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LGBTQ+ and Elderly Care

I often get asked why there are so many young people coming out. People think it must be a trend. The reality is, that the more people in the LGBTQ+ community that are visible, the more our young people feel comfortable coming out. They maybe recognize themselves in others.  Being gay, lesbian, bisexual, non-binary, transgender becomes normalized. The general population also starts to become more comfortable realizing these are people they know and love.  In part, we have our elder LGBTQ+ population to thank for paving the way for our younger population. Those that came out in a time it was illegal to be gay. Those that fought for accepting laws. Those that came out and lost families to be able to live an authentic life. Those that have passed the baton on to younger generations to fight for visibility and acceptance and basic human rights.

By 2030, it is estimated that the LGBT population over 65 will be approximately 4.7 million. Of this population, they are twice as likely to live alone and four times as likely to not have children. They may have a “chosen” family that needs to step in to help take care of them. Often, they may have come out later in life due to stigma or fear of rejection. They may fear seeking out services, due to discrimination or harassment or fear of having to go “back in the closet”. Studies show that few healthcare providers are competent to meet the needs of the aging transgender population.

Some common issues from our aging LGBT population related to healthcare environments include being forced to conform or wear clothing they are not comfortable in, misgendering or refusing to give hormone treatments. There are stories of abuse from fellow residents and caregivers refusing to bathe or touch them, which can create a distrust of medical providers.

What can we do as home health care providers? We can educate ourselves. We can learn to understand LGBTQ+ health issues, how to respectfully care for our LGBTQ+ elders and learn to understand the specific issues they deal with when seeking care and the desire to avoid moving into community care.

Using supportive and affirming language such as using a person’s preferred name and correct pronouns can make a huge difference between building trust or making them feel misunderstood, rejected, and unwelcome. And I will go a step further and say using the wrong name (often called a “dead name” in transgender communities) is abusive and violent.

In our role as compassionate and patient centered caregivers, we need to make sure all our clients, and sometimes our co-workers, family members and friends, do not feel overlooked but feel valued with the dignity and respect they deserve.

Some simple steps we can take – don’t assume! I know the adage is, treat someone the way you would want to be treated, but I say, ask! How would they like to be treated? Respect their wishes. Maybe start by introducing yourself with your pronouns and then ask what pronouns they use. Ask what name they use – it may not be their legal name, but it may make a huge difference in how they feel about themselves and you!

I have been asked why I have my pronouns on my signature. The fact is that to those who don’t understand, it doesn’t matter – though it brings up questions which are a great opportunity for education. But to someone whose whole identity depends on using the correct pronoun, it can make the difference of feeling heard, welcomed, and validated.  It is a small gesture of letting someone know they are safe with you, and it can have huge implications.


Susanna Bedser, RN is a nurse in the Care Advantage Richmond Southside office. Susanna runs an online support group for parents of transgender kids and facilitates local groups in Virginia. In her spare time, she and her family help support Guiding Eyes for the Blind by training several support guide dogs.

Posted On
June 11, 2021
Susanna Bedser, RN