Being old and being gay may seem like an overwhelming task to accomplish, since aging has its share of emotional challenges and concerns.
Ten years ago Dawson estimated up to 3. A more conservative estimate of 1. Loss is the predominant theme of aging in all older adults who experience many losses which often occur simultaneously, e. Emotional responses experienced by older people such as anxiety, depression, grief and mourning, guilt, helplessness, loneliness, are universal, which means that homosexuals as well as heterosexuals will experience similar emotions in old age. In general the mental health needs of the older homosexual are similar to the needs of the older heterosexual Berger, There are differences, however, in the way both groups have learned to cope with the stresses of life Berger, To be old and gay demands adaptation that most people have never had to experience with life.
Wolf conducted in-depth interviews with older lesbians and gay men and documented their many strengths. These strengths include learning at an early age to fend for themselves; cultivating several noncareer interests; preserving friendships outside a lover relationship; increasing their personal autonomy; and adjusting easier to old age since homosexuality means one has to live with a stigmatized identity throughout life.
As a result of these learned coping strategies, elderly homosexuals may be better prepared for old age and adjust easier to old age than elderly heterosexuals. There is a paucity of published research on the mental health needs of the older gays and lesbians since many tend to be invisible.
The goal of this chapter is to critically analyze the literature on the mental health of aging homosexual men and women from a developmental perspective. Myths, stereotypes, historical events, and developmental issues are evaluated in the context of stress and coping.
Finally, the therapeutic issues discussed are anxiety, bereavement, homophobia, homosexual dissatisfaction, intimacy, and sexuality. Some of the myths perpetuated are: Factors that were identified and contributed to healthy psychological adaptation were integration into the gay community; commitment to homosexuality; low concern with concealment of sexual preference; and satisfactory sex life.
These factors are valuable to a mental health professional who may be working with an older homosexual client.
These correlates of health could be classified as coping strategies and would be helpful in assessing a client. Gray and Dressel challenged previous findings on older gay males from a new perspective. The researchers used a sample consisting of 4, gay males who responded to a self-administered questionnaire in This is the largest sample of gay males available, 50 years and older throughout the United States and Canada, both in urban and rural settings.
Various relationships were manipulated statistically using a control variable, the length of time engaged in homosexual activity. The researchers utilized a process of inductive logic, suggested from the data, to offer alternative interpretations and insight regarding the phenomenon of aging among gay males.
Previous beliefs about the negative stereotypes associated with being old and gay have been attributed to the effects of aging in a youth oriented subculture. Suggestions, or alternative hypotheses, were offered to reconceptualize aging in older gay males, such as subculture opportunity, subcultural aging, subcultural socialization, and, cohort effect. The findings indicate that factors other than aging per se may be important in understanding the experiences of older gay men.
Major criticisms of this study were the non-probability nature of the sample recruited and data from a research study. Lesbians may have an advantage over nonlesbians since far fewer lesbians claimed their own age and concomitantly restricted the age of the prospective ad respondent. There was also no affirmation to support the belief that homosexual women are potential seductresses of the young.
Thanks to the excellent works of these investigators, the body of knowledge pertaining to aging homosexuals has increased; however, it does not identify the diversity in adult development among these individuals.
This cohort of adults, before , had very different life experiences than the cohort past Older gays bring with them these historical factors.
The Gay Liberation movement did not occur until These men and women had to be secretive to survive, in fact gay bars did not even appear until after World War II.
A primary difference between older gays and younger gays is the bar scene. Older gays do not frequent the bars; they tend to have more parties with private circles of friends. These two differences are mentioned because each presents the therapist with a range of possible treatment modalities. Kimmel advocates using the range of services available to the gay community and being creative with the types of therapy prescribed to older gay males.
Gay men will seek the services of a psychotherapist for a variety of reasons just as do all other individuals who are having problems coping with life and are experiencing emotional pain.
The therapist must be aware of personal values and attitudes when treating a homosexual client so as to not subtly disapprove of the homosexual lifestyle. Martin mentions that the views society has about homosexuals are a reflection of two realities: The common therapeutic issues of anxiety, bereavement, homophobia, homosexual dissatisfaction, intimacy, and sexuality issues will be addressed. Anxiety Older adults are at a strong risk of experiencing anxiety and stress related to illness and death.
Both have been implicated in the disease processes of asthma, hypertension, and ulcers. Older gays and lesbians experience all the same stressors in life plus issues such as concealment of their sexuality, loss of support from family, and homophobia. Aging gay males are at a high risk for developing anxiety and this may manifest in the two forms, somatic and cognitive.
Examples of cognitive manifestations of anxiety are rigid thinking to protectively exclude external stimuli; fear of being alone; and suspiciousness to the point of paranoid states.
Cognitive expression of anxiety may produce depression, confusional states or incorrectly label a person as senile. Bereavement All adults may have a difficult time dealing with the death of a spouse or a lover of many years. Pathological bereavement is not easily predictable; however, a combination of the previous factors may indicate when normal grief becomes unresolved or changes its form to a depression.
Since many older adults have a chronic illness, depressive reactions are often associated with physical disease, and often take the form of physical complaints; therefore making a diagnosis complicated.
Increased dependency needs resulting from physical illness are a central issue to be addressed when providing psychotherapy with older adults. Kimmel believes that bereavement is one of the few issues for which an older gay male will seek counseling or psychotherapy. Community support programs and self help groups are other means to offer assistance to older gays and lesbians, and are often only found in large urban settings.
Prime Timers is an example of a self help group started in Boston by individuals and is available in other parts of the country. Kimmel recommends that community centers offer specific outreach programs to the gay and lesbian community for bereavement, physical disability, and stigmatization.
From a cultural perspective, homophobia is as any belief system which supports negative myths and stereotypes about homosexual people. More specifically, it can be used to describe: From a personal perspective, homophobia refers to an irrational fear, or intolerance of homosexuals and homosexuality Lehne, Why then does homophobia become the worst enemy of the older gays?
Since homosexuals know at an early age that they are different from heterosexuals a type of self-hatred is often present. Many gay people become stuck with these irrational fears which surface as self-destructive behaviors. These self-destructive issues need to be exposed in order for the client to move into more self-accepting behaviors. This may indicate an individual is not consciously aware of his internalized hatred of homosexuals.
Homosexual dissatisfaction Not all homosexuals are satisfied with themselves and their sexuality. Schwartz and Masters have developed a short-term intensive intervention adapted from the Masters and Johnson model for treating heterosexual disorders to treat men who want to change their homosexual preference.
The directive psychotherapy alternates between confrontation of maladaptive belief systems and patterns of relating and support for finding new ways of coping that foster a positive self-image. Following the pretreatment period, the patient and opposite-sex partner live in social isolation and meet daily with a therapy team to address fears and anxieties about intimacy as they arise. Intimacy Intimacy is a need basic to all humans; however, the way intimacy needs are met becomes the therapeutic issue.
Loneliness, an emotional concern affecting all older adults, compels people to behave in many different ways and gays become lonely just as all other people do. The way loneliness is handled can be either positive or negative. There are many creative ways to handle issues of loneliness and meet intimacy needs among older persons, both gay and straight.
Various styles of intimacy are described, neogamy being a generic term meaning new forms of intimate bonding and is described in this paper as those phenomena usually labeled alternative lifestyles Dressel and Avant, The types of neogamous relationships that will be discussed are cohabitation, polygyny, and communal arrangements. The author quotes statistics from and showing that the number of unmarried elderly couples of the opposite sex living together has increased from 18, to 85, While part of this figure represents landlord-tenant or head of household-paid employee relationships, the likelihood is that a substantial portion of these unmarried couples live as partners, since their ages tend to be similar.
Polygyny is another alternative living arrangement based on the imbalance in the same sex ratio among older people. Kassel discussed some of the social and emotional advantages of this lifestyle such as, obtaining group health insurance policies; division of household chores and care for the sick; improved diets and housing; creation of a family network; sexual outlet; and improving grooming.
Polygyny is hypothetically a structural alternative addressing an imbalanced sex ratio; however, it seems unlikely that it will be legalized in the foreseeable future.
Communal arrangements may be useful for older people who do not mind sharing housing. Maggie Kuhn of die Grey Panthers advocates communal living arrangements of intergenerations. This intergenerational approach more appropriately resembles a nuclear family. In this arrangement, residents share economic resources and provide each other companionship and emotional support. Homosexuality has also been considered as a means for older females to address unmet intimacy needs.
This is based on the disproportionate number of older females to males. Neogamy as an alternative method of meeting intimacy needs has many social prejudices to hurdle before being accepted.
Legal obstacles, societal prejudice, and going against traditional family mores are some of the negative implications involved in acceptance. How does neogamy apply to homosexual elders? Many gays grow into adulthood without role models and rarely does a young homosexual have meaningful contact with elderly gay and lesbian people.
Most older homosexuals do not socialize in the bars and tend to entertain at home with close friends. This lack of a role model helps perpetuate some of the myths of aging among gays and aging in general.
Since older people including older gays do have the special characteristics of wishing to leave a legacy, the elder function, and a sense of the entire life cycle, then younger gays might learn a great deal from having older role models Butler and Lewis, Developing alternate forms of sharing intimacy is one way to perpetuate positive role modeling.
A community center or a social group may be an option for developing alternate forms of intimacy among gay males and lesbians, young and old. Castleman identified that a significant problem for older gays was a scarcity of social service programs that attend to the needs of older homosexuals.
A center offering programs to all ages and sexes of gays and lesbians would allow for socialization. Younger gays then will have exposure to older gays and through interaction learn some of the coping strategies used by the older gays; also, some of the alternative living arrangements such as cohabitation, renting of rooms to college students, and other combinations of the above.
Sexuality Sexuality and aging is another area where little research has been done.