
LGBT Inclusivity in Senior Housing in Cambridge
LGBT seniors face additional challenges and discrimination in senior housing. Here we use research and recommendations to help.
Introduction
LGBT seniors face many unique challenges, including financial and health difficulties, as well as issues in senior housing. They may face abuse, microaggressions, neglect, and other forms of disparate treatment both by other tenants and by staff. Many return to what is termed the “Institutional Closet” to protect themselves, and not being able to live their full identities can be harmful. The Cambridge LGBTQ+ Commission seeks to better understand these issues and provide a report to senior housing sites in Cambridge that will help them to become more inclusive and better serve their LGBT seniors. This Story Map goes over national findings, results from our surveys, and recommendations.
The Cambridge LGBTQ+ Commission: Who We Are
The Cambridge LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, Plus) Commission is an official Commission of the City of Cambridge. Started in 2004, it consists of up to twenty volunteers who live and/or work in Cambridge. The mission of the Cambridge LGBTQ+ Commission is to advocate for a culture of respect and to monitor progress toward equality of all persons with regard to sexual orientation and gender identity and expression. The Commission also promotes policies and practices that have a positive effect on the health, welfare and safety of persons who live, visit or work in the City of Cambridge with regard to sexual orientation, and gender identity and expression.

Numbers
There are over 2.7 million LGBT adults over age 50 in the US, and that number is expected to double by 2030.
And there are many LGBT older adults in Cambridge, many of whom do or may soon live in senior housing.
Conservative estimates say that 5%, or one in twenty, seniors identify as LGBT.
Senior Housing Sites
Below is a map of all senior housing sites in Cambridge, both private and Cambridge Housing Authority. Some sites are omitted due to privacy issues.
Senior Housing in Cambridge, MA
Housing Discrimination
While this report focuses on what happens inside senior housing, just getting housed in the first place is a challenge for some. Housing discrimination is a major issue for the LGBT older adult community.
- For adults ages 45-75, one in eight (13%) LGBT older people reported that they had been discriminated against when searching for housing due to their sexual orientation.
- One in four (25%) transgender older people reported experiencing housing discrimination on the basis of gender identity.
- 26% of housing agencies tested treated same-sex couples differently by either quoting higher monthly rent or denying housing applications.
- Transgender adults found that 19% were refused a home or apartment and 11% were evicted because of their gender identity or expression.
- 24% of non-white LGBT older people reporting experiencing housing discrimination on the basis of race or ethnicity, compared to 18% of non-white, non-LGBT older people.
Even as we consider the history of LGBT people in this country, it must be remembered that some of it is a living history. It was not until June 15, 2020 that the Supreme Court issued its decision in Boston, V. Clayton City., 140 S. Ct. 173 (2020), ruling that Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on sexual orientation or gender identity. The Biden administration extended this protection to housing through Executive Order on January 20, 2021.
Health
Living in an environment that is politically and socially hostile toward LGBT people has left this population facing many challenges that non-LGBT older adults do not, including many health disparities. LGBT older adults face higher rates of diabetes, high blood pressure, Alzheimer’s Disease, infectious disease, depression, anxiety, substance abuse, some chronic diseases and even certain cancers.
Isolation
Isolation can have a huge impact on LGBT elders. Many lost friends during the AIDS Crisis, many are unpartnered, and many do not have children. As much help as LGBT older adults might need, many of them lack adequate caregiving support. In one study of LGBT older adults, 76% of respondents reported being extremely (18%), very (24%), or somewhat (34%) concerned about having adequate family and/or social supports to rely on as they age.
A Note on Language
Ally: A person who works for social change for a group that faces injustice or disadvantage. The ally is not a member of that oppressed group but supports and fights for equality on behalf of the group, e.g. heterosexuals who support LGBT rights.
Bisexual: An individual who is physically, romantically, and/or emotionally attracted to both men and women. “Bisexual” does not suggest having equal sexual experience with both men and women. In fact, some people who identify as “bisexual” have not had any sexual experience at all.
Cisgender: Individuals whose gender identity and/or gender expression do align with their biological or assigned sex. If someone was assigned the sex female at birth and lives comfortably as a woman, she is likely cisgender.
Closeted, In the Closet, or Stealth: Describes a person who does not share with others, or only shares with a few “safe” people, that they are lesbian, gay, bisexual and/or transgender.
Coming Out*: A lifelong process of self-acceptance of one’s sexual or gender identity that may include a sharing of that identity with others. How much people are “out” may differ by setting, people they are with, and life stage. The coming out process is unique for each individual, and is the choice of each individual. LGBT older adults often hide their sexual orientation or gender identity from their health care and social service providers (do not “come out”) for fear of being treated badly.
Discrimination: Unfair and unequal treatment in favor of or against an individual or group based on group identity; e.g. African American, female, Arabic, youth, or LGBT. Discrimination is the actual behavior towards the individual(s).
Dyke: Slang for a lesbian. It originated as a negative label for a masculine or butch woman, and this usage still exists. It has been reclaimed by some as a positive word.
Faggot/Fag: An offensive, negative slang sometimes used to describe gay men. Family of Choice: Diverse family structures usually created by LGBT people, immigrants, and racial or ethnic minorities, that include but are not limited to life partners, close friends, and other loved ones not biologically related or legally recognized but who are the source of social and caregiving support.
Family of Origin: The family in which a person grows up, or the first social group a person belongs to, which is often a person’s biological family or an adoptive family.
Gay: A word used to describe anyone, mainly men, who have primary: physical, romantic, and/or emotional attraction to someone of the same sex, e.g., gay man, gay people. Many gay people prefer this term over “homosexual” which retains negative connotations. Lesbian can be a preferred term for a gay woman. While younger men may use the term “queer,” this terms is generally considered offensive to older people.
Gender: A person’s internal sense of being male, female or another gender. A person may choose to express their gender through culturally defined norms associated with male and female, which may or may not align with a person’s internal gender identity or with the sex they were assigned at birth.
Gender Expression: How a person outwardly expresses their gender identity and/or role; how they dress, walk, wear their hair, talk, etc. Typically, transgender people seek to make their gender expression match their gender identity, rather than their sex assigned at birth.
Gender Identity: The gender you feel you are inside (man, woman, neither or both). For transgender people, their birth-assigned gender and their personal sense of gender identity do not match. Gender identity and sexual orientation are not the same. Transgender people may be heterosexual, lesbian, gay, or bisexual. For example, a transgender woman who was assigned a male gender at birth and is attracted to other women may self-identify as a lesbian.
Gender Role: Societal or ethnic/cultural expectations about how a person should dress, look, talk, and behave based on whether they are female or male.
Gender Perception: How observers classify a person’s gender.
Going Stealth: A person living as a gender different from what was assigned to them at birth without people knowing or being able to tell that the person is transgender.
Heterosexual: Used to describe people whose primary physical, romantic, and/or emotional attraction is to people of the opposite sex; also known as straight. Heterosexism: Belief that heterosexuality is the only “natural” sexuality and that it is inherently healthier or superior to other types of sexuality, including LGBT sexuality. The term refers to the negative attitudes, bias, and discrimination exhibited by people with this belief.
Homophobia/Transphobia/Biphobia: Homophobia refers to a fear of lesbians and gay men. Biphobia is used to describe a fear of bisexual people. Transphobia is used to describe a fear of transgender people. These phobias reflect prejudice, hatred, antipathy, and avoidance toward lesbian, gay, bisexual and transgender people.
Homosexual: An outdated clinical, medical term that is no longer the preferred word used to describe someone who is gay or lesbian. It has taken on negative connotations because of its previous use to denote a mental illness.
Hormone Therapy: Use of hormone treatments to create characteristics that reflect the sex with which a person identifies.
Identity or Self Identify: What people call themselves that expresses their internal reality. This may be different from external characteristics or how others might view them.
Intersectionality: A term used to describe how we are all a combination of different traits or identities, such as culture, ethnicity, race, education, age, language, and also sexual orientation and gender identity.
Lesbian: A woman whose primary physical, romantic, and/or emotional attraction is to other women. Some lesbians may prefer to identify as gay (adj.) or as gay women. Many lesbians view “homosexual” as a derogatory term. While younger women may use the terms “dyke” or “queer,” these terms are generally considered offensive to older people.
LGBT/GLBT: Acronym for lesbian, gay, bisexual and transgender. LGBT and/or GLBT can be used interchangeably.
LGBT Older Adults: The preferred term for LGBT people 65, the current standard age of retirement, or older. The term “older adults” may be preferable to “old,” “senior,” “elderly” or “aging” (terms which many don’t identify with personally). Also acceptable are “older LGBT people” or “LGBT older people” depending on context.
Lifestyle: Term used to refer to lesbian, gay, bisexual, and transgender lives, generally considered offensive to LGBT people. Just as there is no one straight “lifestyle,” there is no one lesbian, gay, bisexual, or transgender lifestyle. Minority Stress: The damaging physical and mental health effects of being stigmatized and/or the focus of prejudice and discrimination, which create a hostile and stressful environment.
Openly Gay: Describes people who self-identify as lesbian or gay in their personal, public and/or professional lives. Terms such as openly lesbian, openly bisexual, and openly transgender are also used. Sometimes referred to as being “out,” as in, “She is an out lesbian.” Openly gay people generally continue to scan each new environment for its level of safety before speaking of their LGBT identity.
Outing: The act of publicly telling (sometimes based on rumor and/or speculation) or revealing another person’s sexual orientation or gender identity without that person’s consent. It is considered inappropriate by a large portion of the LGBT community, and can be very damaging socially, personally, and/or professionally to the individuals who are “outed.” Partner: A nondiscriminatory and gender neutral way to describe one of the people in a committed, long-term relationship.
Queer: Historically a negative term, it is now being used by some LGBT people – mostly younger ones and as a broader term - to describe themselves. However, it is not universally accepted even within the LGBT community and should be avoided unless quoting or describing someone who self-identifies that way.
Questioning: A person who is unsure about his or her sexual orientation or gender identity.
Same-Gender Loving (SGL): A cultural term used most frequently in communities of color that affirms the same-sex attraction of men and women. The term may be favored by some over the labels gay, lesbian, or bisexual.
Sex: The classification of people as male or female based on their anatomy (genitals or reproductive organs) and/or biology (chromosomes and/or hormones).
Sex Assigned at Birth: At birth, infants are usually given a sex designation of male or female by a doctor based on the child’s genitals.
Sex Reassignment Surgery: Surgery performed to create genitalia that reflect the sex with which a person identifies.
Sexual Orientation: A person’s primary physical, romantic, and/or emotional attraction to members of the same and/or opposite sex, including lesbian, gay, bisexual and heterosexual (straight) orientations. It is the accurate term and should be used instead of the offensive term “sexual preference,” which conveys the suggestion that being gay or lesbian is a choice and therefore can be “cured” or changed.
Transgender: An umbrella term for people whose gender identity and/or gender expression differs from the sex they were assigned at birth. The term may include but is not limited to transsexuals and cross-dressers. Transgender people may identify as female-to-male (FTM) or male-to-female (MTF). It is important to use the descriptive term (transgender, transsexual, cross-dresser, FTM or MTF) preferred by the individual. Transgender people may or may not decide to alter their bodies hormonally and/or surgically.
Transition: The process of changing genders in order to match the gender a person identifies as. This can include: Male to Female and Female to Male or Intersex.
Transsexual: An older term that originated in the medical and psychological communities. While some transsexual people still prefer to use the term to describe themselves, many transgender people prefer the term transgender to transsexual. Unlike transgender, transsexual is not an umbrella term, as many transgender people do not identity as transsexual. It is best to ask which term an individual prefers.
Two-Spirit: The term refers to LGBT people and reflects traditions among many Native American nations that accept and celebrate the diversity of human gender, spirituality, and sexuality.
Source: Nation Resouce on LGBT Aging; SAGE- Advocacy and Serviced for LGBT Elders. Site: shorturl.at/bCJP8
The "Institutional Closet"
Having to go back “into the closet” or having to hide one’s identity in order to have access to or receive proper treatment in housing is a concern for one in three LGBT older adults.
Hiding one’s LGBT identity can be harmful because LGBT older adults may not receive special supports and care that they need. It can also be psychologically damaging to have to hide one’s identity.
Because of their history of institutional mistreatment, many LGBT older adults view nursing homes as “institutional closets”—dangerous and unwelcoming places where, at the end of life, being LGBT reverts to how it was in their younger years, facing discrimination, bullying, and harassment, both by staff and tenants.
One study showed that 67% of LGBT older adults feared neglect in long-term care, 60% feared verbal or physical harassment, and 52% feared that they would be forced to hide their LGBT identity.
Resiliency!
Despite the challenges LGBT seniors face, many have survived and even thrived.
Paired with the many challenges are resilience factors for successful aging. In the face of stressors such as those described earlier, LGBT people display resilience through coping and social support. The impact of stress on LGBT populations can be ameliorated by this resiliency so that the outcome of stress is not always negative.
Some studies show that many LGBT older adults are well-adjusted, happy, and thriving. Coping mechanisms can be at the individual level and at the group level, ranging from personal strengths or characteristics, to groups creating a sense of unity by fostering a positive environment of support and protection.
Our Research
Due to the high number of self-identified LGBT respondents (N=10; 15%) we were able to separate data into LGBT and straight/ heterosexual responses. To the right we can see that nearly 100% of both groups reported feeling very comfortable or somewhat comfortable when they are at home, however, while three out of four (75.5%) of straight respondents said they were very comfortable, only half of LGBT respondents did. The difference between “very” and “somewhat” may not seem that important, but the differences in responses is valuable to see.
Research continued...
One of the biggest differences between LGBT and straight respondents was regarding the statement “I would like the training that all my housing organization’s staff receive to include information about the aging concerns and needs of LGBT seniors.”41.5% of straight respondents neither agreed nor disagreed, 54.7% either agreed or strongly agreed, and 3.8% either disagreed or strongly disagreed. By contrast, 100% or LGBT respondents agreed or strongly agreed with that statement.
Research continued...
One of the biggest differences between LGBT and straight respondents was regarding the statement “I would like the training that all my housing organization’s staff receive to include information about the aging concerns and needs of LGBT seniors.”41.5% of straight respondents neither agreed nor disagreed, 54.7% either agreed or strongly agreed, and 3.8% either disagreed or strongly disagreed. By contrast, 100% or LGBT respondents agreed or strongly agreed with that statement.
Staff vs. LGBT Findings
We were able to compare 58 staff responses to the 10 LGBT responses and noticed certain discrepancies. For example, 90% of LGBT respondents either agreed or strongly agreed with the statement "There are LGBT seniors living in my housing organization's senior housing." By contrast only 75.8% of staff agreed or strongly agreed with the same statement.
So what now?!
Don't worry; there is hope. You can transform your worry or concern into something positive. In the following section we will go over recommendations and best practices for senior housing providers, ranging from low effort to high effort, and the LGBTQ+ Commission is here to offer support the whole way through.
Be a visible ally
Creating welcoming spaces can be as simple as posting rainbow flags in public areas of housing. An internal audit can also be done of existing imagery, asking questions such as “Does the couple portrayed in this image appear to be male and female?” “Do we have images of different types of families?” Staff can also be encouraged to wear rainbow pins or use rainbow-design pens. Before this is done, however, it is important that staff go through training so they can support their inclusive images with inclusive attitudes.
Staff Training
SOGI training (Sexual Orientation and Gender Identity training), especially that focuses on the needs of LGBT seniors can be extremely valuable. As mentioned earlier, the film “Gen Silent” may be a good place to start. The Fenway Aging Project may also offer trainings. It is important that these trainings happen on a regular or yearly basis because otherwise, as noted by one of the staff survey respondents, it may be “checking a box.” The issues of this minority community should be considered in an ongoing way so that they are not forgotten or invisible.
Resident Training
Training of tenants may be equally important to training of staff. Most seniors grew up and lived the majority of their lives in a social climate where being LGBT was not acceptable and may have even been a crime. In many places, including Cambridge, there is still a lack of acceptance for LGBT people, including seniors. Having events for LGBT seniors and making sure that everyone is invited is one way to increase LGBT senior inclusion. The Fenway Aging Project also may offer trainings for senior residents. Like staff training, this should be ongoing so it is not quickly forgotten or ignored.
One-time Programming
Not all changes to be inclusive require a significant amount of effort. One suggestion is starting small when it comes to programming for LGBT seniors. Informal social programs such as a lunch or coffee group can be a great way to start. Pride Month (June) and LGBTQ+ History Month (October) can also be great occasions for celebration and inclusion. Both staff and tenants may benefit from a viewing of “Gen Silent,” a salient movie available at the Cambridge Public Library, that goes in depth about the unique challenges that LGBT seniors face.
Ongoing Programming
Following up on a one-time event such as a coffee hour or lunch for LGBT seniors (open to all), private housing sites may consider making such events regular and ongoing. Social isolation is a big issue among seniors generally and LGBT seniors in particular, so a weekly or monthly social event may be very welcome. These can be informal gatherings with food, “lunch and learns” where topics about LGBT aging are discussed, or even a speaker series. This is a high input recommendation because staff time would need to be devoted to organizing and promoting such events.
GSA-type Programming
Another option that staff could work on that would improve the lives of LGBT seniors would be a GSA-type group. GSAs (Gay-Straight Alliance or, to be more inclusive, Genders and Sexualities Alliance) have been proven to reduce discrimination in schools and offer vital social support for youth. The same may be true for seniors and fits into the LGBT community group desire from the survey. The image to the right is an example from Tucson, AZ.
Connect!
One great way to commit to inclusion is by connecting with local organizations that work with LGBT seniors. Some of those include the City of Cambridge LGBTQ+ Commission, the Cambridge Senior Center/Council on Aging, Cambridge Volunteer Clearinghouse, Ethos, and the Fenway Aging Project. You may email the LGBTQ+ Commission at LGBTQPlusCommission@CambridgeMA.Gov. and we can connect you directly.
Conclusion
It is clear from these surveys and from national data that LGBT seniors live in senior housing, and they have unique challenges and needs. This report has offered background data, survey analysis, and comprehensive recommendations. It is the sincere hope of the City of Cambridge LGBTQ+ Commission that senior housing providers take this information to heart, utilize as many recommendations as is feasible, make use of the resource guide, and turn to us for support if needed. We acknowledge that, like many service providers, senior housing providers are busy and may not have time for new initiatives. It is our hope, however, that this report has made clear the importance of inclusion of LGBT seniors in senior housing and speaks to the missions senior housing organizations have around providing safe and quality housing for their tenants.