How discrimination worsens health problems in LGBT+ seniors

Prejudice still constitutes a barrier between LGBT+ seniors and the healthcare system. Discrimination, coupled with unprepared services and fear of hostile reactions, leads many to avoid appointments, skip preventive exams, and postpone essential treatments. The result is aging marked by a higher incidence of physical and mental illnesses, social isolation, and a poorer quality of life.

"It's not common to see LGBT+ seniors in doctors' offices, and many factors contribute to this situation: shorter survival rates due to violence, intense prejudice, and unprepared healthcare systems," says geriatrician Maysa Seabra Cendoroglo of Einstein Hospital Israelita. "When these individuals do manage to grow older, the lack of support they receive throughout their youth often leads them to fear seeking professional help."

This is also the conclusion of several scientific studies. A study conducted with 6,693 Brazilians over 50, the majority of whom were LGBT+ (65%), concluded that this community often feels apprehensive about how they will be treated in healthcare facilities and, therefore, avoids seeking them. Published in 2023 in the journal Clinics , the study was conducted by the Albert Einstein Israelite School of Health Sciences (FICSAE), the University of São Paulo (USP), and the University of São Caetano do Sul (USCS).

In practice, this translates into fewer preventive exams being performed by LGBT+ individuals, when compared to cisgender and heterosexual people. According to the survey, only 40% of lesbian women reported having had a mammogram, compared to 74% of heterosexual women. The same is true for cervical screening exams (39% versus 73%) and colon cancer screenings (50% and 57%, respectively).

Another point highlighted in the study is that 34% of LGBT+ individuals preferred not to disclose their gender identity or sexual orientation to the doctors who treated them. Among those who chose to discuss the issue, 9% reported facing inappropriate reactions. This type of occurrence highlights some of the reasons why approximately 53% of LGBT+ individuals surveyed believe that medical teams are unprepared to deal with their particularities.

"I've spoken to transgender people who reported being advised by doctors to discontinue their hormone therapy in old age, which can sound quite insensitive," says anthropologist Carlos Eduardo Henning, a professor at the Federal University of Goiás (UFG). Regular hormone injections ensure the manifestation of certain physical characteristics that help reaffirm gender identity, such as a higher-pitched voice or a beard.

Health hazards

Frequent—and often early—exposure to adverse physical and emotional conditions can cause LGBT+ people to age more quickly compared to other groups. "We are born with a functional reserve that is consumed throughout life to cope with stressful situations without losing physiological balance," explains Maysa Cendoroglo. "Older people with low reserves are more susceptible to diseases and their serious complications."

As a result of the isolation of healthcare services, LGBT+ patients have a higher prevalence of mental, cognitive, physical, and sexual problems, according to an article published in 2024 in The International Journal of Aging and Human Development . These individuals have higher rates of depression, anxiety, suicidal ideation, social isolation, premature cognitive decline, and substance abuse, which can be exacerbated by risk factors such as diabetes and chronic stress. They also face a high prevalence of cardiovascular, pulmonary, and kidney diseases, as well as chronic pain.

"There are a number of illnesses that can be linked to a history of violence, precarious care pathways, and a lack of access and monitoring within the healthcare system," adds psychologist Marco Aurélio Máximo Prado, a professor at the Federal University of Minas Gerais (UFMG). "Furthermore, there are vulnerability conditions linked to mental health, social isolation, and difficulties in maintaining care networks in aging."

Structural and institutional violence

The discussion about LGBT+ aging has been raised by international activists since the 1960s, especially in countries in the Northern Hemisphere. However, it only began to gain traction in Latin America in recent years. According to the UFG professor, the turning point in Brazil was 2017, with the emergence of the NGO EternamenteSOU, which has dedicated itself to launching psychosocial, medical, and legal support programs focused on the well-being of the elderly LGBT+ population and bringing greater visibility to the issue—including among the younger members of the community.

"For a long time, aging wasn't a major issue for the LGBT+ movement. So, it's very interesting to see that Pride parade organizers in several cities [including São Paulo, considered the largest in the world] have put the topic up for discussion in 2025. Raising the profile of the issue is a way to politicize aging," emphasizes Carlos Henning.

The anthropologist explains that aging is intertwined with issues of class, sexual orientation, gender identity, race, and even geographic location, and this must be considered when considering access to health services for this group. "Brazil is a profoundly ageist society, but in the case of LGBT+ seniors, they don't only suffer from this type of violence."

Ageism often combines with other forms of discrimination, such as LGBT+phobia, sexism, racism, and xenophobia. And this accumulation of violence can occur even within the community itself. Higher-income gay white cisgender men, for example, tend to have greater access to treatment and specialized professionals than Black transvestites living in the outskirts of urban centers.

It's common in these groups for people to rely solely on family, whether "blood" or "heart." "The 'blood' family is the family of origin, formed, for example, by a father, mother, and siblings, and this doesn't always represent a support network for the LGBT+ person. There are, in fact, many cases of violence perpetrated precisely by these family members of origin," explains the UFG professor. "On the other hand, the 'heart' family appears as a support network made up of friends and companions who respect and support the expression of that individual's sexual and gender identity."

However, even when the blood family genuinely cares for the elderly person's well-being or the family takes responsibility for their care, this may not be enough to meet all the support demands and ensure health in old age. Hence the urgent need to develop measures to combat these structural and institutional forms of violence.

Reception through training

Access to healthcare for the LGBT+ population faces legal obstacles. "Some rights are essentially based on legal recognition, lacking consolidated public policies. In the health sector, these policies focus on preventing sexually transmitted infections (STIs)," explains Prado, who also coordinates the LGBT+ Human Rights and Citizenship Center at UFMG. "Without changes in political culture, values, and institutional policies, we won't see a reversal of the exclusion situation, much less actions for equality in healthcare access."

An example of this change is Bill (PL) No. 2,670/2025 , which was introduced in late May to the Chamber of Deputies and is awaiting the appointment of a rapporteur in the Health Committee (CSAUDE). It provides for the creation of a National Policy for the Promotion of Rights and Comprehensive Care for LGBTI Elderly People, to facilitate the process of developing measures, ensure equal access to health services, and combat prejudice against LGBT+ elderly people.

Carlos Henning believes it would be beneficial for public and private institutions to invest in professional training guides and educational processes to demonstrate best practices and avoid discomfort when treating patients. "Questions about why someone doesn't have children or is single, for example, can trigger feelings of guilt, maladjustment, and discomfort, driving them away from these settings," he states.

This care in healthcare settings should begin at the reception desk of the various institutions dedicated to aging and old age management, ensuring that individuals feel welcome and safe in the facility and remain so throughout all stages of medical care. "Discussing the sexuality of older adults is taboo, and the barriers are even greater for LGBT+ individuals. Therefore, a concerted effort must be made to educate these topics in schools and higher education programs, both for new generations of professionals and for society in general," says the Einstein geriatrician. "Prejudice cannot prevent people from accessing the care they need."

Source: Einstein Agency

The post How discrimination worsens health problems in LGBT+ seniors appeared first on Agência Einstein .