. 6 and led by Dr. Karen Fredriksen-Goldsen and colleagues at the University of Washington School of Social Work. The study identifies widespread social and health disparities experienced by LGBTQ older adults in Seattle and King County who, Fredriksen-Goldsen said, have unique needs and multiple barriers to accessing appropriate care.

"LGBTQ older adults face very high levels of victimization and discrimination, which increase their risk of significant social and health disparities," said Fredriksen-Goldsen, a UW professor of social work and director of the school's Hartford Center for Excellence. "The obstacles and inequalities they face can jeopardize their health in later life and make them reluctant to seek out aging and other support services."

The study surveyed 203 LGBTQ people aged 50 to 85 in Seattle and King County and found that:

  • More than two-thirds of participants have experienced three or more incidents of victimization in their lifetimes; almost 70 percent had been verbally assaulted and 40 percent threatened with physical violence.
  • More than one in five participants visited the emergency room in the previous year.
  • Despite the majority of respondents being college graduates, nearly one-quarter were living below 200 percent of the federal poverty level.
  • Participants were at high risk of social isolation—more than 45 percent live alone.
  • Most human service providers lack adequate training to serve LGBTQ older adults; 16 percent of participants reported being denied services or given inferior care based on their actual or perceived sexual orientation or gender identity.
  • One in six participants were fearful of obtaining services outside the LGBTQ community.

One of the main barriers facing LGBTQ older adults is a lack of service providers skilled at understanding them and their particular needs, Fredriksen-Goldsen said.

Dr. Karen Fredriksen-Goldsen, Caring and Aging with Pride over Time (left), and Aging and Disability Services director Maureen Linehan, at the May 13, 2015 Aging the LGBTQ Way Town Hall meeting. (Photo by Lorraine Sanford.)

"Many providers lack the communication skills to talk with LGBTQ older adults about their lives," she said. "For example, if a transgender older adult needs nursing home care, the staff often has no idea how to treat the person respectfully and ensure appropriate care.

"So LGBTQ older adults are often reluctant to seek services and may be forced back into the closet, because they don't know if they're going to have culturally appropriate providers."

And while societal awareness about LGBTQ people has increased dramatically in the past few decades, Fredriksen-Goldsen said the older members of that population remain largely invisible.

"People don't think they exist,” she said. "When they think of LGBTQ people, they think of young people. What we often hear from providers is, 'I really want to help support those people, but we don't have any of them here.'"

On the upside, the survey found that, despite their challenging circumstances, many LGBTQ older adults have developed supportive communities and 90 percent were satisfied with their lives. The majority exercised regularly, and nearly half attended religious services or participated in spiritual activities.

The study is part of a national research project, The National Health, Aging and Sexuality Study: Caring and Aging with Pride over Time, that Fredriksen-Goldsen and colleagues are conducting that involves surveying more than 2,400 LGBTQ adults aged 50 to 99 across the United States. Launched in 2010, the project is the first ongoing nationwide longitudinal study examining the health and well-being of LGBTQ aging adults.

While Seattle is known as one of the most progressive cities in the country, Fredriksen-Goldsen said it is surprisingly lacking in services for aging LGBTQ people. Accordingly, she is leading a proposal to develop and test an evidence-based training program for health and human services professionals in Seattle and King County. The one-year pilot program would provide support, resources and referrals for LGBTQ older adults and their families and caregivers, and would aim to train 100 practitioners.

Seattle City Councilmember Tom Rasmussen has proposed that the City provide half the cost of funding for the program, or $75,000. The remainder would be provided in-kind by Aging with Pride. Rasmussen's proposal must still be approved by the city council and Mayor Ed Murray.

The pilot program would increase the knowledge and skills of service providers and could translate to a significant improvement in the quality of care provided to LGBTQ aging adults, Fredriksen-Goldsen said.

"As Seattle and King County's population ages and becomes increasingly diverse, there is a growing need for providers who are trained to work with LGBTQ older adults," she said. "This initiative is an important first step in helping to address that need."

Findings from the study can be found in the report At-Risk and Underserved: LGBTQ Older Adults in Seattle/King County—Findings from Aging with Pride. For more information about Dr. Karen Fredriksen-Goldsen, click here. Report co-authors are UW School of Social Work research associate Chengshi Shiu, research scientist Hyun-Jun Kim, professor Charles Emlet and project manager Jayn Goldsen. The study is funded by the National Institutes of Health and the National Institute on Aging.

Photo credit: Aging Out Loud photo at top by Studio5Graphics, accessed via Flickr Creative Commons at on October 16, 2015.

Aging the LGBTQ Way

Aging and Disability Services and the UW School of Social Work co-sponsored an Aging the LGBTQ Way Town Hall meeting in May 2015. Dr. Karen Fredriksen-Goldsen, principal investigator of Caring and Aging with Pride over Time, facilitated discussion with about 75 individuals in attendance. Participants voiced their concerns about the future of LGBTQ aging in our region and identified opportunities to address the needs of this community, which helped with development of the ADS Area Plan for 2016–2019. See related story in this issue.

Photo by Lorraine Sanford.