Out, proud and growing older: Aging in the LGBTQ+ community

“Without the support of our community and our allies we will become even more isolated and may even revert back to the ‘closet’.”

PROVIDENCE – “We’re here, we’re queer, get used to it!”

That forceful phrase marked the rallying cry for a generation of LGBTQ+ Americans as they demanded their right to visibility over the course of many decades.

They are still here. However, for many lesbian, gay, bisexual and transgender people, today’s advocacy efforts are focused on issues of aging gracefully rather than sexual freedom. Their fight has turned to the need for access to safe, welcoming housing, affirming healthcare and inclusive social circles.

“As we age, we become more and more invisible and, I believe, this is even more prevalent in the LGBTQ+ community,” explained Linda Ciolfi, a retired licensed clinical social worker and therapist. Ciolfi specialized in working with members of the LGBTQ+ community and continues to provide training on this topic.

According to a report from the Rhode Island Foundation, LGBTQ+ Voices in RI (Voices), published in July 2024, the Ocean State has one of the largest LGBTQ+ populations in the country, ranking 10th nationwide: 54,800 adults or nearly 6.5 percent of the population.

Much like the rest of the country, members of this community are growing older in large numbers. According to the U.S. Census Bureau, the number of Americans ages 65 and older will more than double over the next 40 years, reaching 80 million in 2040. The number of adults ages 85 and older, the group most often needing help with basic personal care, will nearly quadruple between 2000 and 2040.

In local terms, Rhode Island has the fourteenth highest population of 65+ year old adults in the nation and the fifth highest population of adults aged 85 or older.

As each of us have unique needs as we age, so too does the LGBT+ community.

A Welcoming Home

Many LGBTQ+ seniors worry about how they will be accepted and treated if they had to move into a nursing or assisted living home.

Quinten Foster, Director of Transgender Whole Healthcare for the East Bay Community Action Program (EBCAP), conducted the 2024 RI LBGTQIA+ Needs and Experiences Assessment (Assessment), which provided invaluable information regarding the LGBTQ+ perspective on a wide range of subjects, including housing.

“When we consider the experiences of LGBTQ+ elders, there are unique factors that influence how that housing crisis is impacting them. First, they are less likely than their cisgender straight counterparts to have family members who are involved in their care as they age.”

Without children of their own, LGBTQ+ elders may not have a readily available caregiver and often hire someone to come into their home which understandably raises issues of trust and safety.

Ultimately, like many older Rhode Islanders, LGBTQ+ adults needing more care will seek to move into assisted living or a nursing home, which brings with it unique concerns.

Foster adds, “This can be a challenge for a lot of elders as they have to manage their own safety while receiving very intimate types of care—is it better for them to continue living their truth, or is it better to go back into the closet for safety reasons?”

The thought of moving into a long-term care facility with strangers is a worrisome prospect for many.

Mev Miller, founder and director of Wanderground Lesbian Archive/Library and member of Old Lesbians Organized for Change (OLOC) shared her concerns.

“I’m not excited about going into a senior facility. My partner and I own our home and hope to be able to stay here as long as we can.”

Speaking of friends who have moved into congregate housing, she added:

“The older lesbians that I know are living in a very heterosexual environment. One couple is often referred to as ‘friends’ when they’ve been in a relationship for ages. They’re not treated poorly but they constantly have to come out. Plus many couples end up separated in living facilities.”

Affirming Healthcare

The concerns about access to healthcare are similar to those related to housing. Older LGBTQ+ folks want to feel that they can be open and honest about their sexual and gender identity with the people responsible for their well-being.

Ciolfi shared, “I would want staff at medical facilities who were friendly and knowledgeable about medical issues facing older LGBTQ+ folks. Having to explain your identity when facing a medical crisis only adds to one’s anxiety and fears.”

According to the EBCAP Assessment, 26% of respondents shared that they were concerned that their providers would not understand or respect their LGBTQ+ identities and needs.

Although LGBTQ+ competence in healthcare is not where it needs to be, Foster explained that the team at EBCAP is addressing the issue, “We are doing our best to improve those numbers by providing professional development opportunities on LGBTQ+ health and needs to healthcare providers.”

When seeking care, Miller said that she worries about how she’ll be treated, “As out as I am, there are still moments where I have to assess the situation. Can I trust these people? Especially with the climate we’re in now [in this country].”

She adds that she considers herself fortunate to have found a healthcare professional who understands her needs as a lesbian.

Meaningful Social Circles

Isolation is a major issue for aging adults from every walk of life. Friends and family pass away, often leaving elders on their own without networks of support.

The research from the Rhode Island Foundation’s Voices report indicates that forty percent of LGBTQ+ elders experienced dwindling social connections as they have aged and about 34% of older LGBTQ+ people live alone, compared to 21% of non-LGBTQ+ people.

States Ciolfi: “Without the support of our community and our allies we will become even more isolated and may even revert back to the ‘closet’.”

In Foster’s Assessment, they observed that “dwindling social networks in older age have a strong impact on many LGBTQ+ elders.”

Describing her own situation, Miller said “I haven’t particularly felt lonely, although without Zoom I would be pretty isolated. The spaces where we used to meet don’t exist anymore.”

Still Here, Still Queer and Not Going Anywhere

But the LGBTQ+ community is nothing if not resilient. Many individuals are creating solutions to the unique challenges facing them as they age.

Mev Miller with Wanderground — Submitted photo

To address the issue of isolation, Miller founded the lesbian archive/library Wanderground which brings women together to celebrate their history and accomplishments.

“With Wanderground,” she explained, “we’re creating a space where lesbians can meet, where they can come together as a community. It’s a social space where we can explore our herstory with a collection of materials from 1950 to 2000. As people age and die off, that story gets lost.”

The archive is not just for famous or well-known people. Anyone can contribute their personal items to the archive. Every story has value.

Wanderground continues to host pop-up events throughout New England and welcome guests by appointment at their permanent space.

Members of the LGBTQ+ community are also joining together to support one another through the Circle of Pride, a chapter of The Village Common of Rhode Island, a community organization of members and volunteers working to enhance the experience of growing older.

Circle of Pride Picnic – Submitted photo

The Circle recruits volunteers who assist LGBTQ+ elders with basic activities like driving them to appointments, running errands, household chores and light maintenance, as well as providing technology support for TVs, phones and computers. Volunteers connect with members which also allows them to check in on their socio-emotional well-being.

Ciolfi, one of the Circle’s founding members, describes their impact, “The Circle of Pride offers a safe, inclusive place for older adults to access needed services as well as hosting events to bring community together and hopefully lessen isolation.”

In 2025, the Circle of Pride volunteers plan to increase their presence, serving even more members in need of resources and support.

LGBTQ+ elders are often concerned about the institutions where they receive their services, particularly healthcare. To ensure that they feel comfortable in a welcoming environment, Blue Cross Blue Shield of Rhode Island created the Safe Zone program.

“Our Safe Zone program helps guide older LGBTQ+ Rhode Islanders to care settings that have demonstrated they are providing a safe, inclusive, and affirming experience for LGBTQ+ individuals,” said Scott Gowrie, Corporate Social Responsibility Specialist and Safe Zone Program Lead.

Participating organizations earn their Safe Zone endorsement from Blue Cross by verifying that they follow best practices including training staff in cultural competency, establishing and following non-discrimination policies, providing gender-neutral facilities, and ensuring identity is affirmed during intake and thereafter.

Currently more than 130 sites in the Ocean State are now certified as Safe Zones. Many of them provide care and services for older adults.

For elder LGBTQ+ adults, the future is now. As this irrepressible population grows, so do the struggles they face, but these challenges are not insurmountable. Historically, this group has overcome obstacles by joining together and rallying for progress. Age will not alter their strategy which has already been shown to have a long-lasting impact.