Vital Services for Our Queer and Trans Elders and Adults with Disabilities

By Kelly Dearman

Older adults are the fastest-growing age group in San Francisco. However, the specific needs of queer and trans adults over 60 have often been overlooked.

Kelly Dearman

My name is Kelly Dearman, and I am the Executive Director of the San Francisco Department of Disability and Aging Services (DAS). DAS provides a wide range of services that promote health, safety, and independence for our city’s older adults, people with disabilities, veterans, and caregivers.

As a leader in our department, I strive to be a strong ally to everyone in our community, meeting people where they are in order to make sure that our services can be accessed by San Francisco seniors and people with disabilities from diverse backgrounds and financial circumstances. A critical part of this work is making sure we are serving our queer and trans community’s elders and those who experience disabilities.

This year’s SF Pride theme is “Looking Back and Moving Forward,” so it seems appropriate to make sure our community knows what we have been able to accomplish—so far—in serving LGBTQ+ older adults and adults with disabilities, and what our plans are for the future to ensure those in need are accessing our services.

LGBTQ+ adults with disabilities and seniors face a heightened risk of isolation, a significant risk factor for future determinants of health. Queer and trans people are less likely than their peers to have traditional sources of support like biological family as they age or experience a disability. Further, many LGBTQ+ seniors have lost chosen family and close friends to illness, including HIV/AIDS. We can observe these broad trends among our clients: in DAS community-based services, 61 percent of LGBTQ+ senior clients live alone, a much higher rate than older adults generally (just 39 percent of whom live alone).

Other research by our department has revealed that some queer and trans older adults have been forced “back into the closet” because of discrimination they experience across health, housing, and social services systems. These fears and experiences of discrimination can cause people in need to hesitate to access services or seek out support. We also know that these challenges can be compounded for LGBTQ+ older and disabled adults of color, who may experience systemic barriers to participation in services at the intersection of sexual orientation, gender identity, race, age, and ability.

The community’s needs were highlighted by the groundbreaking work of the LGBT Aging Policy Task Force, which in 2014 identified specific recommendations for programs and policies to address the challenges facing older LGBTQ+ adults. Since the report was issued, the task force’s recommendations have resulted in the implementation of numerous city programs, services, and trainings that have enabled more queer and trans seniors to age with dignity within their homes and neighborhoods, adding to the vibrancy of our communities.

Services for our queer and trans elders and those with disabilities include the LGBTQ+ Care Navigation program that utilizes trained staff and peer mentors to help clients access social services and reduce isolation; the LGBTQ+ Mental Health Connections program, which bridges the digital divide to connect users with culturally competent mental telehealth services; cultural sensitivity trainings for service providers in working effectively with LGBTQ+ seniors; a housing subsidy program for those at risk of eviction; a financial literacy empowerment program; and legal and life planning services to ensure their chosen family relationships and end-of-life choices are respected.

We continue to invest in reinforcing and expanding our existing LGBTQ+ programming. We are working to establish new programs based on our findings from the Dignity Fund Community Needs Assessment, such as the nation’s first services specifically for transgender and gender-nonconforming older people and adults with disabilities. The services focus on providing programming and social services in a supportive and genderaffirming environment.

However, it’s clear we have much more to do. We need to reach more LGBTQ+ older and disabled adults with our supportive services. LGBTQ+ seniors tend to access DAS community services at much lower rates than their peers—about one-third as often as San Francisco’s older adults generally. The same pattern holds true for queer and trans adults with disabilities, who access these services at about half the rate of all disabled adults. For example, approximately 12 percent of city seniors are estimated to be LGBTQ+, but only about 4 percent of our clients that participate in our community-based services self-identify as LGBTQ+ seniors. In addition, disabled adults represent approximately 22 percent of our city’s population, but only 12 percent access our DAS community services.

Our in-depth research and conversations with the community have also told us some of the reasons behind these disparities: LGBTQ+ seniors and people with disabilities are not always aware there are tailored programs that serve them. We need to inform the community about our services so they can feel included and safe in accessing these programs. We also know our challenge is not just in funding LGBTQ+ focused programs but also in ensuring that queer and trans consumers can access any service provided by DAS or its partners in a culturally responsive way—ensuring that we affirm their identities and make them feel included, accepted, and safe across our entire service portfolio.

To help further our goal of serving more LGBTQ+ San Franciscans, we need the community’s help to spread the word that there are many services to help our queer and trans older and disabled adults age in place, with us, in our neighborhoods and districts. DAS provides vital supports across a wide range of needs—whether it’s through our Community Service Centers where people can socialize and participate in a variety of programs and classes, or food programs that provide nutritious meals and promote healthy eating habits, or individualized case management services to help clients get the support and

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