Loud, proud and aging

Sexuality affects health and aging, according to a first-of-its-kind study.

Lesbian, gay, bisexual and transgender (LGBT) seniors are more resilient and at higher risk of cardiovascular disease, depression, social isolation and disability, according to results from the first longitudinal study of LGBT older adults, “Aging with Pride: National Health, Aging, Sexuality/Gender Study.” The findings have been published as 10 articles in a 2017 supplement of The Gerontologist, which focus on the influence of life events, diversity and subgroup differences and processes and mechanisms underlying health and quality of life.

“The insights gleaned from this study of aging among LGBT older adults can deepen our understanding of the richness, diversity and resilience of lives across the life course,” said principal investigator Karen Fredriksen-Goldsen, professor of social work and director of the University of Washington’s Heathy Generations Hartford Center of Excellence, in a press release. She was named one of Next Avenue's 2015 Influencers in Aging. “As we move forward in aging-related research, services and policies, it’s important to understand that these communities are diverse, and that unique groups face distinct challenges to their health.”

The team surveyed 2,450 adults aged 50 to 100 to see the impact of historical, environmental, psychological, social, behavioral and biological factors on LGBT adult health and well-being, which was funded by the National Insitutes of Health. The articles examine race/ethnicity, partnership status, resiliency among HIV-positive gay and bisexual men and transgender older adults with prior military service, the role of social networks, mental health, high-risk alcohol consumption and healthcare engagement.

 An estimated 2.4 percent of the older population self-identifies as LGBT, with many more who haven’t yet “come out,” Fredriksen-Goldsen said. 

“We need to develop interventions to reduce disparities, promote health in these communities, and ensure we have services for these older adults that they are culturally competent,” she said. “We do find that even though there are many disparities, most LGBT older adults are aging well and have good health. Linked to that, we keep finding consistent predictors are greater levels of social support, less victimization and discrimination, more community engagement and a sense of community connectedness and belonging.”

The social support seems to make LGBT seniors more resilient and help them to stay out of the closet if they have additional healthcare needs or move into a long-term care facility.

Key findings from the study include:

  • Gay and bisexual older men are more likely to experience poor physical health and to live alone than heterosexual older men.
  • Lesbian and bisexual older women have higher rates of cardiovascular disease and obesity than heterosexual older women.
  • 82 percent have been victimized at least once in their lives with 64 percent at least three times.
  • 68 percent have experienced verbal harassment; 43 percent were threatened with violence
  • 31 percent report depression, and 53 percent experience loneliness.
  • 82 percent engage in moderate physical activity. In addition, 91 percent engage regularly in wellness activities.
  • 89 percent feel positive about belonging to their LGBT communities and 38 percent attend spiritual or religious activities at least once a month.
  • 41 percent of transgender older adults, 41 percent of bisexual men and 34 percent of gay men have served in the military.
  • 13 percent have been denied healthcare or received inferior care. Access to healthcare may also be hampered because of sexual or gender identity.
  • 21 percent do not disclose their sexual or gender identify to their physician and 15 percent fear accessing healthcare outside the LGBT community.
  • 41 percent have a disability, higher than for heterosexual adults of the same age, and tend to start at younger ages.

Related: Health risks and the aging LGBT community


Topics: Clinical