Westwood, S. and Wathern, T. (2017), "Introduction to “housing, care and support for older lesbians, gay, bisexual and trans* people”", Housing, Care and Support, Vol. 20 No. 3, pp. 85-88. https://doi.org/10.1108/HCS-07-2017-0018
Emerald Publishing Limited
Copyright © 2017, Emerald Publishing Limited
Introduction to “housing, care and support for older lesbians, gay, bisexual and trans* people”
This special issue builds upon the previous special issue in Quality in Ageing and Older Adults (Willis et al., 2016) which highlighted many gaps in knowledge about the care/housing issues, needs and concerns of older lesbian gay, bisexual and/or trans* (LGBT*) people. In this second, related, special issue, we develop this “conversation” further by showcasing recent cutting-edge research in the field of older LGBT* housing, care and support. This is both a pressing and highly topical concern. It was addressed at several symposia at the British Society of Gerontology’s annual conference in 2016, at several workshops run by Stonewall Housing in 2015/2016, in a review Stonewall Housing also commissioned (Shelley, 2016) and in a document produced by the Chartered Institute of Housing (2011). There are two central issues: first, a lack of LGBT*-“friendly” or inclusive mainstream older age housing, care and support; second, a lack of specialist housing, care and support services dedicated to either older LGBT* people collectively, or to particular individuals/groups within the “LGBT*” umbrella. There are, at the time of writing, no such services in the UK, only a handful in Europe, by contrast with an ever-expanding number in the USA (Ross, 2016).
At first sight, it might seem odd to be singling out older LGBT* people, given the increasing legal recognitions and protections, and the growing acceptance and inclusion of LGBT* people in many parts of the world. However, a growing body of research, both in the UK and internationally, would suggest that mainstream older age housing, care and support providers remain ill-prepared to meet the needs of older LGBT* people (Carr and Ross, 2013; Ward et al., 2010; Wathern, 2013; Sullivan, 2014; Jones and Willis, 2016; Porter et al., 2016; Willis et al., 2016; Simpson et al., 2017). Their services would appear to be sites of a lack of recognition and validation at best and of prejudice and discrimination at worst. Many older LGBT* people are very fearful of needing to access such services in older age (Addis et al., 2009; Persson, 2009; Stonewall, 2011; Ward et al., 2012; Westwood, 2015, 2016a), to the point that some will avoid them, even when in great need, and others are even considering taking their own lives as an alternative (Westwood, 2017).
The lack of appropriate housing care and support in the UK has profound equality and human rights implications (Ward et al., 2010; Shelley, 2016; Westwood, 2016b). Under the European Convention on Human Rights, incorporated into UK law by the 1998 Human Rights Act, at least two Articles apply. The first, Article 8, protects the “Right to respect for private and family life” and “Right to respect for home”. The second, Article 9, protects the “Right to freedom of thought, conscience and religion”. Both could potentially be breached by a lack of appropriate housing, care and support where older LGBT* people’s identities, histories, lifestyles and significant relationships can be openly and safely performed. Under the Equality Act 2010, sexual orientation and gender identity are two of the “protected characteristics”, which the Act protects from direct and indirect discrimination. Housing, care and support which is prejudicial (i.e. has explicit or implicit negative attitudes at organisational and/or staff levels) and/or discriminatory (i.e. treats older LGBT* people less favourably than older non-LGBT* people) would clearly constitute direct discrimination. Housing care and support which assumes that older people are not LGBT* people and/or inadvertently privileges older non-LGBT people would also constitute indirect discrimination.
The Public Sector Equality Duty under the Equality Act requires a public authority (and this includes organisations performing a public function) to have due regard to eliminate discrimination, advance equality of opportunity and remove or minimise disadvantage, taking steps to meet the needs of individuals with a particular protected characteristic. Failing to do so by not providing appropriate housing care and support for older LGBT* people could constitute a breach of that Public Sector Duty. The provision of specialist housing, support and/or care for older LGBT* people would demonstrate steps by public authorities to “address the different needs or past track record of disadvantage or low participation of people who share a particular protected characteristic” (EHRC, 2014). This would constitute “Positive Action” which “may involve treating members of a group who share a particular protected characteristic more favourably than other groups” (Equality and Human Rights Commission (EHRC), 2011, p. 10.4). Positive Action includes “providing additional or bespoke services, separate facilities, accelerated access to services, targeting resources […] to benefit a particular disadvantaged group” (EHRC, 2011, p. 10.5). It is lawful if it is proportionate means for public or private sector organisations “to improve their services or to increase take-up or participation by particular groups within the community, as good business practice or as a more effective way of providing services” (EHRC, 2011, p. 10.6).
Older LGBT* people are not a homogenous group and unsurprisingly their wishes and preferences for housing, care and support in later life are varied and diverse (Carr and Ross, 2013; Shelley, 2016; Westwood, 2015). Until recently, the largest ever survey of older lesbian, gay and bisexual (LGB) people (trans* people were not included) was that of Hubbard and Rossington (1995) over 20 years ago. However, the University of Surrey has very recently conducted the largest survey of older LGBT* people in England. We are delighted that Andrew King and Paul Stoneman are publishing their findings here, linking them to the concept of social capital (King and Cronin, 2016). Their findings confirm and clarify older LGBT* people’s concerns about their future housing, care and support needs, highlighting in particular the importance of the themes of connectedness and disconnectedness. They report that a significant number of their sample (over half) were interested in alternative forms of housing, care and support instead of mainstream provision. Notably their older lesbian respondents expressed the strongest preference for gender-specific housing.
King and Stoneman’s study echoes the findings of many other pieces of research which indicate a gendered difference in the housing preferences of older LGB women and older gay and bisexual men. There is a tendency for the women’s narratives to be superseded and subsumed by those of the men (Westwood, 2015, 2016a, b, c), echoing lesbian and gay political histories. This in turn means that advocacy, policy and specialist provision is more likely to attend to the wishes of gay and bisexual men, than the wishes of LGB women. This is, of course, both a (gendered) human rights and an equality issue as well as the ongoing privileging of male sexualities over women’s sexualities in a patriarchal society. In order to reflect upon this, and to redress the balance, Sue Westwood’s article explores and considers these issues, calling for a more nuanced, gendered discourse about older LGBT* housing, care and support issues. There is a demographic imperative to this, as – given women live longer than men, but with higher levels of disability (including dementia, Westwood, 2016c) – older LGBT* housing care and support issues have greater significance for older women than older men.
Paul Willis’ article is a conceptual discussion about how LGB people’s lives, identities and politics can be made more visible in order to promote social inclusion in care environments for older people. Willis argues that visibility is not enough to counter the prejudice and discrimination which underpins much of the inadequacies in provision and service delivery, and which can also be encountered from other service users, their families and friends. This echoes Westwood’s (2015) research which found that older LGB people feared both a lack of visibility and “risky visibility” in older age care spaces (p. 3). Willis reports on his own study exploring the views and attitudes of care staff and their managers towards LGB-identifying, asking whether increased visibility alone is sufficient to improve social inclusion. He suggests that increasing visibility without addressing power and oppression risks inadvertently reinforcing both.
As noted above, the USA is far ahead of the UK in terms of the development of specialist housing care and support for older LGBT* people. Tim Johnston and Hilary Meyer’s paper is also a first, providing as it does a comprehensive survey of LGBT*-specific housing in the USA. There are, from a UK perspective, an enviable range and number of specialist housing options across the USA. However, given the size of the US population, there is, proportionately, still a long way to go. They consider how mainstream older age housing provision can be supported to become more attuned to the needs of older LGBT* people by becoming more LGBT* affirmative. Strategies to promote increased LGBT* affirmative approaches are also discussed.
The final paper in this special issue is written by Tina Wathern and Bob Green, OBE, of Stonewall Housing. They outline Stonewall Housing's work in the UK, networking and campaigning about older LGBT* housing. They consider the challenges faced in trying to develop specialist older LGBT* housing provision. This is of particular significance since there are now two nascent projects in the UK which may lead to the creation of the UK’s first older LGBT* housing provision. They also explores ways in which mainstream provision might be improved, specifically via improved monitoring, policies, training and engagement with local LGBT* networks.
We hope that you will enjoy this special issue and that you will find it stimulating and thought-provoking. Most of all, we hope that it will contribute to increasing awareness of the needs, issues and concerns of older LGBT* people with regard to housing, care and support. Our vision is a menu of high quality housing, care and support options for older LGBT* people, designed to meet their varied and diverse preferences.
Trans* is an umbrella term which covers the sex/gender identity spectrum: transgender, transsexual, transvestite, genderqueer, genderfluid, non-binary, genderless, agender, non-gendered, third gender, two-spirit, bigender and other sex/gender non-conformity (Tompkins, 2014).
Addis, S., Davies, M., Greene, G., MacBride‐Stewart, S. and Shepherd, M. (2009), “The health, social care and housing needs of lesbian, gay, bisexual and transgender older people: a review of the literature”, Health & Social Care in the Community, Vol. 17 No. 6, pp. 647-58.
Carr, S. and Ross, P. (2013), Assessing Current and Future Housing and Support Options for Older LGB People, Joseph Rowntree Foundation, York.
Chartered Institute of Housing (2011), Delivering Housing Services to Lesbian, Gay Bisexual and Transgender Customers, CIH, London.
Equality and Human Rights Commission (EHRC) (2011), Equality Act 2010 Statutory Code of Practice for Services, Public Functions and Associations, EHRC, London.
Equality and Human Rights Commission (EHRC) (2014), Services for Particular Groups, EHRC, London.
Hubbard, R. and Rossington, J. (1995), As We Grow Older: A Study of the Housing and Support Needs of Older Lesbians and Gay Men, Polari, London.
Jones, S.M. and Willis, P. (2016), “Are you delivering trans positive care?”, Quality in Ageing and Older Adults, Vol. 17 No. 1, pp. 50-9.
King, A. and Cronin, A. (2016), “Bonds, bridges and ties: applying social capital theory to LGBT people’s housing concerns later in life”, Quality in Ageing and Older Adults, Vol. 17 No. 1, pp. 16-25.
Persson, D.I. (2009), “Unique challenges of transgender aging: implications from the literature”, Journal of Gerontological Social Work, Vol. 52 No. 6, pp. 633-46.
Porter, K.E., Brennan-Ing, M., Chang, S.C., Dickey, L.M., Singh, A.A., Bower, K.L. and Witten, T.M. (2016), “Providing competent and affirming services for transgender and gender nonconforming older adults”, Clinical Gerontologist, Vol. 39 No. 5, pp. 366-88.
Ross, P.D. (2016), “Learning from international experiences – developing older LGBT affirmative housing and care options in England”, Quality in Ageing and Older Adults, Vol. 17 No. 1, pp. 60-70.
Shelley, J. (2016), Building Safe Choices. LGBT Housing Futures: A Feasibility Study, Stonewall Housing, London.
Simpson, P., Horne, M., Brown, L.J., Wilson, C.B., Dickinson, T. and Torkington, K. (2017), “Old(er) care home residents and sexual/intimate citizenship”, Ageing & Society, Vol. 37, pp. 243-65.
Stonewall (2011), Lesbian, Gay and Bisexual People in Later Life, Stonewall, London.
Sullivan, K.M. (2014), “Acceptance in the domestic environment: the experience of senior housing for lesbian, gay, bisexual, and transgender seniors”, Journal of Gerontological Social Work, Vol. 57 Nos 2-4, pp. 235-50.
Tompkins, A. (2014), “Asterisk”, TSQ: Transgender Studies Quarterly, Vol. 1 Nos 1-2, pp. 26-7.
Ward, R., Pugh, S. and Price, E. (2010), Don’t Look Back? Improving Health and Social Care Service Delivery for Older LGB Users, EHRC, London.
Ward, R., Rivers, I. and Sutherland, M. (2012), Lesbian, Gay, Bisexual and Transgender Ageing: Biographical Approaches for Inclusive Care and Support, JKP, London.
Wathern, T. (2013), Building a Sense of Community: Including Older LGBT in the Way we Develop and Deliver Housing with Care, Housing Learning & Improvement Network, London.
Westwood, S. (2015), “‘We see it as being heterosexualised, being put into a care home’: gender, sexuality and housing/care preferences among older LGB individuals in the UK”, Health & Social Care in the Community, Vol. 24 No. 6, doi: 10.1111/hsc.12265.
Westwood, S. (2016a), “‘Institutions, they’re very straight. My god I hope I don’t have to go into a care home’: spatial inequalities anticipated by older lesbians and gay men”, in Harding, R., Fletcher, R. and Beasley, C. (Eds), ReValuing Care in Theory, Law & Policy: Cycles and Connections, Routledge, Abingdon, pp. 215-32.
Westwood, S. (2016b), “LGBT* ageing in the UK: spatial inequalities in older age housing/care provision”, Journal of Poverty and Social Justice, Vol. 24 No. 1, pp. 63-76.
Westwood, S. (2016c), “Dementia, women and sexuality: How the intersection of ageing, gender and sexuality magnify dementia concerns among older lesbian and bisexual women”, Dementia: The International Journal of Social Research and Practice, Vol. 15 No. 6, pp. 1494-514.
Westwood, S. (2017), “Older lesbians, gay men and the ‘right to die’ debate – ‘I always keep a lethal dose of something, because I don’t want to become an elderly isolated person’”, Social and Legal Studies, pp. 1-23, doi: 10.1177/0964663917693916.
Willis, P., Hafford-Letchfield, T. and Smith, A. (2016), “Guest editorial: in the margins or the mainstream? Future directions and innovations in providing inclusive accommodation and support for older LGBTI adults”, Quality in Ageing and Older Adults, Vol. 17 No. 1, pp. 1-5.
Willis, P., Maegusuku-Hewett, T., Raithby, M. and Miles, P. (2016), “Swimming upstream: the provision of inclusive care to older lesbian, gay and bisexual (LGB) adults in residential and nursing environments in Wales”, Ageing & Society, Vol. 36 No. 2, pp. 282-306.
About the authors
Sue Westwood is a Lecturer at the School of Law, Keele University, Keele, UK.
Tina Wathern is the Director of National Engagement at the Stonewall Housing, London, UK.