Executive Summary
This report provides a description of demographic and health characteristics of lesbian, gay and bisexual (LGB) older adults living in California. The data show that 431,786 older Californian adults identified as LGB in 2015–2016: of them, 268,766 were lesbian or gay and 163,020 were bisexual. Of this group, 269,526 LGBs were aged 50–64 and 162,260 were aged 65 and older.
The report draws on data from the 2015–2016 California Health Interview Survey (CHIS). Sexual orientation can be measured through the constructs of identity, attraction, and behavior (SMART, 2009). Analysis for this report is based on the CHIS survey measure of sexual identity, that is, people identifying as LGB and straight or heterosexual. In 2015–2016, CHIS included, for the first time, LGB people aged 70 and older who previously had not been asked CHIS survey questions related to sexual identity. Because CHIS is a population-based survey, findings from this report are representative of California’s older adult population. We present demographics and health characteristics by sexual identity within different age groups (ages 50–64, and ages 65 and older) and, within the LGB population, by gender, sexual identity, and ethnicity. Throughout the report, we noted some large differences even though they did not reach statistical significance, such as psychological distress, because these areas may have important policy and clinical implications. Because of the small sample size of older transgender individuals in the data, we could not analyze the demographics of the transgender population; however, transgender sample characteristics are included in Appendix B1 and B2 to the report.
Key Findings
Differences between LGB Older Adults and Straight Older Adults
- LGB and straight older adults had similar characteristics in terms of educational levels, employment, and living in rural and urban areas. However, more LGB older adults were male compared with straight older adults.
- LGB older adults were more likely to have never married, and to live alone, than their straight counterparts. In the age group, 50–64, 30.6% of LGB adults lived alone compared with 13.6% of straight adults. Among the age group 65 and older, 39.8% of LGB adults lived alone compared with 26.2% of straight adults.
- LGB adults experience different socio-economic disparities by age group. Among the 50–64 age group, more LGB adults than straight adults received Supplemental Security Income (SSI), but there was no difference between LGB and straight adults in the 65 and older age group. In terms of homeownership, LGB adults aged 65 and older (59.6%) were less likely to own a home than their straight counterparts (71.3%), but there was no statistically significant difference in homeownership between LGB and straight adults aged 50–64.
- In both the 50–64 and 65 and older age groups, LGB and straight older adults had similar health outcomes and access to healthcare. In contrast to previous studies, we found no health disparities between LGB and straight older adults in terms of general health and specific health conditions such as diabetes or heart disease: nor did we see healthcare access disparities in terms of having health insurance or delaying care.
- Perhaps reflecting their need for more specialized health information, more LGB than straight older adults used the internet to look up health information.
Differences by gender (male vs. female), sexual identity (lesbian/gay vs. bisexual), and ethnicity (Hispanic/Latino vs. non-Hispanic/Latino) within California’s LGB older adult population
LGB Men and Women
- LGB men and women did not differ on most demographic characteristics and health outcomes. However, gay and bisexual men aged 65 and older were more likely than their lesbian and bisexual women counterparts to have served in the U.S. Armed Forces.
Bisexuals Compared to Gay Men and Lesbians
- We found differences between sexual identity groups (L/G v B) among older adults. Among people aged 50–64, bisexuals were more likely to experience food insecurity, and among those aged 65 and older, more likely to live 200% below the federal poverty level, compared to lesbian and gay adults in the same age groups.
- Among the 65 and older group, more lesbian and gay older adults compared with bisexual older adults have used the internet or used the internet to look up health information.
Hispanic /Latino Compared to non-Hispanic/Latino LGBs
We compared Hispanic/Latino with non-Hispanic/Latino LGBs because the sample size of other non-White race/ethnicities did not afford the necessary statistical power required to examine within-LGB-group analysis of other racial/ethnic groups.
- Compared with their LGB non-Hispanic/Latino peers (of all race groups), more LGB Hispanic/Latino people had a lower level of education, were born outside the U.S., lived 200% below the federal poverty level, and experienced food insecurity. Compared with their non-Hispanic/Latino counterparts, LGB Hispanic/Latinos aged 50–64 were more likely to be food insecure without periodic experiences of hunger and LGB Hispanic/Latinos aged 65 and older were more likely to be food insecure with periodic experiences of hunger.
- Compared with non-Hispanic/Latino LGBs, more LGB Hispanic/Latinos aged 50–64 lacked health insurance and more LGB Hispanic/Latinos aged 65 and older had diabetes and experienced psychological distress.
- LGB Hispanic/Latino older adults, compared with all other race groups, were less likely to have used the internet. Additionally, in the 50–64 age group, Hispanic/Latino adults were less likely to look up health information online.
In contrast to many previous studies, which have shown health disparities between LGB and straight older people (see Introduction), LGB older adults in the CHIS have similar health statuses to their straight counterparts. Similar to previous studies, however, LGB older adults were more likely to live alone and therefore may be more isolated in terms of traditional social support systems. Additionally, our findings indicate that LGB older adults’ experiences and health statuses differ by sexual identity and ethnicity, particularly in the 65 and older age group.
Our findings show less disparities between LGB and straight older adults than were found in a previous study that also used CHIS 2003, 2005, 2007 data. These differences may be indicative of the improved social and policy environment for LGBT people in California.
Seeing that older LGB adults used the internet more than straight older adults to find information about health needs, utilization of the internet for future public health interventions targeting LGB older adults could be an effective way to reach this population.
Our results are the first to utilize the CHIS revised sexual orientation questions that include people over age 70. There is further need to understand the differences between our findings in California, and those of previous studies that documented greater health disparities between LGB and straight older adults. Also, there remains need to further evaluate how intersectional identities can influence the health and healthcare of LGB older adults and, to more fully than we are able to, assess the health of transgender older adults.