Growing older as an LGBTQ+ person: care, rights, health and staying connected in later life

Growing older as an LGBTQ+ person brings the same joys and worries everyone faces, plus a few extra ones. Many older gay, lesbian, bisexual and trans people lived through times when their love was illegal or called an illness. Many lost friends to AIDS. Many built families of friends instead of, or as well as, families of blood. In later life, that history can show up as loneliness, fear of disrespect in health care or care homes, and legal gaps that leave partners and chosen family without a say.

The good news is that a lot can be prepared in advance, and there are more groups and services for older LGBTQ+ people than ever before. This guide explains the common challenges, the papers that protect you and your people, how to find respectful care and how to stay connected. It is also for families, friends and carers who want to help.

A generation that lived through a lot

Today’s older LGBTQ+ people grew up in a very different world. A few dates help explain why some feel cautious:

When	What changed
1973	The American Psychiatric Association removed homosexuality from its list of mental disorders.
1980s–1990s	The AIDS crisis killed huge numbers of gay and bisexual men and trans women, many of them young.
17 May 1990	The World Health Organization voted to remove homosexuality from its classification of diseases. This date is now the International Day against Homophobia, Biphobia and Transphobia.
2001 onward	Countries began to open marriage to same-sex couples, starting with the Netherlands.

Laws changed at different times in different countries, and in some places they still have not changed. A person who is 75 today may have spent half of their life hiding. Our guide to why Pride exists tells more of this story.

Common challenges in later life

Not every older LGBTQ+ person faces these problems, but they come up often.

• Living alone and loneliness. LGBTQ+ older adults are more likely to live alone and less likely to have children who could help them, according to SAGE, a US organisation for LGBTQ+ elders. The World Health Organization estimates that about one in four older people are socially isolated, and isolation harms both mental and physical health.
• Fear of disrespect in care. Many worry that doctors, home carers or care-home staff will judge them, ignore their partner or refuse to use the right name and pronouns.
• Going back into the closet. Some people who were out for decades hide again when they need care, because they feel vulnerable.
• Legal gaps. Without the right papers, a partner who is not married to you, or a close friend, may have no right to visit you in hospital, make medical decisions or inherit.
• Money. Some older people faced job discrimination for years or lost pension rights for partners before same-sex relationships were recognised.
• Health history. Long-term survivors of HIV are now growing old with the virus, and some trans elders have specific health needs that not all doctors understand.
• Grief. Losing a partner is hard for anyone. It can be harder when others did not treat the relationship as real.

Papers that protect you and your people

This is the most practical step you can take, and it matters most for people whose closest person is not a spouse or blood relative. Names and rules differ by country, so ask a local lawyer, notary or advice service, but the main tools are similar almost everywhere.

1. A will. Without one, the law often gives everything to blood relatives, even ones you have not spoken to in years. A will lets you leave your home, savings and belongings to a partner, friends or causes you care about.
2. Power of attorney for money and property. This names a person who can handle your bank accounts and bills if you cannot.
3. Power of attorney for health or a health care proxy. This names the person who can talk to doctors and decide for you if you cannot speak for yourself.
4. An advance directive or living will. This writes down what treatment you do or do not want near the end of life.
5. Next of kin and emergency contacts. Tell your doctor and hospital who your people are and put it in writing.
6. Funeral wishes. Write down how you want to be remembered, which name to use and who should be there. Trans people can state clearly which name and gender should appear.

Keep copies in a safe place and tell the people involved where to find them. Review the papers after big life changes, such as a breakup, a move or a death.

Finding respectful health care

You deserve health care that sees all of you.

• Ask around. Local LGBTQ+ groups, HIV services and online communities often know which doctors are respectful.
• Bring a support person to important appointments if that helps you feel safe.
• Say what matters. You can tell a doctor “This is my partner” or “Please use this name”. If you do not feel safe saying it, you do not have to.
• Keep up with screenings that match your body. Trans people may need checks for organs they still have, whatever their gender.
• Long-term HIV survivors can ask about heart health, bones, memory and mental health, which often need extra attention with age.
• Mental health counts. Depression in later life is common and treatable. It is not “just getting old”.

Care at home and care homes

If you need help at home or are choosing a care home, these questions can help you judge how safe a place will be:

Question to ask	Why it matters
Do you have a written policy against discrimination, including sexual orientation and gender identity?	It shows the place has thought about it and gives you something to point to.
Have staff had training on LGBTQ+ residents?	Training lowers the chance of hurtful comments and mistakes.
Can my partner visit freely and stay overnight or share a room?	Couples should be treated like any other couple.
Will my name and pronouns be used, also in records?	Respect for identity should not stop when someone needs care, including people with dementia.
Do you have other LGBTQ+ residents or events?	Not being the only one makes a big difference.

If something goes wrong, write down what happened and when, and use the complaint process. Many countries have an inspector or ombudsman for care services.

Staying connected

Loneliness is not a personal failure. It often comes from losing friends, moving or health problems. Small steps help:

• Join a group for older LGBTQ+ people. Many cities have social clubs, choirs, walking groups, coffee mornings or befriending services where a volunteer visits or calls regularly.
• Mix generations. Some projects pair older and younger queer people to share stories. Younger people often value hearing what life was like.
• Go online, at your own pace. Video calls and moderated online LGBTQ+ communities can keep you in touch. Ask a friend or library to help you set things up.
• Volunteer. Helping at a Pride event, a helpline or a local charity brings purpose and new contacts.
• Look after your chosen family. Our guide to building chosen family has ideas for keeping these bonds strong.
• If you live far from a big city, our guide to finding queer friends in a small town has tips that work at any age.

Coming out later in life

Some people come out at 60, 70 or older, after a marriage, after children have grown up or after the death of a spouse. It is never too late. Coming out later can bring relief and new relationships, and also worries about how adult children or old friends will react. Our guides to coming out on your own terms and to questioning your sexuality or gender are written for any age.

For families, friends and carers

If you care about an older LGBTQ+ person, you can help a lot:

• Treat their partner and chosen family as family. Invite them, inform them and include them in decisions when the person wants that.
• Use the right name and pronouns, including when talking to doctors and staff.
• Do not assume they are straight or cisgender. Ask open questions, such as “Is there anyone special in your life?”
• Help with the paperwork if they ask, and respect their choices even if you would choose differently.
• Speak up if you see disrespect in health care or a care home.
• Listen to their stories. Many older LGBTQ+ people carry memories that few people have asked about.

The short version

• Many older LGBTQ+ people lived through criminalisation, stigma and the AIDS crisis, and that history shapes later life.
• Living alone, loneliness, fear of disrespect in care and legal gaps are common challenges.
• A will, powers of attorney and an advance directive protect partners and chosen family.
• Respectful health care and care homes exist; asking the right questions helps you find them.
• Groups, volunteering, online contact and chosen family help prevent loneliness.
• It is never too late to come out or to build new connections.

Growing older as an LGBTQ+ person can be a time of pride, freedom and deep friendship. Planning ahead gives you more control over the years to come.

Sources and references

• SAGE: advocacy and services for LGBTQ+ elders
• National Resource Center on LGBTQ+ Aging
• Opening Doors: charity for older LGBTQ+ people in the UK
• World Health Organization: reducing social isolation and loneliness among older people
• National Institute on Aging: advance care planning and health care directives