The absence of overt discrimination or complaints does not in itself make aged care services LGBTI inclusive. Rather than promoting acceptance and tolerance, inclusive service is about providing safe and respectful care, a leading researcher will tell providers next week.
Catherine Barrett tells a story about a teenager who went to a party one night.
The party ended abruptly when police carried out a raid and Noel Tovey, who was just 17 at the time, was arrested and imprisoned for the “abominable crime of buggery.”
It’s just one of the “extraordinary and yet relatively commonplace” stories that older lesbian, gay and trans people have shared with Dr Barrett for her latest research.
Her report on the experiences of older lesbian, gay, bisexual, transgender and intersex (LGBTI) people for beyondblue, which is yet to be published, recounts other examples of the discrimination that a generation of LGBTI people faced, and how this impacted on anxiety and depression.
Dr Barrett heard stories of people who disclosed their sexual orientation and were sent to psychiatric institutions and given shock therapy. She heard from gay men who were entrapped by undercover police officers and put in prison. People told her about disclosing their sexual orientation when they were in the military and being discharged. She heard from people who had been disowned by family and friends, and had lost their job. And she spoke to someone who had lost their partner to suicide.
Key societal structures during that period, such as psychiatry, medicine and the law, reinforced the discrimination against LGBTI people. “What we found was that families often took their cues from these prestigious institutions. So if medicine and psychiatry is saying that this is a madness, families will say, ‘Oh my god my daughter’s a lesbian and that’s terrible’. People were disowned and disinherited. Most of the people we talked to had experienced depression and also had some symptoms of anxiety,” Dr Barrett says.
Dr Barrett will be sharing these and other stories with aged care providers and staff at a workshop on LGBTI inclusive aged care practice hosted by the Australian Association of Gerontology next week.
Dr Barrett, who manages a program promoting the sexual health of older people at the Australian Research Centre in Sex, Health and Society at La Trobe University, will be presenting alongside Carolyn Whyte and Pauline Crameri from Val’s Café, established to support the development of LGBTI inclusive services.
Dr Barrett said that outlining these examples of historical discrimination helped to emphasise why LGBTI inclusive practice was so important. Research showed that a number of older LGBTI people still believed discrimination existed. As a result, many did not disclose their sexual orientation or gender identity when they accessed aged care, and in turn, service providers often did not realise they had LGBTI clients and were therefore unconcerned about inclusive practice, Dr Barrett said.
Steve Teulan, director of UnitingCare Ageing NSW.ACT, which is a sponsor of the AAG workshop, echoed this.
He pointed to a survey his organisation had undertaken within LGBTI communities. “People told us that they have a fear of disclosure of their sexuality or gender identity and that they are afraid of discrimination, particularly from church-based organisations.”
Having difficulty or a reticence to access service had the potential to delay treatment and exacerbate the effect of individual health issues, Mr Teulan said.
“Aged care providers need to be able to demonstrate to the community that they are able to provide inclusive services to be able to breakdown any reluctance to access services and better meet the needs and aspirations of LGBTI people,” he said.
Dr Barrett said there was some confusion among providers about what LGBTI inclusive practice was and what it strived to achieve.
“We found in our work people don’t know where the benchmark is. Some people think the absence of overt discrimination or complaints means they’re LGBTI inclusive. That’s not the case. It’s not about acceptance and tolerance, it’s about valuing and respect.”
She said the aim of LGBTI inclusive services was not increased numbers of people outing themselves, rather it was about providing a service that was safe and accessible to everybody.
Dr Barrett pointed to the set of six national standards for LGBTI inclusive service which was developed by Gay and Lesbian Health Victoria. These will be outlined at the AAG workshop.
Understanding the issues
When asked how UnitingCare Ageing NSW.ACT had gone about ensuring its services were LGBTI inclusive, Mr Teulan said the organisation had implemented a model, Inspired Care, which was about clients feeling “accepted, valued and loved for who they are.”
The organisation recruited an LGBTI project officer who engaged with both groups and individuals within LGBTI communities to get an understanding of the issues people faced, as well as their needs and expectations for future service provision.
Among the steps UnitingCare Ageing NSW.ACT had taken were connecting with LGBTI organisations; becoming members of the LGBTI Health Alliance and Pride in Diversity; representing ACSA on the working group for the Commonwealth LGBTI Ageing and Aged Care Strategy; and participating in LGBTI interagency groups in Sydney and on the NSW North Coast.
Meantime, Dr Barrett is part of a new research project, which was funded by the Commonwealth Department of Health, to support the development of LGBTI inclusive services nationally. The project has so far partnered with Carers Australia, Alzheimer’s Australia and COTA in Victoria.
It will conduct research on older LGBTI people living with dementia, LGBTI carers, and older trans and intersex people. As part of the project national conferences will be held in October next year and in 2015.
AAA will carry further updates and reports from this latest research in coming issues.