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OPINION: Championing LGBTI+ Older People in Healthcare

Composite of : Marcus Aurelius for Pexels Brett Sayles for Pexels MART PRODUCTION for Pexels Edit by James O'Hagan

All ageing populations share common lifestyle, health, and social concerns as they plan for old age, however many older LGBTI+ people face significant additional challenges.  While there have been huge advances in LGBTI+ rights and recognition in Ireland in recent years, it is apparent that the older LGBTI+ population are benefiting least from these positive changes. Older LGBTI+ people contacting LGBT Ireland’s national LGBT helpline will voice concerns that older age health and social care services are not welcoming of them or will discriminate against them, and some feel they are forced back into the closet to feel safe accessing vital services. 

Homosexuality was listed as a mental disorder by the World Health Organisation (WHO) until 1990 and was criminalised in Ireland until 1993. Transgender health issues were classified as mental and behavioural disorders until as recently as 2019.  These issues and the prevailing social, religious, and cultural attitudes which existed in Ireland until relatively recently, mean older LGBTI+ people grew up in a society where being a member of the LGBTI+ community led to exclusion and isolation. Coming out often meant the loss of relationships with parents, siblings, spouses, children, and friends and could lead to discrimination, marginalization, or loss of employment.

Ireland’s National LGBTI+ Inclusion Strategy was launched in November 2019, this strategy contained over 100 actions aimed at improving the quality of life and wellbeing of LGBTI+ people and highlighted the need to provide health and social care services that meet the needs of older LGBTI+ people.

The ‘Lesbian, Gay & Bisexual People in Later Life’ report published by Stonewall found that “older LGB people are nearly twice as likely as their heterosexual peers to expect to rely on a range of external services, including GPs, health and social care services and paid help”. 

The Visible Lives study, which was commissioned by GLEN (Gay and Lesbian Equality Network) and conducted by a team of researchers from the School of Nursing and Midwifery at Trinity College Dublin, showed that 40% of older LGBTI+ people in Ireland were not comfortable being open with their health and social care providers about their sexual orientation, sexual identity or sexual expression for fear of rejection or discrimination.  Many of those surveyed feared that healthcare staff would not understand or would discriminate against them because they were LGBTI+.

These factors and the lack of meaningful community and social support mean that older LGBTI+ people are at a much higher risk of being lonely and isolated compared to older people in general, having a huge negative impact on their mental and physical health and well-being over time. 

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