National Resource Center on LGBT Aging
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Old Fears: Afraid Of Renewed Harassment, Many LGBT Seniors Return to The Closet

June 17, 2011 — By Jeff Krehely — Playboy Magazine

For most of her adult life, 64-year old Denise Bonenfant lived as an openly gay woman. She spent half those years—more than three decades—in a loving relationship with her partner, Sunny Toscano, who died in 2007 from cancer and heart disease. But as Toscano grew sicker and she and Bonenfant witnessed a close friend being denied access to her dying partner by estranged family members, they decided to go back into the closet, telling Toscano's doctors and nurses that they were sisters.  "I fought so hard to get out of the closet," Bonenfant explained to the gay rights organization SAGE as part of its 2011 policy brief "LGBT Older Adults and Reauthorization of the Older Americans Act." "But nobody was going to keep us away from each other."
Bonenfant's experience is hardly atypical. As baby boomers age, so too does the first generation of LGBT people who pioneered an open lifestyle.  There are about 1.5 million lesbian, gay and bisexual seniors in the U.S. today—a total that's expected to double in the next 20 years. (It's difficult to estimate the number of transgender seniors.)
NONE OF THEM IS AFFORDED the same rights as their heterosexual counterparts because many federal and state safety-net programs are based on the presumption of a marriage between two straight people. For example, Social Security provides extra benefits and the estate-tax laws provide tax exemptions to opposite-sex spouses.  But only five states and Washington, D.C. allow same-sex couples to marry, and even then, the Defense of Marriage Act prevents the federal government from recognizing these unions. Additionally, policies that regulate hospital visitation, medical decision making and inheritance rights prioritize blood and legal relatives over longtime partners and friends. For her part, Bonenfant was unable to cover Toscano's medical expenses through her insurance policy. Instead, they used their savings and credit cards to pay hospital bills, leaving  Bonenfant nearly broke upon Toscano's death—a common outcome for older same-sex couples since so many laws treat them as legal strangers.
THEN THERE ARE THE SOCIAL STIGMAS, which are still pervasive despite the gains the gay rights movement has made in the past 40 years. Whether they lived openly or not, today's LGBT seniors came of age at a time when their relationships and core identities were declared illegal, called immoral and considered a national security risk. Basically, they can't shake the fear that comes with growing up in yesterday's hostile environment. As such, according to the MetLife Mature Market Institute, almost 20 percent of lesbian and gay baby boomers aren't confident that health care professionals will treat them with respect and dignity as they age.  Another study, published by the Journal of Homosexuality, found that one third of gays and lesbians assume they will need to hide their sexual orientation if they move into a retirement home.  Finally, further research by the Lesbian and Gay Aging Issues Network shows that about two thirds of Area Agencies on Aging, the local organizations that deliver services to the country's seniors, provide no training related to LGBT seniors for their staff, and less than 10 percent provide targeted services to LGBT adults. Not surprisingly, many older gays and lesbians reported feeling anxious about seeking services through their AAA.
THE ANECDOTAL EVIDENCE seems to confirm these concerns. "I had home attendants who wouldn't wash me because they said they're not homos," 70-year-old Myron Gold explained in the SAGE policy brief. "I even had an aide who wouldn't walk me around the park because he was upset that he would be perceived as gay if he was holding on to my hand." Such treatment is of particular concern because compared with straight or non-transgender seniors, older LGBT people are more likely to be single, childless and estranged from biological family members. In other words, they are more likely to be dependent on professional caregivers to provide emotional and physical support as well as basic needs as they age. And so, LGBT seniors often go to great lengths to hide their sexual orientation and gender identity. This re-closeting involves throwing away LGBT-related books and movies; hiding pictures of partners and asking significant others to leave home when caregivers are present. When receiving care at a retirement home or hospital, many LGBT seniors discourage their partners and/or LGBT friends from visiting because they're afraid being outed will lead to discrimination and harassment by staff or other patients. "They do so to ensure that they will receive the appropriate health care," says Hilary Meyer, director of the National Resource Center on LGBT Aging. Of the assisted-living facilities in her area, Bonenfant told SAGE researchers, "They're all very nice straight people, but I'm no more going to go in there and say, ‘Hi, I'm a lesbian' than I'm going to jump off the roof of my house."
MEYER ADDS that she's heard stories about home health aides who, on learning the sexual orientation of their patient, quoted passages from the Bible to express their disapproval. She also cites a recent case of a transgender woman with Alzheimer's disease at a long-term care facility whose staff refused to respect the woman's gender identity.  "Instead, they would dress her in men's clothing—a daily occurrence that was incredibly distressing for a woman already struggling with day-to-day cognitive functioning," says Meyer.  At the most extreme, some transgender people have reversed their transitions because they were afraid caregivers— especially those in nursing homes and hospitals—would harass (or assault) them if they discovered their gender identity.  The biggest fear is that LGBT seniors who are wary of how caregivers might interact with them will eschew needed medical services, causing health problems to go undiagnosed until they are untreatable. To say nothing of how pushing away longtime friends and loved ones could exacerbate feelings of isolation and loneliness—something many older people struggle with already, regardless of sexual orientation or gender identity.
AS WITH EVERYTHING ELSE, no cure-all will solve these problems. That said, marriage equality would help address many of the legal inequities facing LGBT seniors by allowing same-sex couples access to Social Security benefits, family medical leave and spousal impoverishment protections under Medicaid. Additionally, staff and volunteers at any facility or program that receives public funding and provides services to elders—whether hospitals, nursing homes or senior centers—should be required to undergo annual cultural-competency training that is LGBT-inclusive.  Navigating end-of-life care and facing death are excruciating experiences.  Our laws and health care practices shouldn't make things even tougher for gays and lesbians.  

"I fought so hard to get out of the closet."