LGBTI Ageing and Aged Care

This Australasian Journal on Ageing Special Issue is a beginning – while it is a significant achievement milestone (the first of its kind in Australian and New Zealand) it is not the definitive work on LGBTI (Lesbian, Gay, Bisexual, Transgender and Intersex) ageing and aged care in Australia. It aims to create more awareness of the experiences and needs of LGBTI older people. Historically older LGBTI people have been invisible, particularly in research on ageing as well as in policy and practice. Older LGBTI people are diverse, with different lived experiences across multiple communities, although what unites LGBTI people is a shared lived experience of discrimination.

It took a community to produce this Special Issue through collaborative connections and a passionate commitment to promote the visibility of older LGBTI people. The strong connections developed through members of the National LGBTI Ageing and Aged Care Strategy Working Group combined with the creation of an LGBTI Ageing Interest Group by the Australian Association of Gerontology (AAG) created a structure to progress this Special Issue. The AAG's mission is to expand knowledge on ageing, connecting researchers, policymakers and practitioners to build evidence-based practice. The alignment of the AAG mission with the major principles of the National LGBTI Ageing and Aged Care Strategy – to better understand older LGBTI people and increase service delivery and reduce invisibility – supported the development of this Special Issue. All members of the Board and staff of AAG have been supportive but we would especially like to thank Savio D'Sa for his practical help and support. This Special Issue affirms the importance of gerontology research in understanding the diversity of lived experiences of older LGBTI people as well as evidence based practice and policy in working with older LGBTI people.

We would also like to thank the older LGBTI people who shared their stories, as well as the authors and researchers who contributed to the journal. We acknowledge the contribution of the ground breaking Australian researchers such as Dr Jo Harrison and Professor Mark Hughes whose work and advocacy has contributed to understanding the lived experiences of older LGBTI people. Our colleague Sujay Kentlyn whose energy and passion contributed to make this project happen including providing extensive contacts across LGBTI communities in Australia. Organisations such as the National LGBTI Health Alliance and Uniting1 whose work has shifted the boundaries and created a ground swell of advocacy promoting the visibility of older LGBTI people. This Australasian Journal on Ageing Special Issue would not have been possible without the financial contribution from Wiley, AAG and Uniting.

We would also like to thank the Australian Lesbian and Gay Archives for their assistance in providing the photos for the front and back covers of the issue. Dr. Graham Willett and Gary Jaynes from the archives have both been extremely generous in their time and support for this project.

We invited older LGBTI people to share their experiences of ageing and aged care in this special edition – to privilege their voices. However, it was not possible to cover the full diversity of the different identities and communities and personal experiences of older LGBTI people in one issue. We hope this Special Issue will stimulate debate about the needs of older bisexual people and lead to publications on this topic in future editions of the Australasian Journal on Ageing.

The articles in this Special Issue presents a broad range of perspectives on LGBTI ageing and aged care. We hope the divergent voices presented here will engage readers and stimulate further discussion, debate and research about what is needed to promote healthy LGBTI ageing and LGBTI inclusive aged care services. We further hope it will encourage gerontology researchers to consider the needs of older LGBTI people and likewise researchers with LGBTI interests to take a life-course approach and include the experiences of older LGBTI people.

Each article in the Special Issue raises issues for further conversation about the lived experiences of older people across the LGBTI communities. Noel Tovey's piece, Little Black Bastard is a poignant reminder of the lived experience of institutionalised discrimination for many older gay men, particularly gay men who are Aboriginal or Torres Strait Islander. The state sanctioned discrimination experienced by older gay men is a recent history with many having criminal records because of the illegality of homosexuality. Noel's story and activism is a testament to his resilience and activism as a gay Aboriginal man.

The activism of members of the older LGBTI communities in Australia explored in the article Silver Rainbows: Advances in Australian ageing and aged care has promoted the visibility of older LGBTI people. This includes the critical work of the National LGBTI Health Alliance in creating a coalition across LGBTI communities in Australia. Significant developments including the release of the National LGBTI Ageing and Aged Care Strategy in 2012 by the federal government are milestones in recognising older LGBTI people's rights. While there is more work to be done, these recent changes have led to increased knowledge and understanding across all levels of Australian society and continue to improve the lives of all older Australians.

The diversity of the lived experiences of older LGBTI people needs to be recognised. This is apparent in the article Old Lesbians: Gendered histories and persistent challenges. The paper uses a feminist methodology to explore how gender and historical contexts influences the well-being of older lesbians. Older lesbians being selectively ‘open’, their use of health services and the desire for lesbian specific aged care are all influenced by lesbophobia, a complex of discriminations. Nevertheless, many older lesbians have created social groups and intentional communities where there is support and freedom. Furthermore, it is contended that an ‘inclusivity’ approach is insufficient for culturally appropriate aged care for older lesbians.

Building on the diversity of older LGBTI people, the journey of people of trans and non-binary experience is also explored. Using a cisgender framework to meet the practical needs of older people of trans and non-binary experience is explored in the article Challenging cisgenderism in the ageing and aged care sector: meeting the needs of older people of trans and/or non-binary experience. Applying the cisgenderism framework in the ageing and the aged care sectors can enhance service providers' ability to meet the needs of older people of trans and/or non-binary experience.

The stories and lived experiences of intersex people in research, policy and practice in Australia have also been lacking. The article, Appropriate bodies and other damn lies: Intersex Ageing and Aged Care tells the story of an older intersex person's ageing and encounters with service providers. The story highlights how little we know about the lives of older intersex people. Understanding the journey of intersex people throughout the life course is critical if health and aged care services are to promote healthy ageing and well-being.

Older LGBTI people have a lived history of discrimination and as a result are often reluctant to access aged care services – particularly faith-based organisations – because of the fear of discrimination. Promoting the development of LGBTI inclusive aged care services is essential if we are to recognise older LGBTI people's right to equitable access to aged care. The article, It's more than sex and clothes – culturally safe services for older LGBTI people explores the importance of creating culturally safe services for older LGBTI people.

Creating culturally safe services for older LGBTI people requires a strategic commitment at all levels of aged care services. Uniting is a leader in Australia for LGBTI inclusive aged care services. Their article, Welcoming and Celebrating Diversity: Uniting's journey of learning on inclusive practice explores their journey, as a faith based organisation, to create a culturally safe place for older LGBTI people. As one of the largest providers of aged care in NSW & ACT they are demonstrating the importance of inclusion for LGBTI people across their whole organisation. Uniting is a member of Pride in Diversity, which is a not-for-profit workplace program designed to assist Australian employers with the inclusion of LGBTI employees. In 2013, Uniting was named the inaugural winner of the Pride in Diversity Not-For-Profit/Charity LGBTI Australian Workplace Equality Index Award.

The coming – out narratives of older gay men in New Zealand are explored in the article Coming out narratives of older gay men living in New Zealand. Older gay men come from diverse socio-cultural backgrounds. However, they share the experiences of growing up in an era where same-sex attraction was a criminal offence. The article explores older men's journeys through the life-course to self-acceptance. Consequently health and social service providers need to support the ongoing development of resilience and provide a person-centred approach to care that promotes well-being.

The article Understanding the experiences and needs of lesbian, gay, bisexual and trans Australians living with dementia and their partners describes the importance of recognising historical experiences, understanding familial relationships, and providing advocacy to ensure sexual and gender rights are not violated. These experiences and perspectives of LGBT people living with dementia need to inform the development and design of services.

Understanding the attitudes of LGBT people to advanced care planning and decision-making at the end of life is described in LGBT people's attitudes to end-of-life decision-making and advance care planning. Despite the significance of advance care planning for promoting the rights of LGBT people at the end of life, the take-up of these options was nearly as low as for the general population. The potential for targeted strategies to increase the take-up of advance care planning is identified.

We are delighted to have had the opportunity to bring together the first Special Issue on LGBTI Ageing and Aged Care. We hope this Special Issue will stimulate improved understandings of the needs of older LGBTI Australians, increased accessibility of services and increased submissions to the journal by others who want to share their perspectives.

Dr. Anthony Brown, Adjunct Fellow, School of Science and Health, Western Sydney University.

Carrie Hayter, Co-Convener, LGBTI Ageing Special Interest Group, Australian Association of Gerontology.

Dr. Catherine Barrett, Senior Research Fellow, Chief Investigator/Coordinator, Sexual Health and Ageing Program. Australian Research Centre in Sex, Health & Society, La Trobe University.