Skip to main content
SpringerLink
Log in

Older Adults

  • Chapter
  • First Online:
Trauma, Resilience, and Health Promotion in LGBT Patients

Abstract

Lesbian, gay, bisexual, and transgender (LGBT) older adults, their families, and communities have been and continue to be subjected to significant individual and collective trauma. Although they demonstrate incredible resilience and agency, they also experience ongoing barriers to healthcare access and disparities in health outcomes. This chapter highlights how traumatic historical discourses and current social contexts negatively impact health and well-being for these individuals and offers specific recommendations for healthcare providers that can further support resilience and health equity among LGBT older adult populations.

Some research reported in this publication was supported in part by grants from the National Institute on Aging of the National Institutes of Health under Award Numbers R01AG026526 and 2R01AG026526-03A1 (Fredriksen-Goldsen, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, National Institute of Aging, or the University of Utah.

Correspondence regarding this article should be addressed to Charles P. Hoy-Ellis, College of Social Work, University of Utah. 395 South 1500 East, #311 Salt Lake City, UT 84112. Email: Charles.Hoy-Ellis@socwk.utah.edu

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. U.S. Census Bureau. 2014 National population projections: summary tables. Table 9. Projections of the population by age and sex for the United States: 2015 to 2060: U.S. Census Bureau; 2015. Available from: https://www.census.gov/population/projections/data/national/2014/summarytables.html.

  2. Gates GJ, Newport F. Special report: 3.4% of U.S. adults identify as LGBT. Inaugural Gallup findings based on more than 120,000 interviews. Princeton: Gallup Polls; 2012. Available from: http://www.gallup.com/poll/158066/special-report-adults-identify-lgbt.aspx

    Google Scholar 

  3. Fredriksen-Goldsen IK, Hoy-Ellis CP. LGBT older adults emerging from the shadows: health disparities and risks and resources. In: Wilmoth J, Silverstein M, editors. The hierarchy of social support revisited. New York: Baywood Publishing Company, Inc.; (in press).

    Google Scholar 

  4. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: The National Academies Press; 2011.

    Google Scholar 

  5. Penhallurick RJ. Studying the English language. 2nd ed. Basingstoke/New York: Palgrave MacMillan; 2010. xv, 358 pp.

    Book  Google Scholar 

  6. Canaday M. The straight state: sexuality and citizenship in twentieth-century America. Princeton: Princeton University Press; 2009. xiv, 277 pp.

    Google Scholar 

  7. Johnson DK. The lavender scare: the Cold War persecution of gays and lesbians in the federal government. Chicago: University of Chicago Press; 2004. xii, 277 pp.

    Google Scholar 

  8. Carpenter D. Flagrant conduct: the story of Lawrence v. Texas. 1st ed. New York: W.W. Norton; 2012. xv, 345 p, 8 p. of plates p.

    Google Scholar 

  9. Carpenter D. Flagrant conduct: The story of Lawrence v. Texas. 1st ed. New York: W.W. Norton; 2012.

    Google Scholar 

  10. AVERT. History of HIV & AIDS overview Brighton, UK; 2015. Available from: http://www.avert.org/professionals/history-hiv-aids/overview.

  11. Supreme LA. Court bolsters gay marriage with two major rulings. New York; 26 June 2013. Available from: http://www.nytimes.com/2013/06/27/us/politics/supreme-court-gay-marriage.html?pagewanted=all&_r=0.

  12. Obergefell v. Hodges. No. 14-556, slip op. at 22 (U.S. June 26, 2015) (“The Court now holds that same-sex couples may exercise the fundamental right to marry.”). Available at: https://www.supremecourt.gov/opinions/14pdf/14-556_3204.pdf

  13. Fredriksen-Goldsen KI, Kim H-J, Emlet CA, Muraco A, Erosheva EA, Hoy-Ellis CP, et al. The aging and health report: disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle: Institute for Multigenerational Health; 2011.

    Google Scholar 

  14. Foucault M. The history of sexuality. 1st American ed. New York: Pantheon Books; 1978.

    Google Scholar 

  15. van Dijk TA. Critical discourse studies: a sociocognitive approach. In: Wodak R, Meyer M, editors. Methods of critical discourse analysis. 2nd ed. Los Angeles: Sage; 2009. p. 62–86.

    Google Scholar 

  16. Foucault M. The care of the self. 1st Vintage Books ed. New York: Vintage Books; 1988.

    Google Scholar 

  17. Silverstein C. The implications of removing homosexuality from the DSM as a mental disorder. Arch Sex Behav. 2009;38(2):161–3.

    Article  PubMed  Google Scholar 

  18. Koh J. The history of the concept of gender identity disorder. Seishin Shinkeigaku Zasshi. 2012;114(6):673–80.

    PubMed  Google Scholar 

  19. D’Emilio J. Sexual politics, sexual communities: the making of a homosexual minority in the United States, 1940–1970. Chicago: University of Chicago Press; 1983.

    Google Scholar 

  20. Archive, of American Television. TV history Los Angeles academy of television arts & sciences foundation; 2013. Available from: http://www.emmytvlegends.org/resources/tv-history.

  21. Berube A. Coming out under fire: the history of gay men and women in World War II. New York: Free Press; 1990.

    Google Scholar 

  22. Curran JW, Jaffe HW, (CDC) CfDCaP. AIDS: the early years and CDC’s response. MMWR Surveill Summ. 2011;60 Suppl 4:64–9.

    Google Scholar 

  23. Root PM. Reconstructing the impact of trauma on personality. In: Brown LS, Ballou M, editors. Personality and psychopathology: feminist reappraisals. New York: Guilford; 1992. p. 229–65.

    Google Scholar 

  24. Szymanski DM, Balsam KF. Insidious trauma: examining the relationship between heterosexism and lesbians’ PTSD symptoms. Traumatology. 2011;17(2):4–13.

    Article  Google Scholar 

  25. Human Rights Campaign. Why the equality act? Washington, DC: Human Rights Campaign; 2015. Available from: http://www.hrc.org//resources/entry/why-the-equality-act

    Google Scholar 

  26. Esping-Anderson G. De-commodification in social policy. The three worlds of welfare capitalism. Cambridge: Polity Press; 1990. p. 35–54.

    Google Scholar 

  27. Social Security Administration. Social security basic facts. Washington, DC: Social Security Administration; 2015. Available from: http://www.ssa.gov/pressoffice/basicfact.htm.

    Google Scholar 

  28. Fitzgerald E. No golden years at the end of the rainbow: how a lifetime of discrimination compounds economic and health disparities for LGBT older adults. Washington, DC: National Gay and Lesbian Task Force; 2013.

    Google Scholar 

  29. Hatzenbuehler ML, Keyes KM, Hasin DS. State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. Am J Public Health. 2009;99(12):2275–81.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Rostosky SS, Riggle EDB, Horne SG, Miller AD. Marriage amendments and psychological distress in lesbian, gay, and bisexual (LGB) adults. J Couns Psychol. 2009;56(1):56–66.

    Article  Google Scholar 

  31. Russell GM, Bohan JS, McCarroll MC, Smith NG. Trauma, recovery, and community: perspectives on the long-term impact of anti-LGBT politics. Traumatology. 2011;17(2):14–23.

    Article  Google Scholar 

  32. Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and all-cause mortality in sexual minority populations. Soc Sci Med. 2014;103:33–41.

    Article  PubMed  Google Scholar 

  33. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.

    Article  CAS  PubMed  Google Scholar 

  34. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Hendricks ML, Testa RJ. A conceptual framework for clinical work with transgender and gender noncomforming clients: an adaptation of the minority stress model. Profess Psychol Res Pract. 2012;43(5):460–7.

    Article  Google Scholar 

  36. Hoy-Ellis CP. Concealing concealment: the mediating role of internalized heterosexism in psychological distress among lesbian, gay, and bisexual older adults. J Homosex. 2015;63(4):487–506.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Hammack PL, Cohler BJ. Narrative, identity, and the politics of exclusion: social change and the gay and lesbian life course. Sex Res Soc Policy. 2011;8:162–82.

    Article  Google Scholar 

  38. Kertzner RM, Meyer IH, Frost DM, Stirratt MJ. Social and psychological well-being in lesbians, gay men, and bisexuals: the effects of race, gender, age, and sexual identity. Am J Orthopsychiatry. 2009;79(4):500–10.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Herek GM, Gillis JR, Cogan JC. Psychological sequelae of hate-crime victimization among lesbian, gay, and bisexual adults. J Consult Clin Psychol. 1999;67(6):945–51.

    Article  CAS  PubMed  Google Scholar 

  40. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  41. Fredriksen-Goldsen KI, Emlet CA, Kim H-J, Muraco A, Erosheva EA, Goldsen J, et al. The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. Gerontologist. 2013;53(4):664–75.

    Article  PubMed  Google Scholar 

  42. Fredriksen-Goldsen KI, Cook-Daniels L, Kim H-J, Erosheva EA, Emlet CA, Hoy-Ellis CP, et al. Physical and mental health of transgender older adults: an at-risk and underserved population. Gerontologist. 2013;54(3):488–500.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Fredriksen-Goldsen KI, Kim H-J, Barkan SE, Muraco A, Hoy-Ellis CP. Health disparities among lesbian, gay male and bisexual older adults: results from a population-based study. Am J Public Health. 2013;103(10):1802–9.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Zucker AN, Landry LJ. Embodied discrimination: the relation of sexism and distress to women’s drinking and smoking behaviors. Sex Roles. 2007;56(3/4):193–203.

    Article  Google Scholar 

  45. Absolut ES. Celebrates its 30 years of marketing to gay consumers. New York Times [Internet]. 2011; (Business Day Media & Advertising). Available from: http://www.nytimes.com/2011/10/27/business/media/absolut-heralds-its-marketing-to-gay-consumers.html?_r=0.

  46. Blosnich J, Lee JG, Horn K. A systematic review of the aetiology of tobacco disparities for sexual minorities. Tob Control. 2013;22:66–73.

    Article  PubMed  Google Scholar 

  47. National Center on Elder Abuse. Elder abuse FAQs. 2011. Updated 19 July 11. Available from: http://www.ncea.aoa.gov/faq/index.aspx.

  48. Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, Muzzy W, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100(2):292–7.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Frazer S. LGBT health and human services needs in New York State. Albany: Empire State Pride Agenda Foundation; 2009.

    Google Scholar 

  50. Fredriksen-Goldsen KI, Kim H-J, Hoy-Ellis CP, Goldsen J, Jensen D, Adelman M, et al. Addressing the needs of LGBT older adults in San Francisco: recommendations for the future. Seattle: Institute for Multigenerational Health; 2013.

    Google Scholar 

  51. Cook-Daniels L. Lesbian, gay male, bisexual and transgendered elders: elder abuse and neglect issues. J Elder Abuse Negl. 1997;9(2):35–49.

    Article  Google Scholar 

  52. and CfDC, Prevention. HIV in the United States: at a glance. Atlanta: Centers for Disease Control and Prevention; 2015. Available from: http://www.cdc.gov/hiv/statistics/overview/ataglance.html

    Google Scholar 

  53. Addis S, Davies M, Greene G, Macbride-Stewart S, Shepherd M. The health, social care and housing needs of lesbian, gay, bisexual and transgender older people: a review of the literature. Health Soc Care Community. 2009;17(6):647–58.

    Article  PubMed  Google Scholar 

  54. National Senior Citizens Law Center. LGBT older adults in long-term care facilities: stories from the field. 2011. Available from: http://www.lgbtlongtermcare.org/authors/.

  55. Nyblade L, Stangl A, Weiss E, Ashburn K. Combating HIV stigma in health care settings: what works? J Int AIDS Soc. 2009;12:15.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Fabbre VD. Gender transitions in later life: a queer perspective on successful aging. The Gerontologist. 2015;55(1):144–53.

    Article  PubMed  Google Scholar 

  57. Cook-Daniels L. Transgender elders and significant others, friends, family and allies (SOFFAs): a primer for service providers and advocates. Milwaukee: Transgender Aging Network; 2007.

    Google Scholar 

  58. Witten T. End of life, chronic illness, and trans-identities. J Soc Work End Life Palliat Care. 2014;10:1–26.

    Article  Google Scholar 

  59. American Medical Association. Removing financial barriers to care for transgender patients, House of delegates. Washington, DC: American Medical Association; 2008. p. 4.

    Google Scholar 

  60. Orel NA. Investigating the needs and concerns of lesbian, gay, bisexual, and transgender older adults: the use of qualitative and quantitative methodology. J Homosex. 2014;61(1):53–78.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Krehely J. How to close the LGBT health disparities gap. Washington, DC: Center for American Progress; 2009.

    Google Scholar 

  62. Foglia MB, Fredriksen-Goldsen KI. Health disparities among LGBT older adults and the role of nonconscious bias. Garrison: The Hastings Center; 2014. Contract No.: no. 5

    Google Scholar 

  63. LGBT SSaAf, Elders. Out & visible: the experiences and attitudes of lesbian, gay, bisexual and transgender older adults, ages 45–75. New York: SAGE; 2014.

    Google Scholar 

  64. Hildon Z, Montgomery SM, Blane D, Wiggins RD, Netuveli G. Examining resilience of quality of life in the face of health-related and psychosocial adversity at older ages: what is “right” about the way we age? Gerontologist. 2010;50(1):36–47.

    Article  PubMed  Google Scholar 

  65. Netuveli G, Wiggins RD, Montgomery SM, Hildon Z, Blane D. Mental health and resilience at older ages: bouncing back after adversity in the British Household Panel Survey. J Epidemiol Community Health. 2008;62(11):987–91.

    Article  CAS  PubMed  Google Scholar 

  66. Yates TM, Masten AS. Fostering the future: resilience theory and the practice of positive psychology. In: Linley PA, Joseph S, editors. Positive psychology in practice. Hoboken: Wiley; 2004. p. 521–39.

    Google Scholar 

  67. Centers for Disease Control and Prevention. Physical activity for everyone: older adults 2011. Available from: http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html.

  68. McFadden SH, Frankowski S, Flick H, Witten TM. Resilience and multiple stigmatized identities: lessons from transgender persons’ reflections on aging. In: Sinnott JD, editor. Positive psychology. New York: Springer; 2013. p. 247–67.

    Chapter  Google Scholar 

  69. Metlife Mature Market Institute. American society on aging. Still out, still aging: the Metlife study of lesbian, gay, bisexual, and transgender baby boomers. New York: Metlife Mature Market Institute and American Society on Aging; 2010.

    Google Scholar 

  70. Friend RA. Older lesbian and gay people: a theory of successful aging. J Homosex. 1991;20(3):99–118.

    Article  Google Scholar 

  71. Kimmel DC. Adult development and aging: a gay perspective. J Soc Issues. 1978;34(3):113–30.

    Article  Google Scholar 

  72. Bogart P. Torch song trilogy. United States: New Line Cinema; 1988.

    Google Scholar 

  73. Tedeschi RG, Calhoun LG. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq. 2004;15(1):1–18.

    Article  Google Scholar 

  74. Unger RK. Outsiders inside: Positive marginality and social change. J Soc Issues. 2000;56(1):163–79.

    Article  Google Scholar 

  75. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing Company; 1984.

    Google Scholar 

  76. de Vries B, Croghan C. LGBT aging: the contributions of community-based research. J Homosex. 2014;61:1–20.

    Article  PubMed  Google Scholar 

  77. de Vries B. Stigma and LGBT aging: negative and positive marginality. In: Orel NA, Fruhauf CA, editors. The lives of LGBT older adults: understanding challenges and resilience. Washington, DC: American Psychological Association; 2015. p. 55–71.

    Chapter  Google Scholar 

  78. Knauer NJ. Navigating a post-windsor world: the promise and limits of marriage equality (August 28, 2014). Available at SSRN: https://ssrn.com/abstract=2448296.

  79. House JS, Lantz PM, Herd P. Continuity and change in the social stratification of aging and health over the life course: evidence from a nationally representative longitudinal study from 1986 to 2001/2002 (Americans’ changing lives study). J Gerontol Series B-Psychol Sci Social Sci. 2005;60B(Special Issue II):15–26.

    Article  Google Scholar 

  80. American, Aging So. What’s different about LGBT informal caregiving? San Francisco: American Society on Aging; 2016. Available from: http://www.asaging.org/blog/whats-different-about-lgbt-informal-caregiving

    Google Scholar 

  81. Sabin JA, Riskind RG, Nosek BA. Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. Am J Public Health. 2015;105(9):1831–41.

    Article  PubMed  Google Scholar 

  82. Hays AP. Addressing cultural complexities in practice: a framework for clinicians and counselors. Washington, DC: American Psychological Association; 2001.

    Book  Google Scholar 

  83. Fredriksen-Goldsen KI, Simoni JM, Kim H-J, Lehavot K, Walters KL, Yang J, et al. The health equity promotion model: reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities. Am J Orthopsychiatry. 2014;84(6):653–83.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Fredriksen-Goldsen KI, Hoy-Ellis CP, Goldsen J, Emlet CA, Hooyman NR. Creating a vision for the future: key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services. J Gerontol Soc Work. 2014;57:80–107.

    Article  PubMed  PubMed Central  Google Scholar 

  85. American Psychological Association. Publication manual of the American Psychological Association. 6th ed. Washington, DC: American Psychological Association; 2010.

    Google Scholar 

  86. American Psychological Association. Practice guidelines for LGB clients: guidelines for psychological practice with lesbian, gay, and bisexual clients. Washington, DC: American Psychological Association; 2011. Available from: http://www.apa.org/pi/lgbt/resources/guidelines.aspx.

    Google Scholar 

  87. Knochel KA, Croghan CF, Moone RP, Quam JK. Training, geography, and provision of aging services to lesbian, gay, bisexual, and transgender older adults. J Gerontol Soc Work. 2012;55(5):426–43.

    Article  PubMed  Google Scholar 

  88. Orel NA, Fruhauf CA. The lives of LGBT older adults: understanding challenges and resilience. 1st ed. Washington, D.C: American Psychological Association; 2015.

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. College of Social Work, The University of Utah, 395 South 1500 East, Salt Lake City, UT, 84112, USA

    Charles P. Hoy-Ellis MSW, PhD, LICSW

Authors
  1. Charles P. Hoy-Ellis MSW, PhD, LICSW
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles P. Hoy-Ellis MSW, PhD, LICSW .

Editor information

Editors and Affiliations

  1. Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Kristen L. Eckstrand

  2. William B. Castle Society, Harvard Medical School, Boston, Massachusetts, USA

    Jennifer Potter

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Hoy-Ellis, C.P. (2017). Older Adults. In: Eckstrand, K., Potter, J. (eds) Trauma, Resilience, and Health Promotion in LGBT Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-54509-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54509-7_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54507-3

  • Online ISBN: 978-3-319-54509-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation