Groundbreaking Study Highlights Needs and Challenges of California’s LGBTQIA+ Older Adults
23 Jan 2025

Groundbreaking Study Highlights Needs and Challenges of California’s LGBTQIA+ Older Adults

California, home to one of the largest and most diverse populations in the United States, is also home to an aging population. By 2030, over 10.3 million Californians will 60 or older. Among them, approximately 5% identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, or as a sexual and/or gender minority (LGBTQIA+), yet the health and wellbeing of LGBTQIA+ older adults has largely been overlooked.

“We don’t have an accurate picture of the LGBTQIA+ community in California,” said Vince Crisostomo of the San Francisco AIDS Foundation. “We need to know where people are and what services they need as they age to help policymakers distribute resources equitably.”
Recognizing the pressing need for data to inform service delivery, the California Department of Aging (CDA) conducted the state’s first comprehensive survey of LGBTQIA+ older adults, titled From Challenges to Resilience. This landmark study, conducted in collaboration with universities and nonprofits, provides new insights into the challenges faced by this community and offers a blueprint for improving their lives.

Key Findings: Health Disparities and Quality of Life
The survey, involving 4,037 LGBTQIA+ Californians aged 50+, revealed considerable disparities in physical, mental, and cognitive health:
• Physical Health: A quarter (23%) of respondents reported fair or poor physical health. Seventeen percent (17%) were living with HIV.
• Mental Health: One in five respondents rated their mental health as fair or poor. Eleven percent (11%) reported serious thoughts of suicide in the past year. 24% experienced symptoms consistent with post-traumatic stress disorder.
•Cognitive Health: Fifteen percent reported worsening confusion or memory loss, underscoring the need for dementia-related services.

The survey also highlighted stark disparities among subgroups, with transgender and gender-expansive individuals and people of color reporting poorer quality of life and higher rates of health challenges compared to their cisgender and White counterparts.

Economic and Social Wellbeing: Persistent Inequalities

Economic and social challenges were pervasive among survey participants:
• Financial Insecurity: One quarter reported financial insecurity. Among transgender and gender-expansive respondents, 19% had annual incomes below $20,000, compared to 9% of cisgender respondents.
• Housing and Food Instability: About 12% of respondents worried about housing stability, while over 20% struggled to afford nutritious meals.
• Social Isolation: More than one in four (28%) reported dissatisfaction with their social relationships, and 7% had no one to turn to for support.

These findings reflect broad societal issues, including systemic discrimination and California’s high cost of living, which disproportionately impact marginalized communities.

Discrimination and Trauma: A Lingering Legacy

Experiences of discrimination, stigma, and trauma were disturbingly common among respondents:
• Trauma: Almost half (49%) reported experiencing a traumatic life event, with higher rates among transgender and gender-expansive individuals.
• Abuse: 19% reported being in an abusive or threatening situation in the past year, yet most had not reported these incidents due to mistrust of authorities or feelings of shame.
• Discomfort with disclosing sexual orientation or gender identity to first responders and healthcare providers was prevalent, particularly among transgender and gender-expansive individuals.

SAGECare’s Role in Supporting LGBTQIA+ Older Adults

SAGECare, a training and consulting division of SAGE (Services & Advocacy for GLBT Elders), is working to provide critical training for those providing care to LGBTQIA+ older adults. SAGECare’s mission is to create a more inclusive and affirming environment within healthcare and residential settings by providing care professionals with the tools and education they need to better serve LGBTQIA+ seniors. Through SAGECare’s credentialed training, organizations and service providers can demonstrate their commitment to delivering culturally competent care and ensuring the dignity and safety of LGBTQIA+ older adults.

By improving access, inclusivity, and safety of services, SAGECare aims to help mitigate many of the disparities identified in the California survey, such as healthcare discrimination and mental health challenges, particularly for transgender and gender-expansive individuals. SAGECare’s goal is to build a workforce prepared to engage with this community in a compassionate and understanding manner.

Recommendations: A Roadmap for Change
The study’s findings underline the urgent need for targeted interventions to support LGBTQIA+ older adults. The following priorities and recommendations aim to address the identified disparities:

Improve access, inclusivity, and safety of services for LGBTQIA+ older adults
Expand culturally responsive training for service providers to increase the availability of LGBTQIA+ affirming healthcare and social services. Enhance access to specialized services, including suicide prevention and trauma-focused treatments. SAGECare’s foundational training courses provide essential support for this recommendation, ensuring a high standard of care and expertise.

Increase social and economic support for LGBTQIA+ older adults
Promote LGBTQIA+ affirming programs to reduce isolation and strengthen community networks. Provide financial literacy training, employment support, and access to secure housing. Understanding the Financial Needs of Older LGBTQ+ Adults, by SAGECare, provides an in-depth exploration of their financial concerns.

Address disparities among marginalized subgroups, including transgender and gender-expansive older adults and older adults of color
Develop standards of care tailored to the unique challenges faced by transgender and gender-expansive individuals and people of color. Ensure language accessibility for services and support anti-racist, community-based organizations. SAGECare offers two training courses focused on combating anti-racism in community-based organizations: Trans Aging and Enriching Care for LGBTQ+ Older Adults of Color.

Enhance data collection and policy evaluation
Monitor the impact of policies on LGBTQIA+ older adult communities by collecting comprehensive demographic data. Asking Inclusive Demographic Questions, provided by SAGECare, helps participants learn how to effectively ask these questions and become comfortable with various responses they may receive.

As California’s LGBTQIA+ older adult population grows, the work to address their unique needs and challenges is more important than ever. SAGECare is proud to play a key role in shaping a healthier, more equitable future for all.

Contact SAGECare to learn more about our training and consulting. 


SAGECare Editorial Team