As the American population ages, the number of lesbian, gay, bisexual, and transgender (LGBT) individuals ages 65 and older is also increasing. However, we know surprisingly little about unique health issues and needs that may pertain to this group. Much of the data available are based on small studies and are not nationally representative. In particular, bisexuals, transgender individuals, LGBT persons of color, and the “oldest old” in these communities (ages 85 and older) are significantly under-studied, according to the 2011 Institute of Medicine (IOM) Consensus Report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. (See below for more on this report.)
The NIA currently supports several LGBT-relevant studies and anticipates funding additional research under several recently released Funding Opportunity Announcements (FOAs) and other mechanisms. Recently, results from the NIA-supported study Caring and Aging with Pride, the first national, federally funded project examining LGBT aging and health, were released. Led by Dr. Karen I. Fredriksen-Goldsen of the University of Washington, this pioneering project involved collaboration from 11 other community-based agencies serving LGBT elders across the United States.
Key findings from the study include:
Lesbian, gay, and bisexual older adults report higher rates of disability and mental distress than heterosexual older adults. Nearly a third report depression, and over half experience loneliness.
Some 68 percent report experiencing verbal harassment, and 43 percent say they have been threatened with physical violence due to their sexual or gender identity.
Access to health care remains a concern. Some 21 percent of study participants indicate that they do not disclose their sexual or gender identity to their physician; 15 percent fear accessing health care outside the LGBT community; 22 percent of transgender older adults can’t afford needed medical care; and 13 percent say they have been denied health care or provided with inferior care, as a result of their sexual or gender identity.
Caregiving was an important focus of this study. The investigators found that 30 percent of women and 26 percent of men surveyed were acting as a caregiver to a partner or spouse, friend, parent, adult child, or other relative. Caregivers were more likely than non-caregivers to report disability, depression, victimization, and verbal and physical abuse.
Nevertheless, LGBT older adults report tremendous resilience, with 91 percent engaging in regular wellness activities and 89 percent indicating that they feel positive about belonging to their LGBT communities.
Study participants identified senior housing, transportation, social events, support groups, and legal support as the services for which LGBT elders are most in need. The full report, executive summary, and fact sheets are available at http://caringandaging.org.
Recognizing a need for more information on the health of LGBT people of all ages, the NIH commissioned an IOM study in 2009. In its 2011 report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Greater Understanding, the IOM committee noted the lack of research in this area and recommended a number of steps, including implementation of a research agenda to advance knowledge and understanding of LGBT health; support of methodological research that relates to LGBT health; and establishment of a comprehensive research training approach to strengthen LGBT health research at NIH.
In response to these recommendations, NIH formed the LGBT Research Coordinating Committee to develop and coordinate potential research and training activities, assess relevant past and current activities across NIH, and develop recommendations for new activities focused on research and training. The committee performed a comprehensive portfolio analysis and reported that the NIH LGBT research portfolio was distributed across 13 Institutes, Centers, and Offices, with most of the existing research in behavioral and social science, mental health, and drug abuse, particularly as they relate to HIV/AIDS.
In addition, the Committee coordinated reissue, by 12 ICs, of FOAs (R01, R03, R21) on LGBT and Intersex Health. For more information on NIH research on LGBT populations, visit the NIH website.