Chronic conditions can be difficult to manage at the best of times. But if you’re an LGBTQ+ older adult, barriers to health care—such as fear of mistreatment by doctors—can threaten your ability to age well.
Studies suggest LGBTQ+ older adults have higher rates of chronic conditions and other health problems, such as cancer, mental health disorders, cardiovascular disease, and more. Due to factors like health care discrimination, they may delay doctor’s visits or screenings that would help them address these conditions. Understanding their risk and finding supportive providers can help older LGBTQ+ people stay one step ahead of health issues.
The three chronic conditions LGBTQ+ older adults are at greater risk for
Cancer
According to the National LGBT Cancer Network website, an estimated 81,000 LGBTQ+ people are diagnosed with cancer every year.
We also know that:
- LGBTQ+ older adults face more frequent cancer diagnosis when compared to the general older adult population. This may be due to elevated rates of obesity, smoking, and substance use.1
- LGBTQ+ older adults encounter obstacles at every stage of cancer care. These include discrimination and stigma, invisibility of LGBTQ+ identities in cancer care, and little representation in cancer research studies. These barriers can lead to decreased access to cancer screenings and delayed diagnosis and treatment.1
- Compared to heterosexual populations, LGBTQ+ people diagnosed with certain types of cancer tend to experience less satisfaction with quality of care and poorer outcomes.
Early detection of cancer is key to successful treatment. Whether or not you’re experiencing any symptoms, it’s essential to keep up to date with annual cancer screenings as you age.
"Cancer screenings can help detect cancer early when treatment is more likely to be successful," says Jody Hoyos, president and CEO at the Prevent Cancer Foundation.
Early detection of cancer can mean less extensive treatment, more treatment options, and better chances of survival," she said.
People in the LGBTQ+ community should also ask their provider about routine tests for detecting HPV and anal cancer. Risk factors for anal cancer include HIV infection and receptive anal intercourse.
It's important to have a health care provider you can trust. To find an LGBTQ-welcoming provider near you, visit the National LGBT Cancer Network Provider Database.
Mental Health
From an early age well into their later years, many LGBTQ+ people face social barriers such as stigma, isolation, and inequitable mental health care access. Older LGBTQ+ adults may also experience “dual” discrimination due to their age and sexual or gender identities. It’s no surprise, then, that this community is more likely to experience mental health challenges.
Consider these facts about LGBTQ+ older adults and mental health:
- They have higher rates of depression, anxiety, loneliness, suicidal ideation, and eating disorders.
- Older LGBTQ+ adults are more likely to be burdened by substance use disorders, including alcohol and tobacco use.
- These populations are less likely to have support from caregivers when compared to their cisgender heterosexual peers.2
Feeling sad and hopeless or anxious all the time is not a normal part of aging, and it can impact your physical health and cognitive well-being. Once your depression or anxiety is properly treated, you can reclaim your quality of life and even cognitive abilities you might have lost.
A supportive doctor can help you explore healthy avenues for managing your symptoms, such as anti-depressants or anxiety medications. You might also benefit from incorporating stress-relieving activities into your life, and taking steps to combat loneliness. These include:
- Meditation, yoga, and regular exercise to release endorphins and those “feel good” brain chemicals
- Sharing your feelings with someone you trust, like a friend or therapist, or joining a support group
- Finding purposeful opportunities to get out and socialize, such as visiting your local senior center or volunteering
- Being mindful of what you put in your body—remember that alcohol is a depressant, and research suggests caffeine and unhealthy foods can impact your mood
If you’re having thoughts about suicide or harming yourself, know you’re not alone. The first thing you should do is contact a trusted friend, family member, or health care provider immediately. If you have no one to call, contact the National Suicide Prevention Lifeline by dialing or texting 988. Trained, compassionate counselors are available 24 hours a day, seven days a week.
Heart disease
Heart disease is the leading cause of death in America, and the average age of a person experiencing their first heart attack is between 65 and 72.3 Research shows LGBTQ+ adults experience worse cardiovascular health compared to their cisgender heterosexual counterparts. This is likely due to a complex interplay of life stressors and behavioral, psychosocial, and physiological factors.4
You can take charge of your heart health by improving your diet, increasing your exercise, managing your stress, and curbing alcohol and smoking.
If you’re concerned about your risk factors, or you have family history of heart disease, talk with your doctor. Ask to get screened for hypertension, high cholesterol, and diabetes—all of which can lead to cardiovascular disease.
A special note about heart disease for people in the transgender community: Studies show the use of hormone therapy can potentially increase the risk of cardiovascular events. Along with all the regular steps to take charge of your heart health, make sure to ask your doctor if there are signs or symptoms you should watch for as you age.
More information on managing your chronic conditions as an LGBTQ+ older adult
NCOA's friends at SAGE run a national resource center on LGBTQ+ aging. They have an excellent Health Resources library that we encourage you to explore.
If you’ve been diagnosed with a chronic condition, community programs like the Chronic Disease Self-Management Program (CDSMP) can help you build the skills to manage it.
CDSMP is a six-week, interactive, small-group workshop that helps participants build the skills necessary to control how chronic conditions affect their life. Sessions focus on dealing with fatigue, frustration, or isolation; maintaining strength and physical activity; managing medications; communicating with health care professionals; and healthy eating. These workshops can be completed in-person at a local organization in your community or even online. To learn more about CDSMP workshops in your community, contact your local area agency on aging.
Sources
1. Koshy, A., Smita, C. B. (2019). Older Sexual and Gender Minorities with Cancer: A Population Hidden in the Open. Found on the internet at https://ascopost.com/issues/october-10-2019/oldersexual-and-gender-minorities-with-cancer
2. Naseem S. Miller. Mental health disparities in older LGBTQ+ populations: A research roundup. July 5, 2023. The Journalist's Resource. Found on the internet at https://journalistsresource.org/health/lgbtq-older-adults-disparities/
3. American Heart Association. 2024 Heart Disease and Stroke Statistics Update Fact Sheet. Found on the internet at https://www.heart.org/-/media/PHD-Files-2/Science-News/2/2024-Heart-and-Stroke-Stat-Update/2024-Statistics-At-A-Glance-final_2024.pdf
4. Billy A. Caceres, PhD, RN, FAHA et. al. Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association. Circulation. October 8, 2020. Found on the internet at https://www.ahajournals.org/doi/10.1161/CIR.0000000000000914
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