Many LGBTQ+ Adults Worry About Social Isolation, Support as They Age

While caregiving can be joyful, it’s a role that comes with stress and challenges. About 78 percent of LGBTQ+ caregivers say they feel stressed emotionally, the AARP survey shows.

Large numbers of LGBTQ+ caregivers find it difficult to do the things they need to do to care for themselves, according to the report, such as getting enough rest (61 percent), exercising (60 percent), maintaining a healthy diet (50 percent) or going to see their own doctors (28 percent).

Additionally, the survey reveals that 14 percent of LGBTQ+ caregivers feel obligated to care for someone who is not accepting of their identity — a burden likely to intensify an already stressful situation, says David Moskowitz, a professor at the University of Chicago who researches LGBTQ+ health disparities.

“Having to take care of someone who doesn’t accept you and having to take care of them for free, that creates an enormous amount of dissonance and psychological distress,” he says.

2. Health care access is improving

Three out of four older LBGTQ+ adults rate their health as good, even though about half report having a disability or chronic disease.

Notably, 84 percent say they trust their health care provider, and more than eight in 10 say they feel comfortable discussing medical issues with their provider.

Although fewer bisexual, transgender and nonbinary individuals felt the same, Adams says the high numbers demonstrate significant progress. He notes that health care access has historically been a challenge for LGBTQ+ adults.

“That progress is really largely about the work of the community to insist upon providers understanding our health care needs and being more open and empathetic and inclusive,” he says.

Adams highlights two programs in particular: SAGECare, a program that has provided competency training to more than 1,000 health care providers, and the Human Rights Campaign Foundation’s Healthcare Equality Index, which measures how well health care systems provide equitable care across diverse populations.

Moskowitz says many medical schools have incorporated cultural competency training regarding LGBTQ+ patients.

Still, he says, other data from the survey indicates more progress is needed. For example, three in 10 survey respondents say that they did not seek medical treatment in the past when they needed it. And 23 percent say they have experienced a problem with the quality of care they have received.

3. Transgender and nonbinary adults face unique challenges

Trans and nonbinary respondents were considerably more likely than other LGBTQ+ groups to rate their physical health as poor and to report problems with the quality of health care they received.

In addition, about 38 percent of bisexual, trans and nonbinary respondents report a negative experience related to their gender identity, such as being misgendered.

Bernie Wagenblast, a 67-year-old trans woman who lives in Cranford, New Jersey, says she feels fortunate that her health care providers have been supportive of her transition. However, with her primary care physician retiring, she says she has been searching for a new provider who is knowledgeable about trans health issues.

“To me, that is the tough part,” she says. “The trans community has unique issues — both physically with our prescriptions and specific mental health issues. I’d like to be able to find someone who is familiar with those issues.”

Transgender and nonbinary respondents report lower mental health outcomes, with only about 40 percent describing their life satisfaction and overall happiness as excellent or very good, compared to about half of gay men and lesbian women.

Furthermore, 63 percent of transgender and nonbinary people report feeling isolated from others and 64 percent report feeling left out — also figures that are significantly higher than those reported by other LGBTQ+ groups.

Moskowitz observes that some transgender and nonbinary adults feel rejected not only by the heterosexual community, by also by the gay and lesbian community.

“Being marginalized by both the heterosexual population and then marginalized also by the gay male or the lesbian female, it adds insult to injury, and it leads to these negative health outcomes because of this perception of alienation,” he explains.

Adams, the SAGE CEO, says the AARP report illustrates the “particularly acute challenges” that transgender older adults face amidst a backdrop of evolving laws and policies that impact their access to health care and overall well-being.

“This survey demonstrates quite clearly that this is a very vulnerable, high-risk population at a time when transgender people are dealing with incredible hostility in our nation,” he says. “It shows that the older trans and nonbinary population needs more help, but the reality is that’s the opposite of what’s happening in this country right now.”

4. Many LGBTQ+ adults are parents or grandparents

More than one in three LGBTQ+ older adults (35 percent) have children or grandchildren.

However, gay men are a notable exception: only 17 percent have children or grandchildren, compared to 55 percent of lesbian women and about half of bisexual, transgender and nonbinary respondents.

Fifty-six percent of those surveyed identified the lack of legal protections for LGBTQ+ families as one of the biggest obstacles to starting a family.

About a third of all LGBTQ+ older adults live with a partner, and those who live with someone report lower rates of social isolation. Lesbian women are most likely to live with a partner (61 percent) and be married (49 percent).

Although gay men could be at risk of social isolation due to their lower likelihood of having a partner, they do not report feeling more isolated than other LGBTQ+ individuals.  

Blake, the artist and activist from Phoenix, says he has noticed that loneliness and isolation is more profound in the LGBTQ+ community.

Given that social isolation is linked to reduced longevity, increased risk of dementia, and other health issues, he says he encourages his LGBTQ+ friends to get out each day and start conversations with others.

“It can just be saying hello or ‘I like the color of your hat,’ ” he says. “Just open up a conversation because that can lead to something. … I’ve made friends doing this. In fact, that’s how I met my husband.”