Inclusion and Support at the Intersections of Neurodivergence, LGBTQIA+, and Older Adulthood

Bridgette Hamstead - Presentation to the National LGBTQIA+ Task Force - Creating Change Conference - January 2024

In the tapestry of society, individuals over the age of 50 often occupy a space colored by experience and wisdom. However, when this demographic intersects with neurodivergence and LGBTQIA+ identities, unique challenges and needs arise. This article explores the intersectionality of being neurodivergent and LGBTQIA+ in the over-50 age group, underscoring the importance of tailored inclusion and support.

It is increasingly increasingly clear that this intersectionality is not just a mere overlap of identities but a complex interplay of experiences shaping the lives of many. In recent years, there has been a burgeoning awareness of the unique challenges and needs at this intersection, yet much remains unexplored and unaddressed.

The emergence of evidence and statistics in this realm paints a vivid picture of the realities faced by neurodivergent individuals who are also part of the LGBTQIA+ community and over the age of 50. Neurodivergence, a term encompassing a variety of neurodevelopment conditions such as autism, attention differences (ADHD), learning differences (dyslexia etc.), and more affects an estimated 1 in 7 people globally. Among these, autism and ADHD are particularly noteworthy due to their distinct lifelong impact on social interaction, behavior, executive functioning, and communication.

Simultaneously, the LGBTQIA+ community, encompassing individuals with diverse sexual orientations and gender identities, continues to grow in visibility and recognition. However, this increased visibility has not always translated into increased support and acceptance, especially for older adults. According to a report by SAGE (Services & Advocacy for GLBT Elders) and the National Resource Center on LGBTQ+ Aging, LGBTQIA+ older adults are twice as likely to be single and live alone, three to four times less likely to have children, and more likely to be estranged from their biological families compared to their heterosexual, cisgender counterparts.

When these aspects of identity - neurodivergence and LGBTQIA+ - intersect in older adults, the landscape becomes even more complex. A study from the University of California found that autistic adults are significantly more likely to identify as LGBTQIA+, with transgender and gender-diverse individuals being 3-6 times more likely to be autistic than cisgender individuals. This intersectionality poses unique challenges, including higher rates of mental health issues, social isolation, and discrimination.

Ageism adds another layer to this intersection. The World Health Organization reports that nearly every second person in the world is believed to hold ageist attitudes, leading to poorer physical and mental health and reduced quality of life for older persons. For those over 50 who are neurodivergent and LGBTQIA+, ageism compounds the difficulties they face. This demographic is often invisible in policy discussions, healthcare planning, and social support systems, leading to a lack of tailored resources and advocacy.

Furthermore, financial and employment issues are prevalent among this group. The AARP (American Association of Retired Persons) highlights that LGBTQIA+ older adults face higher poverty rates than their heterosexual, cisgender peers, compounded by a history of employment discrimination, wage gaps, and a lack of legal protection in many regions. For neurodivergent individuals, the situation is exacerbated by challenges in finding and maintaining employment due to societal misconceptions and inadequate workplace accommodations.

In light of these realities, the need for inclusive and supportive measures at the intersection of neurodivergence, LGBTQIA+, and age is not just necessary but critical. This article aims to unravel the layers of challenges, highlight the gaps in support and inclusion, and propose pathways towards a more equitable and understanding society for neurodivergent, LGBTQIA+ individuals over 50. Through this exploration, we seek to illuminate the strengths and resilience within these communities and advocate for a future where diversity in all its forms is not just accepted but celebrated.

The Double Edge of Stigma and Discrimination: Older adults at this intersection often face a dual stigma: ageism intertwined with biases against their neurodivergent and LGBTQIA+ identities. This can manifest in many settings, for example - healthcare, where their specific needs may be overlooked or misunderstood, and in social settings, where they might encounter exclusion or misunderstanding from both the neurotypical and younger LGBTQIA+ communities. This also leads to challenges finding inclusive and affirming care in retirement homes, long-term care facilities, and community services.

Healthcare Hurdles: As individuals age, health becomes a paramount concern. Neurodivergent LGBTQIA+ elders may deal with chronic health conditions, mental health issues, and age-related changes like menopause or andropause. Accessing healthcare that is both neurodivergent and LGBTQIA+ friendly can be a significant challenge, and even if inclusive care is available, accessing healthcare providers who are knowledgeable about both neurodivergence LGBTQIA+, and elder health needs is extraordinarily rare. In the current healthcare environment, there is increased risk of misdiagnosis and inadequate treatment due to a lack of understanding of how aging intersects with neurodivergence and LGBTQIA+ identities. There is a pressing need for healthcare professionals who are not only sensitive to but also knowledgeable about the unique health concerns at this intersection.

Mental Health Issues: There is also a higher risk of mental health issues such as depression, anxiety, and PTSD, often stemming from lifelong experiences of stigma and discrimination in this population. There is also a greater risk of loneliness and social isolation due to factors like a lack of family support, the death of partners and friends, and the challenges of forming new social connections in older age leading to further mental health issues. The often prohibitive out-of-pocket costs of health care services, and the lack of accessible mental health services that are tailored to the specific needs of older, neurodivergent LGBTQIA+ individuals are major problems for these individuals and often result in people not seeking services or help for their mental health issues. Mental health care providers need to seek specific training and education in this area and offer affordable options for older neurodivergent LGBTQIA+ people.

Social Networks and Support Systems: Social connections play a critical role in the well-being of neurodivergent LGBTQIA+ elders. Many may lack traditional family support due to estranged relationships, a common issue within the LGBTQIA+ community. Building and maintaining robust social networks and finding community spaces that are inclusive of both their neurodivergent and LGBTQIA+ identities are essential for mitigating the risks of loneliness and social isolation.

Financial and Employment Concerns: Employment discrimination based on age, neurodivergence, or LGBTQIA+ identity can lead to financial instability. This demographic may face challenges such as unemployment or underemployment, impacting their retirement planning and savings. Moreover, transitioning roles in the workplace and adapting to new technologies or work environments can be particularly challenging for neurodivergent individuals, and concerns about the adequacy of retirement savings and the affordability of healthcare and long-term care is valid, anxiety producing and stressful.

Navigating Lifestyle and Wellness: Maintaining a healthy lifestyle, including regular physical activity, balanced nutrition, and mental stimulation, is crucial for this group. However, tailored programs that cater to the specific needs of neurodivergent LGBTQIA+ elders are rare. Lifelong learning opportunities, wellness programs, and community activities that are inclusive and understanding of their unique experiences can significantly enhance their quality of life.

Legal and Estate Planning Concerns: Legal and estate planning issues, particularly for those who may not have traditional family structures to rely on, are incredible complex for neurodivergent LGBTQIA+ older people. These concerns are multiplied when these individuals are parents of neurodivergent children themselves, as neurodivergent condition are genetic, and plans and financial arrangements must also be made for the guardianship, long-term care, and support of their children.

End-of-Life Planning: End-of-life planning is a sensitive but vital topic for neurodivergent LGBTQIA+ elders. Issues around estate planning, healthcare directives, and funeral arrangements can be complex, especially for those who may not have supportive biological family, traditional family structures, or who have faced lifelong discrimination. Ensuring that their wishes are respected and that they have agency in their end-of-life planning is crucial.

Conclusion: The intersection of neurodivergence, LGBTQIA+ identity, and aging over 50 brings unique challenges that require thoughtful and inclusive responses. Finding a sense of community and belonging can be challenging for these individuals, particularly for those who feel marginalized within both neurodivergent and LGBTQIA+ communities. Accessible, knowledgable, and inclusive community programs and services that address the unique needs of older neurodivergent LGBTQIA+ individuals are so important. Societal support systems, healthcare providers, and community networks must evolve to recognize and meet the distinct needs of this group. In doing so, we can ensure that these individuals are not just aging but thriving, with dignity, respect, and a sense of belonging.