Supporting LGBTQ+ Older Adults’ Primary Wants

This reality sheet was co-authored by Aaron Tax, Managing Director of Authorities Affairs & Coverage Advocacy, Jane Haskell, Director of Collaborations, and Terri L. Wilder, Supervisor of Well being and Financial Safety Coverage at SAGE. We want to thank SAGE and FORGE for his or her contributions to this challenge temporary concerning culturally competent service supply to LGBTQ+ older adults.

Notice: On this useful resource, we use the acronym LGBTQ+ to explain the lesbian, homosexual, bisexual, transgender, queer, and gender expansive group. Using this broad-encompassing acronym displays SAGE and Justice in Growing old’s dedication to uplifting the various views within the LGBTQ+ older grownup group. Often, nonetheless, this challenge temporary makes use of the acronym LGBT or LGB when that’s the language used within the cited supply.

Desk of Contents

Introduction

LGBTQ+ older adults face vital challenges. Lately, the rise of focused threats towards the LGBTQ+ group,^[1] together with the weaponization of insurance policies to erase LGBTQ+ folks, mixed with vital cuts and restrictions to security internet packages like Medicaid^[2] and the shortage of enforcement of anti-discrimination protections^[3] all hurt LGBTQ+ older adults.

Regardless of their indeniable existence all through historical past and essential contributions in our communities, LGBTQ+ older adults proceed to be systemically focused in unconscionable methods by policymakers. This challenge temporary highlights enhancements to packages and providers that might allow LGBTQ+ older adults to age with dignity in the US.

“It’s not a colour of the rainbow, however gray will be homosexual. You simply must study to interchange informal intimacies with informal knowledge.” — Martin Boyce, SAGE Participant

Discrimination and Poverty Amongst LGBTQ+ Older Adults

There are an estimated 3.6 million older LGBTQ+ folks in the US, and by the yr 2030, there shall be seven million LGBTQ+ folks over the age of fifty.^[4] Regardless of their rising numbers, LGBTQ+ older adults face vital inequities and discrimination by way of entry to well being care, housing, and financial safety. Well being inequities stem from stigmatization in medical analysis, lack of social helps and assets, and medical mistreatment (akin to lack of gender affirming care), which finally result in a larger chance of despair, dementia, and power well being situations.^[5]

The seeds of financial inequity are sowed at a youthful age. For instance, office discrimination towards LGBTQ+ folks earlier of their lives—and particularly transgender folks—ends in not being employed for sure jobs, not being promoted, being fired, or not being paid equitably on account of one’s sexual orientation or gender id. The compounding impact of a lifetime of discrimination leads many LGBTQ+ folks to age into poverty. These impacts are exaggerated in particular conditions, such because the COVID-19 pandemic (e.g., extra LGBT older adults reported dwelling in poverty and experiencing meals insecurity than their non-LGBT counterparts)^[6] and incarceration (85% of incarcerated LGBTQ folks have been put in solitary confinement).^[7]

For LGBTQ+ older adults who belong to different traditionally marginalized communities, systemic inequities will be compounded or distinctive. LGBTQ+ folks of colour expertise heightened charges of discrimination and hate crimes.^[8] For transgender folks of colour, these experiences are sadly too widespread—with 68% reporting destructive or discriminatory therapy from well being care suppliers and 28% reporting that that they had a physician refuse to see them based mostly on their gender id. LGBTQ+ folks of colour are additionally extra doubtless than their white counterparts to expertise office discrimination—together with harassment, destructive feedback, not being contemplating for promotions—finally resulting in financial inequity that compounds over one’s lifetime.^[9]

Roughly 30% of LGBTQ+ folks report having a incapacity, which may improve discrimination in well being care and employment settings and improve the danger of home violence.^[10] On account of these dangerous discriminatory experiences, many LGBTQ+ older adults who produce other marginalized identities might keep away from well being care or different providers or select to not out themselves to their employer, suppliers, or caregivers.^[11]

The mix of getting older and trauma brings distinctive challenges for older adults as they grapple with the cumulative results of previous and current traumatic experiences. Many LGBTQ+ older adults lived by means of state-sanctioned discrimination and health-related trauma perpetuated by establishments.^[12] Legalized discrimination towards the LGBTQ+ group reinforces institutional oppression,^[13] and the latest spherical of coverage assaults towards LGBTQ+ communities by means of govt orders and different administrative actions will increase inequities for LGBTQ+ older adults. Discrimination that highlights the shortage of authorized protections for LGBTQ+ people in areas like housing, well being care, schooling, and employment, financially penalize the group all through their lives.^[14]

Given the variety inside the LGBTQ+ group and the challenges LGBTQ+ older adults expertise, beneath we element ways in which well being care, financial, and different social help packages can meet the wants of LGBTQ+ older adults.

Sal’s Story: A lifetime lived from 1952 to 2025, framed by means of the lens of somebody who’s 85 years outdated in 2025.

Over the course of 85 years, Sal has witnessed profound shifts in LGBTQ+ rights and visibility. At age 12, through the early Fifties, the McCarthy hearings focused “homosexuals,” and the American Psychiatric Affiliation (APA) listed homosexuality as a psychological dysfunction. By age 29, Sal noticed the Stonewall Riots in New York Metropolis, a pivotal second that ignited the trendy LGBTQ+ rights motion. At 33, the APA eliminated homosexuality from its checklist of psychological issues, marking a big step towards destigmatization. The AIDS disaster started once they have been 43, bringing concern and prejudice but in addition galvanizing activism. At 54, the “Don’t Ask, Don’t Inform” coverage was enacted, barring overtly LGBTQ+ people from navy service. At age 63, the Supreme Courtroom struck down legal guidelines criminalizing same-sex sexual conduct in Lawrence v. Texas.

By 75, Sal witnessed the legalization of same-sex marriage nationwide by means of Obergefell v. Hodges, adopted by the designation of the Stonewall Monument as a U.S. Nationwide Monument at age 76. At 80, Bostock v. Clayton County prolonged federal employment protections to LGBTQ+ staff. At 82, a transgender lady gained a landmark settlement in King v. Dawn Assisted Residing.^[15] At 84, gender id and sexual orientation have been added to the definition of “Biggest Social Want” underneath the Older Individuals Act. Now, at 85, Sal resides by means of a time marked by a surge in assaults through govt orders and authorized challenges geared toward dismantling LGBTQ+ rights, with organizations like SAGE and Justice in Growing old preventing again by means of litigation and administrative advocacy. This timeline displays each the resilience and the continued battle for equality throughout generations.

LGBTQ+ Technology Timeline

LGBTQ+ Technology Identify	Beginning 12 months Vary	Age Vary (as of January 2024)	Cohort Experiences	Mainstream Technology Identify
Invisible Technology	1934 and earlier	90 years+	Sexual and gender identities have been “invisible”; WWII, Nice Melancholy; rising gender fluidity as ladies entered labor drive throughout WWII; medical and authorized establishments outlined homosexuality as an “inclination”	Biggest Technology (born 1901–1924)
Silenced Technology	1935–1949	75–89 years	Lavender Scare; medical and authorized establishments outlined homosexuality as a “perversion”; Kinsey scale launched	Silent Technology (born 1925–1945)
Pleasure Technology	1950–1964	60–74 years	Civil rights period; reproductive rights; rise of collective activism; Stonewall; creation of rainbow flag	Child Boomer Technology (born 1946–1964)
Caregiver Technology	1965–1979	45–59 years	AIDS epidemic; DOMA; Don’t Ask, Don’t Inform	Technology X
Equality Technology	1980–1996	26–44 years	Marriage equality; repeal of Don’t Ask, Don’t Inform and DOMA; extra public figures popping out	Millennials
Ze Technology	1997–2013	11–25 years	Gender range; fluidity; rise of discriminatory legal guidelines based mostly on gender expression and id (trans exclusions)	Technology Z

Perone AK, Toman L, Glover Reed B, Coldon T, Osborne A, Cook dinner J. Growing old and Mentorship within the Margins: Multigenerational Information Switch Amongst LGBTQ+ Chosen Households. J Gerontol B Psychol Sci Soc Sci. 2025 Might 8;80(6):gbaf027. doi: 10.1093/geronb/gbaf027. PMID: 39953965; PMCID: PMC12067074.

Notice: DOMA = Protection of Marriage Act.

Utilizing Information to Advance Fairness

Information assortment is important to higher perceive the unmet wants of LGBQ+ older adults and their experiences with federal and state profit packages. Whereas the packages mentioned on this challenge temporary collect and analyze details about people, they hardly ever accumulate information on sexual orientation and gender id (SOGI). Furthermore, information that’s collected will not be all the time analyzed intersectionally—for instance by age and gender id.

Equitable information assortment additionally requires survey individuals to really feel snug in disclosing SOGI data to businesses, which requires insurance policies that make LGBTQ+ folks really feel secure and included. Some examples embody guaranteeing people know their information is not going to be used towards them or lead to different dangerous penalties, deploying culturally competent direct-services workers, utilizing imagery that’s consultant of the LGBTQ+ group, and having clearly articulated and enforced anti-discrimination and privateness protections which might be straightforward to navigate.^[16]

Till just lately, the federal authorities was making strides towards information assortment that extra precisely captured the experiences of LGBTQ+ older adults following a long time of advocacy. Nevertheless, the administration’s assaults towards LGBTQ+ folks have reversed this progress. Not solely have most SOGI information assortment efforts been halted and a few even scrubbed,^[17] however trainings and insurance policies that allow culturally competent information assortment are additionally being focused as “unlawful DEI.”^[18]

Latest information abuses by the federal authorities (together with sharing Medicaid beneficiaries’ personally identifiable data with immigration brokers for the needs of deportation motion) additional breeds marginalized communities’ distrust that private information shared with the federal authorities might finally be used towards them.

Well being Applications

Medicare

Medicare is a federal medical insurance program out there to folks age 65 and older or folks with sure disabilities. Between 595,00 and 790,000 LGBTQ+ older adults are estimated to be enrolled in Medicare in 2021, with 69% of LGBT older adults nationwide counting on Medicare as their main supply of medical insurance.^[19] Medicare protection consists of hospital care (Half A) and physician’s visits (Half B) and might embody prescription drug protection (Half D).^[20]

Along with the age or incapacity necessities, all older adults, together with LGBTQ+ older adults, should have an applicable work historical past to obtain Medicare Half A (i.e., hospital insurance coverage) premium-free, which is roughly the equal of 10 years of taxable employment. Given the limitations to LGBTQ+ folks gaining and sustaining employment—akin to discrimination in hiring practices and homophobic or transphobic harassment that will make them go away a job^[21]—this requirement could be a barrier to LGBTQ+ older adults accessing Medicare. Furthermore, many LGBT individuals are extra more likely to have unpaid caregiving tasks than non-LGBT counterparts, an important function that doesn’t rely towards the requisite work historical past.^[22]

Whereas an individual who lacks the requisite work historical past can nonetheless entry Medicare if their partner—dwelling or deceased—meets the necessities, this selection is inequitable because it disadvantages LGBTQ+ older adults for whom marriage was not an choice till comparatively just lately. An individual with out qualifying quarters can enroll in Medicare however shall be required to pay a premium to entry Half A hospital insurance coverage, which may quantity to as much as over $500 per 30 days.^[23] Paying the premium out-of-pocket is troublesome for LGBTQ+ older adults who expertise financial inequities, and thus they could depend on Medicaid to pay the premium.

Medicaid

Medicaid is a state-administered medical insurance program out there to qualifying folks with restricted earnings and belongings, the thresholds of which differ by state. It’s a lifeline for many individuals, together with LGBTQ+ older adults. LGBT (13%) adults are twice as doubtless as non-LGBT (7%) adults to have Medicaid as their main supply of medical insurance, and an estimated 1.8 million LGBTQ adults are enrolled in Medicaid.[24] Medicaid is especially useful for LGBTQ+ older adults who should not but Medicare age (i.e., within the 50-64 vary) and don’t have different sources of well being care protection.

Medicaid can also be an essential profit for LGBTQ+ older adults who do have Medicare. As defined beforehand, for these with out ample work histories to entry premium free Half A hospital insurance coverage, Medicaid can pay the price of the premium.^[25] Furthermore, it’ll additionally assist to pay for different coinsurance prices—akin to co-pays on the physician and drug prices—thus releasing up typically restricted earnings for LGBTQ+ older adults to pay for lease, groceries, and different requirements.^[26] Lastly, Medicaid permits LGBTQ+ older adults to entry essential well being care providers that aren’t out there by means of Medicare, all of which permit LGBTQ+ older adults to age with dignity in the neighborhood. These embody dental, imaginative and prescient, listening to, and long-term care, together with home- and community-based providers (HCBS).

LGBTQ+ older adults typically face limitations remaining at residence as they age as they could not have conventional sources of unpaid care from household. In comparison with non-LGBTQ+ older adults, LGBTQ+ older adults are twice as more likely to be single and 4 occasions much less more likely to have kids.^[27] Unpaid caregiving help from associates and neighbors isn’t assured and is particularly difficult for these dwelling in rural areas. When it’s out there, it lacks the authorized protections enforced on suppliers (akin to anti-discrimination legal guidelines) and its long-term sustainability is precarious, particularly as these offering unpaid care might themselves be older adults.^[28]

The choice of institutional care (i.e., nursing services) will not be solely undesirable for a lot of older adults, however can even current threats of cultural unresponsiveness, discrimination, exclusion, isolation, and denial of important look after LGBTQ+ older adults. Certainly, many LGBTQ+ older adults have reported discrimination and having to cover their id in nursing services.^[29]

Medicaid-funded HCBS empowers hundreds of thousands of older adults—together with LGBTQ+ older adults—to age of their communities with the assistance of paid care aides, residence modifications, and different helps that allow them to dwell at residence. These providers are ruled by anti-discrimination guidelines detailed later. Moreover, protections for LGBTQ+ older adults and people with HIV could also be additional reiterated on the state stage, akin to by means of implementing the LGBTQ+ and HIV Lengthy-Time period Care Invoice of Rights–a coverage initiative that codifies protections within the context of nursing services, assisted dwelling services, and home- and community-based providers packages.^[30]

HIV Care and Gender Affirming Care

Medicare and Medicaid are important for LGBTQ+ older adults requiring HIV care and gender affirming care. Older adults are disproportionately impacted by HIV worldwide.^[31] Within the U.S., homosexual and bisexual males of colour (particularly Black and Latino males who’ve intercourse with males) and transgender folks expertise increased charges of HIV than different populations.^[32] Fifty-four % of all folks dwelling with HIV in the US are aged 50 or older.^[33]

Medicaid is the nation’s largest supply of protection for folks with HIV, and nearly all of Medicaid beneficiaries with HIV are dually enrolled in Medicare.^[34] Medicaid covers a broad vary of providers which might be vital for folks with HIV, starting from physician’s appointments, hospital visits, laboratory providers, pharmaceuticals, and HCBS. LGBTQ+ older adults who’re youthful than 65 and have HIV are additionally eligible for Medicare,^[35] which is the second largest supply of federal funding for HIV care within the U.S..^[36] One other essential supply of medical care and help is the Ryan White HIV/AIDS Program, which, like Medicare and Medicaid, is run by the federal Division Well being and Human Providers (HHS) and Well being Sources and Providers Administration (HRSA).

Medicaid and Medicare additionally play an essential function in making gender affirming care accessible to LGBTQ+ older adults. Gender affirming care consists of well being care providers and inclusive approaches that help a person’s gender id, together with hormone therapies, psychiatric providers, and first care.^[37] A 2022 examine estimated that 60% of transgender Medicaid beneficiaries have affirmative entry to protection for gender-affirming care underneath specific insurance policies in state regulation, which facilitates an improved high quality of life for transgender and gender expansive older adults.^[38] Nevertheless, plenty of states are passing bans on gender affirming look after youth, which can have implications for older adults. Up to now, Medicare has lined gender affirming providers—akin to gender reassignment surgical procedure—on a person foundation when deemed medically mandatory.^[39]

“Residing in a rural space is difficult as you age. Well being care is 1.5 hours away (in the event you may even discover a physician), there isn’t a public transportation in any respect, no senior housing close by. The few age-related providers (i.e., senior facilities) should not homosexual pleasant. There aren’t any funds to help a homosexual program for the aged.” — Nameless, LGBTQ+ Older Grownup

Anti-Discrimination Protections in Well being Care

Part 1557 of the Inexpensive Care Act prohibits discrimination in well being care packages and providers that obtain federal funds—i.e., nearly all well being care suppliers, settings, and providers. A 2024 rule clarified that its protections prolong to discrimination on the premise of intercourse, gender id, sexual orientation, and intercourse traits and particularly banned the denial of gender affirming care, however these laws have been challenged in courtroom.^[40]

As of Might 2025, the Division of Well being and Human Providers (HHS) has rescinded earlier sub-regulatory steering that articulated the company’s interpretation of Part 1557 to ban discrimination on the premise of sexual orientation and gender id and associated enforcement.^[41] Though HHS’s interpretation and enforcement has shifted, Part 1557’s statutory language stays unchanged and continues to ban discrimination in well being care on the premise of intercourse, race, ethnicity, age, and incapacity (together with HIV).^[42]

Part 504 of the Rehabilitation Act prohibits discrimination on the premise of incapacity. HHS has beforehand reiterated its dedication to defending LGBTQ+ folks in rulemaking stating that LGBTQ+ people with gender dysphoria or HIV are protected by these legal guidelines in packages that obtain federal funds, together with well being care settings.^[43] Proper-wing states challenged the laws in 2024, and in 2025 the federal authorities indicated it is not going to be imposing nondiscrimination protections for folks with gender dysphoria underneath Part 504.^[44]

“When individuals are in good, competent care, they really feel empowered to entry their healthcare. There’s actually some trepidation with my LGBTQ+ purchasers when it comes time to discover a new physician or specialist. Folks suppose ‘I’ve to undergo this over again, I’ve to inform them every little thing about myself, and also you by no means know the way it’s going to be taken.’ There’s lots of concern round Medicare/Medicaid this yr. They typically ask, ‘Will I nonetheless get my HIV medicine? How am I going to pay my payments? What else goes to be taken away?’ This isn’t simply LGBTQ+ folks, I do see this throughout the board, however I see it particularly with LGBTQ+ elders as a result of we now have particular circumstances. It will likely be attention-grabbing to revisit this dialog in January after the open enrollment interval to see what has modified and the way that has impacted folks of their on a regular basis lives. Fortunately, most of my purchasers, even in conservative states like Florida, are in additional city areas, which provides a sure stage of entry.” — Stephanie Smith, LGBTQ+ Elder and Unbiased Licensed Medicare Agent, St. Petersburg, FL

Financial Assist Applications

Folks with requisite work histories—roughly ten years of incomes taxable earnings—can entry Social Safety Retirement or Social Safety Incapacity Insurance coverage. The office inequities that LGBTQ+ folks expertise can restrict their capacity to entry or stay in jobs that contribute to Social Safety-earning work historical past, and finally negatively affect their capacity to entry these advantages in older age. Very like Medicare, older adults who don’t have the requisite work historical past may have the ability to entry Social Safety advantages if their partner qualifies. Accordingly, for many years, same-sex {couples} couldn’t entry spousal advantages in any respect.

Though this restriction was reversed in 2015 following the US Supreme Courtroom’s determination in Obergefell v. Hodges, many LGBTQ+ older adults might face limitations in getting Social Safety spousal advantages on account of stigma, ignorance, and rising assaults towards the LGBTQ+ group that affect {couples}’ determination to formally marry.^[45] In actual fact, a 2021 examine confirmed that almost 50% of LGBTQ+ folks 45 and older are single, and this disparity is even larger for homosexual males and transgender and nonbinary folks.^[46] Even post-Obergefell, advocates needed to safe survivor’s advantages for same-sex companions by means of litigation within the courts.^[47]

In a reversal from earlier coverage, the Social Safety Administration will not course of adjustments to gender markers, although title adjustments stay permissible. People who beforehand modified their gender marker should not impacted by the coverage reversal. The shortcoming to alter one’s gender marker might current problems for transgender older adults who possess inconsistent paperwork.

Supplemental Safety Earnings

LGBTQ+ older adults aged 65 and older who’ve very restricted earnings and assets can entry Supplemental Safety Earnings (SSI).^[48] SSI is a lifeline for people who’ve little to no different earnings as it’s out there to people incomes $967 or much less per 30 days, together with by means of sources like pensions, Social Safety advantages, in-kind donations, and different money help packages.^[49] SSI advantages are essential for LGBTQ+ older adults who’ve skilled a lifetime of financial inequities. For instance, 25% of transgender and nonbinary older adults have reported that they earn lower than $25,000 yearly.^[50] Relatedly 28% of LGBT adults haven’t any emergency funds.^[51]

Housing, Meals, and Different Assist Applications

Inexpensive Housing and Homelessness Help

Housing considerations affect many older adults, however for the greater than 2.7 million LGBTQ+ adults age 50 or older,^[52] there are added challenges which have constructed up over a lifetime. Though lack of long-term information makes it troublesome to adequately doc the challenges confronted, we all know that concern of discrimination and financial inequities have contributed to housing inequities. For instance, years of employment discrimination can lead to decrease retirement financial savings and Social Safety earnings.

In well being care, challenges accessing medical care and aging-specific providers can improve well being dangers, and, with fewer connections to households of origin, LGBTQ+ older adults could also be at elevated danger for social isolation. With out financial savings, confronted with higher-than-average medical payments and missing youthful relations to fall again on for help, the danger of housing instability will increase for LGBTQ+ older adults. Inexpensive and inclusive housing packages—akin to Housing Alternatives for Individuals with AIDS Program (HOPWA) and federal rental help packages—are mandatory for LGBTQ+ older adults and others to age of their communities.^[53]

In contrast with the 70% of non-LGBTQI+ adults who personal their properties, solely 54% of all LGBTQI+ adults are householders^[54] and one examine discovered that 12% of LGBT adults expertise housing hardships.^[55] The challenges are even larger for transgender and nonbinary older adults, who’re much less more likely to be householders than their LGB friends.^[56]

Housing discrimination, e.g. the denial of rental purposes or being turned away at nursing services, contributes to problem to find housing, in addition to making a tradition of concern for these looking for a secure place to dwell. Thirty 4 % of LGBTQ+ older adults fear they should disguise their id in senior housing,^[57] and 48% of older same-sex {couples} confronted housing discrimination when looking for elder housing.^[58] Whereas practically 23% of transgender people report experiences with housing discrimination.^[59] Older adults with HIV proceed to face discrimination in accessing housing as effectively, together with within the context of nursing residence admissions.^[60]

Sadly, LGBTQ+ housing discrimination protections haven’t been enacted and enforced uniformly throughout the nation. Landmark choices have been made underneath the Biden administration to increase the Truthful Housing Act (FHA) to bar discrimination on the premise of sexual orientation and gender id based mostly on the Supreme Courtroom’s determination in Bostock v. Clayton County.^[61]

Nevertheless, many states and territories nonetheless lack express legal guidelines to forestall LGBTQ+ housing discrimination, and the present administration has taken steps to undermine Bostock and different federal housing protections. This consists of the Equal Entry Rule (EAR), which is a collection of laws that guarantee many U.S. Division of Housing and City Improvement (HUD) funded providers should not denied based mostly on sexual orientation, gender id, or marital standing. Sadly, on February 5, 2025, the administration introduced it could cease imposing the EAR, and shortly after started the method to formally repeal the rule.^[62]

Past undermining discrimination protections, the administration has moved to implement govt orders focusing on range, fairness, and inclusion. This has meant many LGBTQ+ affirming organizations who present homeless providers and help victims of home violence, have had their federal grant funding revoked or threatened.^[63] The lack of affirming service suppliers, which goal to serve everybody whether or not they’re a member of the LGBTQ+ group or not, removes one of many solely security nets out there to LGBTQ+ older adults.

Older Individuals Act Applications

The Older Individuals Act (OAA) is the main federal statute that addresses the wants of individuals age 65 and over. It encompasses a number of safety-net providers, akin to diet helps (e.g., home-delivered meals, congregate meal websites), help for caregivers, long-term care ombudsmen, and authorized help.^[64] Native Space Companies on Growing old are the first car for delivering these providers to older adults in communities all through the U.S. and infrequently collaborate with a community of state and native businesses and nonprofits to satisfy the wants of older adults. These stakeholders are required to focus on service supply to marginalized older adults, together with these going through social and geographical isolation.

What Service Suppliers Can Do to Higher Serve LGBTQ+ Older Adults

LGBTQ+ older adults expertise social isolation at increased charges than non-LGBTQ+ counterparts on account of a number of causes and subsequently might disproportionately depend on public social providers as they age.^[65] Lifelong experiences of discrimination can result in concern, lack of belief, and strains on the relationships of LGBTQ+ older adults.^[66] Some LGBTQ+ older adults could also be estranged from their households and equally lack supportive group assets, a barrier which may be exacerbated in rural areas. Because of this, LGBTQ+ older adults usually tend to expertise destructive psychological well being outcomes (akin to despair) and bodily well being outcomes (akin to elevated danger of dementia, coronary heart illness, and stroke), in addition to extra useful challenges if getting older alone.^[67] Older adults with HIV face many of those similar inequities and disparities and lack the social helps wanted to age with dignity.

To make sure that LGBTQ+ older adults can absolutely entry the providers they deserve, the service supply have to be culturally competent, gender affirming, and welcoming. Focused outreach to LGBTQ+ older adults is important as many might keep away from participating with authorities businesses and associated packages out of concern of discrimination. This outreach can contain connecting with trusted LGBTQ+ advocacy teams, guaranteeing that the advertising and marketing strategies are LGBTQ+ pleasant (e.g., range in imagery, range statements, including SOGI to consumption types), and coaching direct providers workers.

In at present’s shifting political local weather, getting older service businesses and repair suppliers might really feel stress to cut back public visibility of their work with LGBTQ+ elders. Nevertheless, such withdrawal will be deeply dangerous and probably be perceived as abandonment by older adults already going through heightened concern and isolation. Companies should discover discreet, privacy-conscious methods to take care of and strengthen relationships. This consists of consulting authorized counsel to evaluate dangers and persevering with outreach by means of trusted channels and supplies that don’t explicitly establish LGBTQ+ content material.

Strategic partnerships are important. Companies ought to collaborate not solely with LGBTQ+ organizations, however with cultural, faith-based, authorized, and advocacy teams as effectively to share assets and visibility. Importantly, businesses are inspired to shift from a hierarchical service mannequin to a collaborative one, empowering LGBTQ+ older adults as companions slightly than purchasers. Internet hosting focus teams might help co-create options, foster group, and establish remoted people in want of help. Volunteer roles, akin to greeters, academics, or audio system, can spotlight elder strengths and construct resilience.

Privateness stays a central concern, particularly given LGBTQ+ older adults’ experiences with discrimination and violence. Companies should work with older adults to design service fashions that shield their identities whereas nonetheless providing significant help. Employees, too, might discover hope and function in these partnerships, even when they take part as volunteers. Finally, this second requires compassionate, inventive, and community-driven approaches to make sure LGBTQ+ older adults stay related, supported, and empowered.

“[I’m] frightened how coverage will affect my capacity to seek out an Assisted Residing place. [I] fear too in regards to the thought of getting to fully disguise who I’m in public, on social media, with police, and VA care.” — Nameless LGBTQ+ Older Grownup

Diet Helps

Inequities in entry to diet and diet helps are additionally prevalent for LGBTQ+ older adults. LGBTQ+ people disproportionately dwell in poverty, contributing to lack of funds for meals, and obtain Supplemental Diet Help Program (SNAP) advantages at twice the speed of non-LGBTQ+ folks.^[68]

Diet associated disparities for the broader LGBTQ+ inhabitants can come up on account of societal elements, akin to lack of culturally responsive well being care suppliers and diet counseling; elevated stress, together with on account of discrimination and isolation and ensuing psychological well being situations and coping mechanisms; discrimination in and distrust of security internet packages; and financial insecurity, which immediately impacts the power to afford meals and impacts entry to housing, well being care, and different protecting elements.^[69]

Diet help packages—akin to congregate meal websites, home-delivered meals, SNAP—are important for LGBTQ+ older adults who can’t in any other case afford groceries, are unable to independently store for groceries or cook dinner, or who want medically applicable meals.^[70]

“The most important challenge I see concerning meals insecurity at Edie Windsor SAGE Middle, understanding we dwell in Manhattan, it’s not a problem of availability, it’s a problem of value. Folks like our members must determine the place to spend their fastened earnings…drugs, lease, meals, garments, and meaning they must determine what’s a precedence, and infrequently occasions they lower meals out. Any supplemental earnings and packages like SAGE’s pantries, lunch and dinner service, and Seize-&-Go feeding packages go an extended technique to ensuring SAGEr’s get at the very least one wholesome balanced meal, and hopefully can avoid wasting cash.” — Bob Gurecki, Meals Providers Coordinator, Edie Windsor SAGE Middle

Conclusion and Further Sources

The present administration continues to assault the LGBTQ+ group by means of its homophobic and transphobic rhetoric, dismantling of federal protections, anti-DEIA initiatives, and pulling vital funds from packages that help well being and financial safety. These efforts will solely widen the present inequities that LGBTQ+ older adults expertise in each facet of life. Defending, increasing, and bettering the federal packages and methods mentioned on this challenge temporary are essential to help LGBTQ+ older adults as they age.

Endnotes

See e.g., The White Home, Government Order 14168 Defending Ladies from Gender Ideology Extremism and Restoring Organic Reality to the Federal Authorities (January 20, 2025). ↑
See e.g., H.R. 1 (2025-2026). ↑
See e.g., 90 Fed. Reg. 20393 (Might 14, 2025) (notifying that the Division of Well being and Human Providers intends to cease enforcement of the Inexpensive Care Act’s Part 1557 protections towards discrimination on the premise of sexual orientation and gender id). ↑
U.S. Census Bureau, Information Set, filtered by age and intercourse information from the American Group Survey 2023 (final visited Aug. 26, 2025) (reporting that there are 121,843,541 folks age 50 and older in the US); Andrew Flores & Kerith J. Conron, Williams Institute, Grownup LGBTQ+ Inhabitants in the US (2023) (reporting that 3% of individuals age 50 and older reported being LGBTQ+); Michael Adams & Ryan Skultety, SAGE, Constructing an LGBTQ+ Inclusive PACE Program (2023). ↑
Nik M. Lampe et all., Well being Disparities Amongst Lesbian, Homosexual, Bisexual, Transgender and Queer Older Adults: A Structural Competency Strategy, 98 Int. J. Growing old Hum, Dev. 39-55 (2023). ↑
Lauren J.A. Bouton et al., Williams Institute, LGBT Adults Aged 50 and Older within the US Through the COVID-19 Pandemic (2023). ↑
Wanda Bertra, Jail Coverage Initiative, 6 details in regards to the mass incarceration of LGBTQ+ folks (2024). ↑
Lindsay Mahowald, LGBTQ Folks of Shade Encounter Heightened Discrimination (2021). ↑
Brad Sears et al., Williams Institute, LGBTQ Folks’s Experiences of Office Discrimination and Harassment (2024). ↑
GLAAD, LGBTQ Folks with Disabilities (final visited July 30, 2025). ↑
See usually Lindsay Mahowald, LGBTQ Folks of Shade Encounter Heightened Discrimination (2021). ↑
Judtih Graham, KFF Well being Information, LGBTQ+ Folks Relive Outdated Trauma as They Age on Their Personal (2024). ↑
Nationwide Park Service, Pleasure within the 1950’s (2025). ↑
Denny Chan & Vanessa Barrington, Justice in Growing old, How Can Authorized Providers Higher Meet the Wants of Low-Earnings LGBT Seniors (June 2016). ↑
Maine Human Rights Fee (2022); see SAGE, Nursing residence settles historic transgender discrimination criticism (June 16, 2022). ↑
SAGE, Inclusive Questions for Older Folks: A Sensible Information to Accumulating Information on Sexual Orientation and Gender Id (2024). ↑
Hansi Lo Wang, NPR, Census Bureau stopped work on information for safeguarding trans rights, former director says (2025). ↑
Workplace of the Lawyer Normal, Steering for Recipients of Federal Funding Relating to Illegal Discrimination (2025). ↑
Brad Sears et al., Williams Institute, LGBT Adults With Medicaid as Their Main Well being Insurance coverage 7 (2025). ↑
Dean Bunis & Kimberly Lankford, AARP, Understanding Medicare’s Choices: Components A, B, C, and D (2024). ↑
Brad Sears et al., Williams Institute, LGBTQ Folks’s Experiences of Office Discrimination and Harassment (2024) (noting {that a} third of LGBTQ staff report leaving a job sooner or later on account of therapy due to their gender id or sexual orientation). ↑
Ulrike Boehmer et al., Variations in Caregiving Outcomes and Experiences by Sexual Orientation and Gender Id (2018). ↑
Medicare.gov, Prices (final visited July 30, 2025). ↑
Brad Sears et al., Williams Institute, LGBT Adults With Medicaid as Their Main Well being Insurance coverage 2, 7 (2025). ↑
Justice in Growing old, LGBTQ+ Older Adults Can’t Afford Cuts to Medicaid (2025). ↑
Medicare.gov, Medicaid (final visited July 30, 2025). ↑
SAGE, Information on LGBT Growing old (2021). ↑
Jisoo Choi, Medicare Rights Middle, (2025). ↑
Justice in Growing old, Tales from the Area: LGBT Older Adults in Lengthy Time period Care Services (2015). ↑
See SAGE, LGBTQ+/HIV Lengthy Time period Care Invoice of Rights Toolkit(2025); see additionally SAGE, Minnesota Introduces Groundbreaking LGBTQIA2S+ and HIV Lengthy-Time period Care Protections (Might 27, 2025). ↑
Charles A. Emlet et al., The World Impression of HIV on Sexual and Gender Minority Older Adults: Challenges, Progress, and Future Instructions (2019). ↑
CDC, Quick Information: HIV in the US (2024).; CDC, Quick Information: HIV and Transgender Folks (2024). ↑
U.S. Dep’t of Well being & Hum. Servs., HIV.gov, Growing old and HIV(Aug. 20, 2024). ↑
Lindsey Dawson et al., KFF, Medicaid and Folks with HIV (2023). ↑
Medicare.gov, HIV (Human Immunodeficiency Virus) Screenings (final visited July 30, 2025). ↑
https://www.kff.org/hivaids/issue-brief/medicare-and-people-with-hiv/ Lindsey Dawson et al., KFF, Medicaid and Folks with HIV (2023). ↑
https://justiceinaging.org/lgbtq-older-adults-cant-afford-cuts-to-medicaid/ Justice in Growing old, LGBTQ+ Older Adults Can’t Afford Cuts to Medicaid (2025). ↑
Christy Mallory & Will Tentindo, Williams Institute, Medicaid Protection for Gender Affirming Care (2022). ↑
Middle for Medicare & Medicaid Providers, Gender Dysphoria and Gender Reassignment Surgical procedure (final visited July 30, 2025). ↑
https://www.kff.org/affordable-care-act/issue-brief/the-biden-administrations-final-rule-on-section-1557-non-discrimination-regulations-under-the-aca/ 45 CFR 92.101; Texas v. Kennedy, 24-40568 (beforehand Texas v. Becerra). ↑
https://www.govinfo.gov/content material/pkg/FR-2025-05-14/pdf/2025-08393.pdfWell being and Human Providers, Notification of HHS Paperwork Recognized for Recission (2025). ↑
42 U.S.C. § 18116 (2024). ↑
89 Fed. Reg. 40066 (Might 9, 2024). ↑
90 Fed. Reg. 15412 (Apr 11, 2025). ↑
Obergefell v. Hodges, 576 U.S. 644 (2015); Social Safety Administration, What Identical-Intercourse {Couples} Have to Know (2022).; AARP, Can same-sex married {couples} get Social Safety Advantages? (2022) (noting that capacity to entry spousal advantages for folks in common-law marriages is state dependent). ↑
AARP, Dignity 2022: The Expertise of LGBTQ Older Adults, 13 (2022). ↑
Lambda Authorized, Victory! Lambda Authorized Secures Social Safety Survivor’s Advantages for Identical-Intercourse Companions (2021). ↑
Social Safety Administration, Understanding Supplemental Safety Earnings SSI Eligibility Necessities — 2025 Version (2025). ↑
Social Safety Administration, SSI Federal Cost Quantities for 2025 (2025). Social Safety Administration, Countable Earnings for SSI Program (final visited July 30, 2025). ↑
AARP, Dignity 2022: The Expertise of LGBTQ Older Adults, 37 (2022). ↑
Emmett R. Henderson et al., Materials hardship and using social security internet packages amongst LGBT adults and their households (2024). ↑
Lauren J.A. Bouton et al., Williams Institute, LGBT Adults Aged 50 and Older within the US Through the COVID-19 Pandemic (2023). ↑
Nat’l HIV/AIDS Housing Coalition, Factsheet: FY26 President’s HUD Price range Impression on Folks Residing with HIV(2025); see Ctr. on Price range & Coverage Priorities, Excessive Hardship Amongst Black and Latinx LGBTQ Renters Underscores Want for Extra Housing Vouchers(Oct. 17, 2022) (citing now-deleted information from the U.S. Dep’t of Housing & City Improvement stating that LGBTQ households make up 12% of federal rental help customers). ↑
Andrew Cray & Jack Harrison, Ctr. For American Progress, ID Precisely Reflecting One’s Gender Is a Human Proper (2012). ↑
https://spssi.onlinelibrary.wiley.com/doi/full/10.1111/asap.12432 Id. ↑
AARP, Dignity 2022: The Expertise of LGBTQ Older Adults(2022). ↑
AARP, Sustaining Dignity: An AARP Survey of LGBT older adults age 45-plus (2018). ↑
Equal Rights Middle, Opening Doorways: An Investigation of Limitations to Senior Housing for Identical-Intercourse {Couples} (2014). ↑
Sandy E. James et al., Nat’l Middle for Trans Equality, 2015 U.S. Transgender Survey (2016). ↑
See, e.g., POZ.com, 6 Nursing Properties Accused of HIV Discrimination (Sept. 21, 2016), ↑
590 U.S. 644 (2020). ↑
Nationwide Alliance to Finish Homelessness, HUD’s Equal Entry Rule (2025). ↑
https://www.nytimes.com/2025/06/29/nyregion/trump-cuts-lgbtq-funding.html?unlocked_article_code=1.Sk8.jTjZ.JWgTb1fu4bQY&smid=url-shareLiam Stack, The New York Instances, Trump Cuts Threaten L.G.B.T Senior Facilities: ”That is About Folks” (2025). ↑
https://acl.gov/about-acl/authorizing-statutes/older-americans-actAdministration for Group Residing, Older Individuals Act (final visited July 30, 2025). ↑
https://www.aarp.org/pri/matters/social-leisure/relationships/loneliness-social-connections/G. Oscar Anderson & Colette Thayer, AARP, Loneliness & Social Connections: A Nationwide Survey of Adults 45 and Older (2018). ↑
https://hign.org/information/hign-news/addressing-loneliness-and-social-isolation-lgbtq-older-adults-perspectiveFidelindo Lim, Residence of Geriatric Innovation, Addressing Loneliness and Social Isolation: LGBTQ+ Older Adults Perspective (2024). ↑
https://www.hhs.gov/websites/default/information/surgeon-general-social-connection-advisory.pdfWell being and Human Providers, Our Epidemic of Loneliness and Isolation: The U.S. Surgeon Normal’s Advisory on the Therapeutic Results of Social Connection and Group (2023). ↑
Transfer for Starvation, Starvation within the LGBTQIA+ Group(final visited Sep. 3, 2025), ↑
Elisabetta M. Ferrero, Diet and well being within the Lesbian, Homosexual, Bisexual, Transgender. Queer/Questioning Group: A Narrative Assessment 14 Adv. Diet 1297-1306 (2003). ↑
Meals and Analysis Motion Middle, Federal Diet Applications for LGBTQ+ People & Households (2022). ↑