KEY ISSUES

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KEY ISSUES

• SPECIFIC TO LESBIANS

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BRITISH RESEARCH

• Only a handful of small studies on lesbians and
  health in Britain
• Mugglestone Bolton Wigan
• Shady Liverpool
• Leeds, Sheffield, Manchester.
• Some on sexual health
• Some on alcohol misuse
• None specifically on older lesbians
• Currently, social work student, Ann Cronin,
  University of Surrey experiences of lesbians and
  gay men aged between 55-64 and 65-75 six
  discussion/focus groups three with each gender
  currently writing up findings.

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CARLY HALL Nursing background, p/t Ph.D
health status and social care of older British
Lesbians 60

• Very hard getting a sample face-to-face
  interviews 9
• Few women who have always identified as lesbian
• Majority been married, have families and have
  come out later in life. Some single, some in
  r/ships.
• None particularly well off yet 80 use/d comp.
  therapies. 
• Growing older is seen as a positive experience.
  Physical health of these women generally good. 
• Some bad experiences with healthcare profs but
  mostly OK.
• Some are out to primary healthcare providers some
  dont see their sexuality as relevant to this
  relationship. 
• Interested in factors which may impact on health
  and well being e.g. the acceptance of a lesbian
  identity, long-term effects of heterosexism/homoph
  obia, whether not having children means less
  contact with healthcare professionals and what
  this means.

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Calderdale Pride 2001 OlderLesbian Gay
Workshop

• 10 lesbians and gays, half male, half female
• Some people as they age become more true to
  themselves (being out, being camp), making own
  life choices and letting others react as they
  will. However, as get older, concern that
  openness will result in less adequate care (not
  necessarily open discrimination, maybe last in
  line for resources).
• Ageism in gay community
• Gay community shrinking as one ages
• Fear of isolation, discrimination, prejudice,
  residential care, ignoring needs, e.g.
• Own choice of support
• Maybe single but want contact with gay friends
• Next of kin, maybe out of touch with family,
• Access for those we care about

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U.S. Research

• Studies tend to use small, convenience, samples
  (orgs networks, therefore out to some level)
• U.S. Studies often biased with participants being
  white, middle-class, well educated, between 25-40
  years of age
• Other criticisms of research
• Inconsistent definition of sexual orientation
• Lack of appropriate controls/comparison groups
• Lack of longitudinal data

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US research with Older Lesbians and Gays (Optimal
Affirmative Outcome)

• Psychologically well adjusted, happy and adapting
  well to getting older
• Not experience any significant decrease in
  self-acceptance or increase in loneliness,
  anxiety or depression as they got older
• Sources of strength crisis competence gender
  role flexibility
• Sources of well-being
• positive identity
• managing conflicts about sexual orientation prior
  to self-identification
• disclosure
• integration with LGB community
• interpersonal support

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Kaiser, Oregon, 2000 93,311 _at_ 40 sites in USA
50-79 year olds

• 740 bisexual 264 lifetime lesbian 309 lesbian
  after 45 1,420 never had adult sex rest
  heterosexual
• Lesbians bisexual women higher socio-economic
  status and more education, but
• Higher rates of
• Obesity
• Smoking
• Alcohol use
• Scored lower on measures for
• Mental health
• Social support
• Use preventive screening services e.g. mammograms
  and Pap test less often

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Other Risk FactorsHate Violence

• High percentage of lesbians experience hate
  violence therefore at risk for
• physical injury
• symptoms of post-traumatic stress syndrome
• death

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Other Risk FactorsHomophobic Stress

• All lesbians experience homophobic stress,
  therefore increased risk of
• myocardial infarction
• asthma
• diabetes
• gastrointestinal diseases
• Perhaps cancer, viral infections, auto-immune
  system deficiencies
• Possible factor in substance abuse, unhealthy
  eating habits and sleeping problems

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Adolescent Risk Factors

• Depression
• Suicide
• Anxiety
• Self-harm
• Eating disorders
• Phobias
• Possible continue into adulthood if not develop
  positive identity, support, come out

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Other Health Risk Factors (from all ages)

• Twice more likely to be smokers
• More likely to be obese
• Less likely to have children
• Less likely to use contraceptives
• More likely to have drink problem
• Drink problem more likely to continue as get
  older
• Possible higher levels of child sexual abuse
• Lack of appropriate services

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Possible High Risk Illnesses

• Greater risk of certain cancers breast, lung,
  ovarian, colon
• Greater risk of coronary heart disease
• Greater risk of alcohol related illnesses
• Greater risk of mental health problems

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Services

• Fear that services and staff e.g. nurses,
  doctors, social workers, other health care
  workers, voluntary organisation staff, will be
  heterosexist and homophobic and not respect
  relationship
• Reality that many services are heterosexist and
  staff are homophobic
• Possibly prevented from visiting partners in
  hospitals/nursing homes excluded from decisions
  re care ignored at funeral services problems re
  inheritance

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PROJECTS

• USA loads see www.sageusa.org (brilliant
  website)
• UK very few
• Polari London awareness raising, action, care
  social services
• Various older lesbian networks e.g. London, NOLN,
  Manchester. But some 35, 40 mainly social
  rather than providing specific support
• Labyris Trust Brighton
• LG Bereavement Project

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GAPS Everywhere

• Research
• Services mainstream
• Support Social Projects
• Policies
• Strategy
• Visibility of issues
• Mainstream
• LGB communities/media