LGBTQ+ elders of color face special challenges
By Jay Nachman
Not all needs are the same for people who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ+). People of color face additional challenges, according to Dane E. Menkin, a family nurse practitioner and director of LGBTQ Services for Main Line Health.
Many of these issues are compounded further for older LGBTQ+ people of color. Older members of LGBTQ+ communities can confront isolation, lack of access to social services and financial support.
“Many (older adults) have less access to quality care,” Menkin said. “You see higher rates of people covered under Medicare who are unable to afford quality supplement coverage for their out-of-pocket costs, which limits their access to high quality health systems and specialty care.”
Also affecting people of color Menkin said is that “built-in institutional biases unfortunately means different levels of care. If you have an already dwindling social support network, then as soon as you add in that recognizable minority status, then you have added on (the challenges of discrimination). So now you’re older and you’re LGBTQ+, and you have Medicaid or Medicare with maybe inadequate supplements. And now you are a visible, recognized minority. That plays a big role in how you’re perceived. And we know perception is everything in treatment.”
It will take decades before some of the institutional biases and societal racism will be dismantled, Menkin said.
Whether older or not, transgender people of color are at the highest risk of violence, poor or inadequate health care, and poverty, Menkin said.
One patient of Menkin’s provides an instructive example of the challenges LGBTQ+ people of color face. His patient is a transgender woman of color in her early 60s with Type 2 diabetes. She doesn’t like to do a lot of the health screenings and maintenance that comes with that diagnosis, such as mammograms or specialty checkups with podiatrists or optometrists.
The gender marker on her Medicare card remains male. “She feels like every time she accesses any health care services, that gender marker outs her as transgender. This prevents her from pursuing vital screenings,” Menkin said. “She’s not recognizable as anything other than female except in certain vulnerable ways and that’s where she draws the line.”
This vulnerability happens across the board in many areas of health care, Menkin said, pointing out home care and hospice as other examples. “Now we’re having aides coming into LGBTQ+ people’s homes to provide these services, which raises a whole other level of worry,” he said. “Who am I living with, and what does my house look like? It heightens that level of vulnerability. I think home care and end-of-life care are places that we have not done well by aging LGBTQ+ people in many, many ways. It’s important for our aging community (to receive compassionate services). I do think there is progress, albeit slow. Anytime you raise awareness, you move the needle.”
Support for LGBTQ+ elders of color
Call BlackLine provides a space for peer support, counseling, reporting of mistreatment, witnessing and affirming the lived experiences for people who are the most impacted by systematic oppression with an LGBTQ+ Black lens. Call 1-800-604-5841, go to CallBlackLine.com or download the app.
SAGE (Advocacy and Services for LGBTQ+ Elders) partnered with HearMe, an on-demand mental wellness app, to provide compassionate support 24/7. For information, go to sageusa.org/hearme.
Jay Nachman is a freelance writer in Philadelphia who tells stories for a variety of clients.
