According to the national Caring and Aging with Pride survey, transgender older adults are a “critically underserved population[ ] at heightened risk of physical and mental health disparities often combined with less social and community support.” The same survey found that 40% of transgender older adults have been denied
health care or received inferior care due to bias. A recent survey of 320 area agencies and state units on aging found that more than one in four reported that
transgender older adults would either not be welcomed by local service providers or the agency was unsure of how welcome they would be. Other research has revealed discrimination and abuse of transgender residents in long-term care facilities.
Some initial steps have been taken by the Obama Administration to address these issues. In 2010, the U.S. Administration on Aging awarded an historic grant to establish the National Resource Center on LGBT Aging, to provide training, assistance and information to aging providers and older adults. The Centers for Medicare & Medicaid Services are also taking initial steps to promote LGBT cultural competence in long-term care. And the Departments of Housing and Urban Development and Health and Human Services held a summit in December 2011 to discuss promising practices for meeting the housing needs of LGBT older adults.
- Congress should reauthorize the Older Americans Act and amend the Act to make explicit that LGBT older adults constitute a group with “greatest social need” and that federally-funded service providers may not exclude LGBT older adults from programs and services.
- Congress should fully fund implementation of the Elder Justice Act, and the Department of Health and Human Services should ensure that programs supported by the law give adequate attention to the vulnerabilities of LGBT older adults.
- The Administration on Aging should clarify through interpretive guidance that LGBT older adults constitute a group with “greatest social need” and that federally-funded service providers may not exclude LGBT older adults from programs and services.
- The Centers for Medicare & Medicaid Services should eliminate the arbitrary exclusion of transition-related surgical care from Medicare.
- The Centers for Medicare & Medicaid Services should revise federal nursing home guidelines to clarify the rights of LGBT residents to freedom from discriminatory abuse, personal privacy and dignity, and treatment consistent with a resident's gender identity.
- The Centers for Medicare & Medicaid Services should revise federal Medicaid regulations to explicitly prohibit discrimination based on gender identity and sexual orientation in home- and community-based services.
- The Centers for Medicare & Medicaid Services should develop and promote LGBT competence training and tools for long-term care facility staff, surveyors and ombudspersons, home care providers, and others who work with older adults.