LGBTQ barriers: Health care, financial security

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By Jerry Nowicki

Many aging LGBTQ Illinoisans face barriers to health care and financial security and fear discrimination in senior communities, according to a combined report from senior and LGBTQ advocacy groups released Tuesday.

The Disrupting Disparities: Challenges and Solutions for 50+ LGBTQ Illinoisans report by the senior advocacy group AARP Illinois and the LGBTQ advocacy group SAGE said the barriers to well-being are largely attributable to historic discrimination.

“When I was born August 9, 1949, homosexuality and homosexual acts were universally against the law,” Don Bell, an advocate and member of the LGBTQ community, said in a video presentation at a virtual news conference Tuesday.

Mary Anderson, director of advocacy and outreach at AARP Illinois, said the report was an effort “to take an up-to-date look” at the issues facing the community as 24% of the state’s estimated 506,000 LGBTQ individuals are over age 50.

“We found pervasive discrimination keeps LGBTQ individuals from securing good jobs with family-sustaining wages and benefits, which ultimately hurts our retirement security and ability to age with dignity,” she said.

Nearly one-third of LGBTQ older people live at or below 200% of the poverty level, she said.

“With poverty as the ultimate social determinant of health, the income insecurity so many LGBTQ older adults face affects their ability to attain health care, secure and culturally competent housing, and caregiving support,” she added.

The disparities are multiplied for LGBTQ individuals of color, she said.

The study showed both past and present discrimination has taken a toll on LGBTQ individuals, with more than 60% of LGBTQ older adults fearing neglect, abuse, or verbal or physical harassment when seeking senior care.

That’s a contributing factor to why LGBTQ older adults are extremely, very or somewhat interested in LGBTQ-welcoming older adult housing developments, according to the study. As well, 48% of big-city respondents and as low as 10% of rural small-town respondents said they have access to “LGBTQ-inclusive elder services” in their community.

The study also said 34% of LGBTQ older adults and 54% of transgender and gender nonconforming older adults fear they will have to “re-closet” themselves when seeking senior living.

“Oftentimes, to obtain housing or other services, LGBT people have to go back into the closet, meaning they have to deny their authentic selves and their authentic lives,” Bell said.

The report said economic instability is due in large part to “a lifetime of employment discrimination that LGBTQ older adults have faced, resulting in lower earning power and lower payments or income from Social Security, retirement, or pensions.”

“Further, LGBTQ older adults whose spouse or partner died or retired before the freedom to marry may be unable to access Social Security survivor benefits or their partner’s benefits or assets,” according to the report. “As a result, 44% of LGBTQ older adults report being concerned about having to work well beyond retirement age (compared to 26% of non-LGBTQ people).”

LGBTQ individuals may also be facing estrangement from family, and many don’t have children to provide informal care. Anderson said older LGBTQ adults are twice as likely to live alone and three out of four are “very concerned about who will care for them as they age.”

“We’ve made a lot of strides in the last 20 years,” she said. “I mean, 20 years ago, I never would have thought that my wife and I could get legally married. I never would have thought we’d actually been able to create a family.

“But we still have a long ways to go. The decades of discrimination LGBTQ folks have felt is having an effect on the way we age. It affects how much money we can save. It affects the health care that we can get. And that discrimination is still continuing to this day.”

The report also identifies several policy changes for lawmakers to consider, some of which Department on Aging Director Paula Basta said she has already worked to implement.

Basta, identifying herself as an “out, older lesbian,” said the agency is “including the needs of LGBT older adults in everything that we do.”

The agency has specific objectives for LGBTQ adults, provides cultural competency training for its employees and provider agencies, and has LGBTQ representation on the advisory Illinois Council on Aging. The report suggested lawmakers should write those efforts into law.

Advocates praised governor JB Pritzker for designating people living with HIV and LGBTQ individuals as having “greatest social need” for inclusion in aging programming under federal law. But, the report said, “Illinois policymakers can do more to make sure that this designation is fully implemented and enforced,” such as by publishing an annual report outlining progress made for the populations.

The state should also establish a statewide commission on LGBTQ aging, and should create LGBTQ-inclusive state and area plans on aging. State officials should also “issue more detailed guidance on LGBTQ-specific nondiscrimination and the respectful treatment of older transgender Illinoisans,” and should adopt an LGBTQ long-term care residents’ bill of rights, the report recommends.

The report calls on the state to fund LGBTQ-specific programming and expand outreach targeted to LGBTQ aging populations.

But many of the disparities persist because not enough data is collected on LGBTQ populations, Anderson said. To counteract that, she added, “every time demographic data is collected by the state of Illinois, LGBT individuals should be included in that data collection. We need to build that database up.”

The report recommends the state create an ombudsperson on LGBTQ aging to address discrimination when it is unearthed in other parts of the plan.

Capitol News Illinois is a nonprofit, nonpartisan news service covering state government and distributed to more than 400 newspapers statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.

— Capitol News Illinois

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