Ageing, Sexual Orientation and Mental Health: Lesbian, Gay, Bisexual, Transgendered and Intersex Older People

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Discrimination against lesbian, gay, bisexual, transgendered and intersex (LGBTi)i people can often mean they are denied the basic human right to live the life they are born to lead (Kimmel et al. 2006). Traditionally, LGBTi people have often had to live in secret, hidden from the dominant heterosexual society, and many older people are still worried about disclosing their sexual identity (Kimmel et al. 2006). In this chapter I will explore some of the many issues facing older LGBTi people.

The chapter starts with a brief overview of the history of the LGBTi communities and how they have been treated as ‘invisible citizens’ through mechanisms of the law and the medicalisation of the ‘homosexual’ (Jennings 2007). Then I examine some of the fears and concerns held by members of LGBTi communities when accessing services, and this is discussed in relation to issues of sexuality, mental health and ageing. It is my hope that in reading this chapter you will gain a deeper understanding of the issues raised and then think of areas of application for your own development as a non-discriminatory practitioner, as well as identifying needs for further service development.

Absent from history:

LGBTi people in the UK LGBTi people have often been absent from the writing of history. Evidence suggests that same-sex relationships existed before the emergence of Christianity, as far back as the Celts, and at certain times in history LGBTi people were commonly seen as unremarkable (Ellis 2004). However, over time the category of heterosexuality developed as the dominant sexual value in society, especially in relation to the family, and consequently other experiences of sexuality became constructed as ‘abnormal’. The criminalisation of homosexual sex apparently came about because of its growing visibility in the Victorian era amongst (though not limited to) the upper and aristocratic classes (Cook 2011). In order to prevent the visibility of homosexuality in all forms, there was a movement to stop what was viewed as ‘indecency in private’ as well as in public (Jennings 2007).

In 1886 in England, the Criminal Law Amendment Act outlawing sexual relations between men (but not between women) was given Royal Assent by Queen Victoria. As most British colonies at the time had been forced to give up their own legal systems and operate under the British legal system instead (Tiwari 2013), this law was also enacted across the British colonies. The Offences Against the Person Act 1861 was amended to remove the death sentence for ‘buggery’; however, the penalty became imprisonment between ten years and life (Licata and Petersen 2013).

Unfortunately, trans and intersex people often got persecuted under the same law, which is typical of the tendency to place transgendered and intersex people under the label of sexuality and not in their rightful place under the label of gender (Whittle 2011. Prior to colonisation by the Europeans, many cultures and countries had LGBTi practices that were considered normal as part of a continuum of sexuality and gender (Tiwari 2013). As a result of the British colonial mechanisms of power and the regulation of homosexuality, many minorities from member states of the Commonwealth of Nations are still more likely than not to keep their sexuality or gender private, for fear of a cultural backlash (Amory 1997). It is argued that this continues to have a profound effect on many Black and minority ethnic LGBTi people in the UK, who often have to struggle with cultural tensions about sexuality/gender as well as the racism that can occur within LGBTi communities in the UK today (Varney 2012).

For example, in Sri Lanka, where people often have arranged marriages, the expectation is that a person will marry for the honour of the family, which may cause difficulties when sexuality or gender does not match. Therefore, some married men or women are not enjoying a full marriage because they have been forced to marry, for ‘family honour’, a gay, lesbian or trans person (Equal Ground et al. 2014). Many of the worst examples of state killings of lesbian and gay people came during the Nazi atrocities of the Second World War, when almost 1 million gay men and women living in Berlin disappeared and 100,000 known gay and lesbian people were sent to the death camps.

This has left a historical legacy that should never be repeated (Herzog 2004). However, in many countries heterosexuality continues to be viewed as the ‘normal’ way of living, and this is backed up by legislation; consequently, many LGBTi people continue to find themselves persecuted or prosecuted by the state. This is the case in at least 82 countries (Stocks 2015), including Russia, Turkey, Uganda and the Gambia (Thompson 2014). So far, I have shown how LGBTi people have historically received prejudicial treatment, and it may be suggested that as a consequence of this many people from LGBTi communities are likely to be hesitant in trusting both state-provided and private health services. This may be particularly true for older people who remember and may have direct experiences of this persecution. In the next section, I look at some of the state reforms that have impacted upon the lives of LGBTi people in the UK. I then discuss how the law dominated lives in such a way that LGBTi people have historically gone ‘underground’ and become invisible rather than be prosecuted or persecuted, which I argue may have muted the conversation between healthcare services and LGBTi people.

State reforms in the UK

The retelling of LGBTi history is often constructed as a story of ‘progressive enlightenment’ in which LGBTi people emerged into liberation (Chauncey 1989). However, while these stories of resistance are valuable, many others present experiences of shame and, with it, a life of silence and secrecy for fear of judgement by others (Stonewall 2011). Knocker (2012) investigated the perspectives of older LGBTi people and interviewed a cross-section of older people including Patrick, whose experiences were similar to the many who lived in fear, having seen their friends taken into the care of psychiatric services just because they were gay. Patrick states: You just tried to lead a normal life as a ‘bachelor’. People used to say about me, “He’s very shy!” I just closed off my sexual life. I would joke with other people and be a bit anti-gay myself, which I feel sad about now. (Knocker 2012, p.5)

In the same study, Adam described how he felt like an invisible man, as the only way to encounter other gay or bisexual men was to meet in communal areas like parks or public toilets. Meetings like these were eventually described with the term ‘cottaging’, which became a criminal offence. Undercover policemen would try to entrap gay and bisexual men through these meetings in order to control their behaviour, which turned the meetings into a dangerous risk. Those who were arrested would suffer humiliation and future difficulties, especially if the arrest resulted in a police record, making the prospect of applying for jobs or indeed getting married problematic. Many people also found the persecution of their sexuality traumatic as, if identified, they were recorded on the sex offenders register alongside convicted paedophiles and rapists (Knocker 2012). Many LGBTi people were vilified as sexual deviants, which was consistently confused with being a sex offender.

As such, many LGBTi people would seek heterosexual marriages to ‘feel normal’ or to hide their sexuality so they did not ‘stand out’ (Kimmel et al. 2006). This discriminatory stance overflowed into the care of children, and as recently as 1988, section 28 of the Local Government Act stated that that no local authority shall ‘promote homosexuality’ nor the ‘acceptability of homosexuality as a preferred family relationship’. This further exacerbated the idea of LGBTi people as deviant, although it is notable that no local authority has ever been charged or prosecuted under section 28. The LGBTi charitable organisation Stonewall argues that fear of the effects of section 28 did hinder the work of local authorities in providing services and support to LGBTi communities, and it was not until 2003 that section 28 was finally taken off the statute books (Stonewall 2012). Many older people will still remember the Wolfenden report (1957) which recommended that ‘homosexual acts between consenting adults’ should be decriminalised, and in 1967 the Sexual Offences Act came into force in England and Wales, decriminalising homosexual acts between two men over 21 years of age ‘in private’. In 1980, male homosexuality was also decriminalised in Scotland.

The European Commission ruled unanimously that the British government was guilty of breaching article 8 of the European Convention on Human Rights by refusing to legalise consenting homosexual behaviour in Northern Ireland, and in 1982 male homosexuality was decriminalised in Northern Ireland with the passing of law reform in the House of Commons (Stonewall 2012). Like gay, bisexual and trans people, lesbians have also suffered the humiliation of being arrested, suffering equally devastating, but notably different, discrimination and abuse (Stocks 2015). For example, a research study reported the atrocities that happened to a participant called Jo, who recalled losing her girlfriend to a stabbing in a violent street attack after they had both been raped (Knocker 2012). Jo believes that the police were heavily biased by the fact that the women were lesbians, and, as a consequence, no one was charged for the murder. One policeman had apparently said to her that if they had not been lesbians then the crime would not have occurred. Unsurprisingly, Jo felt completely unsupported by the police and felt that they were blaming her and her ‘lifestyle’ for the tragedy, despite her devastation at the death of her partner (Knocker 2012).

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Survey on ageing and transgender

Also if you are aged 50 plus and are of transgender status then I would love it if you would complete my survey. It would really help me in my current research project