Project Respect: experiences of seriously ill LGBTQ+ patients and partners with their health care providers.

Discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons in health care creates barriers to serious illness care, including patients avoiding or delaying necessary care, providers disrespecting wishes of surrogates, and adverse outcomes for patients and families. A cross-sectional mixed-methods study using an online survey was used to determine the extent to which LGBTQ+ patients and spouses, partners, and widows experienced disrespectful or inadequate care due to sexual orientation or gender identity. A total of 290 LGBTQ+ patients and partners reported high levels of disrespectful and inadequate care, including 35.2% stating their provider was insensitive to them because of their identity; 30% reporting their provider was unaware of LGBTQ+ health needs; 23.1% feeling judged; 20.7% experiencing rudeness; 20.3% stating providers did not use their correct pronouns; and 19.7% reporting their treatment decisions were disregarded. Black and Hispanic patients were 2-4 times more likely than non-Hispanic White patients to report discrimination. This study demonstrated high levels of disrespectful and inadequate care towards patients and partners due to being LGBTQ+, which was especially problematic for Black and Hispanic patients and those living in politically conservative regions. Recommendations include federal and state civil rights laws to prohibit LGBTQ+ discrimination and institutional practices to address discrimination, including cultural sensitivity training for staff.

Lift every voice: voices of African-American lesbian elders.

Old lesbians of African descent have experienced racism, heterosexism, homophobia, and ageism. This article explores the topics of aging, ageism, heterosexism, and minority stress among older African-American lesbians. The narratives and subsequent analysis offer significant contributions to the dialogue regarding Black aging lesbians in the aging and lesbian, gay, bisexual, and transgender (LGBT) communities generally and in the African-American and African-American lesbian communities specifically.

Aging out: a qualitative exploration of ageism and heterosexism among aging African American lesbians and gay men.

African Americans elders, like their non-African American counterparts, are not a homogeneous group; however an early characteristic placed on all African Americans is in their shared history in the United States. As members of multiple minority groups, older lesbian, gay, bisexual, and transgender (LGBT) people of African descent have survived racism, heterosexism, homophobia, and now ageism. This article describes a qualitative study grounded in Black feminist and minority stress theories that explored the issues of perceived social discrimination and alienation of 15 older African American lesbians and gay males whose lived experiences were captured using in-depth, face-to-face interviews. Several themes were identified in the study, including (a) Sense of Alienation in the African American Community, (b) Deliberate Concealment of Sexual Identity and Orientation, (c) Aversion to LGBT Labels, (d) Perceived Discrimination and Alienation From Organized Religion, (e) Feelings of Grief and Loss Related to Aging, (f) Isolation, and (g) Fear of Financial and Physical Dependence. The implication of the findings suggests that the ethos and needs of older African American lesbian women and gay men need to be addressed to eliminate potential barriers to successful aging for this cohort.