Developing an LGBTQ-Affirming Facility at Green Hill - PowerPoint Presentation

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Developing an LGBTQ-Affirming Facility at Green Hill

October 8, 2018 David Rosen, DBH, LCSWClinical Director(201) 963-4779 x 119 drosen@hudsonpride.orgwww.hudsonpride.org

Slide2

LGBT Community in Context

3-5% of U.S. population is currently

estimated

to be LGBT (depending upon surveyor group)

Williams Institute – UCLA Law School Think Tank utilizes Pew Research data to conclude that ~3.6% of Americans are likely LGB and ~0.3% are likely T

http

://williamsinstitute.law.ucla.edu/wp-content/uploads/Census2010Snapshot_New-Jersey_v2.pdf

In NJ, about 3.7% of all state residents likely self-identify as LGBT.

255,000 NJ adults likely self-identify as LGBT (~3.0% of state population)

57% of LGBT are white vs. 65% non-LGBT

21% of LGBT are African American (v. 13% non)

20% of LGBT are Hispanic (v. 18% non)

Slide3

LGBTQ Community in Context

Why only estimates?

Not all LGBTQ openly self-identify

Safety/Discrimination

Privacy

Access

Religious/Social

Acceptance

Current lack of federal or state census tracking of individual sexual orientation or any non-cisgender status within populace

Census tracking of same-sex households (i.e. same-sex couples living together) only since 2000 – does not capture LGB youth living with parents, single LGB adults, non-living together LGB adults and no Transgender individuals at all of any category

Slide4

LGBTQQIAA Communities: A Primer on Language and Culture

Lesbian

Gay

Bisexual

Transgender

Questioning

Queer

Intersex

Asexual/

agender

Ally

Slide5

Words of Caution on Language:

QueerOnce pejorative, now reclaimed by some LGBT people (<40) to self-describe NOT a universally accepted term among LGBT people (especially those older than 50) so please be aware of your audience when using it. When included as part of acronym “LGBTQ,” the “Q” usually means questioning, but can sometimes mean queerSexual preference NOT synonym for sexual orientation - it describes levels of sexual attraction and/or types of sexual activities one enjoysNegatively loaded term for many LGBT peopleWhen intentionally misused in place of Sexual Orientation , “sexual preference” suggests degree of voluntary choice to perpetuate idea in public discourse that Sexual Orientation is changeable - despite overwhelming scientific consensus to contrary (www.apa.org/topics/lgbt/orientation.aspx)

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LGBTQ Community

Differences in

LGBTQ

community varied as society in general - race, age, income status, education, geography, politics, language, etc.

Grounds for exclusion are similar:

Racism

Classism

Disability

Ageism

Religious

Transphobia/Biphobia

Sexism

Slide7

Family of Origin vs Choice

LGBT individuals are more likely to have decreased contact with families of origin (McCarthy & Edwards, 2011) Move away first and then lose contact?Lose contact first and have freedom to move away? LGBT perceive less social support from families of origin - cause or consequence of lack of contact w/ families or > geographical distance from them?LGBT individuals often prefer to establish "families of choice"' w/in LGBT communities – w/friends, partners and ex-lovers

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What is an LGBTQ Identity?

To answer this,

we first have to understand

the building blocks of human

sexuality

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Human Sexuality

Sexuality is a natural and healthy part of human lifeAll of us are sexual beings from birth to death Sexuality is complex and multifaceted   Biological, Social, Psychological, Spiritual, Ethical, CulturalSexuality is fluidFluid over range: Not easily “categorized”Fluid over time: Both identity and understanding

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Determinants of Human Sexuality O.B.I. Approach

Orientation

Attraction/Affection towards an individual, animal, and/or object (living and

nonliving)

Examples

: Arousal by appearance (such as images of sexual and/or reproductive organs)

Behavior

Manner of acting

Identity

Awareness

of being oneself and not another;

Condition or character

as to who

a person

or what a thing is;

Exact

likeness in nature or qualities

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Sexual Orientation

To which sex/gender one is physically, romantically and erotically attracted Males or masculinity, females or femininity, bisexual, trans-males, trans-females, pan-sexual, asexual, etc.If you are attracted to both males and females, you might consider yourself to be bisexualIf you do not feel attracted to any type of person, you may be asexual If you feel attracted to both males and females, but also to trans males and trans females or really, to any human adult, you may call yourself pansexualRemember - gender identity and sexual orientation ARE NOT THE SAME THING!Sexual Orientation is not chosen!However, one’s understanding and identification of sexual orientation can change over time

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Is Sexual Behavior the Same as Sexual Orientation?

NO!!!!!Behavior = w/ whom one is sexually active – not attractedBehaviors are alterable:There is definitely choice here!Sex behavior complex –not always match sex orientation:People trying to hide their sexual orientationNot sexually activeExclusive Relationship vs. PromiscuityAvailability (people in prison, in military action, etc)Sex work and/or survival tactics

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Lectures 1 -3

Slide13

Gender Identity Terminologieshttp://itspronouncedmetrosexual.com/2013/01/a-comprehensive-list-of-lgbtq-term-definitions/

cis-gender: when a person’s birth biology matches their internal sense of gender identitytrans-gender:when a person’s birth biology does not align with their internal sense of gender identitygender fluid:gender identity of a dynamic mix of boy and girl, where person may always feel like mix of two traditional genders, but may feel more “male” some days, and more “female” other daysgender non-conforming:gender expression indicating non-traditional gender presentation (masculine woman or feminine man) and/or gender identity label that indicates a person who identifies outside of the gender binary (cis-gender male/female).

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What is Gender Transitioning?

Transgender people may choose to transition to living as the gender opposite to their bio sex assigned at birth Male to Female [MTF] Female to Male [FTM]Transitioning may include any or all of the following appearance choices:Dressing as the gender with which they identifyHormones Breast reduction, breast augmentationSex reassignment surgery Doing nothing at all

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Gender Expression and Gender Roles

How a person feels comfortable expressing oneself

Clothing, accessories (hair, nails,

etc

), movements & behaviors, speech patterns and word choice

You have “choice” in selecting clothing/accessorizing BUT…

You don’t have a choice in what you like or what makes you comfortable or happy

Some forms of expression and behaviors (speech & movements) can be difficult to control

Gender roles

are behaviors

, expectations, beliefs, attitudes, values

and

norms defined by society as

“Male”

or

“Female”

Typed, or restricted on basis of biological gender (male roles/attributes vs. female

roles/attributes)

We often feel they are innate but they are actually socially constructed and vary by time and culture

Slide16

So then, what exactly is an LGB Identity?

Homosexuality is:

Core component of person’s identity -

not

mental or physical disorder requiring

intervention

(Mallon, 2009)

1973: American Psychiatric Association declassified homosexuality as illness and removed it from DSM

All major

mental health

professional associations recognize that being LGB

inherently

poses no obstacle to leading happy, healthy & productive lives

Level of Acceptance of LGB identity by self and/or others that is the key factor

NASW (2014)

requires members to provide LGB-affirming services to LGB-identified clients – regardless of personal views of the practitioner

Slide17

What about a Transgender Identity?

Among most misunderstood/least served population

No estimates on prevalence in US population

Social marginalization, stigmatization and discrimination

Lack of legal protection in most areas of the U.S.

No clinical consensus

on whether transgender identity constitutes a mental health

disorder

(

Drescher

, 2014)

Gender Dysphoria current DSM 5

diagnosis

strong and persistent cross-gender identification

persistent discomfort with sex assigned at birth

clinically significant distress/impairment in important areas of

function

Inclusion

in DSM 5 is

still hotly debated….why?

Slide18

LGBT Identities: What we know …(and don’t)

“

Causes”

are

unclear:

Likely

due to mix of genetic, hormone and social factors

LGBT identities are NOT “catching”

Sexual

orientation

and gender

identity

are NOT changeable – whether through counseling, prayer or medical intervention

Reparative therapy is damaging to

subject and

unethical to

deliver!

And illegal to deliver to minors

in

NJ

Sexual

behaviors

and gender

expressions

CAN be changed

Identifying as LGBT is NOT a form of acting out behavior or experimentation that will “go away” in

time

Slide19

LGBT Identities: Bottom Line….

No

clinical evidence

that any of the following “factors” can lead to someone becoming

LGBT

(Mallon, 2009)

Parenting styles (e.g., smothering mother/distant father, allowing non-gender conforming play…)

“Exposure

” to other

LGBT people

Sexual abuse by same-sex adult

Experiencing some other undefined “adverse

life events

”

But exposure

to LGBT people and affirming

concepts…

CAN

ease

self-identification

process for

already existing same sex and/or non-cis gender feelings and thoughts

CAN accelerate

# of

LGBT people willing to publicly self-disclose their sexual orientation and/or gender identity

Slide20

Ultimately…

For many LGBT individuals, Self-Identity

supersedes

Orientation and Behavior:

Up

to the individual to self-identify

gender and orientation across spectrum – make no assumptions!

What someone does sexually does not necessarily define who that someone is/sees self to be inside

Need to describe/refer

to individuals with respect to the

gender or orientation with

which they

identify

Some

transgender males and females do not

self-ID

as “trans” and just adopt “male” or “female”

identity

Some women may be married to men but consider themselves to be

Lesbians

Some men may have sex with other men but consider themselves straight if they only “top” with other men

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What Does All of This Mean?

To address the physical, mental, and social needs of individuals both like and different from us, we must take into account theirsexual Orientationsexual Behaviorsexual Identity …realizing that each may not align with the others in ways that are familiar (or comfortable) to us…or other residents in our facility…so what can we do?

Slide22

Making our Facility LGBTQ-Affirming

Slide23

Some Definitions…(Paradies et al., 2016)

Stereotyping

–

characteristics of group

based

on insufficient information.

Stigma

– severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society

Prejudice

– preconceived opinions about a

group

based on stereotyping.

Privilege

– an unearned right, advantage or immunity granted to or enjoyed beyond the common advantages of all others; an exemption in many

certain

cases from burdens of liabilities.

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Defining types of anti-LGBT biaseshttps://lgbtrc.usc.edu/education/terminology/

Homophobia/Transphobia

– fear or hatred of those assumed LGBT & anything connected to their culture.

Internalized homophobia/transphobia

: fear/self-hatred

occurring

in LGBT people who have incorporated negative ideas about their orientation and/or culture.

Heterosexism

: applies to negative attitudes, bias, and discrimination of opposite-sex sexuality & relationships.

Often presumes that

everyone is heterosexual or that opposite-sex attractions

&

relationships are the norm and

thus

superior.

Heteronormativity

:

Assumption, in individuals/institutions, that all who conform to socially approved cis-gender expression are str8 cis-gender (e.g. automatically asking “rugged” man if he has

girlfriend

or questioning

if

person

who doesn’t look “female enough”

could

enter woman’s bathroom)

Leads to invisibility/stigmatizing of unconventional gender expressions by assuming all masc. men/fem. women are str8

Slide25

Blatant Homophobia & Heterosexism

Verbal Assault

Physical Violence

Vandalism, defamation and destruction of property, including defacing or removing posters for LGBT support meetings, dances or other events

Discrimination such as firing an employee, evicting someone from housing, or denying someone access to public accommodations based solely on their SO/GI or their perceived/assumed SO/GI

Using terms like “lesbian,” “sissy,” “gay,” or “tranny” (etc.) as a generalized insult

That’s so gay!

What a sissy!

Slide26

Subtle Homophobia & Heterosexism

Assuming that everyone you meet is heterosexual.

Thinking only in terms of one’s sexuality instead of seeing the whole person (gay co-worker, gay kid)

Avoiding

locker room thinking

they

will make

sex

advances

Thinking you can spot one based on stereotypes.

Not allowing same-sex couples same privileges given to mixed gender couples (i.e. showing signs of disgust with same-sex PDAs but not M/F

)

Not confronting a homophobic remark because it doesn’t affect you, or for fear of being identified with gay people.

Feeling that gays and lesbians are too outspoken about lesbian and gay civil rights.

Slide27

Understanding “Coming Out”

Figure of speech acknowledging and revealing one’s sexual orientation and/or gender identity to self and/or to others vs. hiding it from self and/or others (“being in the closet”)

Up to person to decide when (if) to come out - typically occurs when certain level of comfort exists

Typically triggered by a need to disclose, to find a community, to find a partner, to feel included

LGBT person may not be out to everyone in life

Involuntary “outing” can and does occur

Reasons to come out

Improve personal relationships

Enhance mental, physical and spiritual health

Change societal attitude

Challenges to coming out

Loss of support (housing, job, family, spiritual community, etc.)

Forced Reparative therapy

Violence/IPV

Slide28

Coming Out as a Family Issue

Most families need an adjustment period

during which

family relationships may be strained, but ultimately reach a “new normal”

w/embracement

of

LGBT

family member

Family members experience their own coming out

process.

Typically

“come out” to someone they feel emotionally close and secure to first.

Coming out may also become professional issue

.

Providers must

help

individual

to manage conflicts

between

their desire to come out and

potential

implications on their safety/well being

!

Slide29

So who are our LGBTQ Seniors?

~ 3-4 million in US, born prior to 1957 and more likely to live in urban areas (Cahill, et al, 2000)Culturally/economically diverse, but hard to study, esp. if born before1950 due to major sampling issuesMost grew into adulthood “Pre-liberation” – significant levels of internalized homophobia, but also dealing with societal homophobia, sexism, racism and now ageism as well!Up to 2/3 of LGBT seniors could not ID someone who would provide care for them if disabledProfound Invisibility (Brotman et al,. 2003)Stay out (or come out) and risk discriminationGo back in closet and “pass”If never out, continue to be in closet

Slide30

LGBTQ Seniors

2011 national

study of 2,560 LGBT

seniors (age 50+) found (compared to straight peers):

Greater rates of disability, depression & loneliness

Increased likeliness to smoke and binge-drink

Increased health barriers due to isolation, lack of LGBT services and culturally competent providers

(Fredriksen-Goldsen,

2011)

2011 national on-line study

of

769

LGBT

seniors found 40% abused in long term care facilities:

Harassment by residents and staff

Refusal by staff to use preferred name and/or pronoun

Refusal to provide care

Wrongful transfer or discharge

(www.lgbtagingcenter.org/resources/pdfs/NSCLC_LGBT_report.pdf)

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“Fully Closeted” LGBT Seniors

Spent much of their lives in a world that is actively hostile and oppressive towards sexual minorities

Survival coping mechanisms to manage stigma attached to images of “pervert” and “sexual deviant” prevalent in culture

Dunker (1987) wrote: “The excesses of the McCarthy era with the persecution of homosexuals frightened many of [them] into keeping [their] private lives private” (p. 75)

Grew up afraid of being discovered and institutionalized and of losing close interpersonal relationships, so as adults they placed distance between themselves and their families and friends for fear of losing support

(Friend,

1987, 1990

)

Internalized homophobia often resulted in feelings of distress, shame, lack of self-respect, and self-loathing--ultimately,

leading

to despondency, misery, and suicide

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“Passing” LGBT Seniors (Friend, 1987, 1990)

Accepts heterosexist discourse and is only conditionally comfortable with their sexual identity

Views heterosexuality as superior, investing considerable energy to appear heterosexual–so they can exist in two separate compartmentalized worlds of public identity as heterosexual and private identity as a sexual minority

Results in segmented

self

with

lack of genuineness in

both heterosexual

relationships

and relationships

with other sexual

minorities

Leads to increased

levels of anxiety and self-consciousness about being discovered (lack of emotional support in times of crisis) and increased

levels

of stress

Slide33

33

“Self-Affirming” LGBT Seniors

Challenge heterosexist ideology and reconstruct for themselves a positive image and identity

(Friend,

1987)

The route that individuals take in creating this affirmative identity varies--some may view the process of self-empowerment as a form of personal activism, while others extend the process, making it a form of personal as well as professional activism

NOTE:

Although the specific number of individuals in each identity group is unknown (prevalence) we do know that the majority of research with older lesbians and gay men has been with those who portray an affirmative image

(Friend,

1987,

1990)

Slide34

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Older Lesbians: Health Issues(Wallace, et al., 2011)

Heart diseaseCancersArthritisHigher rates of smokingHigher BMIFewer preventive health exams

Slide35

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Older Gay Men: Health Issues(Wallace, et al., 2011)

Heart disease/ strokeCancersSTDs/HIVMany do not take safer sex practices seriously b/c they believe HIV/AIDS is young gay man’s diseaseMany who have lived lifetime in closet are not willing to reveal sexual orientation in later years and will not reach out to ASOsSome elderly gay men are engaging in high-risk behaviors such as having sex with strangers and hiring sex workersHigher rates of smokingHepatitis B & C

Slide36

36

Transgender Seniors: Health Issues(Fredriksen-Goldsen, 2013)

HormonesSurgical changesOrgans & Organ sizeLab valuesSTI/HIVHepatitis B & C

Slide37

37

LGBT Senior Sex Lives

53% all seniors 65-74yo sexually active

(Lindau et al., 2007)

26% all seniors 75-85yo sexually

active

(Lindau et al., 2007)

2010 study of sexual health from Indiana University found the lowest rates of condom use were among people ages 45 and

older

(https

://abcnews.go.com/blogs/health/2012/02/03/older-people-getting-busy-and-getting-stds

/)

48

%

gay/bi M

seniors not

regularly

use condoms;

9

%

never

(Stall & Catania, 1994)

Beyond 20 years together, gay males often decrease

freq.

of sex with their partner but sex outside the relationship may increase

(Rothberg,

1996)

2011

study pub. in

J. Women & Aging

(Paige, et al., 2011)

found

:

> half of lesbians aged 55 and older have been married to a man at some point in their lives

more than 90% said their families knew about their lesbian relationships

Slide38

38

Mental Health / Spiritual Issues

Depression/Grief and lossDisenfranchised griefSubstance abuseMore exclusion from religious support and families of origin, but greater support from friendship networksLesbians more well adjusted to aging –Gay men, much less so (39 = old)Crisis competentMajor concerns: loneliness, health, income, and discrimination/internalized homophobia

Slide39

39

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40

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41

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Slide43

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43

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Strategies to Improve QoL for LGBT Elders

Welcoming agencies and health care providersSensitive assessmentsEducation for providersAppropriate screeningsMental health careResources for uninsuredSupport networksLocal resources

Slide45

Creating LGBT Safe Spaces

Familiarize w/LGBT community, culture, values, beliefs, risks and related issuesDisplay symbols that identify agency as LGBT-welcoming (e.g., rainbow flag, pink triangle, HRC logo, etc.)Share news affecting LGBT communityIncorporate LGBTQ events (e.g. No Name-Calling week, Day of Silence, Coming Out Day, Transgender Day of Remembrance)Where appropriate, access services, resources and referrals that address the specific needs of the LGBT communityHave culturally appropriate/sensitive programming, events, courses, literature etc. targeting various LGBT populations

Slide46

Addressing Concerns of Residents Uncomfortable with Green Hill’s new LGBTQ-Affirming Approach to Care

Slide47

Managing the Upset Resident

Innate

resistance and defensiveness

will likely arise during a conversation

about

what ultimately amounts to bigotry on the part of a resident who complains to staff about LGBT-affirming policies at Green Hill

This doesn’t mean staff should back away from having this important discussion – or any others that address issues like racism

, sexism,

or

other kinds of hate.

But these

conversations

need to be

held

in a way that position the resident into

a more receptive position to hear what these problems are all

about and why Green Hill is enacting these policies.

One key issue

to remember when engaging the resident is

that people want to feel heard before they can open their minds to other people’s points of view. 

Slide48

Active Processing Dialogue

Conversation technique shown in 2016 study on impact of canvassing to change people’s opinions about Transgender bathroom access laws

to

successfully inoculate

people against

prejudice:

(

Broockman

and

Kalla

, 2016)

People

learn lessons more durably when they come to the conclusion themselves, not when someone

“talks at them with a statistic” or “labels them a pejorative term for thinking a certain way”

Develop

empathy with

the resident and

help them connect the prejudice they've felt in their

own lives

with the prejudice

LGBTQ people face and that a potential LGBTQ resident could face without Green Hill’s actions

Slide49

Active Processing Dialogue

At start of

Canvassing conversation

, Virginia asks Gustavo how likely he'd be to support transgender rights legislation.

Gustavo

says he wouldn't support it

b/c worried

about predatory men

using law as opportunity

to enter women's

bathrooms

Virginia asks why he feels that way.

"I'm from

S. America

, and in

S.

America we don't like

fags"

According to

Broockman

&

Kalla

(2016), this

next moment is crucial:

Virginia

doesn't jump on Gustavo for

slur

,

but says

, "I'm gay," in

friendly tone.

Gustavo

doesn't

recoil but actually

,

becomes

more interested

.

Gustavo and Virginia go on to discuss how much they love their partners, and how that love helps them overcome adversity.

Gustavo tells Virginia that his wife is a disabled person.

"God gave me the ability to love a disabled person," he says, and that taking care of one another is why love matters.

"That resonate a lots with me," Virginia responds. "For me, these laws, and including transgender people are about that. They're about how we treat one another.“

Slide50

Active Processing Dialogue (con’t)

Now

that Gustavo is in a place where he's more open, Virginia asks him to imagine what the worst thing could happen if he used a bathroom with a transgender person.

He admits he wouldn't be scared.

Then, according

to

Broockman

&

Kalla

(2016),

comes the

breakthrough:

"Listen, probably I was mistaken,"

Gustavo

says of his original position on trans rights.

Virginia asks him again if he'd vote in favor of banning transgender discrimination.

"In favor," he says.

Slide51

Active Processing Dialogue (con’t)

Broockman

&

Kalla

(

2016) go on to suggest the following communication tactics

seem to be the most promising at

reducing subconscious LGBT biases and anxiety:

presenting

people with examples that break

stereotypes

asking

them to think about

LGBT people as individuals, not as a group

asking them to describe their concerns in greater detail – what specifically matters to them about…

The facility getting an LGBT reputation in the community?

Having an LGBT roommate?

Sharing a bathroom with an LGBT person?

Slide52

Active Processing Dialogue (con’t)

tasking

them

w/taking

on

1

st

person

perspectives of

LGBT people & staff

If they were that LGBT person….where might they go to feel safe?

If they were the nursing staff….should they turn away someone in need to suffer unwanted and alone because that person says they are LGBT?

What could we do instead to not cause harm to them but be OK for you

increasing

contact between

LGBT people and non-LGBT

Would you be willing to meet an LGBT educator to talk about your concerns, maybe ask questions?

We

have someone willing to come here to be asked anything about being LGBT to help our residents feel less concerned

…

Slide53

Active Processing Dialogue Demo

https://youtu.be/2663J2d3VY4 (8:30)

Video clip demonstrating

“

Active Processing Dialogue”

during

a canvassing encounter

about

transgender bathroom access laws

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Additional LGBT-related Resources

New Jersey/Hudson County

Hudson Pride

Center

:

www.hudsonpride.org

YouthConnect

(free support & linkage to care program for LGBTQ youth 14-24)

TransView

(free support & linkage to care group for Transgender individuals)

Men of Pride

(free support & linkage to care group for gay and bisexual males)’

SAGE

(free support & linkage to care group for LGBT seniors over age 50)

LGBT Alcohol & Drug Prevention Education & Support

(free on-site LGBT AA meeting for clients and community prevention education by staff for LGBT clients and for providers)

PrEP

(free program to connect GB males and TG women to HIV prevention health care, prevention case management and

PrEP

adherence counseling)

HIV Linkage to Care

(free program for MSM, TGW and WOC to get them HIV tested and if HIV+, linked to free HIV medical Care)

LGBT Sensitivity Training

(in-service

ed

to providers/public on LGBT awareness & issues)

Garden

State

Equality:

www.gardenstateequality.org

Lambda Legal-NJ:

www.lambdalegal.org/states-regions/new-jersey

African

American Office of Gay Concerns:

www.aaogc.org

Out

In New Jersey (LGBT magazine):

www.outinjersey.net

National

Gay, Lesbian, Straight Education Network:

www.glsen.org

Parents & Friends of Lesbians & Gays:

www.pflag.org

Queer Resources Directory:

www.qrd.org

The Trevor Project (suicide prevention):

www.thetrevorproject.org

The Sylvia Rivera Law Project (transgender

rights):

www.srlp.org

Slide57

References

American Psychological Association. (2008).

Answers to your questions: For a better understanding of sexual orientation and homosexuality

. Washington, DC: Author. [Retrieved from

www.apa.org/topics/sorientation.pdf]

Broockman

,

D. &

Kalla

, J. (2016).

Durably reducing transphobia: A field experiment on door-to-door

canvassing.

Science

. 

352(6282): 220-224

doi

: 

10.1126/science.aad9713

Brotman

S, Ryan B, Cormier R. The Health and Social Service Needs of Gay and Lesbian Elders and Their Families in Canada. 

The Gerontologist

. 2003;43:192–202.

Cahill, S., South, K., & Spade,

J. 

(2000).

Outing

age: Public policy issues affecting gay, lesbian, bisexual, and transgendered elders

. New York, NY: Policy Institute of the National Gay and Lesbian Task

Force.

Drescher

, J.

(2013

). Controversies in Gender Diagnoses.

LGBT Health

.

Advanced on-line

publication. https

://doi.org/10.1089/lgbt.2013.1500.

Dunker, B. (1987). Aging lesbians: Observations and speculations. In 

Lesbian Psychologies: Explorations and

Challenges.

ed. Boston Lesbian Psychologies Collective, 72-82. Chicago: University of Illinois Press

.

Fredriksen-Goldsen, K.I. (2011

). Resilience and Disparities among Lesbian, Gay, Bisexual, and Transgender Older Adults. 

The Public policy and aging report

, 

21

(3), 3-7

.

Fredriksen-Goldsen, K. I., Cook-Daniels, L., Kim, H. J.,

Erosheva

, E. A.,

Emlet

, C. A., Hoy-Ellis, C. P.,

Goldsen

, J.,

&

Muraco

, A. (2013). Physical and mental health of transgender older adults: an at-risk and underserved population. 

The Gerontologist

, 

54

(3), 488-500

.

Slide58

References

Friend, R. (1987). The individual and social psychology of aging: Clinical implications for lesbians and gay men. 

Journal of Homosexuality

, 14, 307-331.

Friend, R. (1990). Older lesbian and gay people: A theory of successful aging. 

Journal of Homosexuality

, 20, 99-118.

Gann, Carrie. (2012).

Sex Life of Older Adults and STDs

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Questions? Comments?Thank You!