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Gray, Gay...and Worried

September 30, 2010 — By PAULA SPAN — THE NEW YORK TIMES

David and his partner, Paschal, together for more than 20 years, married during the brief period that same-sex marriages were legal in California. They're in their 60s, in decent health and financial shape. Yet thinking about their future makes David uneasy.

With an eldercare system (if you can call it a system) that depends on younger family members shouldering responsibility for older ones, perhaps any childless and aging couple would share his concerns. But gay men and lesbians face particular challenges, as David pointed out to me in a recent e-mail.

Let him count the ways. "The guys who are 65 and older now generally came of age, and came out, when doing so meant alienation from your family," David wrote. "Many of the older gays I know are still estranged." They don't feel they can rely on younger relatives for help.

David and Paschal (citing privacy concerns, they asked that their full names not be used) expect to have to care for themselves—not because they're estranged from family members, but because their nieces and nephews live far away. So David is considering other options.

If the couple wanted to retire to Paschal's home state in the South, where senior housing communities would be much less expensive, "we'd have a hard time finding a life care facility that would accept us as a married couple," David wrote. "And I doubt the other residents would be too welcoming if we did get in. And church-sponsored places—often a good value for straight folks—are largely not available for open gays."

A number of researchers have found that, for those reasons, older gay men and lesbians sometimes conceal their sexual orientation when they enter nursing homes or assisted living facilities, effectively recloseting themselves at one of life's most vulnerable passages.

At older ages, too, a number of the federal policies that protect married couples come into force, leaving gay men and lesbians, even those who marry in their own states, at a comparative financial disadvantage. Paschal's Social Security benefits, for instance, are considerably greater than David's, but David won't be eligible for the spousal and survivor benefits that other widowers receive should something happen to Paschal.

Inheritance and tax laws that protect opposite-sex spouses don't apply (although federally regulated retirement plan distributions have been made more equitable). Nor do Medicaid provisions that allow one spouse to remain in the couple's home when the other enters a nursing home.

A study by the Urban Institute and the Human Rights Campaign Foundation documented many of these inequities in 2004, and its conclusions remain largely unchanged.

"It was a different world for people now in their 70s and 80s," said Sandra Butler, professor of social work at the University of Maine, who has studied aging among gay men and lesbians. "Anybody fears going into a nursing home, but it's an added fear if you think you might not be safe there, or you think you can't find a paid caregiver to come into your home who will treat you with respect."

One bright spot, David pointed out, are the friendship networks that sustain many lesbians and gay men. He saw this community in action when its members nursed one another (and buried many) during the height of the AIDS crisis. "There are often emotional supports available that are not based in a biological family, but are real and valuable assets," he wrote.

But such "families of choice" may be less effective later in life, as members cope with age-related illnesses and frailty themselves.

Organizations that serve the gay population recognized these issues more than 30 years ago. The oldest group for seniors, SAGE (an acronym for Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders), was founded in 1978 and will unveil a new, federally financed National Resource Center on LGBT Aging next month.

A few housing and care facilities especially for gay seniors have opened around the country, including Openhouse in San Francisco, Rainbow Vista near Portland, Ore., and Rainbow Vision in Santa Fe, N.M.

The most encouraging development for gay seniors may be the most intangible: a long-term shift in American attitudes.

"The gay rights movement has been a spectacularly successful movement for cultural change," Andrew Koppelman, a law professor at Northwestern University, declared in a New York Times article last week. The so-called post-Stonewall generation may have less to fear as it ages.

But that change hasn't come fast enough to reassure David as he mulls his future with Paschal. "This list of anxieties can get quite long," he said.


“A number of researchers have found that, for those reasons, older gay men and lesbians sometimes conceal their sexual orientation when they enter nursing homes or assisted living facilities, effectively recloseting themselves at one of life's most vulnerable passages. ”