Many of you probably know, or can relate to, someone like Vivian. At aged 74, she is a lesbian who recently went to her regular doctor for a medical check-up. The doctor noted that Vivian was quieter than usual and that she had lost weight, wasn’t sleeping well, could not concentrate, no longer enjoyed gardening, had low energy and was tearful. He suspected depression, and referred her to a mental health specialist, but Vivian did not follow through. She later told a friend that she felt uncomfortable with the recommendation. Her partner of 30 years had recently passed away, but Vivian had never come out to her doctor and felt that “he’d never understand” what she was experiencing.
LGBT elders like her face unique issues not shared with the rest of the population. Educating both ourselves and health care professionals about these issues is increasingly important. The Lesbian Health & Research Center at UCSF (LHRC) is focused on doing just that.
LHRC (www.lesbianhealthinfo.org) is dedicated to improving the health and well being of Lesbians, Bisexual Women, Transgender (LBT) people and our families. LHRC staff members convene resource events for the general public and provide educational forums on LBT health issues for health care practitioners. In giving these presentations, we’ve found that even the most progressive clinicians aren’t necessarily aware of the unique mental health and other challenges that older LBT people may face (see Dr. Marcy Adelman’s inaugural Aging in Community column).
For example, when older LBT people came of age, discrimination against them was routine. In addition, they are more likely to live alone than heterosexual peers and are less likely to access senior centers, housing assistance, meal programs, and other resources. Also, despite the many civil rights advances, discrimination continues. It may be frightening for an older LBT person to consider bringing a potentially biased or hostile in-home care aid into her home or to seek residential care and risk discrimination by staff and residents.
LHRC is working to change lives. We aim to broaden awareness of the importance of health for all of us. LHRC has three new initiatives towards that aim.
Ask Us: The LHRC website has a new “Ask Us” feature through which individuals from across the globe can send in health questions (www.lesbianhealthinfo.org/you/ask_us.asp). Volunteer physicians with specialized knowledge in LBT health, including mental health, answer the questions confidentially. Questions cover a wide variety of topics such as depression recognition and treatment, referrals to LBT-sensitive primary care clinicians, information about sexually-transmitted infections, and evaluation and management of fatigue.
Blog: A new blog is also now on our website. It covers general issues of interest to the LBT community (lesbianhealthresearchcenter.wordpress.com). Authors cover diverse topics including the impact of aging, and the experience of getting legally married.
Visibility: The new Visibility Project is now online to further educate the general public about the importance of health issues. It includes short public service announcements aimed at encouraging all of us to take care of ourselves. These videos can be viewed at www.youtube.com/user/LesbianHealth?feature=watch
What about mental health? Older LBT people may view the mental health system as biased and unwelcoming due to their own past experiences. Many of these women may have received “treatment” in the past aimed at changing their sexual orientation. In contrast, appropriate mental health treatment can make a significant difference in improving overall quality of life.
UCSF has an LGBT Psychiatry Clinic, staffed by LGBT clinicians, which provides evaluation and treatment for mental health concerns. (Call 415-476-7500 to schedule an initial appointment; the clinic is able to see patients covered by most insurance plans, including Medicare.) In addition, Gaylesta, the LGBT Psychotherapy Association, (www.gaylesta.org) is an SF Bay Area organization that is a resource for LGBT individuals seeking therapy. Additional local mental health resources include the Access Institute (www.accessinst.org), Queer Life Space (https://www.queerlifespace.org/) and the UCSF Alliance Health Project (www.ucsf-ahp.org).
Through our multiple projects, the LHRC at UCSF is reaching out to people like Vivian to ensure they receive the care and support they need. Change will come through increasing the visibility of LBT seniors and educating health care practitioners about the unique needs and experiences of LBT older adults and seniors.
Ellen Haller, MD, is a Professor of Clinical Psychiatry at UCSF where she serves as a Co-Director of the Lesbian Health & Research Center and of the LGBT Psychiatry Clinic. In addition, she is the Director of Clinical Services for Langley Porter Psychiatric Hospital & Clinics and Acting Director of the Adult Psychiatry Clinic. She can be reached at ellen.haller@ucsf.edu. For additional information about the LHRC, email lhrc@ucsf.edu
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