VIGNETTE

Mike, a slight man in his mid-sixties, stood in the crowded room of healthcare professionals and told his story – life as a young trans person, undergoing counselling, living as a male, and implementing a hormone therapy regimen prior to breast removal. Mike shared that he had not pursued surgeries on his ‘lower half ‘ to turn his vagina into a penis, because of cost, complexity and questionable success. Having recently lost his partner of many years, Mike predicted that a time would come when, unable to care for himself, he would need to reside in a nursing home. In a soft-spoken voice he concluded by saying, “When that happens, I don't want to be viewed as abhorrent. I don't want to know that workers are repulsed when they touch me. I am a person.” The silent audience could hear Mike's vulnerability as he shared these feelings during a training sponsored by the LGBT Roundtable of San Joaquin County, California.

Introduction

This chapter presents the efforts of one community in the United States (US) to better understand and address health and ageing needs of lesbian, gay, bisexual and trans (LGBT) older people, including Mike. The chapter introduces readers to the LGBT Roundtable of San Joaquin County, California; it describes how this collaborative advocates for equal access to services and to eliminate heteronormative bias in services to LGBT older people. The chapter reviews the societal context for Mike's lived experience of growing old and being LGBT in the US and how that experience differs from those of heterosexual older people as well as younger LGBT populations. The chapter discusses the seminar at which Mike presented his story and identifies training content that can be adapted for use by local communities. Lastly, the chapter examines the importance of social workers and other health providers taking immediate steps to make services to ageing individuals, including Mike, more LGBT-competent and friendly.

Origin and composition of the collaborative

In 2007 and 2009, California implemented two important laws to prevent discrimination based on gender identity and sexual orientation of LGBT older people such as Mike. The Older Californians Equality and Protection Act 2006 required ageing services agencies to identify and address the needs of LGBT older people through culturally competent service delivery systems.