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Results and Implications of the St. Louis LGBT Older Adults Needs Assessment
posted 11.15.2012

By Meghan Jenkins Morales

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The journey to meet the needs of LGBT older adults in the St. Louis region began in 2008 with the formation of SAGE (Services and Advocacy for GLBT Elders) Metro St. Louis. Early on, SAGE developed a local task force and referenced reports to estimate the needs of LGBT older adults in St. Louis. Although this information provided a helpful foundation, more information was needed at the local level to ensure the needs of LGBT older adults in the SAGE service area were understood.

St. Louis LGBT Older Adults Needs Assessment

In 2010, SAGE partnered with the nonprofit volunteer service organization One St. Louis to implement a local needs assessment. The research team developed the St. Louis needs assessment modeled after the 2009 LGBT Health and Human Services Needs Assessment conducted in New York. Information was gathered on perceived and actual barriers to using services, mental health status, violence and victimization experiences and disclosing LGBT identity.

Examination of the Silent and Baby Boom Generations

Historical context has shaped the lives of LGBT older adults; however, limited research has examined the heterogeneity of the LGBT older adult population by exploring variation between generations. Potential differences between generations help us to better understand the current cohort of LGBT older adults and anticipate any upcoming changes. A study was conducted using the needs assessment data to examine two cohorts of older LGBT adults: the baby boom generation (50 to 64 years old in 2010) and the Silent generation (65 to 79 years old in 2010). Members of the Silent generation came of age prior to the type of LGBT identity and disclosure we’re familiar with today. In contrast, baby boomers experienced major cultural shifts at a younger age and were the first cohort to experience the LGBT visibility that came with the gay rights movement.

Results and Implications

Many differences were found between baby boomers and members of the Silent generation. Baby boomers were found to perceive more barriers to healthcare and legal services, have fewer legal documents in place, feel less safe in their communities, and have experienced an increased rate of verbal harassment compared to their predecessors. The findings also indicate that as age increases, the willingness to disclose LGBT identity decreases. The results suggest that more LGBT identity disclosure among baby boomers has brought opportunities for change, but also challenges.

In the St. Louis needs assessment all members of the Silent generation reported having some form of health insurance, while 10 percent of baby boomers were uninsured. More than 55 percent of baby boomers felt that there were not enough adequately trained and knowledgeable mental health professionals to meet their needs, compared to 12 percent of the Silent generation. Both Silents (39 percent) and baby boomers (48 percent) were fearful they would be treated differently if medical professionals discovered their sexual orientation and-or gender identity.

SAGE Metro St. Louis used these results during a healthcare provider forum in the summer of 2011. The forum kicked off a community dialog about barriers to healthcare and health disparities within the LGBT community. Following the forum, SAGE and PROMO Fund, the Missouri statewide equality organization, received a planning grant from the Missouri Foundation for Health to address LGBT health disparities in Missouri. SAGE also joined an advisory council dedicated to training mental health professionals on the needs of the LGBT community.

Close to 63 percent of baby boomers viewed restricted access to LGBT friendly attorneys as a barrier to legal services compared to 34 percent of Silents. In addition, 29 percent of baby boomers and 15 percent of Silents had no legal documents in place. Having legal documents in place is especially important for partnered members of the LGBT community who do not enjoy the same rights as their heterosexual counterparts. Continued advocacy is crucial toward marriage equality and creating targeted programs to decrease barriers to legal services and assist LGBT baby boomers with preparing legal documents.

More than 26 percent of baby boomers and 9 percent of Silents reported that they do not feel safe in their community when it comes to their sexual orientation and-or gender identity. In addition, regardless of generational cohort, as experiences of different forms of violence and victimization increased, feelings of safety in community decreased. The needs assessment revealed that close to 22 percent of LGBT baby boomers and 15 percent of Silents have been physically assaulted because of homophobia, and more than 21 percent of baby boomers and 19 percent of Silents have experienced property damage. Although a large proportion of Silents (40 percent) reported experiencing homophobic verbal harassment, more Baby Boomers (63 percent) reported being verbally harassed. In all, 62 percent of respondents have experienced homophobic violence or victimization across their lifetime, yet only 17 percent have reported the incident.

These startling statistics can help support advocacy efforts by emphasizing the importance of putting into place non-discrimination policies and procedures inclusive of sexual orientation and gender identity. Without these mechanisms, LGBT individuals will continue to be victimized with few, if any, safe options for reporting such victimization.

Respondents who have endured various forms of homophobic violence and victimization were also more likely to have probable depression and increased loneliness. The needs assessment revealed that 59 percent of baby boomers and 66 percent of Silents felt that they “sometimes” or “often” lack companionship. LGBT older adults are also less likely to seek supportive services, which in turn may leave them at risk for social isolation and depression. As a result, SAGE established a friendly visitor program to reach homebound LGBT older adults.

In a world that continues to stigmatize LGBT individuals, the findings from the needs assessment support the perspective that LGBT identity disclosure has brought risk and opportunity for LGBT baby boomers. It can be reasoned that disclosing one’s LGBT identity can positively affect mental well-being, while also increasing stress. The results also may reflect cultural differences between the two generations. The baby boom generation is known to challenge restrictions, and may have higher expectations than do members of the Silent generation when accessing services.  

As LGBT baby boomers reach their later years, the results of this study strongly support the need for continued and improved efforts to meet their needs. Organizations must galvanize members of the baby boom generation to mobilize around issues related to LGBT equality. Getting LGBT baby boomers and allies involved with efforts to advance policy may prove to bring about dramatic change. The time is now to build awareness, advance practice and create policies that improve the lives of LGBT individuals across the life course.



Meghan Jenkins Morales, M.S.W., is a former intern of SAGE Metro St. Louis, and works as the planning specialist for AgeOptions in Oak Park, Ill. Contact her at

This article was brought to you by the editorial committee of ASA’s LGBTQ Aging Issues Network (LAIN).


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