Photo: LGBT seniors ward off feelings of isolation at Openhouse's games day in San Francisco. (Jane Philomen Cleland/Bay Area Reporter)
Part 3 of series. For links to the entire series, see Part 1.
SAN FRANCISCO--A walk through Manhattan's gay Chelsea district is no longer as enjoyable for Charles Cole as it once was. Many of his longtime neighborhood haunts, from gay bars and hangouts to gay-catering businesses, closed as the area's lesbian-gay-bisexual-transgender (LGBT) population moved to other sections of New York City.
At age 64, the gay, single New Yorker can sense the remaining younger men don't acknowledge him when he does venture out.
"One of the things I do notice when I am out in the real world -- since I am an older gay man I can be invisible to a lot of people.
LGBT Research Should
Show Asian Subgroups
Demographers predict that by 2050, Asian American and Pacific Islander (API) older adults will have "the largest relative population growth among all older adults," notes a 2013 report on LGBT older adults issued by the National Gay and Lesbian Task Force.
API seniors constituted the smallest group (23 of 616 participants) represented in the 2013 report "Addressing the Needs of LGBT Older Adults in San Francisco," based on a survey commissioned by the city's LGBT Aging Policy Task Force.
Despite the survey’s being made available in Chinese and Tagalog, the report did not report subgroup variations, although it noted, "Translation alone was clearly not enough to penetrate hard to reach subpopulations."
API Wellness Center Executive Director Lance Toma suggested that so few LGBT API seniors took the survey because so many experience social isolation and mental health issues.
Targeted outreach, he said, is important. For instance, his agency has partnered with religious institutions to reach API LGBT seniors, for example by conducting HIV testing at local Thai and Laotian temples.
Cecilia Chung, of the San Francisco health commission and a consultant on LGBT health policy, noted, "Within the API community there are many different nationalities, so for some of the Asian countries where Catholicism or Christianity are more prominent, they tend to seek out support from churches more so than some of the other communities, such as the Chinese community," said Chung, a transgender woman who works as a senior strategist at the Transgender Law Center.
API participants in the task force survey said their greatest needs were meal sites and free groceries. Among the services they most wanted were caregiver support and adult day health programs. Although home ownership was high among API seniors in the survey, those who worried about their future housing said they may have to move out of their current homes for economic or health reasons.
Roughly 2 percent were living with HIV or AIDS, the lowest rate among the various ethnic groups surveyed.
Vincent Baduel, 63, who helps run the Gay Asian Pacific Alliance's 35-Plus group for LGBT API men, said many "are also taking care of either partners or loved ones that need caregiving."
--Matthew S. Bajko
New York LGBT Senior Center
His isolation changed four years ago, though, while attending a job fair at New York City's LGBT community center. Cole overheard talk about computer classes offered by the nonprofit Services and
Advocacy for GLBT Elders (SAGE) and enrolled. Although he knew about the agency, Cole didn't see himself as a senior and had never sought out its services.
"I don't know why; I definitely was. I laugh now when I think about it," he recalled. "When I came through the doors here the very first time, I thought, for the first time I was somewhere where being an older gay man wasn't going to automatically be two strikes against me."
Today, Cole volunteers at the SAGE Center, a community center for LGBT seniors the group opened in 2012, where he works as a receptionist and programs a popular movie night. Instead of eating a TV dinner alone at home, Cole now often dines at the center, breaking bread nightly with other LGBT seniors and SAGE staffers.
"I like to say that I came here to get some computer classes, and I found a community and I found a home," said Cole.
Yet many LGBT older adults lack the social bonds and connections that Cole has formed through the center. Various studies have found that LGBT seniors are vulnerable to social isolation, which can hamper their well-being and elevate their risk for depression, anxiety and other maladies.
"LGBT elders don't feel like they fit into the LGBT community, which is more youth focused," said Robert Espinoza, SAGE's senior director for public policy and communications. "In general, the aging field believes isolation is one of the biggest issues facing all older people,” a problem even more pronounced among LGBT elders, he stressed.
Years Not Golden by the Golden Gate
A 2011 study by the University of California, Los Angeles, Center for Health Policy Research found that half of gay and bisexual men in the state live alone compared with 13.4 percent of heterosexual men. Lesbians were more likely to live with a partner than gay men, according to the study, but more than 25 percent of lesbians lived alone compared with about 20 percent of straight women.
"Social isolation and lack of family and community support has a significant impact on the mental and physical health of LGBT older adults," noted a 2013 report by the National Gay and Lesbian Task Force titled "No Golden Years at the End of the Rainbow: How a Lifetime of Discrimination Compounds Economic and Health Disparities for LGBT Older Adults."
A 2013 survey of 616 LGBT San Francisco residents ages 60 to 92 found that almost 60 percent lived alone. That’s twice the level for all of the city’s seniors, according to a separate 2010 study.
"LGBT participants who live alone are at risk for poorer outcomes on all assessed health indicators, compared to those who live with others," concluded the survey report, titled "Addressing the Needs of LGBT Older Adults in San Francisco: Recommendations for the Future."
That report determined that most of the participants "have moderate levels of social support." But it also found almost one in 10 who said they have no social connections they can turn to.
Among the 15 percent of the seniors with adult children in the survey, 60 percent reported that their children were not available to help them if needed.
Commissioned by the San Francisco’s LGBT Aging Policy Task Force [http://bit.ly/1hC5Hct], the survey report found that "gay men are at higher risk for lacking social support than lesbians," support "critical to our health and well-being, especially among older adults."
The survey found that almost three-quarters (72 percent) of the survey participants indicated they had a "close friend," who was their "most common source of social support." The next most common was a partner or spouse (36 percent), therapist (23 percent) and neighbor (22 percent). The survey's transgender participants were the most likely to turn to faith communities for social and emotional support.
Few Children or Other Family
One alarming statistic for researchers behind the survey was the finding that 15 percent of the respondents had "seriously considered" committing suicide within the previous year. LGBT seniors in legally recognized relationships were less likely to have contemplated suicide than those in relationships not legally recognized or those not in a relationship.
"We need to bring older people together to counter that isolation. It is why senior centers all around the country and day centers exist," said SAGE’s Espinoza.
At Openhouse, a nonprofit serving LGBT seniors in San Francisco, "Isolation is a huge theme for much of [our] work," said Seth Kilbourn, the agency's executive director. "LGBT seniors have a higher risk for isolation than non-LGBT seniors because they tend not to have children, tend to live alone and don't have family members to step in for them like non-LGBT seniors."
Kilbourn added, "The more isolated the senior is, the less likely they are to maintain their health and well-being," he said. "The more connection to family and community members, they live longer, stay out of the hospital or delay any type of institutional housing placements."
For that reason, Openhouse added more social programs over the last five years. The organization offers such fare as monthly film showings, potlucks for men, women-specific gatherings and groups focused on poetry, opera or books. Openhouse recently started offering Spanish classes, and based on its success is looking to add other language courses.
Such programs provide LGBT seniors an entrée into Openhouse that may lead to their receiving other needed services, such as assistance finding affordable housing.
The agency also launched a friendly visitors program to match volunteers with homebound or frail seniors needing some companionship, perhaps someone to help them get out of the house.
Call for More Support Services
In its report, "LGBT Aging at the Golden Gate: [http://tinyurl.com/l99prq7] San Francisco Policy Issues and Recommendations," the city's LGBT Aging Policy Task Force determined that "currently there are very limited individual supportive services that address the emotional and behavioral health challenges of isolated LGBT older adults in San Francisco."
The Task force found only four agencies in the city – Openhouse, the Alliance Health Project, Queer Lifespace and the Access Institute – that offer some supportive services specifically geared for LGBT seniors. The Task Force is recommending that city officials expand peer support-based counseling, as well as emotional and practical support services for these older adults.
"As a social worker, I am really concerned about the issue of emotional well-being as the older adults community continues to age," said Scott Haitsuka, 52, a member of the Task Force who served on its health and social services work group.
Haitsuka, a clinical social worker, traces the lack of social support services for LGBT seniors in San Francisco to the 2010 closure of the nonprofit New Leaf, which offered mental health services to LGBT clients.
"Now there isn't one place that focuses on - and is welcoming and understands the life experiences of LGBT older adults,” Haitsuka said. “That is key to having a safe and welcoming space where LGBT older adults can get mental health services." He hopes the city's Department of Aging and Adult Services will implement the Task Force's recommendations to fund an LGBT senior peer-counseling and peer support volunteer program.
At SAGE's senior center in New York City, Cole has seen firsthand the positive impacts that come with providing a safe space for LGBT seniors to connect with one another and access the services they need.
"It is great to feel I do have a network here and that I am not alone out there," Cole said of the friends he has made at the center. "We do take care of each other … like I said, it is a family."
Matthew S. Bajko wrote this article for the Bay Area Reporter through the MetLife Foundation Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America.