Building a body beautiful in midlife

Photo by Gordon Cowie on Unsplash
man in white crew neck t-shirt and black shorts
By Liz Massey

The Baby Boom generation, the demographic “bulge” in the American population composed of people born between 1946 and 1964, has redefined every life stage its citizens have passed through. And, as the leading edge of that generation approaches 70, they are remaking the aging process.

The size and personality of this group, estimated at 77 million strong, is causing huge logistical ripples that younger generations are struggling to cope with.

LGBT Boomers – the group fresh out of college during the early years of post-Stonewall gay liberation and the group that also dealt with the brunt of the AIDS crisis in the 1980s and 1990s – are now poised to redefine queer aging.

A report by the group Services and Advocacy for GLBT Elders (SAGE) estimates that the current number of queer adults in America – about 3 million – will double in the next 20 years.

One of the greatest concerns for all older adults is how they can best take care of their health, so that they might live independently for as long as possible. Researchers and service providers who work with LGBT elders are making strides in understanding the unique needs of this population, and they emphasize that LGBT community members of all ages and their allies, can play a role in helping our oldest members live a healthy life.

Huge Leaps, Huge Challenges

One of the largest challenges facing older LGBT adults, particularly those who are old enough to consider either proactively joining a retirement community, or who are frail enough they must give up living independently, is a fear of being discriminated against on the basis of their sexual orientation or gender identity.

“Caring and Aging with Pride,” the first federally funded project to examine LGBT aging and health, revealed that more than two-thirds of LGBT adults surveyed indicated they had been victimized three or more times over the course of their lifetimes for being LGBT. Experiences of discrimination are linked to poorer health outcomes, both among chronically ill older LGBT adults and their caregivers.

Thirteen percent of LGB individuals and nearly 25 percent of trans elders reported having been denied health care, or receiving inferior care, based on their identity. As a result, nearly 20 percent of those surveyed stated that they did not reveal their sexual orientation or gender identity to their health care provider.

To combat these challenges, and make health care a friendlier environment for older LGBT individuals, earlier this year the American Geriatrics Society (AGS) published a position statement on the care of older LGBT adults. The statement charts a path forward for professions that work with older adults, by advocating policies for equal treatment, professional training for providers on LGBT needs, deeper awareness of the unique circumstances facing LGBT older adults and an enhanced research agenda supporting these policies.

The research is sorely needed, according to Dr. Manuel A. Eskildsen, an AGS member who is an associate professor of medicine at Emory University and medical director of a skilled nursing facility located on the Emory campus.

“LGBT medical research represents only 0.3 percent of all total publications ... and NIH funding related to LGBT health remains low,” he said. So there are many gaps in research for LGBT older adults.”

Eskildsen said it was particularly important for organizations such as AGS to take the lead in sensitizing the medical profession to LGBT issues and needs, as it had a direct impact on the health of the patients involved.

“Patients who do not feel like their providers will be understanding of their sexuality or their relationships will be less likely to share important details about their lives and health problems, which may ultimately affect outcomes or the ability to make important health decisions,” he asserted.

Another significant challenge facing many LGBT adults as they age is their economic preparation (or lack there of) for retirement, which can have a direct impact on the level of medical care and healthy self-care they are able to achieve.

According to a 2010 MetLife Mature Market Institute study of LGBT Baby Boomers, nearly half of the queer persons surveyed expected to work until at least age 70, with few having already reached their financial goals related to retirement. The SAGE study mentioned earlier, which was conducted in 2014 and surveyed LGBT adults ages 45-75, reported that 42 percent of those surveyed were “very” or “extremely concerned” they would outlive the money they had saved for retirement.

Dr. Eskildsen echoed the notion that these were common fears among LGBT elders, and mentioned that up until just a few years ago, this fear was buttressed by the reality that same-sex relationships were accorded almost no legal recognition.

“Before marriage equality became law in most of the country, widowhood not only meant emotional suffering, but also the very real possibility of significant financial hardship because of the loss of a spouse’s social security benefits and perhaps even other retirement savings,” he said.

A final factor influencing LGBT health in old age is their access to informal social networks, which has often proven more reliable for this group than family ties. The SAGE study notes that 34 percent of older LGBT people reported living alone, and 40 percent said their support networks had become smaller over time.

Taking Care Of Our Own

Despite the strength of the forces challenging LGBT elders, many are responding with vigor and bouncing from setbacks and crises.

According to the 2011 report from the “Caring and Aging with Pride,” study, while nearly one-half of LGBT seniors surveyed reported having a physical disability diagnosis, and one-third reported suffering from depression, 91 percent were engaging in wellness activities and 82 percent exercised regularly.

Michael Peck (pictured), a Phoenix therapist who operates Q Counseling practice, sees many of these dynamics at the , where he leads a biweekly Older Men’s Support Group. The support group is open to all male-identified members of the community; participants discuss everything from relationships and dating to health, finances, family and politics.

Peck said support group participants bring whatever issues they are currently confronting to the sessions, and, contrary to stereotypes of older people, they are often quite open-minded and interested in the perspectives of younger people.

“I am impressed with the many ways older men want to share their wisdom,” Peck said. “Despite the ageist biases in our youth-based culture–a bias even more intense in gay culture–the older men in the group see the value in age diversity. While the men may notice differences between themselves and younger persons, the older men respect the knowledge and perspectives of youth.”

Another thing that the men possess, he said, was resilience, the capacity to recover well from difficulties.

“Think about all that the older adults in our community have endured; they are survivors,” he said. “Resiliency is an outcome of being a survivor, and LGBT elders happily pass this survival wisdom onto other generations.”

Getting Ready For The Future

For both those currently classified as an “older adult,” and those who hoped to live long enough to fit in that age group, the advice from sources interviewed for this article was simple: keep moving and keep your friendships strong.

Eskildsen said, when asked for his prescription for preparing for old age, “Exercise, exercise, exercise. Keep your blood pressure under control, check your cholesterol. And nurture healthy relationships that will serve as a basis of social support as you get older.”

Peck’s words of wisdom were similar, and he added the caveat to watch one’s diet, as well.

“Healthy aging involves maintaining physical activity and emotional well-being,” Peck said. “We require motion [physical exercise], emotion [social interactions] and fuel [good nutrition] for healthy aging!”

One proactive step that younger adults can take is to diversify their friendship network, Eskildsen said. This builds in protection by making connections with those who may be in a caregiving position for them many years from now, he said; and by reaching out to today’s elders, community members can both assist the queer movement’s pioneers and create a model of intergenerational support.

“Helping an older person who is isolated to know that they are not alone and can have new relationships and friendships even in their older years is very important,” he said. “Many areas in the country, especially urban centers, have community elder LGBT groups that are there to help older persons broaden their networks and find resources.”

Eskildsen wryly noted that doing all these things would not forestall the inevitable, but that it could make later life a much more positive experience.

“The death rate for the human race is still 100 percent, so for those of us who are lucky to live long enough, frailty and disability are likely possibilities,” he said. “The real question is how to forestall the worst health problems and live a healthy life for as long as possible.”

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