Recently, I’ve been doing some work with a network for older LGBT people. The issues raised in the meetings are so important that I’ve decided to share some of them here. When older LGBT people require extra care or need to enter residential accommodation they encounter a whole range of problems which heterosexual people do not experience, some of which can have a devastating impact on their lives.
At present, managers and care workers in the UK are not required to undertake training in LGBT issues and they often do not know how to deal with the specific problems that may arise. A lot of the trouble stems from good old fashioned heterosexism – the assumption that the world is heterosexual – but older people also have to face more overt homophobia and transphobia. In the first instance, when placed in residential care, they have to confront the coming out process. Bearing in mind that they have to live with these people every day, do they come out to their care workers and fellow residents, or face a secret life again? If they’ve lost their partner, is it safe to put out photographs? Is it safe to talk about their life to anyone? A fairly large percentage of older LGBT people are single and questions and comments about grandchildren and family can be very painful, especially if they have been disowned by their own families. If they do have a partner how do they insist on staying together in a system which tends only to recognise marriage and in accommodation where staff and other residents may not react positively to the presence of a lesbian or gay couple? Moreover, homes rarely recognise the alternative families of choice often so important to LGBT people.
Actions which seem unimportant to heterosexual people can cause intense distress to older LGBT people. We have cases of older lesbians denied pyjamas and given nightdresses when they haven’t worn such a garment for 40 or 50 years and to do so is wounding to their sense of identity. Older gay men express fear that their camp self-expression will be received badly by their heterosexual male peers. For some older people whose sexuality has long been repressed, desires can surface late in life. The staff in one home were bewildered when two older men who had been married and widowed entered into a sexual relationship together. It had simply never occurred to them that this could happen. Dementia can also bring long repressed desires to the surface and create a situation which, without training and proper understanding, can be distressing to everyone.
In the UK the Government is pushing for more care in the home. This is all well and good, but the shift actually presents additional fears for older LGBT people. Members of the network expressed a feeling that this could lead to a worse situation if they found themselves alone in their homes with a homophobic or transphobic carer. They don’t want to denigrate the work carers do, but where are the safeguards against bullying?
Unsurprisingly, some of the worst stories have to do with transsexual and transgendered older people. We have one older pre-operative transsexual woman who’s been in hospital for a year because all the local homes are refusing to accommodate her. Worse still, we have recently had two cases of older pre-operative transsexual women actually being denied their hormone prescriptions when they entered residential care because the care home doctors “didn’t believe in it.” They rely on the hormones to keep them physically, mentally and emotionally stable. ** During the 1960s an influential psychiatrist discouraged people from fully transitioning and some of these women are now surfacing as they grow older and need care. They’re in a kind of gender limbo and can be treated as the sex written on their birth certificates, despite the fact that they have lived as women for many years. When I hear these stories I’m angered by the disjunction between some kinds of feminist theory and the dangerous reality of people’s lives. Some feminists argue that people shouldn’t get bottom surgery because it reiterates gender roles; well, tell that to an older LGBT person denied treatment or refused admission to a care home because she or he didn’t get the surgery. I doubt it would be much consolation. But if you have had the surgery, you still have to face the decision whether to tell people or the fear of being found out.
Of course this is also an economic issue. As ever, people with money will have a fair bit of choice and power in terms of what kind of services they use, whereas poorer people will have to take what they’re given and will not have much chance of changing the situation if it turns out badly. I’m therefore convinced that we’re in dire need of good advocacy services for older LGBT people and that those who work with older LGBT people must receive compulsory training in the issues. We probably need care homes and services which are publicly designated LGBT friendly and we might even need LGBT-only homes, as some older people are not comfortable living with heterosexual peers who they fear may well be homophobic and transphobic.
** I should add that this situation has now been rectified, but not without a considerable struggle.