In lieu of an abstract, here is a brief excerpt of the content:

  • LGBTQ+ Aging during COVID-19
  • Angela K. Perone (bio), Keisha Watkins-Dukhie (bio), and Judith Lewis (bio)

Lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and same-gender-loving (LGBTQ+) older adults have unique needs based on experiences related to LGBTQ+ aging across the life course. LGBTQ+ older adults encompasses a large and heterogenous group that spans several generations and cohorts of life experiences: the Silent Generation, the Invisible Generation, the Pride Generation, and the AIDS Generation. The Invisible Generation includes LGBTQ+ older adults who came of age during the Great Depression.1 Many LGBTQ+ older adults of the Invisible Generation fought during World War II. They remained largely invisible during this time. The Silent Generation includes LGBTQ+ older adults who came of age during McCarthyism and the Lavender Scare of the 1950s. During this time, LGBTQ+ individuals were heavily criminalized and penalized in employment, housing, and social spaces for their sexual orientation, gender identity, and gender expression. Desegregation was slowly permeating institutions after Brown v. Board of Education; however, de facto segregation also remained. And many places throughout the United States vigorously fought racial integration in schools, clubs, and spaces like bars that provided public spaces where LGBTQ+ individuals could meet. The Pride Generation came of age during an era of tremendous social change. Although some LGBTQ+ leaders like Bayard Rustin held prominent roles in the Civil Rights Movement, most LGBTQ+ individuals were excluded in one way or another because of their race, gender, sexual orientation, gender identity or expression, or the intersection of these positionalities. Organizations like the Gay Liberation Front, the Combahee River Collective, Daughters of Bilitis (DOB), and Street Transvestite Action Revolutionaries (STAR) provided new spaces of safety and community amidst exclusion. The AIDS Generation includes individuals who [End Page 117] came of age during the devastation of the AIDS epidemic in the 1980s and early 1990s. Organizations like Gay Men's Health Crisis, ACT UP, and Men of Color Motivational Group emerged to provide support and spark change for people living with HIV. Even for LGBTQ+ older adults who came out later in life, these historical moments shaped their lived experiences. For example, a seventy-year-old gay man from the Silent Generation who came out at age sixty would likely still be aware of ways in which LGBTQ+ people were criminalized during that time. That knowledge may have even shaped his decision to remain in the closet throughout much of his life.

The accrual of decades of experiences of discrimination can negatively affect LGBTQ+ older adults' physical and mental quality of life, including physical functioning, bodily pain, vitality, social functioning, and general mental and physical health.2 LGBTQ+ older adults face a bevy of health disparities compared to heterosexual, cisgender peers, including worse mental health, higher rates of smoking, and limitations in activities of daily living (e.g., walking, eating, bathing, dressing, toileting).3 The Aging with Pride: National Health, Aging, Sexuality and Gender Study found that transgender older adults had a higher risk of poor physical health, disability, depressive symptoms, and stress than cisgender peers.4 Research on LGBTQ+ older adults with HIV has found increased rates of depression, anxiety, and suicidal thoughts compared to LGBTQ+ older adults without HIV.5 LGBTQ+ older adults of color have even higher health disparities. In the Aging and Health Report, African American LGBTQ+ older adults reported higher rates of HIV, obesity, and blood pressure than whites.6 These health disparities likely increase the risk of COVID-19 for LGBTQ+ older adults.

Families of choice have become a critical network for caregiving for many LGBTQ+ older adults. LGBTQ+ older adults are twice as likely to live alone and four times less likely to have children as their non-LGBTQ+ peers.7 State-sponsored discrimination in family formation and rejection by biological kin have necessitated that LGBTQ+ persons create their own families to provide social connection, and emotional and physical support. However, much caregiving provided by families of choice occurs with individuals in the same age cohort. As caregivers age together, they may encounter similar health challenges associated with aging. If four friends rely on each other for support for getting groceries or doctors' appointments and only one...

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