Miki Odawa dreads the idea of an assisted living facility.
“Extended care scares the death out of me,” says Odawa, 72 and in good health.
It’s not that she is frightened of growing older and needing help.
It’s that the help she receives may not embrace who she is: A transgender woman.
“The thought that I am going to have people who refuse to accept my identity …,” says the Tucsonan, who cares for her 99-year-old mother. “How do I fight that when I am weak and incapable? How do I deal with people who have never seen a trans before? If I come up with a situation like that, it will tear me apart.”
Odawa isn’t alone in her concern. As the lesbian, gay, bisexual and trans community across the country reaches and creeps past retirement age, many have chosen to climb back into the closet. The fear of being mistreated because of who they are is that great.
That’s something Serena Worthington wants to change.
Worthington is with the New York City-based organization SAGE (Services & Advocacy for Gay, Lesbian, Bisexual & Transgender Elders), which advocates on behalf of LGBT seniors. She is in Tucson on Sunday, Feb. 7 speaking at a community forum organized by several local groups intent on building a strong, visible network for LGBT seniors.
It is essential to build that support she said, pointing out that without it there is an increased risk of depression, substance abuse, early institutionalization and premature death.
“It’s our shared responsibility to make sure all communities are served,” she said in an interview late last month.
“The community needs to take on that challenge. The numbers are dramatic — there are 2.5 million LGBT seniors 65 and older, and that’s going to grow because of boomers.”
It isn’t just the fear of mistreatment that’s facing that aging population.
There are health issues, as well: “A major need is getting health care providers and medical institutions to have more welcoming care,” said Lavina Tomer, 66, chair of Southern Arizona Senior Pride, one of the forum’s sponsors.
For example, she said, “Lesbians have a high incidence of breast cancer, but they don’t always feel comfortable coming out to their doctors. It’s changing, but it’s nowhere near where it needs to be. We are still a hidden population of people. We need all sorts of health care, and people are still prejudiced against us.”
Health issues are compounded for transgender people.
“Transgender people really struggle with this,” said Worthington. “They need competent health care, but also somebody who is understanding of diverse bodies. A trans woman, for instance, might need a prostate exam.”
If extended care is necessary for someone like Odawa, there can be threatening moments.
“I have male body parts,” she said. “You don’t know that when I’m walking down the street, but you’ll find out when you have to change my diaper.”
LGBT seniors also face increasing isolation.
“Many people lost groups of friends that they should have been growing old with,” said Worthington. “They may not have children, which provide a layer of care, or may be disenfranchised from their families.”
Safe housing is another issue, added Tomer.
“I just met a woman who lives in subsidized housing,” she said. The woman is lesbian and proud. “She puts out things on her door, rainbow colors or some kind of statement that says ‘I’m a lesbian,’ and people tear them down and make snide remarks. She doesn’t feel safe.”
“Our families have rejected us, our church has rejected us, and we don’t have the same kind of network,” said Tomer. “We rely on friends and resources, and if they are not visible, we will not pursue them.”
Even for out and proud elders, there can be hesitation.
Dea Brasgalla is 82 and has been out since 1955, when she told a fellow nurse she was a lesbian and was promptly fired.
She lives alone in a cozy central Tucson home. She has osteoporosis and looks frail, but Brasgalla has an inner strength that has allowed her to care for herself while she actively volunteers in political campaigns and reaches out to others with advice and spiritual guidance (she is an ordained minister).
She understands that transparency about your sexuality isn’t for everyone. “It takes a long time for people to get where I am,” she said. “Those in the closet are so fearful.”
Still, she says, she has a pulmonologist who doesn’t know her sexual orientation. And there are others she hasn’t told.
“I wouldn’t come out unless asked,” she said. “They would just shun you.”
While more and more resources are available to LGBT seniors, they won’t do much good unless they reach those who need them.
A network of Southern Arizona organizations is actively trying to change things for the aging LGBT community.
Two years ago, the Pima Council on Aging launched its Project Visibility program, a training program for the staffs of nursing homes, assisted living facilities, and home care agencies. It encompasses terminology, history, personal stories and suggestions on how to provide a welcoming environment to LGBT people.
Tucsonan Robert Bell, vice chair of Senior Pride, is a volunteer in the program and regularly conducts training to sensitize staff to LGBT issues.
“It’s important that we get people trained and understanding us before we need it,” he said.
The response from caretakers is often confusion, the 68-year-old said.
“They say ‘We treat everyone the same, so it’s not an issue.’ Well, it is an issue. Others don’t have the same fear of being who they are found out, and being rejected and abused because of it.”
He recently addressed a staff of 60 at a 200-bed elderly care facility in Tucson. “I asked how many LGBT people are here. ‘We don’t have any,’ they said. I said, ‘Well, you do. That you don’t know is the problem, and that’s one of the reasons I’m here.’”
He doesn’t believe it’s willful ignorance.
“It’s the classical definition of now knowing,” says Bell, a retired lawyer. “To explain to them what the issues are, their eyes open. It’s something they hadn’t thought of before.”
When the training is complete, the facility is given a pink triangle door sticker indicating a sensitivity toward LGBT people.
“I tell you, if I had to go into an extended care facility and saw that on the door, my shoulders would drop. I would be much more relaxed.”
Odawa, too, works to reach out and sensitize people through her volunteer work with the Arizona Gender Alliance, of which she is president.
“It’s important that we get people trained and understanding us before we need it,” Odawa said. “When I’m at my most vulnerable is not the time I want to educate someone.”
Tomer said activities such as today’s forum, and the outreach done by organizations like Senior Pride and PCOA, are working to up the understanding of and accessibility for LGBT seniors.
In the end, said Odawa, what LGBT seniors want is nothing extraordinary:
“We want what everyone else does,” she said. “Dignity, care, respect. What everyone wants.”