Supporting LGBTQ+ Elders by Fighting Ageism and Ableism

At SAGE, we work to improve the quality of life of LGBTQ+ older people. As part of that work, we typically focus on the LGBTQ+ part of the equation—the unique challenges that this community faces as we age because of our sexual orientation and/or gender identity.?Even though LGBTQ+-specific challenges are important, they're not the whole story.?LGBTQ+ elders are struggling not just because of their sexuality and genders, but also because they are old, and like many older people, they are often aging with disabilities. Despite paternalistic myths that society takes care of its old people (sadly, we barely pretend at that when it comes to people with disabilities), the reality is that our country fails to meet the needs of old people or disabled people.

It’s not just a question of individual attitudes—social perspectives that we sometimes label as “ageist” and “ableist.” As with racism, our society has structures that create and reinforce ageism and ableism. Things get especially tough when structural ageism and ableism intersect with disfavored identities like being LGBTQ+, being a person of color, or being any other kind of person who shows up as a statistic in our country’s copious hate crimes and discrimination reports.

To be clear, ageism and ableism are not the same as racism. But those of us working to combat ageist and ableist structures have a lot to learn from what’s been uncovered about structural racism. Structural racism—things like red-lining, denial of resources to people of color communities, and mass incarceration—can be so entrenched that they become invisible to many people. They are accepted as the norm, as having nothing to with race. This focus on structures helps us understand the hidden roles that institutions and systems play in perpetuating all different kinds of inequity, including ageism and ableism.

Once we open our eyes, we see examples of ageist structures everywhere. According to AARP, 64% of older people have experienced or witnessed age discrimination in the workplace. Older employees are often excluded from training opportunities and choice assignments. That’s not surprising when only 8% of U.S. companies include combating ageism in their diversity and equity initiatives, per the research company Advisory Board.

Structural ageism is also visible in health care. For example, research from Nature Aging clearly shows that healthcare professionals are significantly more likely to withhold life-sustaining treatments for older hospital patients, even after controlling for prognosis and patient preferences.

And the harsh reality is that many older people develop disabilities and encounter the same challenges as younger people with disabilities. Ageism and ableism often reinforce each other with many of the assumptions and negative stereotypes about disability being similar to those about ageing. Again, it’s not just about attitudes. Disability activists remind us that we also need to focus on the structures and environment that lead to exclusion and impairment. When physical environments are built so they are not accessible to people with disabilities or when resources for maintenance are steered away from elevators, ramps and other means of access, we’re watching structural ableism in action. Similarly, when shopping districts are built without benches and bathrooms or when celebrating LGBTQ+ Pride requires standing in the hot sun for hours on end because of lack of resources, we’re looking at structural ageism.

Like ageism, ableism is a system of mutually reinforcing structural discrimination and negative attitudes. And like ageism, it functions at its worst at the intersections—when it’s applied to people who are already disfavored because of who they are. If you can’t get a fair shot at health care when you’re old, imagine what it’s like when you’re old and LGBTQ+, or old and a person of color, or old, queer,?and Black.

The bottom line is, fully supporting LGBTQ+ elders means calling out, and combating, the structures and systems of ageism and ableism. Organizations like SAGE are starting to figure out what this means; though I admit, we still have a long way to go. As we lean-into policy advocacy and other kinds of systems-change work that focus on structural ageism and ableism, we must also combat ageism and ableism within our own organization. And we must speak out in key spaces where the aging world listens. That’s why SAGE is spotlighting an intersectional approach to ageism and ableism at the upcoming national conference of the American Society on Aging and continuing to pioneer new work in the year ahead. So, stay tuned…and join us.