Introduction In this report, we provide a review of what is known about lesbian, gay, bisexual or transgender (LGBT) older adults. In doing so, we rely on previous reviews that have approached the study of LGBT older adults through various perspectives, such as through a life-course (FredriksenGoldsen & Muraco, 2010) or social historical perspective (Morrow, 2001). Some previous reports have focused on areas such as health and wellbeing or access and use of social services (Czaja, 2015; Addis et al., 2009; MAP & SAGE, 2010). We also rely on peer-reviewed articles, organizational reports, and books published regarding the experience of LGBT older adults in the U.S. and Canada (research focusing on populations outside of North American were not included in this report). We also draw upon expert and community members’ perspectives as recorded in a special meeting convened by the Services and Advocacy for GLBT Elderly (SAGE) and the Administration of Community Living (ACL) in Denver, CO in November 2015. The meeting included 50 representatives from various organizations that study and serve LGBT older adults, including LGBT older adults themselves. Their perspectives are represented in text boxes throughout this report. Although definitions vary, broadly LGBT older adults can be defined as the population of sexual and gender minority (SGM) individuals over the age of 50.1 With no accurate census count of LGBT people, investigators used various methods to estimate the size of the population. Fredriksen-Goldsen, Kim, Shiu, Goldsen, and Emlet (2014) estimated that there are over 2.4 million LGBT older adults over age 50 in the U.S., with the expectation that this number will double to over 5 million LGBT adults over age 50 by year 2030. Other estimates suggest that 1.75 to 4 million American adults age 60 and over identify as LGBT (Administration on Aging, 2014). The report suffers from lack of probability samples that can inform us about more accurate estimates of demographics, prevalence of diseases, conditions (e.g., disability), and health behavior and access to health care. Only two studies in this report used probability samples (both studies used state-level data) to characterize LGB older adults (Fredriksen-Goldsen et al 2013a; Wallace et al., 2011). To our knowledge, no representative data on transgender older adults exists. We rely on many studies that use various community-based sampling techniques (Meyer & Wilson, 2009). For that reason, we sometimes present findings that appear contradictory. As we do not have accurate national statistics, we are limited in our ability to judge which of the contradictory findings is correct and which is a function of the particular study’s characteristics. Still, community-based studies provide invaluable data that enriches our knowledge about the variety of experiences that characterize LGBT aging. 1
“Sexual and gender minority” is an all-inclusive term the U.S. federal government and National Institutes of Health has chosen to use that represents lesbian, gay, bisexual, and transgender populations as well as those whose sexual orientation, gender identity, gender expressions, or reproductive development fluctuates from societal, cultural, or physiological norms (NIH SGM Research Coordinating Committee, 2016).
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