Lesbian, Gay, Bisexual and Transgender Aging

A Growing Population

More than 39 million people in the U.S. are age 65 years or older including 1.5 million people who identify as lesbian, gay, bisexual or transgender (LGBT). As the baby boomer generation ages, the older adult population will increase from 12.8 percent to an estimated 19 percent in 2030. Psychological service providers and care givers for older adults need to be sensitive to the histories and concerns of LGBT people and to be open-minded, affirming and supportive towards LGBT older adults to ensure accessible, competent, quality care. Caregivers for LGBT people may themselves face unique challenges including accessing information and isolation.

This page represents an ongoing effort by the APA's Lesbian, Gay, Bisexual and Transgender Concerns Office to help address the needs LGBT older adults and those who provide services and care by highlighting APA resources as well as other helpful resources and organizations.

Unique Disparities

As a group, LGBT older adults experience unique economic and health disparities. LGBT older adults may disproportionately be affected by poverty and physical and mental health conditions due to a lifetime of unique stressors associated with being a minority, and may be more vulnerable to neglect and mistreatment in aging care facilities. They may face dual discrimination due to their age and their sexual orientation or gender identity. Generational differences and lack of legal protection may cause older LGBT adults to be less open about their sexuality. Social isolation is also a concern because LGBT older adults are more likely to live alone, more likely to be single and less likely to have children than their heterosexual counterparts. All of these considerations can be compounded by intersections of sex, race, ethnicity and disability.

Psychologists, mental health facilities and aging services treating older adults are working with LGBT people, whether they have chosen to disclose or not, and providers should be cognizant of their presence and their unique needs should integrated into systems of care. Services intended for the older adult population must be assessed proactively and changes implemented as may be necessary to be welcoming for people who are both older and identify as LGBT.

A helpful introduction to this topic for students and psychologists is Guideline 13 of the Guidelines for Psychological Practice with Lesbian, Gay and Bisexual Clients: "Psychologists strive to recognize cohort and age differences among lesbian, gay and bisexual individuals."

  • Building Respect for LGBT Older Adults
    An online learning tool by the U.S. Department of Health and Human Services' Administration for Community Living to increase awareness of the issues faced by LGBT individuals living in long term care facilities. June 2014.
  • Inclusive Questions for Older Adults: A Practical Guide to Collecting Data on Sexual Orientation and Gender Identity (PDF, 11.8MB)
    From the National Resource Center on LGBT Aging, 2013. A guide for service professionals who work with older adults providing tools and tips for asking questions about sexual orientation and gender identity in safe and respectful ways. 
  • Health and Psychosocial Needs of LGBT Older Adults
    This research study provides one of the most comprehensive descriptions of the health, well-being and social context of LGBT older adults. These data should be used to facilitate policy-making and program decisions to address the current and future needs of these individuals.
  • The Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults (PDF, 14MB)
    Collaborative report with 11 LGBT aging organizations
    The LGBT aging population is resilient but at risk. Social isolation and victimization are major concerns. LGBT family structures are not necessarily based on blood ties and caregivers should be considerate of diverse familial relationships. LGBT older adults must feel welcome to come out to their doctors/care staff to ensure proper treatment.
  • Improving the Lives of LGBT Older Adults (PDF, 3.6MB)
    Movement Advancement Project, Center for American Progress
    Key challenges facing LGBT older adults are social stigma and prejudice, reliance on informal "families of choice" and unequal treatment. Recommendations include meeting critical needs through funding and services, building advocacy efforts and allies, and increasing public understanding of issues through research and public education.
  • Still Out, Still Aging: The MetLife Study of Lesbian, Gay, Bisexual and Transgender Baby Boomers (PDF, 144KB)
    American Society on Aging, MetLife Mature Market Institute
    Key findings include: older retirement age for LGBT baby boomers, issues with relationship recognition, family of choice vs. blood ties, misconceptions about paying for long-term care, expectations of respectful care, men sharing the burden of care, increased resiliency and different experiences for bisexual LGBT older adults.

    Recommendations include understanding workforce challenges with later retirement age, changing perception on who cares for the aging, increasing caregiver support, education about long-term care and heightened research and attention for LGBT aging issues.
  • For a range of reports on LGBT Aging, visit the resources page of Services and Advocacy for LGBT Elders (SAGE).