A study published in the April 2003 issue of The Gerontologist found that older gay men and lesbians often mistrust the health and social service networks as a result of life-long experiences of marginalization and oppression. "Many gay and lesbian elders who experienced the pervasive social stigma that existed prior to the advent of gay liberation movement maintain a sense of extreme caution with respect to whether or not societal attitudes have really changed," according to the authors of the study, Shari Brotman, Bill Ryan and Robert Cormier of the McGill School of Social Work.
Brotman and colleagues assessed a broad range of health and social services in Canada to examine the role of health care and social services organizations towards gay and lesbian elders. They used a focus group design to explore the perceptions and understandings of the experiences and realities facing gay and lesbian seniors in Canada. Four focus groups in three locations across Canada were undertaken.
Although several issues arose from the four focus group discussions, the authors found that "the one theme that emerged repeatedly and most frequently was the profound marginalization experienced by older gays and lesbians in all aspects of social and political life." Gay and lesbian elders are affected not only by their historical experiences of discrimination, but also by discrimination that continues in many social and institutional environments.
"In light of this reality," the researchers noted, "the possibility of one day having to be reliant on the health care system, on a nursing home facility, or any other social institution understandably provokes anxiety and fear in aging lesbians and gay men." Many, they added, may avoid accessing services all together, even when their health, safety, and security depend on it.
Developing resilience in the face of discrimination has helped many gay and lesbian seniors become experts in dealing with adversity, facing change, and learning how to take care of themselves. This adaptive capacity follows them in old age so that, although unable to rely on public services, elderly gays and lesbians have developed a unique capacity to do for themselves and for each other.
This ability to cope has a downside, according to Brotman and others. These populations have learned to adjust to loss and stigma so well that they may delay seeking medical attention. This means that older gays and lesbians may arrive at the doors of the health care system in a more advanced state of risk than their heterosexual counterparts, or not all.
Brotman and others argue that given the context of the current reality, health and social services must begin to ask themselves profound questions about how to transform the system to enhance equity.
The Gerontologist is a refereed publication of The Gerontological Society of America, the national organization of professionals in the field of aging.