Aging is not for the feckless, as my mother used to complain before succumbing to its insults in 2012. The troubles of physical and mental decline come sometimes as single spies and also as whole battalions (to paraphrase Shakespeare).
For sexual minority people, aging’s troubles are often amplified by health care disparities, which have been well documented by the Institute of Medicine’s 2011 report The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding (http://www.iom.edu/reports/2011/the-health-of-lesbian-gay-bisexual-and-transgender-people.aspx). These health disparities may include a lack of health insurance, a lack of trust in health care providers, disrespectful treatment by health care providers, a lack of support from family, and a lack of sons, daughters or spouses who assume the medical caretaker role, all complicated by risks of multiple health conditions. Added to this is the absence of extensive health research on sexual minority populations.
However, despite these disparities, older gay, lesbian, bisexual, and transgender adults often have an important asset: resilience. Sometimes called crisis confidence or perceived hardiness, resilience is earned by a history of rolling with the punches with a resulting sense of self efficacy in which one trusts that one can take what life dishes out. Or to quote Gloria Gaynor’s popular disco hit of the 70s:
Oh no, not I. I will survive
Oh as long as I know how to love
I know I’ll stay alive
I’ve got all my life to live
I’ve got all my love to give and I’ll survive
I will survive,
I will survive! Hey, Hey!
As the IOM (2011) explains:
Definitions of resilience vary, ranging from a risk factor that has been averted or unrealized (Keyes, 2004), to a phenomenon that involves a relatively good outcome despite one’s suffering risk experiences (Rutter, 2007), to a class of phenomena characterized by patterns of positive adaptation in the context of significant adversity or risk (Masten and Reed, 2002). Despite these differing definitions, studies typically focus on the capacity to recover from psychological trauma or to adapt successfully to adversity. Indeed, resilience per se is not directly observable and can only be inferred by observing a person’s adaptation (Masten, 2007) (p. 2-35).
Genke (2004) documents the literature in support of the benefits imparted by resilience and offers a case study to support that claim. Acknowledging the results of stigma and social marginalization, Fredriksen-Goldsen (2011) underscores the significance of group identity and social networks, as well as personal resilience, among sexual minority elders. (See also the entire issue of Public Policy and Aging Report , 21 devoted to queer aging.) One central theme of Fredriksen-Goldsen et al. (2011) is that “resilience often emerges from adversity.”
Lessons learned are clear:
- As we age, we need to acknowledge the realities of health issues and find a health care provider whom we trust.
- We need to continue to seek and maintain networks of social support and learn to ask them for help, even when we’ve been accustomed to going it alone or when we are losing friends to infirmity or death.
- We need to inform ourselves about the unique issues related to aging in sexual minority communities. SAGE: Senior Action in a Gay Environment is one national organization that can provide guidance. Visit http://www.sageusa.org/
Botanists tell us that trees that have been buffeted about by winds over time develop tensile strength that allows trees to bend without breaking. It takes gales to make them strong. In the absence of these challenges, trees break in the first violent storm.
We are made of strong timber.
Fredriksen-Goldsen, K. I. (2011). Resilience and disparities among lesbian, gay, bisexual, and transgender older adults. Public Policy & Aging Report, 21(3), 3-7.
Fredriksen-Goldsen, K. I. (2011). The aging and health report: Disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle: Institute for Multigenerational Health.
Genke, J. (2004). Resistance and resilience: The untold story of gay men aging with chronic illnesses. Journal of Gay and Lesbian Social Services, 17(2), 81-95.
“I will survive.” (1978). Freddie Perren & Dino Fekaris. Universal Music Publishing Group.
Keyes, C. L. M. (2004). Risk and resilience in human development: An introduction. Research in Human Development, 1(4), 223-227.
Masten, A. S., ed. (2007). Adolescent psychopathology and the developing brain: Integrating brain and prevention science. Edited by D. Romer and E. Walker. New York: Oxford University Press.
Masten, A. S., and M. G. Reed. (2002). Resilience in development. In The handbook of positive psychology, edited by S. R. Snyder and S. J. Lopez. Oxford, England: Oxford University Press.
Rutter, M. (2007). Resilience, competence, and coping. Child Abuse & Neglect, 31(3), 205-209.