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This year marks 50 years of Pride celebrations in Seattle. It’s a momentous occasion — and a time to think about the people who started the movement for LGBTQ+ equity.
Many of those people are now becoming elders in their communities. Growing older brings new opportunities and challenges for everyone — and that’s doubly true if you’re queer. But that’s only part of the story: Aging well is possible, too.
Health disparities are real among LGBTQ+ people
First, let’s get the unfortunate truths out of the way: LGBTQ+ adults are more likely to face significant health disparities than heterosexual and cisgender people.
Many of these disparities are a result of the discrimination queer people face in healthcare, as well as the toll of chronic stress from having to live within a society that is not always accepting, says Karen Fredriksen-Goldsen, who uses she/her pronouns, a professor in the School of Social Work at the University of Washington, principal investigator of the Wellness with Pride and Aging with Pride studies, and director of the Goldsen Institute.
Dig deeper into the data from those studies and you’ll see that within the LGBTQ+ community, people with different identities face different risks, too. Lesbians face higher rates of disability at younger ages. Bisexual people deal with more economic and financial instability; they also, according to government research, experience significantly higher rates of domestic violence. Transgender people also experience higher rates of violent victimization, plus lack access to healthcare and experience more discrimination when accessing it. Black, Indigenous and people of color in the LGBTQ+ community face more disparities than white people.
As people age, these disparities create additional problems, as Fredriksen-Goldsen and her fellow researchers have discovered in the Aging with Pride national study of nearly 2,450 LGBTQ+ adults ages 50 and older. Fear of being discriminated against prevents some people from accessing care. Social isolation affects sexually and gender diverse adults even more than straight, cisgender adults. And, in some cases, there’s the risk of out, proud people having to go back in the closet when their living situation changes, such as needing to move in with unaccepting family members or go into assisted living.
“LGBTQ aging is particularly important because many of these older adults have been underserved and have come of age at a time where it was dangerous to be their true selves,” says Fredriksen-Goldsen.
Though the times have (somewhat) changed, given the current political climate and relentless barrage of legislation attempting to deny basic human rights and services to LGBTQ+ people, many younger LGBTQ+ people may also wonder what our futures will look like as we get older.
LGBTQ+ people are resilient and can thrive with age
It’s important not to dismiss the challenges marginalized people face — but it’s equally important to recognize how they have stayed resilient despite discrimination.
“It’s very important to understand that this is a highly resilient community,” says Fredriksen-Goldsen. “This is a population that built the communities that we have today. And they have found ways to take care of themselves in systems that have not been welcoming or inclusive.”
That’s why chosen family, safe community spaces, celebrations like Pride, community events like drag shows, and so many other creative ways to support each other exist for queer people.
Not everything is doom and gloom, either. More and more people are feeling comfortable coming out, especially younger generations: As of 2022, 7.1% of adults in the U.S. — millions of people — identified as LGBTQ+, according to Gallup poll results. A majority of Americans agree that marriage equality is a good thing for society, and, while there is still progress to be made, most also agree that it’s important to protect trans people from discrimination.
There is also a nationwide initiative through the Department of Health and Human Services to achieve better health outcomes for LGBTQ+ people by 2030.
Aging is a gift — and a chance to become an elder
It’s easy to feel negative about aging, especially in a culture obsessed with youth. The thought of facing additional challenges just because you’re sexually or gender diverse — that’s hard to think about, too.
“Aging is difficult as an elder regardless of your community, and exponentially so if you have an identity that is discriminated against or marginalized,” says Dr. Mariebeth “MB” Velasquez, who uses she/her pronouns, a clinical assistant professor of Family Medicine at the UW School of Medicine and leader of LGBTQ+ Clinical Mentorship for the UW Medicine Office of Healthcare Equity.
But one thing often forgotten in the discussion of aging and its challenges is the fact that aging means you’re still here. You’re still alive and able to make connections with others. You still have the chance to thrive.
For marginalized people, aging is also a way to show younger generations that it is possible to grow older and live a good life that can be an example of what to aspire to. Knowing that getting older and thriving is possible — well, that’s a big deal for younger people who may otherwise have a hard time envisioning a future for themselves. LGBTQ+ youth are more likely than their heterosexual, cisgender peers to attempt suicide; so living into old age as your true self is a great example to them that yes, there is hope that things will get better.
Here is some advice for current — and future — elders for how to age with pride.
Find community
For all older adults, loneliness and social isolation present a significant health risk, including an increased risk for dementia, stroke, heart disease and mental illness.
That’s why it’s so important to find community as you age, especially if you belong to a marginalized group. This could look like connecting with existing friends and family who you can be your true self with. It could also look like finding your local pride group and attending a meetup — some groups even have specific events for LGBTQ+ elders.
Make intergenerational connections
People in the LGBTQ+ community know that we don’t always agree on things, especially among different generations. Fear of erasure or of the battles you fought not being remembered can make someone in an older generation resistant to change and to recognizing the ways younger generations are exploring their own identities, says Velasquez.
But there’s so much benefit to making intergenerational connections and remembering that, at the end of the day, we’re all part of the same community.
“Intergenerational connections, for me, have been important to keep a pulse on our roots and to never forget the barriers that older generations overcame,” says Velasquez. “As history repeats itself, we can continue to learn from their experiences, and it’s important to reflect back that gratitude of how much they have gifted us.”
It’s important for people to honor their own struggles while recognizing that the struggles of others within their community may be different — and that’s OK, because each person's experience is valid. LGBTQ+ people are always helping pave the way for future and younger generations.
“Knowing there’s a community of elders, knowing they will support you even if they don’t share the same identities as you, is so important,” says Darlin Lozano, who uses they and she pronouns, 2SLGBTQ+ Program Manager for the UW Medicine Office of Healthcare Equity.
Build a support system
First, try to find a doctor you trust enough to go to regularly, for annual check-ups as well as any health concerns or gender-affirming care. Search doctors’ bios and ask friends for recommendations to find a doctor who is LGBTQ+ friendly (and maybe even part of the community themselves). The annual Healthcare Equality Index from Human Rights Campaign and their new Long-Term Care Equality Index are other helpful resources to see which hospitals and healthcare systems across the country prioritize equity for LGBTQ+ patients.
Why is this important? “Episodic care where one provider isn’t following you continuously is dangerous, as there’s a risk that something won’t be caught before it becomes a problem,” says Velasquez.
It’s also important to find friends, family or people in the community to rely on in times of need.
“LGBTQ+ people often relied heavily on their age-based peers, so they’re often aging together,” says Fredriksen-Goldsen. “And because they have high rates of health disparities and high rates of chronic conditions, they may not be able to provide the same kind of support to each other as they age.”
That’s not to dismiss how difficult it can be to find people who will be caregivers if needed. But it’s yet another reason to get involved in the local LGBTQ+ community sooner rather than later.
Share your story
Moving into an uncertain future, with LGBTQ+ rights still being questioned, it’s more important than ever to share our stories.
“Creating a history that marks our existence: That’s how we confront this idea that we never existed and the silencing and erasure that allows for violence,” says Lozano.
So, as long as it’s safe for you, be loud and be proud — your story and your legacy matter and can have a huge impact on the people who come after you.
