In a different survey of LGBTQ adults aged 50 to 95 years, 21% reported not disclosing their sexual or gender identity to their physicians. This same study reported 22% of transgender adults need to see a physician but cannot afford the visit. Of the LGBTQ individuals surveyed, 15% are fearful of accessing healthcare outside of LGBTQ community. 

In another study of more than 2500 older LGBTQ adults, more than 10% were denied care or provided inferior care because they were LGBTQ.16 A study of administrators and care providers showed that 75% had no existing endeavors to address older LGBTQ individuals’ needs.19,20 For gay men and lesbians, there are several factors that are detrimental to their health. There are higher rates of suicidal ideation, suicide attempts, use of psychiatric medicine, and self-injurious behavior for gay men and lesbians.21-24 There are also higher rates of smoking, excessive drinking, and disability.25,26 

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Another study found that internalized stigma, obesity, lack of healthcare access, lifetime victimization, and limited physical activity were risk factors for disability, depression, and poor general health for LGB older adults.26,27

In a study of more than 2000 LGB adults aged 50 years and older, results showed that obesity, limited physical activity, lifetime victimization, and financial barriers to healthcare were each significantly and independently responsible for disability, depression, and poor general health of the participants.26 

It was also found that internalized stigma was an additional predictor of disability and depression.26 Protective factors relative to poor general health, depression, and disability included increased social support and social network size.26

Mental Health Issues Faced by LGBTQ Elders

One of the reasons for increased mental health issues faced by older LGBTQ people compared with heterosexual people is continuous exposure to discrimination.20,27,28 These mental health issues faced by LGBTQ individuals may be worsened by discrimination or the expectation of discrimination by service providers.29-31 

In a study of people aged 55 years and older living in Britain, older LGB individuals reported being more anxious than heterosexual individuals in the same age range. A lot of their anxiety stemmed from the belief that their sexual orientation or gender identity would affect them as they aged, and they were most specifically concerned about facing discrimination.20,31 

Lesbian and bisexual women were found to be more likely to have ever had a diagnosis of depression or anxiety than heterosexual women, and it was found that 40% have a lifelong prevalence of depression and 33% have lifelong prevalence of anxiety.20,31 Bisexual and gay men were twice as likely to have ever had a diagnosis of anxiety or depression compared with heterosexual men.20,31

Disparities Specific to Elderly Transgender Individuals

There is very limited research available on specific disparities among elder transgender and gender nonconforming populations. Research has shown that older transgender adults, relative to nontransgender older LGB adults, are at a greater risk for disability, depressive symptoms, poor physical health, and perceived stress.27,32 

Relative to non-transgender adults, older transgender adults face higher risks for poor health, which has been linked to less access to healthcare, less social support, less physical activity, and increased levels of victimization, discrimination, and stress.27,32 

This article originally appeared on Psychiatry Advisor