This blog post was written by Meagan McKinstry, a second year law student from Northeastern University School of Law and an Equal Justice Works Elder Justice Americorps law student who worked with the Elder Abuse Prevention Project this Summer
This is the first post in a three-part series written by Meagan and focusing on LGBT elders. Parts two and three will discuss religious exemption laws and LGBT-specific elder abuse issues
Lesbian, Gay, Bisexual, and Transgender (LGBT) older adults confront particular challenges that may prevent successful aging. There are three key elements to successful aging: financial security, good health and health care, and social support and community engagement.  Multiple barriers, discussed below, prevent many LGBT older adults from achieving these important goals.
LGBT older adults have an increased risk of poverty due to the history of discrimination against them.  32% of all LGBT elders age 50+ live at or below 200% of the Federal Poverty Line (FPL), compared to 25% of non-LGBT-elders.   The proportions are even higher for LGBT elders who are over age 80 (40%), African American or Hispanic (40%), bisexual men (47%), bisexual women (48%), and transgender elders (48%).   Employment discrimination is one explanation for this. For instance, 51% of transgender women report not being hired because of their gender identity. Employment discrimination contributes to lower earning power, which can result in lower Social Security payments. Additionally, LGBT elders whose partners died before marriage equality was legalized may not be able to access various spousal benefits. The effect of this is that 42% of LGBT elders are very or extremely concerned they will outlive their retirement savings, compared to just 25% of non-LGBT elders. 
LGBT elders may also encounter housing discrimination. There is already a shortage of affordable housing for elders in general, so when discrimination is factored in, LGBT elders are in considerable danger of being denied housing, evicted, overcharged, or otherwise mistreated. Unfortunately, 50% of the LGBT population in the U.S. lives in states with no law prohibiting housing discrimination on the basis of sexual orientation or gender identity. In one study, half of older same-sex couples applying for housing in 10 states experienced overt discrimination. An LGBT older adult’s race also plays a role; 1 in 4 LGBT elders of color have experienced housing discrimination based on race.  All of this places LGBT elders at greater risk of housing insecurity and homelessness.
Good Health and Health Care
As members of a marginalized community, LGBT elders may experience minority stress, which results from exposure to discrimination and can impact both physical and mental health. In fact, 44% of transgender elders worry that their relationships with healthcare providers would be adversely affected if they were to come out. The same is true for 34% of Hispanic LGBT elders and 23% of black LGBT elders, compared to 16% of white LGBT elders. On top of that, LGBT older adults also encounter barriers within the health care system that prevent them from accessing competent care. For example, LGBT veterans discharged from the military under the Don’t Ask, Don’t Tell policy may be ineligible for veterans’ benefits, including health care. 
Social Support and Community Engagement
While many elders either are alone or fear becoming so, LGBT older adults are especially vulnerable. Sadly, LGBT elders are more likely to be afraid of dying alone, especially in places where LGBT people have fewer rights.  They are twice as likely as non-LGBT elders to live alone , and are “more likely to be single, childless, and estranged from their biological family.”  Those who lack connection to their biological family may have selected a “chosen family” made up of close friends, but chosen families are less reliable than biological families for several reasons. First, chosen family members are often the same age as the elder, so their physical and/or mental condition may limit their ability to provide care and support.  The lack of legal relationship between LGBT elders and their chosen family also means that chosen family members are not entitled to take time off from work to assist with care. Similarly, chosen family may not have the legal right to share health insurance plans with the elder, or to make medical decisions for them.  Therefore, even if LGBT elders have people close to them, they still may lack the support they need, which leaves them vulnerable to abuse and exploitation.
Breaking Down the Barriers
While LGBT elders have some disadvantages when it comes to successful aging, there are things that can be done to address the problems. Several organizations are already making efforts to create change, but a lot more work is needed to close the gap between LGBT elders and their straight counterparts. The following list of action items is adapted from a guide  created by the Movement Advancement Project and the National Resource Center on LGBT Aging:
- Legislatures should pass anti-discrimination employment and housing protections.
- Elder housing facilities should adopt explicit non-discrimination policies.
Health and Health Care
- Medical service providers should receive cultural competency training.
- Congress should pass a law that makes LGBT veterans discharged under the Don’t Ask, Don’t Tell Policy eligible for veterans’ benefits.
Social Support and Community Engagement
- The Older Americans Act should recognize LGBT people as a population of “greatest social need.”
- Elder community centers and LGBT community centers should create supportive spaces for LGBT elders.
- The US Department of Health and Human Services should designate LGBT elders as an underserved population.
Additionally, there are a number of organizations that strive to provide the support that LGBT elders all too often lack. Here are some of them:
- National Resource Center on LGBT Aging (led by SAGE)
- LGBT Aging Project (focused in Massachusetts)
- Flashback Sunday (a support group in Massachusetts for LGBT older adults of color)
- National Organization of Black Lesbians on Aging
- Diverse Elders Coalition
- FORGE Transgender Aging Network
- SAGE LGBT Elder hotline (1-888-234-SAGE or sage@GLBThotline.org)