It has never been an easy path to walk, but by some measures growing up lesbian, gay, bisexual or transgender in the 1950s, ’60s and ’70s was even tougher than it is now. Long after the Stonewall riots of 1969 launched the early gay liberation movement, pronounced social, legal and cultural stigma lingered.
“Most of us have lived through a period of rampant, overt discrimination and violence,” said 72-year-old psychologist Doug Kimmel, who lives with his husband, Ron Schwizer, in Hancock. “We learned to keep a low profile if we wanted to succeed in life.”
In recent years, American culture has become more accepting, Kimmel said, and younger individuals who identify as LGBT are more likely than in earlier times to find support and community if they reveal their gender identity and sexual orientation.
“But many older people are still much less open about their orientation,” Kimmel said. “We’re not sure how open we can be, even now.”
That poses a problem for Maine’s aging LGBT community.
Kimmel is the executive director of SAGE Maine, a nonprofit organization that supports the interests of older LGBT Mainers. It’s part of the national organization of SAGE, which stands for Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders. There are SAGE affiliates in 20 states and the District of Columbia. Maine’s office was established in 2013, after a formal needs assessment — conducted by AARP Maine with support from national SAGE, the University of New England, the Religious Coalition Against Discrimination and other groups — revealed specific concerns within the statewide community of LGBT people 60 and older. Chief among these were fears that access to knowledgeable, LGBT-friendly health care and home-based support services may be hard to come by as demand grows with the aging of the population.
Comprehensive data on LGBT demographics are not easy to come by. According to the Williams Institute at the University of California, Los Angeles, which researches state and national LGBT issues, there are about 4,000 same sex-couples in Maine, including about twice as many female couples as male, according to 2010 census data. Same-sex couples are concentrated in the Portland area and other population centers in the state but also live in every county in the state, including its most rural communities.
Aging Mainers in general are concerned about issues related to growing older, including social and geographic isolation, declining health, the risks of financial fraud and elder abuse, the complexities of the health care system and the availability of services to help them stay safe in their homes and communities. For aging LGBT individuals and couples, these concerns are compounded by fears their sexual orientation will affect the personal care and other services they need, both at home and in an assisted-living or nursing home setting.
These fears are not groundless. SAGE Maine board president John Hennessy recently described calls he received while working as the director for advocacy at Maine’s AARP offices. One came from a 57-year-old disabled man in rural Penobscot County who had been receiving personal care assistance, including bathing, at home.
“His male home care provider found out he was gay and began threatening him financially,” Hennessy said. The client refused to allow the aide back into his home, but the threats continued, Hennessy said. By the time Hennessy got the call, he said “the client had not had a bath or a shower in three weeks.”
Another call came from a 77-year-old woman whose lesbian partner of 44 years was living in a nursing facility. “They were waiting together one day for lunch to be served, and she was holding her partner’s hand,” Hennessy said. “A staff member walked in and said, ‘None of that on my watch.’ She felt humiliated and undermined.
“I began to realize there was a significant problem in Maine, especially in rural areas,” he said, explaining why AARP undertook the needs assessment in 2012. The study included a survey of 468 Maine individuals who identified as LGBT, followed by focus group work in four categories: health care, personal safety, social services and social well-being.
Here are some of the results:
— About one-third of respondents felt that they did not have access to LGBT-friendly health care, housing and social support services.
— While the majority had confided their LGBT status to their health care provider, nearly 22 percent feared the disclosure would result in discriminatory attitudes and care.
— More than half feared that residential and nursing facilities would limit visitation to same-sex partners, even if married, because of facility regulations or staff bias.
— About a quarter of respondents reported feelings of isolation, citing rural life, lack of friends and family and their LGBT identity as leading factors, along with poor health, the recent loss of a partner and lack of transportation services.
— About half said they would be more likely to ask for home care and other services from an agency that identified at LGBT-friendly, and more than 85 percent said they would choose an agency that specifically trained its staff to be sensitive and knowledgeable about LGBT concerns.
“This survey told me that as Maine LGBT people age, they’re feeling the need to go back in the closet,” Hennessy said. “And that is terrible for their health and their sense of belonging.”
Maine’s 2013 marriage equality law, which legalized same-sex marriage and strengthened the legal rights of spouses, represents a huge step toward normalizing same-sex relationships, he said, but it is only that — a step. Much more work needs to be done on the social and cultural level to educate, raise awareness and promote sensitivity around the needs of Maine’s LGBT population.
This past fall, SAGE Maine conducted voluntary four-hour training sessions with each of Maine’s five agencies on aging, in Augusta, Bangor, Lewiston, Portland and Presque Isle. These agencies provide services themselves, including Meals on Wheels, exercise classes, transportation, checkbook management and other nonclinical services. They also refer clients to clinical and personal home care agencies. Jackie McNeil of South Portland, a certified trainer with the National Resource Center on LGBT Aging, said the goal was to help the agencies understand the importance of “creating a safe and inclusive environment for LGBT adults.”
While most people who work in human service organizations already feel accepting of the LGBT community, McNeil said, “it’s important to understand that this person you’re admitting to services didn’t just walk into existence yesterday. They have a long history of not being treated well. They remember the HIV-AIDS epidemic, when physicians were refusing to care for gay patients. You carry that kind of baggage with you; you don’t go into a situation assuming you’ll be treated well.”
The SAGE Maine workshops don’t aim to change anyone’s belief systems, she added. But providers who find it difficult to relate to LGBT people based on religious, philosophical or personal convictions should learn to check their biases at the door.
At Seniors Plus in Lewiston, community services director Connie Jones said about 12 staff members attended the recent training. While most, as McNeil suggested, already were open to working with LGBT clients, the training opened everyone’s eyes.
“We all came away realizing we really didn’t know it all,” she said. For example, “if you’re transgender, you have to choose your health care provider very carefully because not everyone is sympathetic or understanding, and that affects how openly you can communicate with that provider. People can say, ‘Why don’t you just find another doctor,’ but in lots of places in rural Maine, there isn’t a lot of choice.”
This spring, SAGE Maine will conduct certification workshops for clinical home health agencies across the state. Executive Director Doug Kimmel would like to see the day when home care agencies proudly display the iconic rainbow flag of the LGBT movement in their windows, signifying their inclusive and knowledgeable approach to serving LGBT clients.
In time, that same flag should identify LGBT-friendly medical practices, nursing homes, hospice centers and other essential support organizations for Maine’s aging population, he said.
“Fear keeps people from asking for help,” Kimmel said, and the best tool to counteract fear is knowledge.
In addition to its research and training activities, SAGE Maine offers a range of online educational resources and other tools. It also maintains a calendar of LGBT-friendly events, including monthly drop-in meetings, potlucks and other activities at SAGE centers in Bangor, Portland, Ellsworth, Damariscotta and other locations.