The LGBT Elder Americans Act

A Critical Analysis of Policy through Life Course and Equity Perspectives

  • Austin G. Oswald Graduate Center, City University of New York
  • Daniel Gardner Silberman School of Social Work, Hunter College
  • Nancy Giunta Silberman School of Social Work, Hunter College
Keywords: Gerontology, policy change, sexual orientation, gender identity, LGBT, older adults, LGBT Elder Americans Act

Abstract

The social positioning of lesbian, gay, bisexual, and transgender (LGBT) older adults is influenced by a constellation of historic and contemporary policies that shape the way they interact with the world around them. Although the past few decades have witnessed several legislative decisions that reflect a more open stance toward LGBT individuals, there remains a lack of federal policies that protect them. This paper provides a critical analysis of the LGBT Elder Americans Act of 2019, a bill amending the Older Americans Act of 1965 to include LGBT older adults in the definition of those with “greatest social needs” for the purpose of service planning and implementation. As a theoretical framework, we apply a life course perspective and an equity lens to examine the promise and limitations of the LGBT Elder Americans Act in meeting the needs of LGBT older adults. It is critically important for social work practitioners, policy makers, and scholars to understand the principles that drive policy debates so that they can advocate on behalf of the most vulnerable members of the population. We offer three recommendations for future policy making: i) Apply a life course perspective to understand the lived experiences of LGBT elders; ii) Apply an equity lens to public policy; and iii) Expand research to guide and advance policy development.

References

Administration for Community Living [ACL]. (2017). Older Americans Act. Retrieved from https://www.acl.gov/about-acl/authorizing-statutes/older-americans-act

American Psychiatric Association. (1974). Diagnostic and statistical manual of mental disorders (2nd ed.) Washington, DC: Author.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Washington, DC: Author.

Badgett, M. V. L., Lau, H., Sears, B., & Ho, D. (2007). Bias in the workplace: Consistent evidence of sexual orientation and gender identity discrimination. Los Angeles: The Williams Institute, UCLA School of Law.

Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring multiple minority stress: The LGBT People of Color Microaggressions scale. Cultural Diversity and Ethnic Minority Psychology, 17(2), 163-174.

doi: https://doi.org/10.1037/a0023244

Brennan-Ing, M., Seidel, L, Larson, B., & Karpiak, S. E. (2017). Social networks and supports among older gay and bisexual men: The impact of HIV. In J. M. Wilmoth & M. D. Silverstein (Eds.), Later-life social support and service provision in diverse and vulnerable populations (pp. 54-76). New York: Routledge.

doi: https://doi.org/10.4324/9781315222950-5

Cahill, S. R., & Makadon, H. J. (2017). If they don’t count us, we don’t count: Trump administration on rolls back sexual orientation and gender identity data collection. LGBT Health, 4(3), 171-173. doi: https://www.liebertpub.com/doi/10.1089/lgbt.2017.0073

Carter, P. L., & Reardon, S. F. (2014). Inequality matters. William T. Grant Foundation Inequality Paper. Retrieved from https://wtgrantfoundation.org/library/uploads/2015/09/Inequality-Matters.pdf

Chapman, S. J., & Benis, N. (2017). Ceteris non paribus: The intersectionality of gender, race, and region in the gender wage gap. Women’s Studies International Forum, 65, 78-86. doi: https://doi.org/10.1016/j.wsif.2017.10.001

Civic Impulse. (2017). S. 2089 — 115th Congress: LGBT Elder Americans Act of 2017. Retrieved from https://www.govtrack.us/congress/bills/115/s2089

Clements-Nolle, K., Marx, R., Guzman, R., & Katz, M. (2001). HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health interventions. American Journal of Public Health, 91(6), 915-921. doi: 10.2105/ajph.91.6.915

Collins, P. H. (2000). Black feminist thought: Knowledge, consciousness, and the politics of empowerment (2nd ed.). NY: Routledge.

Council on Social Work Education [CSWE]. (2017). 2016 statistics on social work education in the United States: A summary of the CSWE annual survey of social work programs. Retrieved from https://www.cswe.org/CMSPages/GetFile.aspx?guid=6e8bc9e7-ebd6-4288-bc7a-d2d427d68480

D’Emilio, J. (1998). Sexual politics, sexual communities (2nd ed.). Chicago: University of Chicago Press.

Defilippis, J. N., & Anderson-Nathe, B. (2017). Embodying margin to center: Intersectional activism among queer liberation organizations. In M. M. Brettschneider, S. Burgess, & C. Keating. (Eds.), LGBTQ politics: A critical reader (pp. 120-133). NY: NYU Press.

doi: https://doi.org/10.2307/j.ctt1pwt8jh.11

Dodd, S. (2014). LGBTQ poverty in NYC: Busting the gay affluence myth. In Worse than you think. The dimensions of poverty in NYC: What social workers see (pp. 55-59). New York: NASW. Retrieved from https://c.ymcdn.com/sites/naswnyc.site-ym.com/resource/resmgr/Docs/worse_than_you_think_web.pdf

Drescher, J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5(4), 565-575. doi: https://doi.org/10.3390/bs5040565

Elder, G. H. (1998). The life course as developmental theory. Child Development, 69(1), 1-12.

Emlet, C. A. (2016). Social, economic, and health disparities among LGBT older adults. Generations, 40(2), 16-22.

Equality Act of 2019, H.R. 5, 116th Cong. (2019).

Equality Act of 2019, S. 788, 116th Cong. (2019).

Espinoza, R. (2012). Act now! OAA reauthorization must include services for LGBT elders. Aging Today, xxxiii(4), 1-2.

Espinoza, R. (2014). Out and visible: The experiences and attitudes of LGBT older adults, ages 45-75. NY: Sage.

Espinoza, R. (2016). Protecting and ensuring the well-being of LGBT older adults: A policy roadmap. Journal of the American Society on Aging, 40(2), 87-93

Estes, C. L. (2001). Social policy & aging. Thousand Oaks, CA: Sage.

Francis, G. M., & Acey, K. (2013). Reducing isolation: A community engagement service model. Retrieved from http://www.asaging.org/blog/reducing-isolation-community-engagement-service-model

Fredriksen-Goldsen, K. I. (2011). Resilience and disparities among lesbian, gay, bisexual, and transgender older adults. Public Policy Aging Report, 21(3), 3-7.

doi: https://doi.org/10.1093/ppar/21.3.3

Fredriksen-Goldsen, K. I. (2016). The future of LGBT+ aging: A blueprint for action in services, policies, and research. Journal of the American Society on Aging, 40(2), 6-15.

Fredriksen-Goldsen, K. I., & Espinoza, R. (2015). Time for transformation: Public policy must change to achieve health equality for LGBT older adults. Journal of the American Society on Aging, 38(4), 97-106.

Fredriksen-Goldsen, K. I., & Muraco, A. (2010). Aging and sexual orientation: A 25-year review of the literature. Research on Aging, 32(2), 372-413.

doi: https://doi.org/10.1177/0164027509360355

Fredriksen-Goldsen, K. I., Simoni, J. M., Kim, H-J., Lehavot, K.,Walters, K. L.,Yang, J.,…Muraco, A. (2014). The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities. American Journal of Orthopsychiatry, 84(6), 653-663. doi: https://doi.org/10.1037/ort0000030

Gonzales, G., & Henning-Smith, C. (2017). Health disparities by sexual orientation: Results and implications from the behavioral risk factor surveillance system. Journal of Community Health, 42(6), 1163-1172.

doi: https://doi.org/10.1007/s10900-017-0366-z

Grant, J. M., Koskovich, G., Frazer, S., Bjerk, S., National Gay and Lesbian Task Force (U.S.), & Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders. (2010). Outing age 2010: Public policy issues affecting gay, lesbian, bisexual and transgender elders. Washington, D.C: National Gay and Lesbian Task Force.

Grossman, A. H., D’Augelli, R. D., & Hershberger, S. L. (2000) Social support networks of lesbian, gay, and bisexual adults 60 years of age and older. Journal of Gerontology, 55(3), 171-179. doi: https://doi.org/10.1093/geronb/55.3.p171

Healthy People. (2017). Lesbian, gay, bisexual, and transgender health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

Herek, G. M., Chopp, R., & Strohl, D. (2003). Sexual stigma: Putting sexual minority issues in context. In I. H. Meyer & M. E. Northridge (Eds.), The health of sexual minorities (pp.171-208). New York: Springer. doi: https://doi.org/10.1007/978-0-387-31334-4_8

Institute of Medicine [IOM]. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/13128

Kane, M. (2003). Social movement policy success: Decriminalizing state sodomy laws, 1969–1998. Mobilization: An International Quarterly, 8(3), 313-334.

Kennedy, S. (2011). LGBT Older Adults and Reauthorization of the Older Americans Act. Retrieved from https://www.sageusa.org/files/Reauthorization%20of%20Older%20Americans%20Act.pdf

Kite, M. E., & Bryant-Lee, K. B. (2016). Historical and contemporary attitudes toward homosexuality. Teaching of Psychology, 43(2), 164-170.

doi: https://doi.org/10.1177/0098628316636297

Krieger, N., Alegria, M., Almeida-Filho, N., Barbosa da Silva, J., Barreto, M. L., Beckfield, J.…Walters, K. L. (2010). Who, and what, causes health inequities? Reflections on emerging debates from an exploratory Latin American/North American workshop. Journal of Epidemiology and Community Health, 64(9), 747-749. doi: https://doi.org/10.1136/jech.2009.106906

Lawerence v. Texas, 539 U.S. 558 (2003).

LGBT Elder Americans Act of 2011, S. 3575, 112th Cong. (2011).

LGBT Elder Americans Act of 2015, S. 1765, 114th Cong. (2015).

LGBT Elder Americans Act of 2017, S. 2089, 115th Cong. (2017).

MacCartney, D., & Fuwa, M. (2006). Intersecting inequality: The effects of race, class, gender, and sexual orientation. Retrieved from http://paa2006.princeton.edu/papers/61138

Mayer, K. U. (2009). New directions in life course research. Annual Review of Sociology, 35, 413-433.

McGovern, J., Gardner, D., Brown, D., & Gasparro, V. (2017). Long-term care planning and the changing landscape of LGBTQ aging. Urban Social Work, 1(2), 130-143. doi: https://doi.org/10.1891/2474-8684.1.2.130

MetLife. (2010). Still out, still aging: The MetLife study of lesbian, gay, bisexual, and transgender baby boomers. Westport, CT: MetLife Mature Marketing Institute.

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697. doi: https://doi.org/10.1037/0033-2909.129.5.674

Movement Advancement Project. (2019). Equity maps: State non-discrimination laws. Retrieved from http://www.lgbtmap.org/equality-maps/non_discrimination_laws

Mullaly, B. (2007). The new structural social work: Ideology, theory, practice (3rd ed.). NY: Oxford University Press.

Murib, Z. (2017). Rethinking GLBT as a political category in U.S. politics. In M. M. Brettschneider, S. Burgess, & C. Keating (Eds.), LGBTQ politics: A critical reader (pp. 14-33). NY: NYU Press. doi: https://doi.org/10.2307/j.ctt1pwt8jh.6

National Archives. (2016). Executive orders. Retrieved from https://www.archives.gov/federal-register/codification/executive-order/10450.html

Obergefell v. Hodges, 576 U.S. ___ (2015).

Older Americans Act Reauthorization. (2016). An Act to Reauthorize the Older Americans Act of 1965. Retrieved from https://www.congress.gov/114/plaws/publ144/PLAW-114publ144.pdf

O’Rand, A. M. (1996). The precious and the precocious: Understanding cumulative disadvantage and cumulative advantage over the life course. Gerontologist, 36(2), 230-238. doi: https://doi.org/10.1093/geront/36.2.230

Oswald, A. G., & Roulston, K. (2018). Complex intimacy: Theorizing older gay men’s social lives. Journal of Homosexuality, online, e1-e21.

doi: https://doi.org/10.1080/00918369.2018.1536416

Parks, C. A. (1999). Lesbian identity development: An examination of differences across generations. American Journal of Orthopsychiatry, 69(3), 347-361.

doi: https://doi.org/10.1037/h0080409

Pillard, R. (2009). From disorder to dystonia: DSM-II and DSM-III. Journal of Gay and Lesbian Mental Health, 13, 82-86. doi: https://doi.org/10.1080/19359700802690174

Rosenfeld, D. (1999). Identity work among lesbian and gay elderly. Journal of Aging Studies, 13, 121-144. doi: https://doi.org/10.1016/s0890-4065(99)80047-4

Ruthie and Connie LGBT Elder Americans Act of 2017, H.R. 4222, 115th Cong. (2017).

Ruthie and Connie LGBT Elder Americans Act of 2019, H.R. 1777, 116th Cong. (2019).

SAGE. (2012). LGBT Elder Americans Act of 2012. Retrieved from https://static1.squarespace.com/static/566c7f0c2399a3bdabb57553/t/566cb540bfe87338d210d97d/1449964864898/2012-SAGE-LGBT-Elder-Americans-Act-of-2012.pdf

Scharlach, A. E. (2017). Aging in context: Individual and environmental pathways to aging-friendly communities – the 2015 Matthew A. Pollack Award Lecture. The Gerontologist, 57(4), 606-618. doi: https://doi.org/10.1093/geront/gnx017

Shippy, R., Cantor, M. H., & Brennan, M. (2004). Social network of aging gay men. The Journal of Men’s Studies, 13(1), 107-120. doi: https://doi.org/10.3149/jms.1301.107

Smith, L. A., McCaslin, R., Chang, J., Martinez, P., & McGrew, P. (2010). Assessing the needs of older gay, lesbian, bisexual, and transgender people: A service-learning and agency partnership approach. Journal of Gerontological Social Work, 53, 387-401. doi: https://doi.org/10.1080/01634372.2010.486433

Smith, W. C., & Fernandez, F. (2017). Education, skills, and wage gaps in Canada and the United States. International Migration, 55(3), 57-73.

doi: https://doi.org/10.1111/imig.12328

Snyder, J. E. (2011). Trend analysis of medical publications about LGBT persons: 1950-2007. Journal of Homosexuality, 58(2), 164-188.

doi: https://doi.org/10.1080/00918369.2011.540171

Stark, A., Folbre, N., Shaw, L. B., Smeeding, T. M., Sandstrom, S., Shaw, L. B., Lee, S., & Chung K. (2005). Explorations gender and aging: Cross-national contrasts. Feminist Economics, 11(2), 163–197. doi: 10.1080/13545700500115985.

Valanis, B. G., Bowen, D. J., Bassford, T., Whitlock, E., Chamey, P., & Carter, R. A. (2000). Sexual orientation and health: Comparisons in the Women's Health Initiative sample. Archives of Family Medicine, 9(9), 843-853.

doi: https://doi.org/10.1001/archfami.9.9.843

Van Sluytman, L. G. (2013). (Dis)parities and (in)visibilities: Shifting perception of the life course of LGBT elders of color. Retrieved from http://www.asaging.org/blog/disparities-and-invisibilities-shifting-perception-life-course-lgbt-elders-color

Veenstra, G. (2011). Race, gender, class, and sexual orientation: Intersecting axes of inequality and self-rated health in Canada. International Journal for Equity in Health, 10(1), 1-11. doi: https://doi.org/10.1186/1475-9276-10-3

Zaritsky, E., & Dibble, S. L. (2010). Risk factors for reproductive and breast cancers among older lesbians. Journal of Women’s Health, 19(1), 125-131.

doi: https://doi.org/10.1089/jwh.2008.1094

Published
2020-01-22