The LGBT community is a heterogeneous group comprised of lesbian, gay, bisexual and transgender individuals. According to census estimates, there are approximately 335,000 LGBT seniors in Canada, though this figure is understood to be an underestimate. Self-reporting is limited because many LGBT seniors are reluctant to be open about their sexual orientation or gender identity (Tang, 2015).
While many social and legislative changes in Canada have led to a considerable increase in the recognition of the rights of LGBT Canadians (Brotman et al., 2010), the history of the LGBT community is tainted in Canada and around the world by homophobic discrimination, stigmatization and exclusion by society (Brotman et al., 2010; Cassidy, 2007; Groupe SOS, SOS homophobie and AIDES, 2013). Yet LGBT seniors, many of whom were once required to keep their identity or sexual orientation secret, are still afflicted by the consequences of their traumatic experiences; and many forms of discrimination are still ongoing.
Discrimination towards older LGBT adults can be related to numerous factors; for example, as a result of having a sexual orientation that is different from the majority, aging, being a woman, having HIV/AIDS, or identifying with a sub-culture. Such discrimination can have a multiplier rather than a cumulative effect (Hébert et al., 2012; Orel, 2014). For certain LGBT seniors, living with multiple forms of discrimination poses additional challenges when they need support from their friends and families, or when they are looking for a suitable place to live (Orel, 2014). This complicates their access to services, such as health care, and has a direct impact on their overall health (Porter and Krinsky, 2014).
Indeed, there is considerable literature demonstrating that LGBT people experience discrimination in accessing health services. Several studies carried out in the 1990s and early 2000s revealed that older LGBT adults stated that they experienced discrimination in their interactions with health care professionals (Brotman et al., 2010), a situation that appears to be unchanged (Orel, 2014; Stein et al., 2010).
A study in the United States showed that discrimination can prevent LGBT seniors from seeking out resources (Orel, 2014), which may have serious consequences on their well-being (Brotman et al., 2010). Trans seniors who have not completed their physical transformation have even been forced to revert to behaviours associated with their original gender (clothing, etc.) (Latham, 2016). These experiences can lead to social isolation.
Additionally, LGBT seniors may have weak primary networks on which they can count on in situations of lost autonomy (Groupe SOS, SOS homophobie and AIDES, 2013; Stein et al., 2010). This may be due to the fact that they did not have children or that their network does not accept their LGBT identity (Orel, 2014). LGBT individuals who reveal their identity once they are older risk living separated from their friends and family (Groupe SOS, SOS homophobie and AIDES, 2013), which leads to a fear of coming out or a tendency to keep a certain distance in order to avoid rejection (Orel, 2014). Moreover, LGBT seniors who are out and maintain good relations with their friends and family indicate that these ties seem to break down as they get older for no apparent reason (Orel, 2014). The social network of LGBT seniors is therefore most often comprised of other LGBT persons (Orel, 2014). For some of them, in particular lesbians, friends come to be considered as family members (Gabrielson et al., 2014).
Furthermore, the spread of HIV in the 1980s directly affected the primary network of several LGBT people as a result of the death of their significant others, which contributed to the breakdown of their social network and their increased isolation (Groupe SOS, SOS homophobie and AIDES, 2013; Larkin, 2008; Orel, 2014). The weak social network, combined with difficult social recognition leads some LGBT people to dread the moment when they will lose their autonomy (Orel, 2014). Some consider suicide in order to avoid finding themselves in this type of situation (Witten, 2014, quoted by Zelle and Arms, 2015).
Other factors are also important. Isolation is apparently easier to overcome in an urban setting, where the LGBT community is larger and more visible (Erdley et al., 2014). This poses major challenges in a country like Canada, where urban settings are limited. Social isolation seems to have a more direct effect on homosexuals and bisexuals who hide their identity or don’t fully accept it than on those who assume their identity more openly (Camenzind, 2012). Additionally, the more that LGBT seniors live anonymously, the harder it is for services to reach them (Camenzind, 2012). This difficulty is also experienced by trans seniors depending on when their identity change took place (Hébert et al., 2012). Those who begin it later in life have much more difficulty with psychological and physiological adaptation, as well as with social acceptance (Cook-Daniels, 2001, quoted by Hébert et al., 2012).
As they age, older homosexual adults, and in particular men, also report feeling excluded from their community, which has a strong sub-culture that values youth and sexuality (Cassidy, 2007). Some seniors therefore have their need to socialize met in open religious communities, where they can become involved and have social relationships that are not focused on sexuality (Cassidy, 2007).
The literature therefore suggests that LGBT seniors are particularly vulnerable when it comes to social isolation, though precise numbers are often lacking. Given the multilayered challenges they encounter related to complex and ongoing histories of discrimination, LGBT seniors face many challenges that contribute to isolation and loneliness.