Therapeutic Issues with Gay and Lesbian Elders

McDougall helps sensitize us to issues of the homosexual aged, not only their stigmatized existence, but also their remarkable strengths and special needs. 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 (1982) estimated up to 3.5 million homosexual men and women, over the age of 60, were currently living in the United States. A more conservative estimate of 1.75 million was given by Berger in 1984. Loss is the predominant theme of aging in all older adults who experience many losses which often occur simultaneously, e.g., death of spouse and friends, retirement, change in social status and loss of status, loss of income or drastic reductions in income, decline in physical health, and impending death. 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, 1984). There are differences, however, in the way both groups have learned to cope with the stresses of life (Berger, 1982). To be old and gay demands adaptation that most people have never had to experience with life. Wolf (1982) conducted in-depth interviews with 100 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.