Features | Seniors: Out of the closet, into the system

The Canadian health care and social service sectors are fairly saturated with resources for senior citizens, and now more than ever, workers in these fields are beginning to recognize that “seniorhood” is not a stand alone section of the population – health and social work programs tailored to meet specific needs of immigrants, different ethnic groups, and other intersectional diversities have been cropping up more frequently in the last decade. But while recognition of visible minorities in the community is an important step in eldercare, other, less visible groups remain on the margins. Seniors who are lesbian, gay, bisexual, or transsexual are often doubly marginalized, their needs ignored or overlooked by both elder care systems and gay communities.

Laurent McCutcheon, president of Fondation Émergence, a Montreal organization that advocates for LGBT people, stressed that “[health care and social] services are not ready for homosexual seniors.” He pointed out that in terms of eldercare, provisions for sexuality in social work and health care are omitted at almost every level of government  – from municipal Golden Age groups, all the way to provincial and national ministries. “There is complete silence,” he said. 

Shari Brotman, Associate Professor at the Mcgill School of Social Work and co-author of the 2007 study, “The Health and Social Service Needs of Gay and Lesbian Seniors and Their Families in Canada,” has observed similar attitudes in health care and social service providers. Working in gerontology for a number of years, she noticed that her colleagues did not often acknowledge the needs of older LGBT people in discussions of elder care. “I really found that, in the field, people did not consider or understand some of the issues for LGBT seniors. Many even said, ‘we have no gay seniors or gay clients,’” Brotman said.

A 2003 Quebec study, cited in Fondation Émergence’s and Gai Écoute’s 2007 report, “Consultation publique sur la condition des aînés,” found that LGBT seniors were wary of social and health care services due to perceived heterosexist and homophobic attitudes of these systems. The respondents also felt that these service providers lacked knowledge pertaining to their particular experiences, and were not attuned to the realities of LGBT lifestyles. Indeed, many health and social service standards and policies are based on largely on heteronormative assumptions. In cases of loss of autonomy, for example, questions on forms regarding primary caregivers are often limited to husband, wife, or biological children, rather than same- sex partners.

But LGBT seniors have also been invisible in the gay community. People who are over 70 today grew up in the years before the gay liberation movement; homosexuality was only decriminalized in Canada in 1969, and was considered a mental illness until 1972. As a result, many LGBT seniors have a tendency to be more private about their sexuality, and less politically active in terms of demanding LGBT-specific services. Brotman noted that this stands in contrast to the LGBT baby-boomer generation, who have been a strong, loud voice for queer rights and recognition. 

The mostly inhospitable climate within which members of the older LGBT generation came to understand their own sexual orientations has dictated several of the health and social service needs that LGBT seniors face today. “[LGBT seniors’] needs are different, because they are largely folks who may have come out later in their lives…who have experienced an environment with much more hostility, loss of family, potential loss of jobs. And for a lot of these people the health care system would have psychiatrized them,” Brotman explained. She added that, “seniors now, and those who will be seniors soon, may have lived through discrimination and trauma in their lives, so there is a potential distrust of health care, or specific health problems that have arisen as a result.” She noted that special attention needs to be given to health concerns such as depression and addiction, which may have been influenced by an individual’s struggles throughout his or her lifetime.

Although health care and social services systems remain inaccessible for many older LGBT people, work is being done to promote awareness of this community and its particular needs. Several studies published in the past few years have explored and analyzed the concerns of LGBT seniors, and some service providers have taken the hint. Moreover, social work research often does not end with the published paper. The Brotman et. al. study, for example, has a social action component, involving consultation with organizations, presentations, and ongoing discussion with communities nationwide. “Having research to back up and legitimize people’s experience is really positive, as long as that research is being used for social change,” Brotman noted.

The 519 Community Centre in Toronto is a perfect example of this concept. After a 2000 study determined that there was a general oversight and lack of understanding of LGBT seniors’ issues, resulting in exclusion, the Centre initiated a program geared specifically toward older LGBT people. The program offers resources for seniors, book clubs, creative workshops, and a drop-in centre for older LGBT folks to meet, socialize, and provide support for each other.  

The City of Toronto’s Long-Term Care Homes and Services has also begun to acknowledge and celebrate the experiences of LGBT seniors. An initiative in the residences has seen the celebration of Gay Pride Day and the implementation of activities like gay movie nights. “[A gay movie night] may seem like a small thing,” said Brotman, but in terms of recognition it is really important for people in that community – who are in closet, for example – to feel that it is a more welcoming community.” 

McCutcheon emphasized the importance of inclusion when considering the needs of elderly LGBT people. “We must understand that homosexuality is a normal phenomenon, and that [LGBT people] are like everyone else,” he said. “My approach is not to isolate LGBT people. My approach is to say that we need to work to ensure that this becomes a question of inclusion.  All LGBT seniors must find their place in [health care and social service] systems…. [Service providers] need to be ready to welcome LGBT seniors. It’s up to them to adjust.”