The Future of LGBTQ Life and Advocacy for Older Adults

Faria also points to Mary Walsh and Bev Nance, a Missouri couple whose housing application at a local senior-living facility was denied because of a cohabitation policy that defined marriage as between one man and one woman. They sued the facility, but their lawsuit was dismissed by a U.S. district judge in January. Advocates like Faria say the couple's case underscores the need for a federal nondiscrimination law that would protect LGBTQ people in housing, employment and other situations.

In the meantime, SAGE and other organizations around the country are working to develop welcoming living communities, which combine affordable housing units with community centers open to the broader public. SAGE is in the process of constructing two such buildings in New York, and a similar project, the Anita May Rosenstein Campus in Los Angeles, is set to be completed in 2020.

In San Francisco, Openhouse has been at the forefront of the push for LGBTQ-affirming housing and community programs since its founding in 1998. The first building in the organization's two-residence campus, which is run in partnership with affordable housing organization Mercy Housing California, opened in 2016, and a second residence is slated to open this fall.

"The idea somehow that discrimination or oppression is over is a false narrative,” says Openhouse Executive Director Karyn Skultety. “Twenty-five percent of the seniors we serve report being harrassed or being victims of violence in the past year."

That's part of what makes Openhouse's community spaces so important. “This project was really envisioned to be a central hub of activities and services,” Skultety says, “not just for the residents but for the 5,000-plus LGBTQ seniors who aren't living here but see it as a community home.”

And when it comes to activities, Openhouse features something for everyone. Visitors can participate in everything from language classes and art groups to lunches that bring together people with a shared identity, like the monthly TransGenerational Luncheon, which is open to transgender, genderqueer and nonbinary people of all ages.

Health care is another realm in which LGBTQ people are more likely to contend with issues of access, says D Magrini, the assistant director of community commitment and training at Whitman-Walker Health, a nonprofit health center in Washington, D.C., that focuses on care for the LGBTQ community and those living with HIV/AIDS. That could be due to past experiences of discrimination or financial instability, since these adults are more likely to be living in poverty than their heterosexual peers.

As part of her job, Magrini trains medical providers and their staff to offer culturally competent care, which, she says, is “care that is aware of, and responsive to, the needs and situations of the populations they serve."

Ideally, Magrini says, cultural competency would be integrated at every stage in the process — from seeing LGBTQ-friendly waiting-room materials, to intake forms that are inclusive of sexual orientation and gender identity, to physicians and care providers who are able to use LGBTQ terminology in a way that is natural, not stilted.

"Often, providers are not aware that they should be aware when their clients are LGBTQ and that this might have implications for health,” she says. And, Magrini stresses, cultural competence is a model that can be used among other marginalized groups — especially important given that older LGBTQ adults themselves have cross-cutting identities that can affect their needs.

AARP's “Maintaining Dignity” survey found that black and Latino community members, for example, were far more likely than their white counterparts to worry that their racial or ethnic identity put them at risk of poor-quality care. And transgender adults face what GLAAD calls “staggering” rates of poverty, violence and discrimination — including that which occurs within the broader LGBTQ community.

Magrini says that, 50 years from now, she hopes her job doesn't exist — not because older LGBTQ adults will cease to be a vital and vibrant community with a unique set of needs, but because providers will have been trained in cultural competence from the outset. In the meantime, the resilience of older LGBTQ adults remains a guiding force for the policymakers, advocates and providers working to improve housing, health care and more.

"Our LGBTQ elder pioneers are fierce,” says Faria. “They're the ones that lit the spark that ignited the modern LGBTQ rights movement, and they're the fighters on the front lines today saying, ‘We refuse to be treated this way; we refuse to be invisible.’ “