National Resource Center on LGBT Aging
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Resources help LGBT elders face special challenges

May 18, 2011 — By Alicia M. Colombo — Philadelphia Corporation for Aging

At a time when gay men and lesbians enjoy the most social acceptance and legal protection in history, many elders face the daily challenges of aging while isolated from their families and the community. Fear, anti-gay bias and lack of legal standing are among the unique challenges facing an aging gay and lesbian generation. Nancy J. Knauer, author and law professor at Temple University’s Beasley School of Law, has focused her career on the study of same-sex relationships and same-sex marriages.

But it wasn’t until just three years ago that she began to study lesbian, gay, bisexual and transgender (LGBT) elders. Initially, Knauer thought her research would be short, focusing on Medicare and end-of-life decision making. “When I started to research LGBT elders, I realized that was only the tip of the iceberg. The more I started asking questions, the more I realized the treatment of LGBT elders is awful and work needs to be done. The invisibility of an entire generation of LGBT individuals wasn’t being addressed,” said Knauer, 49.

She discovered that LGBT issues were not even being discussed within the broader aging community. She also found the problem to be compounded by ageism that exists within the LGBT community, which is primarily youth-centered and focused on suicide prevention. With approximately two million gay and lesbian elders living in the United States, Knauer felt it was a topic that deserved more attention and has now made it her primary area of research.

“The folks who are LGBT seniors now, came of age when homosexuality was criminalized and considered a severe mental illness. They are familiar with the closet as a coping mechanism. Studies suggest that as people age, they become increasingly more fearful of encountering anti-gay bias and this leads to social isolation. LGBT elders are more likely to be estranged from their natural family. Many LGBT elders rely on chosen family, often of the same generation, as a support group. So they don’t benefit from an intergenerational support system. LGBT elders want to age in place, like everyone, but are reluctant to access services. Closeted gay elders inviting a home health aide into their house can be perceived as risky. They will underutilize senior resources. In the United States, 80% of all caregiving is informal or unpaid. Without a younger support system, caregiving is a big problem for this generation,” she said.

Knauer was raised by her grandmother, so she understands the importance of intergenerational support. Her grandmother, who is now 96, has aged in place and continues to live alone in her apartment with constant visits and support from a warm, loving family. “Grandmom’s pictures surround her. Her stories continue to constitute us as a family. When I think about elders who can’t have that [because of closeting and fear], it breaks my heart,” Knauer said.

Legal Issues
While a number of states and the District of Columbia recognize same-sex marriage or civil unions, Pennsylvania does not. “There is a lack of legal standing here. Surviving partners in Pennsylvania are considered to be legal strangers. Same-sex partners need a will, a power of attorney, and an advance directive. These legal documents can still be contested by the next of kin, who may challenge them due to lack of mental capacity. You need to get these things in place and do so early,” suggests Knauer. She adds that if a gay or lesbian elder dies without a will or next of kin, the state of Pennsylvania will take the individual’s estate – even if there is a surviving partner.

“For elders living in long-term care facilities, it’s also important to know that in the city of Philadelphia residents cannot be discriminated against based on sexual preference or gender identity. LGBT elders can be fearful of other residents, as well as staff,” said Knauer.

Since she started studying LGBT elders in 2008, she’s already seen significant progress. “Part of the struggle is just bringing up the topic and sharing knowledge. Training in culturally competent care and services will go a long way. Signaling to this generation that they can and should demand better treatment is also very important. We suspect that as the Baby Boomers age, they might not be as willing to go into the closet. I hope in the next 5 to 10 years, cultural competence will take care of a lot of this and where it doesn’t, we need more broad-based legal protection,” said Knauer.

Where to Turn for Help? Resources are Available
Knauer suggests that senior services and community agencies become more open and let elders know it’s OK to be gay. She recommends the following resources for LGBT elders, some of which are available locally:

- A great place for LGBT people to go in Philadelphia is the William Way Community Center at 1315 Spruce Street. Several programs are offered for LGBT elders, aged 50+. MorningsOUT, a free social/educational group for senior gay men, meets every Tuesday from 10:30 a.m. to 12:30 p.m. Women’s Wednesdays, a monthly social group for older adult lesbians and transgender women, meets the third Wednesday of each month from 5:30 to 7:30 p.m. These groups hold trips, speakers and events. Silver Foxes, a monthly in-house social group for both men and women, meets the fourth Sunday of each month at center from 3 to 5 p.m. Also available is Connecting Generations, a friendly visitor program which connects younger and older LGBT people to create meaningful mentoring opportunities within the LGBT community. For more information about the center and its LGBT programs, contact Senior Programs Coordinator Ed Miller at 215-732-2220 or go to and click on the SAGE logo.

- Philadelphia is home to the world’s largest transgender conference to be held next month. The 10th annual Philadelphia Trans-Health Conference is June 2 through 4 at the Pennsylvania Convention Center. For the first time, the conference will feature an aging track. Topics for transgender elders include ‘Preparing for Late and End of Life,’ ‘Preventive Care and Hormonal Considerations for Older Adults,’ and ‘Estate and Financial Planning for Trans Folks and Their Families in the 21st Century.’ Three full days of workshops and activities are planned that will focus on individual and community well-being for transgender individuals. There is no fee to attend the conference, which is a program of Mazzoni Center. For more information or to register for the conference, go to

- The National Resource Center on LGBT Aging was established in 2010 through a $900,000 federal grant from the U.S. Dept. of Human Services to provide training, technical assistance and education resources to aging services providers, LGBT organizations and LGBT older adults. The center’s website offers a comprehensive array of online services and topic-specific information. The center is led by Services & Advocacy for GLBT Elders (SAGE) in partnership with 10 leading organizations from around the country.

Knauer’s latest book, “Gay and Lesbian Elders: History, Law and Identity Politics in the United States,” published this year, offers an extensive resource on the subject. It is available through Amazon. Knauer has also written articles about estate planning and end-of-life decision making for elders and LGBT elder law.

“When I started to research LGBT elders, I realized that was only the tip of the iceberg. The more I started asking questions, the more I realized the treatment of LGBT elders is awful and work needs to be done. The invisibility of an entire generation of LGBT individuals wasn’t being addressed."