Sophie Skowronski turned 62 this week, and friends from her senior lunch program sang “Happy Birthday.”
Hearing her friends sing “dear Sophie” was particularly sweet for Skowronski, because, she says, many others don’t feel comfortable calling her by that name.
Skowronski, a transgender woman, was 50 when she finally felt comfortable wearing dresses and being referred to as “she.”
“Trying to wear men’s clothes and a beard didn’t work,” she said. “When women came [to her home], they would say it looked like a woman lived there. I thought I was keeping it clean for them, but it was for me.”
At her senior housing building, Skowronski said, the other residents shun her. “I stay away from them all. They’re stuck in the mainstream group … They’re afraid,” she said.
Skowronski is one of many seniors who visit the Center on Halsted, an LGBT community center in Chicago. The facility, which opened in 1973 as the volunteer-run Gay Horizons, serves more than 500 seniors.
If it weren’t for the Center on Halsted, Skowronski might feel isolated and she might struggle to find care, a plight some say is common for LGBT people her age.
Activists say those elders are disadvantaged in two ways: On one hand, they say, LGBT elders often feel uncomfortable approaching service providers who have not been trained in the special needs of gay elders. In many places, that training isn’t common. On the other hand, LGBT people may be most badly in need of help.
Older adults who are LGBT are twice as likely than their heterosexual peers to live alone and as much as four times more likely not to have children, according to SAGE, an advocacy group.
Today’s seniors came of age before the Stonewall riots of 1969, which marked the beginning of the modern gay rights movement, and few gay people were open about same-sex relationships even when they could establish them.
“I would never have gotten married,” said John Snowhite, a gay man in his 90s. “I knew that wasn’t my cup of tea. My brother and sister both had gotten married and moved away. I was the one that stayed home with my parents—that was my whole lifestyle.”
Access to services
The aging services network is designed to deal with isolation. But across the country, LGBT advocates have raised concerns over whether gay elders feel comfortable approaching service providers.
“A lot of the persecution experienced by the community came from the government and mainstream institutions,” said Tim Johnston, the manager of education and training for SAGE, adding that gay elders grew up in a climate that was “considerably more hostile.”
For example, Skowronski reads at a fourth-grade level and has emotional problems, which she attributes to homophobia she encountered among teachers and therapists. Now she is skeptical of health workers and government agencies.
Older LGBT adults may also be subject to direct discrimination when they look for services. Although Illinois elder-care providers are supposed to serve everyone indiscriminately, activists say individual workers might purposefully or through ignorance provide low-quality care to LGBT seniors.
And elders living in community homes can face abuse or insensitivity from other residents and from staff. A U.S. Agency on Aging training manual tells nurses they need to be ready to intervene and urges them to be respectful toward LGBT people who may have partners they identify as “roommates” or who prefer a certain pronoun.
If providers put a rainbow flag or a “safe zone” sign on office doors, elders may feel more comfortable approaching services in the first place, the manual advises.
Such training is at the forefront of a movement to improve care for LGBT elders.
Filmmaker Stu Maddux highlighted the issue in “Gen Silent,” a film that portrayed elders going back into the closet, fearing discrimination from health-care worker.
“Now we have a much wider understanding, acceptance and [number of agencies] addressing this issue,” Maddux said. “I can tell you that we have scheduled this film at more than 500 agencies around the country that have shown [it] to employees.”
On the West Coast, activist organization Equality California championed a bill that requires resident care facilities to train providers in LGBT cultural sensitivity. In New York, Gov. Andrew Cuomo signed a bill requiring the state’s office on aging to survey the LGBT senior population and assess its special needs. The bill also provided funding for LGBT senior organizations. The state plan on aging in Massachusetts outlines ways to ensure that there are social gatherings for LGBT seniors and identifies culturally competent care as an important concern.
In much of Illinois, though, change is coming slowly or not at all.
The director of the regional agency on aging that serves much of southern Illinois says little has been done to implement best practices for LGBT sensitivity.
“I wouldn’t even begin to say how many Hispanics or gay and lesbians we have in our area,” said John Smith, director of the Egyptian Agency on Aging. “It’s not something we come in contact with very often, so we don’t have the background to deal with it.”
Officials say the state department that oversees regional agencies has made an effort to train its providers in best practices for dealing with LGBT seniors. The Illinois Governor’s Conference on Aging, which many public-sector representatives attend, has hosted workshops and breakout sessions on LGBT issues.
“I think it probably started a couple years ago – we held a pre-conference on inclusivity,” said John Holton, director of the Illinois Department on Aging. “[We wanted] to see if we couldn’t figure out who was least likely to approach a state department like ours and inquire about what services, program, or help might be provided.”
However, the department does not mandate either training or changes based on it.
“A training like this is really just the start of an agency becoming welcoming for the LGBT older adult community,” said Britta Larson, who led a workshop at an IDoA conference.
Smith, of the Egyptian Agency on Aging, said he had not attended any training on LGBT issues provided by the state.
“I need to push myself and my staff to attend all workshops related to discrimination,” he said. “We have dealt with issues of black and white, and I feel very comfortable we have done a good job of settling those complaints. But there are other protected classes for which we have not done a good job of not encouraging enough dialogue.”
The state agency has no way of knowing whether or not regional providers have been trained.
“We haven’t measured that. We don’t know, for instance, who comes in the door to be trained or informed and then what they do with it,” said Holton, the state agency director. “The evaluations typically don’t get at ‘so what did you learn, what are you going to do?’”
But the providers who think there are no LGBT seniors in their area could be in the most need of education, experts said.
“Statistically speaking, anyone who is working with older adults is working with LGBT older adults, and it’s just a matter of finding out how many are keeping that secret from you,” said Johnston, of SAGE.
The state agency director blames the lack of action in his department on weak advocacy by the LGBT community.
“I don’t want to create a ‘blame the victim’ focus,” Holton said. “The challenge is just having someone who’s saying ‘hey, what about my issue, when’s that going to get fixed,’ because that is how we operate when we have people who are advocating for their interest. In government, you have to be inclusive of everybody’s interest, but when you don’t hear those voices, it’s easy to say ‘well, next time.’”
Supporters of the California legislation on resident care facilities said that their bill was easily passed, thanks in part to community support.
“It was real simple,” said Shirley Krohn, senior assembly member with the California Senior Legislature. “Lesbian professionals spread the word like wildfire thought the state. It was amazing.”
Although progress has not been seen statewide, change has come in some parts of Illinois, as evidenced by the Center on Halstead and other organizations.
“We take a ‘no tolerance for intolerance’ approach,” said Todd Shackelford, associate executive director of the West Central Illinois Area Agency on Aging, which also oversees senior housing. “There may have been a comment made by a resident about another resident, but our staff have the training to squash that immediately. It’s a condition on your rental.”
Johnston, of SAGE, hopes to see such attitudes become more widespread.
“Things are getting better, but they need to have been better yesterday,” he said.
About the Author
Andrew Holzman is a student at the University of Chicago. Click here to learn more about him.