LGBT elders health from the minority stress perspective. Literature review and research recommendations

Journal title PSICOLOGIA DELLA SALUTE
Author/s Cristiano Scandurra, Fabrizio Mezza, Vincenzo Bochicchio, Paolo Valerio, Anna Lisa Amodeo
Publishing Year 2017 Issue 2017/2
Language Italian Pages 27 P. 70-96 File size 285 KB
DOI 10.3280/PDS2017-002004
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Lesbian, gay, bisexual, and transgender (LGBT) older adults have not received proper attention by the scientific literature and gerontology research, especially in Italy. This lack represents only an aspect of a more general condition of social invisibility that weighs on this population. The present contribution aims to provide researchers and clinicians with a review of scientific works which, especially in the USA, have casted light on experiences of stigmatization, discrimination, and victimization experienced and perceived by this population. The theoretical framework is represented by the minority stress perspective which provides an overview of risk and protective factors related to physical and mental health of minority groups. In the current review, authors considered studies conducted through quantitative, qualitative, and mixed methods, starting from 2000. Following the above described perspective, results are presented in two sections: the first one is focused on the different forms of stigma which weigh on LGBT older adults and the second one on the mental and physical health outcomes and on protective factors. The application of the minority stress perspective on LGBT older adults provides researchers and social and health care system providers with a psychosocial and clinical framework through which reading the phenomenon. Finally, main research recommendations are discussed.

Keywords: LGBT, elders, minority stress, stigma, protective factors, health.

  1. Shippy R., Cantor M.H. and Brennan M. (2004). Social networks of aging gay men. The Journal of Men’s Studies, 13 (1): 107-120.
  2. Amodeo A.L., Vitelli R., Scandurra C., Picariello S. and Valerio P. (2015). Adult attachment and transgender identity in the Italian context: Clinical implications and suggestions for further research. International Journal of Transgenderism, 16 (1): 49-61. DOI: 10.1080/15532739.2015.1022680
  3. Balsam K.F. and D’Augelli A.R. (2006). The victimization of older LGBT adults: Patterns, impact, and implications for intervention. In: Kimmel D., Rose T. and David S. (eds.), Lesbian, Gay, Bisexual, and Transgender Aging: Research and Clinical Perspectives. New York: Columbia University Press, pp. 110-130.
  4. Brotman S., Ryan B. and Cormier R. (2003). The health and social service needs of gay and lesbian elders and their families in Canada. The Gerontologist, 43 (2): 192-202.
  5. Cook-Daniels L. (2015). Transgender aging: What practitioners should know. In: Orel N.A. and Fruhauf C.A. (eds.), The Lives of LGBT Older Adults: Understanding Challenges and Resilience. Washington: APA, pp. 193-215.
  6. Cook-Daniels L. and Munson M. (2010). Sexual violence, elder abuse, and sexuality of transgender adults, age 50+: Results of three surveys. Journal of GLBT Family Studies, 6 (2): 142-177. DOI: 10.1080/1550428100370523
  7. D’Augelli A. and Grossman A. (2001). Disclosure of sexual orientation, victimization, and mental health among lesbian, gay, and bisexual older adults. Journal of Interpersonal Violence, 16 (10): 1008-1027. DOI: 10.1177/08862600101601000
  8. de Vries B. (2015). Stigma and LGBT aging: Negative and positive marginality. In: Orel N.A. and Fruhauf C.A. (eds.), The Lives of LGBT Older Adults: Understanding Challenges and Resilience. Washington: APA, pp. 55-71. DOI: 10.1037/14436-00
  9. de Vries B. and Megathlin D. (2009). The meaning of friendship for gay men and lesbians in the second half of life. Journal of GLBT Family Studies, 5 (1): 82-98. DOI: 10.1080/1550428080259539
  10. Dean L., Meyer I.H., Robinson K., Sell R.L., Sember R., Silenzio V.M.B., Bowen D.J., Bradford J., Rothblum E., Scout M.A., White J., Dunn P., Lawrence A., Wolfe D. and Xavier J. (2000). Lesbian, gay, bisexual, and transgender health: Findings and concerns. Journal of the Gay and Lesbian Medical Association, 4 (3): 101-151. DOI: 10.1023/A:100957380016
  11. Emlet C.A., Fredriksen-Goldsen K.I., Kim H.J. and Hoy-Ellis C. (2015). The relationship between sexual minority stigma and sexual health risk behaviors among HIV-positive older gay and bisexual men. Journal of Applied Gerontology, 22: 1-22. DOI: 10.1177/073346481559121
  12. Feldman J. (2007). Preventive care of the transgendered patient: An evidence-based approach. In: Ettner R., Monstrey S. and Eyler A.E. (eds.), Principles of Transgender Medicine and Surgery. New York: Haworth Press, pp. 33-72.
  13. Feldman J.L. and Goldberg J.M. (2007). Transgender primary medical care. International Journal of Transgenderism, 9 (3-4): 3-34.
  14. Fredriksen-Goldsen K.I., Cook-Daniels L., Kim H.J., Erosheva E.A., Emlet C.A., Hoy-Ellis C.P., Goldsen J. and Muraco A. (2014a). Physical and mental health of transgender older adults: An at-risk and underserved population. The Gerontologist, 54 (3): 488-500.
  15. Fredriksen-Goldsen K.I., Emlet C.A., Kim H.J., Muraco A., Erosheva E.A., Goldsen J. and Hoy-Ellis C.P. (2012). The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: The role of key health indicators and risk and protective factors. The Gerontologist, 53 (4): 664-75.
  16. Fredriksen-Goldsen K.I., Kim H.J., Berkan S.E., Muraco A. and Hoy-Ellis C.P. (2013). Health disparities among lesbian, gay, and bisexual older adults: Results form a population-based study. American Journal of Public Health, 103 (10): 1802-1809. DOI: 10.2105/AJPH.2012.30111
  17. Fredriksen-Goldsen K.I., Kim H.J., Emlet C., Muraco A., Erosheva E.A., Hoy-Ellis C.P. and Petry H. (2011). The aging and health report: Disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle, WA: Institute for Multigenerational Health.
  18. Fredriksen-Goldsen K.I., Kim H.J., Shiu C., Goldsen J. and Emlet, C.A. (2014b). Successful aging among LGBT older adults: Physical and mental health-related quality of life by age group. The Gerontologist, 55 (1): 154-168.
  19. Fredriksen-Goldsen K.I. and Muraco A. (2010). Aging and sexual orientation: A 25-year review of the literature. Research on Aging, 32 (3): 372-413. DOI: 10.1177/016402750936035
  20. Friend R.A. (1990). Older lesbian and gay people: A theory of successful aging. Journal of Homosexuality, 20 (3-4): 99-118.
  21. Grant J.M., Mottet L.A., Tanis J., Harrison J., Herman J.L. and Keisling M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. DC: National Center for Transgender Equality and the National Gay and Lesbian Task Force.
  22. Grov C., Bimbi D.S., Nanin J.E. and Parsons J.T. (2006). Race, ethnicity, gender, and generational factors associated with the comingout process among lesbian, and bisexual individuals. The Journal of Sex Research, 43 (2): 115-121. DOI: 10.1080/0022449060955230
  23. Gruskin E.P., Greenwood G.L., Matevia M., Pollack L.M. and Bye L.L. (2007). Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California. American Journal of Public Health, 97 (8): 1496-1502. DOI: 10.2105/AJPH.2006.09025
  24. Harley D.A. and Teaster P.B. (eds.) (2016). Handbook of LGTB elders: An interdisciplinary approach to principles, practices, and policies. New York: Springer
  25. Hartzell E., Frazer M.S., Wertz K. and Davis M. (2009). The state of transgender California: Results from the 2008 California Transgender Economic Health Survey. San Francisco, CA: Transgender Law Center. --Retrieved from: http://transgenderlawcenter.org/ wp-content/uploads/2012/07/95219573-The-State-of-Transgender-California.pdf
  26. Hoy-Ellis, C.P. and Fredriksen-Goldsen, K.I. (2016). Lesbian, gay, & bisexual older adults: Linking internal minority stressors, chronic health conditions, and depression. Aging and Mental Health, 20 (11): 1119-1130 DOI: 10.1080/13607863.2016.116836
  27. Huebner D.M. and Davis M.C. (2007). Perceived anti-gay discrimination and physical health outcomes. Health Psychology, 26 (5): 627-634. DOI: 10.1037/0278-6133.26.5.62
  28. Institute of Medicine (IOM) (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington: National Academies Press. DOI: 10.17226/1312
  29. Kimmel D.C., Rose T. and David S. (eds.) (2006). Lesbian, gay, bisexual, and transgender aging: Research and clinical perspectives. New York: Columbia University Press. DOI: 10.1080/08952840903044717
  30. Kuyper L. and Fokkema T. (2010). Loneliness among older lesbian, gay, and bisexual adults: The role of minority stress. Archives of Sexual Behavior, 39 (5): 1171-1180.
  31. Masini B.E. and Barrett H.A. (2008). Social support as a predictor of psychological and physical well-being and lifestyle in lesbian, gay, and bisexual adults aged 50 and over. Journal of Gay & Lesbian Social Services, 20 (1-2): 91-110. DOI: 10.1080/1053872080217901
  32. McFarland P.L. and Sanders S. (2003). A pilot study about the needs of older gays and lesbians: What social workers need to know. Journal of Gerontological Social Work, 40 (3): 67-80.
  33. MetLife Mature Market Institute (2006). Out and aging: The MetLife study of lesbian and gay baby boomers. Westport, CT: MetLife Mature Market Institute. --Retrieved from: https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-out-aging-lesbian-gay-retirement.pdf
  34. MetLife Mature Market Institute (2010). Still out, still aging: The MetLife study of lesbian, gay, bisexual, and transgender baby boomers. Westport, CT: MetLife Mature Market Institute. --Retrieved from: https://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-still-out-still-aging.pdf
  35. Meyer I.H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36 (1): 38-56. DOI: 10.2307/213728
  36. Meyer I.H. (2003). Prejudice, social stress, and mental health in lesbian, gay and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129 (5): 674-697. DOI: 10.1037/0033-2909.129.5.67
  37. Meyer I.H. (2007). Prejudice and discrimination as social stressors. In: Meyer I.H. and Northridge M.E. (eds.), The Health of Sexual Minorities: Public Health Perspectives on Lesbian, Gay, Bisexual and Transgender Populations. New York: Springer, pp. 242-267. DOI: 10.1007/978-0-387-31334-4_1
  38. Mills T.C., Paul J., Stall R., Pollack L., Canchola J., Chang Y.J., Moskowitz J.T. and Catania, J.A. (2004). Distress and depression in men who have sex with men: The Urban Men’s Health Study. American Journal of Psychiatry, 161 (2): 278-285.
  39. National Senior Citizens Law Center (2011). LGBT older adults in longterm care facilities: Stories from the field. Washington, DC: Author. --Retrieved from: http://www.lgbtagingcenter.org/resources/pdfs/NSCLC_LGBT_report.pdf
  40. Orel N.A. and Fruhauf C.A. (eds.) (2015). The lives of LGBT older adults: Understanding challenges and resilience. Washington: APA. DOI: 10.1080/1550428X.2015.107195
  41. Pietrantoni L., Sommantico M. e Graglia M. (2000). Anzianità impreviste. Una ricerca su omosessualità e terza età [Unforeseen seniority. A research on homosexuality and elderly]. La Rivista di Servizio Sociale, 40 (1): 31-42.
  42. Ponce N.A., Cochran S.D., Pizer J.C. and Mays V.M. (2010). The effects of unequal access to health insurance for same-sex couples in California. Health Affairs, 29 (8): 1539-1548.
  43. Ramirez-Valles, J., Dirkes, J. and Barrett, H.A. (2014). Gayby boomers’ social support: Exploring the connection between health and emotional instrumental support in older gay men. Journal of Gerontological Social Work, 57(2-4): 218-234. DOI: 10.1080/01634372.2013.84322
  44. Rawls T.W. (2004). Disclosure and depression among older gay and homosexual men: Findings from the Urban Men’s Health Study. In: Herdt G. and De Vries B. (eds.), Gay and Lesbian Aging: Research and Future Directions. New York: Springer, pp. 117-141.
  45. Russ T.C., Stamatakis E., Hamer M., Starr J.M., Kivimäki M. and Batty G.D. (2012). Association between psychological distress and mortality: Individual participant pooled analysis of 10 prospective cohort studies. British Medical Journal, 345: 1-14.
  46. Scandurra C., Picariello S., Valerio P. and Amodeo A.L. (2017a). Sexism, homophobia and transphobia in a sample of Italian pre-service teachers: The role of sociodemographic features. Journal of Education for Teaching, 43 (2): 245-261. DOI: 10.1080/02607476.2017.128679
  47. Scandurra C., Amodeo A.L., Bochicchio V., Valerio P. and Frost D.M. (2017b). Psychometric characteristics of the Transgender Identity Survey in an Italian sample: A measure to assess positive and negative feelings towards transgender identity. International Journal of Transgenderism, 18 (1): 53-65. DOI: 10.1080/15532739.2016.124197
  48. Valanis B.G., Bowen D.J., Bassford T., Whitlock E., Charney P. and Carter R.A. (2000). Sexual orientation and health: Comparisons in the women’s health initiative sample. Archives of Family Medicine, 9 (9): 843-853.
  49. Van Wagenen A., Driskell J. and Bradford J. (2013). “I’m still raring to go”: Successful aging among lesbian, gay, bisexual, and transgender older adults. Journal of Aging Studies, 27 (1): 1-14.
  50. Wallace S.P., Cochran S.D., Durazo E.M. and Ford C.L. (2011). The health of aging lesbian, gay and bisexual adults in California. Policy Brief UCLA Center for Health Policy Research (PB2011-2), 1-8.
  51. Weinand J.D. and Safer J.D. (2015). Hormone therapy in transgender adults is safe with provider supervision; A review of hormone therapy sequelae for transgender individuals. Journal of Clinical & Translational Endocrinology, 2 (2): 55-60.
  52. Weston K. (1991). Families we choose: Lesbians, gays, kinship. New York: Columbia University Press.
  53. Wight R.G., LeBlanc A.J., Meyer I.H. and Harig F.A. (2015). Internalized gay ageism, mattering, and depressive symptoms among midlife and older gay-identified men. Social Science & Medicine, 147: 200-208.
  54. Williams M.E. and Freeman P.A. (2005). Transgender health: Implications for aging and caregiving. Journal of Gay & Lesbian Social Services, 18 (3-4): 93-108.
  55. Witten T.M. and Eyler A.E. (2012). Transgender and aging: Beings and becomings. In: Witten T.M. and Eyler A.E. (eds.), Gay, Lesbian, Bisexual and Transgender Aging: Challenges in Research, Practice, and Policy. Baltimore: The Johns Hopkins University Press, pp. 187-269.
  56. Zaritsky E. and Dibble S.L. (2010). Risk factors for reproductive and breast cancers among older lesbians. Journal of Women’s Health, 19 (1): 125-131.

  • Pre-service teachers’ approaches to gender-nonconforming children in preschool and primary school: Clinical and educational implications Vincenzo Bochicchio, Pascal Perillo, Antonella Valenti, Fabrizio Chello, Anna Lisa Amodeo, Paolo Valerio, Cristiano Scandurra, in Journal of Gay & Lesbian Mental Health /2019 pp.117
    DOI: 10.1080/19359705.2019.1565791
  • Online Sexual Activities in Italian Older Adults: The Role of Gender, Sexual Orientation, and Permissiveness Cristiano Scandurra, Fabrizio Mezza, Concetta Esposito, Roberto Vitelli, Nelson Mauro Maldonato, Vincenzo Bochicchio, Alessandro Chiodi, Alain Giami, Paolo Valerio, Anna Lisa Amodeo, in Sexuality Research and Social Policy /2022 pp.248
    DOI: 10.1007/s13178-021-00538-1
  • Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals Cristiano Scandurra, Vincenzo Bochicchio, Anna Amodeo, Concetta Esposito, Paolo Valerio, Nelson Maldonato, Dario Bacchini, Roberto Vitelli, in International Journal of Environmental Research and Public Health /2018 pp.508
    DOI: 10.3390/ijerph15030508
  • Group psychodynamic counselling as a clinical training device to enhance metacognitive skills and agency in future clinical psychologists Cristiano Scandurra, Simona Picariello, Daniela Scafaro, Vincenzo Bochicchio, Paolo Valerio, Anna Lisa Amodeo, in Europe’s Journal of Psychology /2018 pp.444
    DOI: 10.5964/ejop.v14i2.1528
  • Aging well in an aging society: physical health in older lesbian, gay, and bisexual adults Roberto Baiocco, Chiara Antoniucci, Jessica Pistella, Guido Alessandri, Fabio Alivernini, Anna M. Borghi, Andrea Chirico, Lorenzo Filosa, Chiara Fini, Tommaso Palombi, Fau Rosati, Simone Tavolucci, Fabio Lucidi, in Frontiers in Psychology 1369021/2024
    DOI: 10.3389/fpsyg.2024.1369021
  • Health of Non-binary and Genderqueer People: A Systematic Review Cristiano Scandurra, Fabrizio Mezza, Nelson Mauro Maldonato, Mario Bottone, Vincenzo Bochicchio, Paolo Valerio, Roberto Vitelli, in Frontiers in Psychology 1453/2019
    DOI: 10.3389/fpsyg.2019.01453
  • Well-Being of Lesbian, Gay, Bisexual Youth: The Influence of Rural and Urban Contexts on the Process of Building Identity and Disclosure Barbara Agueli, Giovanna Celardo, Ciro Esposito, Caterina Arcidiacono, Fortuna Procentese, Agostino Carbone, Immacolata Di Napoli, in Frontiers in Psychology 787211/2022
    DOI: 10.3389/fpsyg.2021.787211
  • The Influence of Minority Stress, Gender, and Legalization of Civil Unions on Parenting Desire and Intention in Lesbian Women and Gay Men: Implications for Social Policy and Clinical Practice Cristiano Scandurra, Dario Bacchini, Concetta Esposito, Vincenzo Bochicchio, Paolo Valerio, Anna Lisa Amodeo, in Journal of GLBT Family Studies /2019 pp.76
    DOI: 10.1080/1550428X.2017.1410460
  • Empowering transgender youths: Promoting resilience through a group training program Anna Lisa Amodeo, Simona Picariello, Paolo Valerio, Cristiano Scandurra, in Journal of Gay & Lesbian Mental Health /2018 pp.3
    DOI: 10.1080/19359705.2017.1361880
  • A qualitative study on minority stress subjectively experienced by transgender and gender nonconforming people in Italy C. Scandurra, R. Vitelli, N.M. Maldonato, P. Valerio, V. Bochicchio, in Sexologies /2019 pp.e61
    DOI: 10.1016/j.sexol.2019.05.002
  • Social relationship experiences of transgender people and their relational partners: A meta-synthesis Tom Lewis, David Matthew Doyle, Manuela Barreto, Debby Jackson, in Social Science & Medicine 114143/2021 pp.114143
    DOI: 10.1016/j.socscimed.2021.114143
  • Italian Sexual Minority Older Adults in Healthcare Services: Identities, Discriminations, and Competencies Fausta Rosati, Jessica Pistella, Roberto Baiocco, in Sexuality Research and Social Policy /2021 pp.64
    DOI: 10.1007/s13178-020-00443-z
  • Same-Sex Parenting in Italy: An Affective and Developmental Psychocultural Analysis Agostino Carbone, Alessandro Gennaro, Paolo Valerio, Cristiano Scandurra, in Sexuality Research and Social Policy /2024 pp.14
    DOI: 10.1007/s13178-023-00838-8
  • Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework Anna Lisa Amodeo, Concetta Esposito, Vincenzo Bochicchio, Paolo Valerio, Roberto Vitelli, Dario Bacchini, Cristiano Scandurra, in International Journal of Environmental Research and Public Health /2018 pp.2318
    DOI: 10.3390/ijerph15102318
  • Minority Stress and Mental Health in Italian Bisexual People Cristiano Scandurra, Andrea Pennasilico, Concetta Esposito, Fabrizio Mezza, Roberto Vitelli, Vincenzo Bochicchio, Nelson Mauro Maldonato, Anna Lisa Amodeo, in Social Sciences /2020 pp.46
    DOI: 10.3390/socsci9040046
  • Gender Felt Pressure, Affective Domains, and Mental Health Outcomes among Transgender and Gender Diverse (TGD) Children and Adolescents: A Systematic Review with Developmental and Clinical Implications Selene Mezzalira, Cristiano Scandurra, Fabrizio Mezza, Marina Miscioscia, Marco Innamorati, Vincenzo Bochicchio, in International Journal of Environmental Research and Public Health /2022 pp.785
    DOI: 10.3390/ijerph20010785
  • Older LGBT+ Adults and Physical Activity: A Systematic Review of Qualitative and Quantitative Data Jessica Pistella, Roberto Baiocco, Chiara Antoniucci, Guido Alessandri, Fabio Alivernini, Anna M. Borghi, Lorenzo Filosa, Chiara Fini, Tommaso Palombi, Simone Tavolucci, Fabio Lucidi, in Sexuality Research and Social Policy /2024
    DOI: 10.1007/s13178-023-00925-w
  • Approcci affermativi e rilevanza del minority stress nel counseling psicologico con persone LGBT: una revisione della letteratura internazionale Cristiano Scandurra, Fabrizio Mezza, Paolo Valerio, Roberto Vitelli, in PSICOTERAPIA E SCIENZE UMANE 1/2019 pp.67
    DOI: 10.3280/PU2019-001004
  • Une étude qualitative sur le stress minoritaire ressenti par les personnes transgenres et de genre non conforme en Italie C. Scandurra, R. Vitelli, N.M. Maldonato, P. Valerio, V. Bochicchio, in Sexologies /2019 pp.142
    DOI: 10.1016/j.sexol.2019.05.001
  • Affective and Attitudinal Features of Benevolent Heterosexism in Italy: The Italian Validation of the Multidimensional Heterosexism Inventory Vincenzo Bochicchio, Selene Mezzalira, Eugene Walls, Lucas Platero Méndez, Miguel Ángel López-Sáez, Bojana Bodroža, Manuel Joseph Ellul, Cristiano Scandurra, in Sexuality Research and Social Policy /2024 pp.1
    DOI: 10.1007/s13178-024-00951-2

Cristiano Scandurra, Fabrizio Mezza, Vincenzo Bochicchio, Paolo Valerio, Anna Lisa Amodeo, La salute degli anziani LGBT dalla prospettiva del minority stress. Rassegna della letteratura e raccomandazioni di ricerca in "PSICOLOGIA DELLA SALUTE" 2/2017, pp 70-96, DOI: 10.3280/PDS2017-002004