Dr David Woodhead PhD
Group facilitator, researcher & writer
Health and Social Care Consultant
The irony was not lost. Here we were in Reading discussing the rights of older LGBT people in 2018, a short distance from the gaol where Oscar Wilde was incarcerated for homosexual crimes in the late 1900s. His account of his time in prison – The Ballad of Reading Gaol, published in 1898 – influenced public debate in the second half of the 20th Century and helped create the climate in which the partial decriminalisation of male homosexuality was achieved in 1967. LGBT people who were in their 20s then are in their 70s now – yet still they face prejudice and discrimination.
Workshop participants came from a range of services including housing associations, care homes and home care providers, energised by the conference and inspired by the morning’s discussions about human rights. They were concerned that older LGBT people’s needs were not being met.
The conversation began with a reflection on the resilience and dignity they witnessed in older LGBT people, often scarred by the past, but determined to enjoy later life. It was noted that some older LGBT people mistrust authority after years of poor treatment at the hands of doctors, police and employers. Participants shared stories about the struggles LGBT people face as they get older:
- the lesbian who hid photographs of her now deceased partner of 40 years, fearful they would lead to uncomfortable questions and affect the quality of care she received
- the older trans woman who was not given prostate medication after an emergency admission to hospital because it said on the box that it was for men only
- the hospital consultant who insisted on referring to a gay male couple – one of whom was dying – as brothers, despite being corrected several times
- the carer who maintained that it did not matter that he made no reference to the sexuality of a lesbian resident with dementia, because she would not be able to remember ‘what she used to be’
- the Trans woman taunted by other residents because ‘her skirt was too short’
- the grandmother of 6 assumed to be heterosexual by staff, despite daily visits from her long-term female partner
The stories rang alarm bells. ‘How truly person-centred are the organisations in which we work?’, asked one participant. ‘How do we challenge our unconscious assumptions?’, asked another. How do we put older LGBT people at ease and reassure them that they are safe to share – and express - their identities? Beyond the tick box criteria of regulators and accreditors, relationships between staff and older LGBT people needed to be strong and respectful.
Potential actions for service providers emerged:
- review initial assessments to include questions about sexuality, make it clear that all questions can be reviewed later; it might take a while to build trust and confidence
- ask questions about significant others and how they would like to be known, including the pronouns they prefer – ‘he/him; she/her; they/them’
- raise the visibility of older LGBT people in the organisation, mark LGBT Pride and LGBT History month, for example
- train staff in LGBT related issues, put policies in place to support change, give a clear message that discrimination will not be tolerated
- provide visual cues to put older LGBT people at ease, for example rainbow lanyards, and pictures of trans people and same sex couples on promotional literature
Progress has been made in securing equality for LGBT older people, yet there remains a great deal to be done. Care providers have a role – in enacting their commitment to person-centred care – to ask the right the questions, listen carefully to the answers, and celebrate the rich diversity of older people.