{"id":354806,"date":"2023-06-20T07:27:44","date_gmt":"2023-06-20T12:27:44","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/lgbtq-law\/lgbtq-older-adult\/laws-affecting-lgbtq-older-adults.html"},"modified":"2026-05-26T11:23:00","modified_gmt":"2026-05-26T16:23:00","slug":"laws-affecting-lgbtq-older-adults","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/lgbtq-law\/lgbtq-older-adult\/laws-affecting-lgbtq-older-adults.html","title":{"rendered":"Laws Affecting LGBTQ+ Older Adults"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7 fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n<div class=\"fl-page-articles fl-section-main fl-section-main-full-width\"><h1 class=\"fl-no-margin-top\">Laws Affecting LGBTQ+ Older Adults<\/h1>\n\n<section class=\"fl-gutenberg-byline\">\n    <div class=\"fl-gutenberg-byline-content\">\n                    By <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">Isobel Healy, J.D., M.P.H.<\/a> | Legally reviewed by <a\n                href=\"https:\/\/www.findlaw.com\/company\/our-team\/bridget-molitor-jd\/\">Bridget Molitor, JD<\/a>\n                | Last updated\n        <time>\n                            May 26, 2026\n                    <\/time>\n    <\/div>\n\n    \n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-legally-reviewed\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Legally Reviewed\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>This article has been written and reviewed for legal accuracy, clarity, and style by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with <a href=\"https:\/\/www.findlaw.com\/company\/company-history\/editorial-policy.html\">our editorial standards<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n\n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-fast-checked\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Fact-Checked\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>The last updated date refers to the last time this article was reviewed by FindLaw or one of our <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/contributing-authors.html\">contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please <a href=\"https:\/\/lawyers.findlaw.com\/?fli=bylinelink\" target=\"_blank\" rel=\"noopener\">contact an attorney in your area<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n<\/section>\n\n\n<div class=\"fl-key-takeaways fl-mb30\" data-testid=\"fl-key-takeaways\">\n    <div class=\"fl-card-content\">\n        <div class=\"fl-card-body fl-card-bg-teal fl-flex fl-flex-column\">\n                            <h2 class=\"fl-card-title fl-h2 fl-no-margin\">Key Takeaways<\/h2>\n                        <p><span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> are protected by several federal laws that support dignified aging, access to affirming <span data-term-id=\"58818328\">healthcare<\/span>, and protection from abuse. While these laws prohibit discrimination and require <span data-term-id=\"58818347\">culturally competent<\/span> services, gaps in enforcement and <span data-term-id=\"58818331\">provider<\/span> training mean many <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> still face mistreatment in long\u2011term care and <span data-term-id=\"58818328\">healthcare<\/span> settings.<\/p>\n\n        <\/div>\n    <\/div>\n<\/div>\n\n\n<p>This article provides an overview of laws directly impacting <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> (OA) and their ability to age with dignity, access affirming <span data-term-id=\"58818328\">healthcare<\/span> and <span data-term-id=\"58818347\">culturally competent<\/span> senior services, and prevent elder abuse.<\/p>\n<p>The\u00a0<a href=\"https:\/\/www.sageusa.org\/wp-content\/uploads\/2021\/03\/sage-lgbt-aging-facts-final.pdf\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818382\">National Resource Center<\/span> on <span data-term-id=\"58818327\">LGBTQ<\/span>+ Aging<\/a>\u00a0estimates there will be 7 million <span data-term-id=\"58818360\">LGBTQ<\/span><span data-term-id=\"58818360\">+ adults<\/span> 65 and older living in the United States by 2030. For some of these <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span>, navigating <span data-term-id=\"58818328\">healthcare<\/span> services and long\u2011term care can feel isolating and unsafe. If you or a loved one is facing discrimination, mistreatment, or barriers to services, contact a <a href=\"https:\/\/lawyers.findlaw.com\/civil-rights\/\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818350\">civil rights<\/span> attorney<\/a> near you for help and <span data-term-id=\"58818341\">advocacy<\/span>.<\/p>\n<h2><span data-term-id=\"58818339\">Older Americans Act<\/span><\/h2>\n<p>Congress originally passed the\u00a0<a href=\"https:\/\/www.findlaw.com\/elder\/what-is-elder-law\/what-is-the-older-americans-act.html\"><span data-term-id=\"58818339\">Older Americans Act<\/span><\/a>\u00a0(<span data-term-id=\"58818358\">OAA<\/span>) in 1965 to develop community and <span data-term-id=\"58818345\">social services<\/span> for older adults, who, at that time, were more likely to live in poverty than any other age group.<\/p>\n<p>The <span data-term-id=\"58818358\">OAA<\/span> authorizes a variety of\u00a0<a href=\"https:\/\/crsreports.congress.gov\/product\/pdf\/R\/R43414\" target=\"_blank\" rel=\"noopener\">supportive and community service programs<\/a>\u00a0for adults aged 60 years or older in each state and the District of Columbia, as well as some federally recognized tribal organizations and U.S. territories.<\/p>\n<p>The <span data-term-id=\"58818358\">OAA<\/span> established the federal\u00a0<a href=\"https:\/\/acl.gov\/about-acl\/administration-aging\" target=\"_blank\" rel=\"noopener\">Administration on Aging<\/a>\u00a0(AoA). The Administration on Aging distributes funds to\u00a0<a href=\"https:\/\/acl.gov\/programs\/aging-and-disability-networks\/state-units-aging\" target=\"_blank\" rel=\"noopener\">State Units on Aging<\/a>\u00a0(SUA), which develop multi-year state plans carried out by\u00a0<span data-term-id=\"58818389\">Area Agencies on Aging<\/span>\u00a0(AAA). These public and private non-profit organizations provide a variety of services to older adults either directly or via local <span data-term-id=\"58818348\">service <\/span><span data-term-id=\"58818331\">providers<\/span>, including:<\/p>\n<ul>\n<li>Funding for senior community centers<\/li>\n<li>Training for elder care and <span data-term-id=\"58818348\">service <\/span><span data-term-id=\"58818331\">providers<\/span><\/li>\n<li>Transportation assistance (e.g., Access-A-Ride)<\/li>\n<li>Congregate and Home-delivery nutrition services (e.g., Meals on Wheels)<\/li>\n<li><span data-term-id=\"58818334\">Caregiver<\/span> resources<\/li>\n<li>Community service employment<\/li>\n<li>Prevention of abuse, neglect, and exploitation of older adults<\/li>\n<li>Dementia support<\/li>\n<li>Respite care<\/li>\n<\/ul>\n<p>The <span data-term-id=\"58818358\">OAA<\/span> also authorizes the\u00a0<a href=\"https:\/\/acl.gov\/programs\/Protecting-Rights-and-Preventing-Abuse\/Long-term-Care-Ombudsman-Program\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818336\">Long-Term Care<\/span> (LTC) Ombudsman<\/a>\u00a0program that works to settle difficulties related to the rights, health, safety, and welfare of individuals living in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> such as <span data-term-id=\"58818361\">nursing homes<\/span>, board and care homes, and <span data-term-id=\"58818356\">assisted living<\/span> facilities. Under the <span data-term-id=\"58818358\">OAA<\/span>, each state must have its own dedicated LTC Ombudsman program to address complaints and advocate for advancements across <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span>. You can\u00a0<a href=\"https:\/\/theconsumervoice.org\/get_help\" target=\"_blank\" rel=\"noopener\">find your state\u2019s LTC Ombudsman<\/a>\u00a0through the National LTC Ombudsman Resource Center.<\/p>\n<h3>Greatest Social Need Under the <span data-term-id=\"58818358\">OAA<\/span><\/h3>\n<p>The <span data-term-id=\"58818358\">OAA<\/span> authorizes programs available to every older adult aged 60 and older. But it prioritizes services for those in \u201cgreatest social need.\u201d <span data-term-id=\"58818358\">OAA<\/span> defines\u00a0<a href=\"https:\/\/acl.gov\/sites\/default\/files\/about-acl\/2020-04\/Older%20Americans%20Act%20Of%201965%20as%20amended%20by%20Public%20Law%20116-131%20on%203-25-2020.pdf\" target=\"_blank\" rel=\"noopener\">greatest social need<\/a>\u00a0as need caused by:<\/p>\n<ul>\n<li>Living below the poverty line,<\/li>\n<li>Physical or mental disabilities, or<\/li>\n<li>Cultural, social, or geographical isolation (includes isolation due to language, race, or ethnicity).<\/li>\n<\/ul>\n<p>Recent federal legislative efforts to incorporate <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> as a greatest social need group within the <span data-term-id=\"58818358\">OAA<\/span> include the:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.congress.gov\/bill\/116th-congress\/senate-bill\/1159?q=%7B%22search%22%3A%5B%22LGBT+AGING%22%5D%7D&amp;s=6&amp;r=18\" target=\"_blank\" rel=\"noopener\">Inclusive Aging Act<\/a>,<\/li>\n<li><a href=\"https:\/\/www.congress.gov\/bill\/116th-congress\/house-bill\/1777?q=%7B%22search%22%3A%22LGBT+elder%22%7D&amp;s=8&amp;r=4\" target=\"_blank\" rel=\"noopener\">Ruthie and Connie <span data-term-id=\"58818353\">LGBT Elder<\/span> Americans Act<\/a>, and<\/li>\n<li><a href=\"https:\/\/www.congress.gov\/bill\/117th-congress\/house-bill\/9142\/text?s=4&amp;r=1&amp;q=%7B%22search%22%3A%5B%22ELDER+PRIDE+ACT%22%5D%7D\" target=\"_blank\" rel=\"noopener\">Elder Pride Act<\/a>.<\/li>\n<\/ul>\n<p><span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> were not officially included as a greatest social need group in the Congress\u2019 2020 reauthorization of the <span data-term-id=\"58818358\">OAA<\/span>. However, the\u00a0<a href=\"https:\/\/acl.gov\/news-and-events\/acl-blog\/acl-proud-serve-and-support-lgbtq-older-adults#:~:text=For%20more%20than%20fifteen%20years%2C%20ACL%20has%20stated,Older%20Americans%20Act%20definition%20of%20%E2%80%9Cgreatest%20social%20need.%E2%80%9D\" target=\"_blank\" rel=\"noopener\">Administration for <span data-term-id=\"58818390\">Community Living<\/span><\/a>\u00a0(<span data-term-id=\"58818391\">ACL<\/span>), which\u00a0oversees the AoA, acknowledges that <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> meet the criteria:<\/p>\n<p>\u201cIsolation due to <span data-term-id=\"58818332\">sexual orientation<\/span> or <span data-term-id=\"58818329\">gender identity<\/span> may restrict a person\u2019s ability to perform normal daily tasks or live independently, and therefore, <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> should be targeted for services and supports because they meet the <span data-term-id=\"58818339\">Older Americans Act<\/span> definition of greatest social need.\u201d<\/p>\n<p><span data-term-id=\"58818391\">ACL<\/span> supports the\u00a0<a href=\"https:\/\/lgbtagingcenter.org\/\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818382\">National Resource Center<\/span> on <span data-term-id=\"58818327\">LGBTQ<\/span>+ Aging<\/a>\u00a0(the Center), the first <span data-term-id=\"58818382\">national resource center<\/span> for <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span>, their families, and <span data-term-id=\"58818334\">caregivers<\/span>. The Center is operated by SAGE (Services and <span data-term-id=\"58818341\">Advocacy<\/span> for GLBT Elders), a national non-profit organization working on behalf of <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> since 1978.<\/p>\n<p>Thanks in large part to the efforts of SAGE, <span data-term-id=\"58818327\">LGBTQ<\/span>+ activists, and allies, each SUA and AAA receiving funding under\u00a0<a href=\"https:\/\/www.sageusa.org\/wp-content\/uploads\/2022\/05\/new-older-americans-act-acl-guidelines-sua.pdf\" target=\"_blank\" rel=\"noopener\">Title IV of the <span data-term-id=\"58818358\">OAA<\/span><\/a>\u00a0must:<\/p>\n<ul>\n<li>Direct outreach efforts towards <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span>,<\/li>\n<li>Collect and report data on the needs of <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span>, and<\/li>\n<li>Collect and report data on whether those needs are being met.<\/li>\n<\/ul>\n<p>The <span data-term-id=\"58818339\">Older Americans Act<\/span> was last reauthorized in 2024.<\/p>\n<h3>Get Involved: <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ Older Adult<\/span> <span data-term-id=\"58818341\">Advocacy<\/span><\/h3>\n<p>SAGE continues its work with states and municipalities to designate <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> as a greatest social needs population at the local level. If you are interested in learning more and getting involved in these efforts, check out the\u00a0<a href=\"https:\/\/www.sageusa.org\/sage-action-alerts\/\" target=\"_blank\" rel=\"noopener\">SAGE Action Squad<\/a>.<\/p>\n<p>You and your <span data-term-id=\"58818334\">caregiver(s<\/span>) can also volunteer with your\u00a0local Aging Advisory Council, where you can actively participate in developing your AAA\u2019s Area Plans on Aging. You can search for your local advisory council using the\u00a0<a href=\"https:\/\/eldercare.acl.gov\/home\" target=\"_blank\" rel=\"noopener\">Elder Care locator<\/a>\u00a0or by contacting the\u00a0Department of Elder Affairs\u00a0in your state.<\/p>\n<h2><span data-term-id=\"58818361\">Nursing Home<\/span> Reform Act (NHRA)<\/h2>\n<p>Congress passed the\u00a0<a href=\"https:\/\/www.findlaw.com\/injury\/torts-and-personal-injuries\/nursing-home-reform-act.html#:~:text=The%20NHRA%20is%20a%20federal%20law.%20Compliance%20with,funding%20are%20substantially%20compliant%20with%20the%20Act%27s%20standards.\"><span data-term-id=\"58818361\">Nursing Home<\/span> Reform Act (NHRA)<\/a>\u00a0in 1987. The Act was intended to guarantee older adults dignity, privacy, autonomy, and freedom from <a href=\"https:\/\/www.findlaw.com\/injury\/torts-and-personal-injuries\/nursing-home-abuse-claims.html\">neglect and abuse<\/a>\u00a0in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> (i.e., <span data-term-id=\"58818361\">nursing homes<\/span>) that accept <span data-term-id=\"58818385\">federal funds<\/span>.<\/p>\n<p>Today,\u00a0nearly all <span data-term-id=\"58818361\">nursing homes<\/span> receive <span data-term-id=\"58818385\">federal funds<\/span>\u00a0in the form of <a href=\"https:\/\/www.findlaw.com\/healthcare\/medicare-medicaid.html\"><span data-term-id=\"58818352\">Medicare<\/span> and\/or Medicaid<\/a> dollars. Some states have incorporated NHRA\u2019s requirements into their laws regulating <span data-term-id=\"58818361\">nursing homes<\/span>. In those states, all<em>\u00a0<\/em><span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> must comply with NHRA standards, not only those seeking federal dollars.<\/p>\n<h3>Your NHRA Rights as a <span data-term-id=\"58818361\">Nursing Home<\/span> Resident<\/h3>\n<p>As a <span data-term-id=\"58818361\">nursing home<\/span> resident, you have certain rights under\u00a0<a href=\"https:\/\/www.findlaw.com\/injury\/torts-and-personal-injuries\/legal-rights-of-nursing-home-residents.html\">federal and <span data-term-id=\"58818369\">state law<\/span><\/a>\u00a0to obtain the dignified care, assistance, and essential services you deserve. Before you are admitted, your <span data-term-id=\"58818361\">nursing home<\/span> must inform you of your rights in writing and in a language you understand. You, in turn, must provide written acknowledgment that you received the information.<\/p>\n<p>At the federal level, NHRA sets the\u00a0<a href=\"https:\/\/downloads.cms.gov\/medicare\/your_resident_rights_and_protections_section.pdf\" target=\"_blank\" rel=\"noopener\">minimum standard for your rights<\/a>\u00a0as a <span data-term-id=\"58818361\">nursing home<\/span> resident in a <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facility<\/span> that receives any amount of <span data-term-id=\"58818352\">Medicare<\/span>\/Medicaid funds. Among other matters, you have the right to:<\/p>\n<ul>\n<li>Dignified and respectful treatment<\/li>\n<li>Freedom from abuse and neglect<\/li>\n<li>Make informed medical decisions and receive proper <span data-term-id=\"58818363\">medical care<\/span><\/li>\n<li>Avoid physical and chemical restraints<\/li>\n<li>Participate in resident groups, activities, and programs<\/li>\n<li>Manage your own money (or choose someone you trust to do so for you)<\/li>\n<li>Obtain suitable privacy, property, and living arrangements<\/li>\n<li>Spend private time with your visitors<\/li>\n<li>Have your doctor and legal representative notified during critical events<\/li>\n<li>Access services (e.g., counseling and legal aid)<\/li>\n<li>Leave the <span data-term-id=\"58818361\">nursing home<\/span><\/li>\n<li>Maintain protection against unfair transfer or discharge<\/li>\n<li>Involve your <a href=\"https:\/\/www.findlaw.com\/lgbtq-law\/important-legal-documents-for-lgbtq-couples.html\">unmarried partner and chosen family<\/a> in your care<\/li>\n<\/ul>\n<p>Additionally, the law provides that <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> that receive any amount of <span data-term-id=\"58818385\">federal funds<\/span> must comply with federal <span data-term-id=\"58818350\">civil rights<\/span> protections for both prospective and current residents. Put another way, it is unlawful for a <span data-term-id=\"58818361\">nursing home<\/span> that receives Medicaid\/<span data-term-id=\"58818352\">Medicare<\/span> funds to discriminate against you because of your race, color, national origin, age, disability, or sex.<\/p>\n<h3>The Affordable Care Act and <span data-term-id=\"58818374\">SOGI<\/span> Discrimination<\/h3>\n<p>Since the passage of the\u00a0<a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/obamacare-basics-understanding-the-affordable-care-act.html\">Patient Protection and Affordable Care Act<\/a>\u00a0(ACA), debate rages on as to whether <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span> (<span data-term-id=\"58818374\">SOGI<\/span>) should be included in the ACA\u2019s protection from discrimination \u201con the basis of sex.\u201d<\/p>\n<p>The\u00a0<a href=\"https:\/\/www.federalregister.gov\/documents\/2020\/06\/19\/2020-11758\/nondiscrimination-in-health-and-health-education-programs-or-activities-delegation-of-authority\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818375\">Nondiscrimination<\/span> in Health Programs and Activities<\/a>\u00a0rule (85 FR 37160, NHPA, \u201c2020 Rule\u201d) set by the U.S. <span data-term-id=\"58818387\">Department of Health and Human Services<\/span> (HHS), rescinded a previous\u00a02016 Rule\u00a0which included <span data-term-id=\"58818329\">gender identity<\/span> as a protected class in accordance with\u00a0<a href=\"https:\/\/www.findlaw.com\/education\/discrimination-harassment-at-school\/title-ix-protections-for-transgender-students.html\">Title IX<\/a>.<\/p>\n<p>In 2021, President Joe Biden released an\u00a0<span data-term-id=\"58818386\">Executive Order<\/span>\u00a0directing all federal agencies (as defined under\u00a0<a href=\"https:\/\/codes.findlaw.com\/us\/title-44-public-printing-and-documents\/44-usc-sect-3502.html#:~:text=44%20U.S.C.%20%C2%A7%203502%20-%20U.S.%20Code%20-,January%2001%2C%202018%20%7C%20Updated%20by%20FindLaw%20Staff\" target=\"_blank\" rel=\"noopener\">44 U.S.C. 3502(1)<\/a>) to enforce federal prohibitions on sex discrimination on the basis of <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span>. HHS is one of those agencies.<\/p>\n<p>On August 4, 2022, HHS issued its latest\u00a0<a href=\"https:\/\/www.federalregister.gov\/documents\/2022\/08\/04\/2022-16217\/nondiscrimination-in-health-programs-and-activities\" target=\"_blank\" rel=\"noopener\">Notice of Proposed <span data-term-id=\"58818392\">Rulemaking<\/span><\/a>\u00a0(87 FR 47824, NPRM), including <span data-term-id=\"58818374\">SOGI<\/span> as protected classes for prohibited sex-based discrimination in health programs or activities receiving any amount of federal dollars. After considering relevant case law and incorporating public comment, HHS will issue its revised Rule. However, until then, the 2020 Rule retains the force of law.<\/p>\n<h3>Gaps in Implementing Federal Laws and Continued Mistreatment<\/h3>\n<p>Broad variance persists in state standards and resources for implementation of federal <span data-term-id=\"58818375\">non-discrimination<\/span> laws at the state and local levels. Wide gaps exist in <span data-term-id=\"58818348\">service <\/span><span data-term-id=\"58818331\">provider<\/span> education and <span data-term-id=\"58818347\">cultural <\/span><span data-term-id=\"58818394\">competency<\/span><span data-term-id=\"58818394\"> training<\/span> focused on <span data-term-id=\"58818335\">LGBTQ<\/span><span data-term-id=\"58818335\">+ communities<\/span> despite a growing number of\u00a0free <span data-term-id=\"58818364\">technical assistance<\/span> resources.<\/p>\n<p>Institutional shortfalls, combined with long-held prejudice and misinformation about <a href=\"https:\/\/www.findlaw.com\/lgbtq-law.html\"><span data-term-id=\"58818335\">LGBTQ<\/span><span data-term-id=\"58818335\">+ communities<\/span><\/a>, contribute to intolerance, abuse, and neglect of <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> and other <span data-term-id=\"58818328\">healthcare<\/span> settings.<\/p>\n<p>For example, one\u00a0<a href=\"https:\/\/www.sageusa.org\/resource-posts\/understanding-issues-facing-lgbt-older-adults\/\" target=\"_blank\" rel=\"noopener\">study of <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> living in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span><\/a>\u00a0uncovered 853 occurrences of mistreatment related to <span data-term-id=\"58818332\">sexual orientation<\/span> and\/or <span data-term-id=\"58818329\">gender identity<\/span>, including:<\/p>\n<ul>\n<li>Verbal or physical harassment from fellow residents (23%)<\/li>\n<li>Verbal or physical harassment from staff (14%)<\/li>\n<li>Rejecting durable medical power of attorney presented by spouse\/partner (11%)<\/li>\n<li>Restricting personal visits (11%)<\/li>\n<li>Misgendering patients (9%)<\/li>\n<li>Refusing to provide basic services or care (e.g., bathing assistance) (6%)<\/li>\n<\/ul>\n<p>Some <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> choose to\u00a0<a href=\"https:\/\/www.pbs.org\/newshour\/nation\/lgbtq-seniors-face-discrimination-long-term-care\" target=\"_blank\" rel=\"noopener\">return to the closet<\/a>\u00a0due to fear of mistreatment in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span>. The\u00a0<a href=\"https:\/\/www.theclowdergroup.com\/gensilent\" target=\"_blank\" rel=\"noopener\">documentary film <em>Gen Silent<\/em><\/a>\u00a0follows the lives of six <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> living in Massachusetts who face the choice of going back into the closet in order to preserve their opportunities for end-of-life care.<\/p>\n<p>Returning to the closet is not an option for everyone. Many\u00a0<span data-term-id=\"58818330\">transgender<\/span> and gender nonconforming (TGNC) older adults fear humiliation and harassment when entering <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span>, especially if they transitioned earlier in life without or with limited medical intervention and their physical anatomy does not match their <span data-term-id=\"58818329\">gender identity<\/span>.\u00a0TGNC older adults are even more vulnerable\u00a0to hostility and mistreatment from <span data-term-id=\"58818328\">healthcare<\/span> personnel than their cisgendered peers in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> and other medical settings.<\/p>\n<h3><span data-term-id=\"58818361\">Nursing Home<\/span> Abuse and Discrimination: Protect Your Rights<\/h3>\n<p>If you believe your rights have been violated at a <span data-term-id=\"58818361\">nursing home<\/span> in any way, contact your state\u2019s <span data-term-id=\"58818336\">Long Term Care<\/span> Ombudsman to\u00a0<a href=\"https:\/\/theconsumervoice.org\/get_help\" target=\"_blank\" rel=\"noopener\">file a complaint<\/a>.<\/p>\n<p>Additionally, if you experience discrimination due to your race, color, national origin, age, disability, or sex (including your <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span>), as a prospective or current <span data-term-id=\"58818361\">nursing home<\/span> resident (or as a patient of any <span data-term-id=\"58818373\">health care<\/span> <span data-term-id=\"58818331\">provider<\/span> that receives <span data-term-id=\"58818385\">federal funds<\/span>),\u00a0<a href=\"https:\/\/www.hhs.gov\/civil-rights\/filing-a-complaint\/complaint-process\/index.html\" target=\"_blank\" rel=\"noopener\">file a written complaint<\/a>\u00a0with the U.S. Department of Health and Hospitals (HHS) Office of <span data-term-id=\"58818350\">Civil Rights<\/span> (OCR). You can file your complaint by U.S. mail, fax, email, or via the\u00a0<a href=\"https:\/\/ocrportal.hhs.gov\/ocr\/smartscreen\/main.jsf\" target=\"_blank\" rel=\"noopener\">OCR online Complaint Portal<\/a>.<\/p>\n<p>You can also reach out to a licensed\u00a0<a href=\"https:\/\/lawyers.findlaw.com\/civil-rights\/?fli=dcta\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818350\">civil rights<\/span> attorney<\/a>\u00a0in your area for advice and assistance.<\/p>\n<h1>Anti-<span data-term-id=\"58818327\">LGBTQ<\/span>+ and <span data-term-id=\"58818374\">SOGI<\/span>-Based Discrimination in <span data-term-id=\"58818328\">Health Care<\/span><\/h1>\n<p><span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> came of age during a time when same-sex attraction and gender variance were classified as severe mental illnesses and grounds for being involuntarily hospitalized. Today, <span data-term-id=\"58818337\">LGBTQ<\/span><span data-term-id=\"58818337\">+ people<\/span> of all ages regularly encounter unaffirming <span data-term-id=\"58818373\">healthcare<\/span> <span data-term-id=\"58818331\">providers<\/span>. For older adults, that includes\u00a0<a href=\"https:\/\/academic.oup.com\/psychsocgerontology\/article\/77\/1\/1\/6314322\" target=\"_blank\" rel=\"noopener\">gerontologists<\/a>\u00a0(doctors who specifically work with elderly patients) and dementia care <span data-term-id=\"58818331\">providers<\/span> who lack the knowledge and <span data-term-id=\"58818347\">cultural competence<\/span> to provide safe, unbiased, and suitable care.<\/p>\n<p><span data-term-id=\"58818330\">Transgender<\/span> and gender non-conforming (TGNC) older adults face\u00a0<a href=\"https:\/\/www.sageusa.org\/wp-content\/uploads\/2018\/08\/lgbt-dementia-issues-brief.pdf\" target=\"_blank\" rel=\"noopener\">distinct barriers accessing <span data-term-id=\"58818328\">healthcare<\/span><\/a>\u00a0services because they often cannot selectively hide their <span data-term-id=\"58818330\">transgender<\/span> status, especially when seeking <span data-term-id=\"58818363\">medical care<\/span> or assistance with tasks like bathing and dressing in hospitals and <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span>. As a result, many TGNC OA avoid <span data-term-id=\"58818373\">healthcare<\/span> <span data-term-id=\"58818331\">providers<\/span> and delay essential <span data-term-id=\"58818363\">medical care<\/span> until they experience a life-threatening crisis.<\/p>\n<h3>Protection Under the Affordable Care Act<\/h3>\n<p>The\u00a0<a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/obamacare-basics-understanding-the-affordable-care-act.html\">Patient Protection and Affordable Care Act<\/a>\u00a0(ACA) refers to a wide-ranging 2010 federal <span data-term-id=\"58818328\">healthcare<\/span> reform law aimed at expanding health insurance coverage and preventative <span data-term-id=\"58818328\">healthcare<\/span> services while at the same time lowering consumer <span data-term-id=\"58818328\">healthcare<\/span> costs. Additionally,\u00a0Section 1557 of the ACA\u00a0(Section 1557) prohibits discrimination on the basis of race, color, national origin, age, disability, or sex in health programs or activities receiving any amount of federal dollars (covered entities).<\/p>\n<p>To identify its grounds for discrimination and enforcement, Section 1557 specifically refers to:<\/p>\n<ul>\n<li>Title VI of the 1964 <span data-term-id=\"58818350\">Civil Rights<\/span> Act (<a href=\"https:\/\/corporate.findlaw.com\/law-library\/epa-using-title-vi-of-civil-rights-act-of-1964.html#WHATIS\" target=\"_blank\" rel=\"noopener\">Title VI<\/a>) (prohibits discrimination based on race, color, or national origin in programs\/activities receiving federal dollars)<\/li>\n<li>Title IX of the 1972 Education Amendments (<a href=\"https:\/\/www.findlaw.com\/education\/discrimination-harassment-at-school\/title-ix-protections-for-transgender-students.html#Definition\">Title IX<\/a>) (prohibits discrimination on the basis of sex in public schools\/education programs\/activities receiving federal dollars)<\/li>\n<li>The Age Discrimination Act of 1975 (<a href=\"https:\/\/www.findlaw.com\/civilrights\/discrimination\/age-discrimination-act-of-1975.html\">Age Act<\/a>) (prohibits aged-based discrimination in programs\/activities receiving federal dollars)<\/li>\n<li>Section 504 of the Rehabilitation Act of 1973 (<a href=\"https:\/\/www.hhs.gov\/sites\/default\/files\/ocr\/civilrights\/resources\/factsheets\/504.pdf#:~:text=Section%20504%20of%20the%20Rehabilitation%20Act%20of%201973,homes%2C%20mental%20health%20centers%20and%20human%20service%20programs.\" target=\"_blank\" rel=\"noopener\">Section 504<\/a>) (prohibits discrimination against qualified individuals with disabilities by employers\/organizations receiving federal dollars)<\/li>\n<\/ul>\n<p>The issue of whether <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span> should be protected under Section 1557 is hotly debated in\u00a0state legislatures\u00a0and\u00a0federal district courts\u00a0across the country. Although the arguments largely center around whether TGNC youth are entitled to <a href=\"https:\/\/www.findlaw.com\/lgbtq-law\/state-laws-on-gender-affirming-care.html\">gender-affirming <span data-term-id=\"58818328\">healthcare<\/span><\/a> and access to gender-affirming in school-based facilities and programs, how these issues are ultimately decided will have a substantial impact on whether <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span> will be protected from discrimination in <span data-term-id=\"58818328\">healthcare<\/span> settings as well.<\/p>\n<h3><span data-term-id=\"58818375\">Nondiscrimination<\/span> in Health Programs and Activities 2016 Rule<\/h3>\n<p>In its\u00a0<a href=\"https:\/\/www.federalregister.gov\/d\/2016-11458\" target=\"_blank\" rel=\"noopener\">2016 Rule<\/a>\u00a0published in the Federal Register, the Obama Administration, via the U.S. <span data-term-id=\"58818387\">Department of Health and Human Services<\/span> (HHS), clarified that Section 1557\u2019s prohibition of discrimination \u201con the basis of sex\u201d included <span data-term-id=\"58818329\">gender identity<\/span> but stopped short of fully including <span data-term-id=\"58818332\">sexual orientation<\/span>.<\/p>\n<p>Relying on the U.S. <span data-term-id=\"58818344\">Supreme Court<\/span>\u2019s 1989 decision in\u00a0<a href=\"https:\/\/www.washingtonpost.com\/history\/2019\/10\/08\/supreme-court-set-rule-lgtbq-rights-work-addressed-gender-discrimination-years-ago\/\" target=\"_blank\" rel=\"noopener\"><em>Price Waterhouse v. Hopkins<\/em><\/a>\u00a0(employer must show that its hiring decisions are not based on sex stereotypes), HHS explained that Section 1557 included <span data-term-id=\"58818332\">sexual orientation<\/span> only where the evidence determined that the discrimination was founded on gender stereotypes.<\/p>\n<h3>Religious Freedom Restoration Act<\/h3>\n<p>The 2016 Rule\u00a0explicitly exempted\u00a0covered entities from conforming with <span data-term-id=\"58818375\">non-discrimination<\/span> regulations that violated federal <span data-term-id=\"58818371\">legal protections<\/span> for \u201creligious freedom and conscience.\u201d Even so, court challenges alleging that Section 1557 violated the\u00a0<a href=\"https:\/\/www.congress.gov\/bill\/103rd-congress\/house-bill\/1308\/text\" target=\"_blank\" rel=\"noopener\">Religious Freedom Restoration Act<\/a>\u00a0(RFRA) were swiftly brought in federal district courts, enjoining (stopping) HHS from interpreting or enforcing Section 1557\u2019s prohibition on <span data-term-id=\"58818329\">gender-identity<\/span>-based discrimination.<\/p>\n<p>Note: some Section 1557 challenges are based on violations of the\u00a0<a href=\"https:\/\/www.law.cornell.edu\/wex\/administrative_procedure_act\" target=\"_blank\" rel=\"noopener\">Administrative Procedure Act<\/a>.<\/p>\n<p>The Religious Freedom Restoration Act prohibits the government from \u201csubstantially burdening a person\u2019s exercise of religion.\u201d Since RFRA was signed into federal law in 1993, several states have passed their own RFRAs, which allow people, churches, non-profit organizations, and sometimes corporations to\u00a0<a href=\"https:\/\/www.lgbtmap.org\/img\/maps\/citations-religious-exemption.pdf\" target=\"_blank\" rel=\"noopener\">request <span data-term-id=\"58818393\">exemptions<\/span> from <span data-term-id=\"58818369\">state laws<\/span> that burden their religious beliefs<\/a>.<\/p>\n<p>Some states have\u00a0RFRAs targeted at <span data-term-id=\"58818373\">healthcare<\/span> <span data-term-id=\"58818331\">providers<\/span>\u00a0and other <span data-term-id=\"58818363\">medical care<\/span> facilities serving the public. These disproportionately affect <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA who seek <span data-term-id=\"58818363\">medical care<\/span> and assistance associated with aging, including <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> like <span data-term-id=\"58818361\">nursing homes<\/span>. The Movement Advancement Project (MAP) maintains interactive maps that show the status of laws affecting <a href=\"https:\/\/www.findlaw.com\/lgbtq-law\/lgbtq-older-adult.html\"><span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adults<\/span><\/a>, including RFRA and <span data-term-id=\"58818328\">health care<\/span>.<\/p>\n<h3><span data-term-id=\"58818375\">Nondiscrimination<\/span> in Health Programs and Activities 2020 Rule<\/h3>\n<p>The <span data-term-id=\"58818381\">Trump Administration<\/span> posted its revised Section 1557 Final Rule (<a href=\"https:\/\/www.federalregister.gov\/documents\/2020\/06\/19\/2020-11758\/nondiscrimination-in-health-and-health-education-programs-or-activities-delegation-of-authority\" target=\"_blank\" rel=\"noopener\">2020 Rule<\/a>) in the Federal Register, rescinding the 2016 Rule\u2019s inclusion of <span data-term-id=\"58818329\">gender identity<\/span> in Section 1557\u2019s definition of \u201con the basis of sex.\u201d As with the opposition to the 2016 Rule, several lawsuits were filed in U.S. District Courts seeking to enjoin (stop) its enforcement.<\/p>\n<h3>The<em>\u00a0Bostock<\/em>\u00a0Impact on Federal <span data-term-id=\"58818375\">Non-Discrimination<\/span> Protections for <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA<\/h3>\n<p>A little over one month after the 2020 Rule, the U.S. <span data-term-id=\"58818344\">Supreme Court<\/span> held in\u00a0<a href=\"https:\/\/supreme.findlaw.com\/supreme-court-insights\/bostock-v--clayton-county-case-summary-.html\" target=\"_blank\" rel=\"noopener\"><em>Bostock v. Clayton County<\/em><\/a>\u00a0that <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span> were included in Title VII of the 1964 <span data-term-id=\"58818350\">Civil Rights<\/span> Act\u2019s prohibition on sex-based employment discrimination.<\/p>\n<p>In response, HHS, this time under the direction of the Biden Administration, issued the\u00a0<a href=\"https:\/\/www.federalregister.gov\/documents\/2021\/05\/25\/2021-10477\/notification-of-interpretation-and-enforcement-of-section-1557-of-the-affordable-care-act-and-title\" target=\"_blank\" rel=\"noopener\"><em>Bostock<\/em>\u00a0Notification<\/a>. This notifcation stated that, effective May 10, 2021, the Office of <span data-term-id=\"58818350\">Civil Rights<\/span> (OCR) would interpret and enforce Section 1557\u2019s prohibition on discrimination on the basis of sex to include discrimination on the basis of <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span>. It cited additional supporting case-law:\u00a0<em>Grimm<\/em>\u00a0(4th Circuit) and\u00a0<em>Adams\u00a0<\/em>(11th Circuit)<\/p>\n<p>As of this writing, at least three court challenges to the Bostock Notification have been filed alleging violations of the RFRA (and the APA) \u2013\u00a0<em>Neese<\/em>\u00a0(5th Circuit),\u00a0<em>Christian Employers Alliance<\/em>\u00a0(D.N.D.), and\u00a0<em>American College of Pediatricians<\/em>\u00a0(6th Circuit).<\/p>\n<p>HHS issued\u00a0additional guidance\u00a0on March 2, 2022, reiterating that Section 1557 forbids <span data-term-id=\"58818329\">gender-identity<\/span>-based discrimination in access to health programs and activities receiving federal dollars. Specifically, HSS said:<\/p>\n<p>\u201cCategorically refusing to provide treatment to an individual based on their <span data-term-id=\"58818329\">gender identity<\/span> is prohibited discrimination. Similarly, federally funded covered entities restricting an individual\u2019s ability to receive medically necessary care, including <span data-term-id=\"58818354\">gender-affirming care<\/span>, from their <span data-term-id=\"58818373\">health care<\/span> <span data-term-id=\"58818331\">provider<\/span> solely on the basis of their sex assigned at birth or <span data-term-id=\"58818329\">gender identity<\/span> likely violates Section 1557.\u201d<\/p>\n<p>On August 4, 2022, HHS issued its current\u00a0<a href=\"https:\/\/www.federalregister.gov\/documents\/2022\/08\/04\/2022-16217\/nondiscrimination-in-health-programs-and-activities#citation-22-p47826:~:text=The%20Department%20also%20proposes%20to%20address%20nondiscrimination%20on%20the%20basis%20of%20sex%2C%20including%20gender%20identity%20and%20sexual%20orientation%2C\" target=\"_blank\" rel=\"noopener\">Notice of Proposed <span data-term-id=\"58818392\">Rulemaking<\/span><\/a>\u00a0( 87 FR 47824, NPRM), reiterating that consistent with the <span data-term-id=\"58818344\">Supreme Court<\/span>\u2019s interpretations of Title VII and Title IX, <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span> are included in prohibited sex-based discrimination in health programs or activities receiving any amount of federal dollars.<\/p>\n<p>Along with other amendments, HHS aims to update <span data-term-id=\"58818375\">nondiscrimination<\/span> regulations for the Centers for <span data-term-id=\"58818352\">Medicare<\/span> &amp; <span data-term-id=\"58818378\">Medicaid Services<\/span> (CMS), Program of All-Inclusive Care for the Elderly (PACE) to clarify that sex-based discrimination includes discrimination based on <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span>. However, until the court challenges are resolved, the 2020 Rule retains the force of law.<\/p>\n<h3>Protection from Discriminatory Health Insurance Practices<\/h3>\n<p><a href=\"https:\/\/federalregister.gov\/documents\/2024\/05\/06\/2024-08711\/nondiscrimination-in-health-programs-and-activities\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818375\">Nondiscrimination<\/span> in Health Programs and Activities<\/a>\u00a0(NHPA) also applies to health insurance issuers that receive <span data-term-id=\"58818385\">federal funds<\/span>. Because health insurance issuers play a significant role in the provision of <span data-term-id=\"58818328\">health care<\/span>, NHPA provides clear <span data-term-id=\"58818375\">nondiscrimination<\/span> standards for the health insurance industry, including protections for <span data-term-id=\"58818374\">SOGI<\/span>.<\/p>\n<p>In the meantime, HSS encourages anyone who experiences discrimination in a <span data-term-id=\"58818328\">healthcare<\/span> setting due to their <span data-term-id=\"58818332\">sexual orientation<\/span> and <span data-term-id=\"58818329\">gender identity<\/span> to\u00a0<a href=\"https:\/\/www.hhs.gov\/civil-rights\/filing-a-complaint\/complaint-process\/index.html\" target=\"_blank\" rel=\"noopener\">file a written complaint<\/a>\u00a0with OCR by U.S. mail, fax, e-mail, or via its\u00a0<a href=\"https:\/\/ocrportal.hhs.gov\/ocr\/smartscreen\/main.jsf\" target=\"_blank\" rel=\"noopener\">OCR online Complaint Portal<\/a>. You can also reach out to a licensed\u00a0<a href=\"https:\/\/lawyers.findlaw.com\/civil-rights\/\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818350\">civil rights<\/span> attorney<\/a>\u00a0in your state for advice and assistance.<\/p>\n<h2>Protecting <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA from Abuse and Exploitation<\/h2>\n<p>As they age and require increased assistance from <a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/lgbtq-health-care-discrimination.html\"><span data-term-id=\"58818328\">healthcare<\/span> and senior services <span data-term-id=\"58818331\">providers<\/span><\/a>, LGBTA+OA face unique safety concerns tied to bias and intolerance of their <span data-term-id=\"58818332\">sexual orientation<\/span> and\/or <span data-term-id=\"58818329\">gender identity<\/span> (<span data-term-id=\"58818374\">SOGI<\/span>), real or perceived.<\/p>\n<h3>Older Adult Abuse<\/h3>\n<p>Older adult abuse, often referred to as\u00a0<a href=\"https:\/\/www.findlaw.com\/elder\/elder-abuse\/elder-abuse-overview.html#Definition\">elder abuse<\/a>, is defined generally as the mistreatment, neglect, or financial exploitation of people age 65 and older. There are\u00a0<a href=\"https:\/\/www.findlaw.com\/elder\/elder-abuse\/types-of-elder-abuse.html\">many forms<\/a>\u00a0of older adult abuse, including:<\/p>\n<ul>\n<li>Physical abuse<\/li>\n<li>Family violence<\/li>\n<li>Intimate partner violence<\/li>\n<li>Domestic violence<\/li>\n<li>Sexual abuse<\/li>\n<li>Emotional abuse<\/li>\n<li>Psychological abuse<\/li>\n<li>Abandonment<\/li>\n<li>Financial exploitation<\/li>\n<li>Neglect<\/li>\n<li>Self-neglect<\/li>\n<\/ul>\n<p>While research on older adult abuse has increased in recent years, there is still a\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7288570\/\" target=\"_blank\" rel=\"noopener\">wide knowledge gap<\/a>\u00a0about how <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA experience abuse and access relief services.<\/p>\n<p>A growing body of\u00a0<a href=\"https:\/\/academic.oup.com\/gerontologist\/article\/57\/suppl_1\/S1\/2904680\" target=\"_blank\" rel=\"noopener\">academic research<\/a>\u00a0confirms that <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA have experienced lifelong anti-<span data-term-id=\"58818327\">LGBTQ<\/span>+ bias and discrimination, leading to <span data-term-id=\"58818355\">higher rates<\/span> of <span data-term-id=\"58818338\">social isolation<\/span> and internalized homophobia and\/or transphobia later in life. They are also likely to:<\/p>\n<ul>\n<li>Be survivors of sexual and\/or intimate partner violence<\/li>\n<li>Heavily rely on chosen family (many who are also <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA) for care and support<\/li>\n<li>Be <a href=\"https:\/\/www.findlaw.com\/lgbtq-law\/legal-protections-for-people-living-with-hiv.html\">living with HIV<\/a><\/li>\n<\/ul>\n<p>All of the above factors place <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA at a\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7288570\/#!po=82.0000\" target=\"_blank\" rel=\"noopener\">higher risk for mistreatment<\/a>\u00a0and financial exploitation as they grow older and their health needs increase. When partners and chosen family become ill or pass away, <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA become more reliant on health and aging <span data-term-id=\"58818331\">providers<\/span> who are often not educated or trained on how to provide\u00a0<a href=\"https:\/\/www.aarp.org\/livable-communities\/housing\/info-2016\/SAGECare-cultural-competency-training.html\" target=\"_blank\" rel=\"noopener\">culturally sensitive and dignified care<\/a>\u00a0to <span data-term-id=\"58818327\">LGBTQ<\/span>+ patients.<\/p>\n<p>The\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23034470\/\" target=\"_blank\" rel=\"noopener\">Aging With Pride<\/a>\u00a0study, funded through the National Institutes of Health\u2019s (NIH)\u00a0<a href=\"https:\/\/www.nia.nih.gov\/health\/sexuality-and-intimacy-older-adults\" target=\"_blank\" rel=\"noopener\">National Institute on Aging<\/a>\u00a0(NIA), generates statistics based on long-term surveys of 2,560 <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA between ages 50-94. In that study:<\/p>\n<ul>\n<li>68% reported verbal harassment<\/li>\n<li>43% reported threats of violence<\/li>\n<li><span data-term-id=\"58818351\">Transgender<\/span><span data-term-id=\"58818351\"> older adults<\/span> reported\u00a0<a href=\"https:\/\/www.lgbtagingcenter.org\/resources\/pdfs\/Attachment%20C%20NCEA_RB_LGBT2021_508web%20(002)1.pdf\" target=\"_blank\" rel=\"noopener\">higher levels<\/a>\u00a0of discrimination and harassment than cisgender LGB older adults.<\/li>\n<\/ul>\n<p>Prejudice and hostility in <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facilities<\/span> create stressful and undignified environments for <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA.\u00a0Numerous reports\u00a0document anti-<span data-term-id=\"58818327\">LGBTQ<\/span>+ bias and abuse by <span data-term-id=\"58818361\">nursing home<\/span> staff:<\/p>\n<ul>\n<li>Denying phone\u00a0calls or visits from partners and chosen family,<\/li>\n<li>Isolating <span data-term-id=\"58818327\">LGBTQ<\/span>+ OA<\/li>\n<li>Preventing partners and chosen family from participating in medical decision-making (even with Advance Directives and medical POAs in place)<\/li>\n<li>Refusing to allow <span data-term-id=\"58818370\">same-sex couples<\/span> to share rooms, and<\/li>\n<li>Blocking gender-affirming accommodations for <span data-term-id=\"58818351\">transgender<\/span><span data-term-id=\"58818351\"> older adults<\/span>.<\/li>\n<\/ul>\n<p>If you believe that you or another older adult in your life is suffering abuse in a <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facility<\/span> or <span data-term-id=\"58818361\">nursing home<\/span>, contact your state\u2019s\u00a0<a href=\"https:\/\/theconsumervoice.org\/get_help\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818336\">Long-Term Care<\/span> Ombudsman<\/a>\u00a0and\u00a0<a href=\"https:\/\/ncea.acl.gov\/Resources\/State.aspx\" target=\"_blank\" rel=\"noopener\">Adult Protective Services<\/a>.<\/p>\n<h3>Elder Justice Act<\/h3>\n<p>The federal government\u2019s first concentrated effort to address older adult abuse, financial exploitation, and neglect was the\u00a0<a href=\"https:\/\/www.findlaw.com\/elder\/elder-abuse\/what-is-the-elder-justice-act.html\">Elder Justice Act<\/a>\u00a0(EJA), which Congress passed as part of the Affordable Care Act (ACA) in 2010. The EJA committed federal public health and <span data-term-id=\"58818345\">social service<\/span> resources to support prevention, detection, and treatment of older adult abuse. It did this primarily through:<\/p>\n<ul>\n<li>Support\u00a0(via grants) for Adult Protective Services (APS) programs across the country<\/li>\n<li>Creation of the\u00a0<a href=\"https:\/\/acl.gov\/programs\/elder-justice\/elder-justice-coordinating-council-ejcc\" target=\"_blank\" rel=\"noopener\">Elder Justice Coordinating Council<\/a><\/li>\n<li>Development of the\u00a0<a href=\"https:\/\/acl.gov\/programs\/elder-justice\/national-adult-maltreatment-reporting-system-namrs\" target=\"_blank\" rel=\"noopener\">National Adult Maltreatment Reporting System<\/a>\u00a0(NAMRS)<\/li>\n<\/ul>\n<h3>Elder Abuse Prevention and Prosecution Act<\/h3>\n<p>Congress passed the\u00a0<a href=\"https:\/\/www.congress.gov\/bill\/115th-congress\/senate-bill\/178\" target=\"_blank\" rel=\"noopener\">Elder Abuse Prevention and Prosecution Act<\/a>\u00a0(EAPPA) in 2017 to set standards for the\u00a0<a href=\"https:\/\/www.justice.gov\/elderjustice\" target=\"_blank\" rel=\"noopener\">Department of Justice<\/a>\u00a0(DOJ) criminal investigation and prosecution of older adult abuse, including\u00a0<a href=\"https:\/\/www.justice.gov\/elderjustice\/financial-exploitation\" target=\"_blank\" rel=\"noopener\">financial exploitation<\/a>\u00a0through email marketing. The law\u2019s requirements include:<\/p>\n<ul>\n<li>Appointing an Elder Justice Coordinator (EJC) for the entire DOJ to improve the department\u2019s understanding, prevention, and detection of older adult abuse and exploitation<\/li>\n<li>Appointing at least one federal\u00a0<a href=\"https:\/\/www.justice.gov\/elderjustice\/prosecutors-0\" target=\"_blank\" rel=\"noopener\">prosecutor<\/a>\u00a0in each federal judicial district to serve as an EJC and prosecute abuse and exploitation cases<\/li>\n<li>Requiring the Federal Trade Commission (FTC) to designate an EJC within its Bureau of Consumer Protection<\/li>\n<li>Training for\u00a0<a href=\"https:\/\/www.fbi.gov\/news\/stories\/elder-fraud-charges-announced\" target=\"_blank\" rel=\"noopener\">FBI<\/a>\u00a0agents investigating older adult abuse and exploitation<\/li>\n<li>Aiding state and local agencies in investigating, prosecuting, and preventing older adult abuse<\/li>\n<li>Encouraging states to share resources to prevent older adult abuse and exploitation<\/li>\n<li>Promoting <span data-term-id=\"58818376\">data collection<\/span> by DOJ as well as use of <span data-term-id=\"58818387\">Department of Health and Human Services<\/span> data from APS investigations (e.g., NAMRS)<\/li>\n<\/ul>\n<p>The overall goal of EAPPA is to expand the federal response to older adult abuse and financial exploitation by promoting the investigation and criminal prosecution of persons who target vulnerable older adults, as well as improving <span data-term-id=\"58818376\">data collection<\/span> and abuse prevention efforts at state and local levels.<\/p>\n<h3>Adult Protective Services<\/h3>\n<p><a href=\"https:\/\/www.findlaw.com\/elder\/elder-abuse\/adult-protective-services-what-you-need-to-know.html\">Adult Protective Services<\/a>\u00a0(APS) programs serve older adults (and adults of all ages with disabilities) in each state and U.S. territory. Typical APS services include:<\/p>\n<ul>\n<li>Managing an abuse reporting system<\/li>\n<li>Investigating abuse\/exploitation reports<\/li>\n<li>Providing counseling and other <span data-term-id=\"58818345\">social services<\/span> to abuse survivors<\/li>\n<li>Ongoing monitoring and risk assessment<\/li>\n<\/ul>\n<p>Most APS programs developed before the EJA was enacted. APS and elder abuse laws vary across states and definitions of what constitutes abuse vary, as well as:<\/p>\n<ul>\n<li>Types of abuse\/exploitation covered<\/li>\n<li>Classification of abuse (<a href=\"https:\/\/www.findlaw.com\/criminal\/criminal-law-basics\/the-differences-between-a-criminal-case-and-a-civil-case.html\">criminal or civil<\/a>)<\/li>\n<li>Who is legally required to report abuse (mandatory reporters)<\/li>\n<li>Who is eligible for APS assistance<\/li>\n<li>Investigative procedures<\/li>\n<li>Remedies for abuse<\/li>\n<\/ul>\n<p>If you believe that you or another older adult in your life is being mistreated,\u00a0<a href=\"https:\/\/ncea.acl.gov\/Suspect-Abuse\/Reporting-Abuse.aspx\" target=\"_blank\" rel=\"noopener\">report it to the APS<\/a>\u00a0as soon as possible. If the mistreatment is happening in a <span data-term-id=\"58818359\">long-term care<\/span><span data-term-id=\"58818359\"> facility<\/span> or <span data-term-id=\"58818361\">nursing home<\/span>, contact your state\u2019s\u00a0<a href=\"https:\/\/theconsumervoice.org\/get_help\" target=\"_blank\" rel=\"noopener\"><span data-term-id=\"58818336\">Long-Term Care<\/span> Ombudsman<\/a>.<\/p>\n<h3>How To Report Abuse and Financial Exploitation<\/h3>\n<p>The National Center on Elder Abuse hosts an\u00a0<a href=\"https:\/\/ncea.acl.gov\/Resources\/State.aspx\" target=\"_blank\" rel=\"noopener\">online directory<\/a>\u00a0of APS offices in each state and territory. You can also use the\u00a0<a href=\"https:\/\/eldercare.acl.gov\/Public\/Index.aspx\" target=\"_blank\" rel=\"noopener\">Eldercare Locator<\/a>\u00a0online or call 1 (800) 677-1116. Other resources include:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.napsa-now.org\/help-in-your-area\" target=\"_blank\" rel=\"noopener\">National Adult Protective Services Association<\/a>\u00a0APS online directory<\/li>\n<li><a href=\"https:\/\/www.thehotline.org\/\" target=\"_blank\" rel=\"noopener\">National Domestic Violence Hotline<\/a>\u00a0or call 1 (800) 799-SAFE (7233)<\/li>\n<li><a href=\"https:\/\/ovc.ojp.gov\/program\/stop-elder-fraud\/providing-help-restoring-hope\" target=\"_blank\" rel=\"noopener\">National Elder Fraud Hotline<\/a>\u00a0or call 1 (833) 372-8311<\/li>\n<li><a href=\"https:\/\/reportfraud.ftc.gov\/#\/\" target=\"_blank\" rel=\"noopener\">Federal Trade Commission<\/a>\u00a0(FTC) or call 1 (877) 382-4357<\/li>\n<li><a href=\"https:\/\/www.ic3.gov\/\" target=\"_blank\" rel=\"noopener\">Federal Bureau of Investigation<\/a>\u00a0(FBI) Internet Crime Complaint Center<\/li>\n<\/ul>\n<p>If you or someone you know is in immediate, life-threatening danger,\u00a0call 911\u00a0right away.<\/p>\n<h2>Get Legal Help With an <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ Older Adult<\/span> Issue<\/h2>\n<p>If you or an <span data-term-id=\"58818333\">LGBTQ<\/span><span data-term-id=\"58818333\">+ older adult<\/span> in your life is facing discrimination, mistreatment in a long\u2011term care facility, or barriers to accessing <span data-term-id=\"58818328\">healthcare<\/span>, legal help is available. A lawyer can explain your options, assist with complaints to state or federal agencies, and advocate for your safety and rights.<\/p>\n<p>FindLaw\u2019s <a class=\"in-cell-link\" href=\"https:\/\/lawyers.findlaw.com\/civil-rights\/\" target=\"_blank\" rel=\"noopener\">directory of <span data-term-id=\"58818350\">civil rights<\/span> attorneys<\/a> can get you started. Because <span data-term-id=\"58818369\">state laws<\/span> are relevant, your attorney should be licensed in your state. Enter your city or ZIP code for a list of qualified legal professionals in your area. Your search results will also show important details about prospective lawyers, including ratings and whether they offer free consultations.<\/p>\n\n\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <g id=\"thumbs-up\" 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<fieldset>\n                    <legend class=\"was-this-helpful__feedback-form-title\" tabindex=\"0\">Why was this not helpful?<\/legend>\n                    <div class=\"was-this-helpful__choose-option-message\" role=\"status\">\n                        <p class=\"was-this-helpful__choose-option-message-text\"><\/p>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--missing-info\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Missing Information\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--missing-info\"\n                        >Missing the information I need<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--complicated\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Too complicated\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--complicated\"\n                        >Too complicated \/ too many steps<\/label>\n                    <\/div>\n                    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class=\"fl-list-item-link\" href=\"https:\/\/www.findlaw.com\/lgbtq-law\/lgbtq-older-adult\/lgbtq-living-with-alzheimer-s.html\">\n                        LGBTQ+ Older Adults: Living With Alzheimer&#8217;s and Dementia\n                    <\/a>\n                <\/li>\n                                                <li class=\"fl-list-item fl-flex\">\n                    <i class=\"fa fa-angle-right medium\" aria-hidden=\"true\"><\/i>\n                    <a class=\"fl-list-item-link\" href=\"https:\/\/www.findlaw.com\/lgbtq-law\/housing-discrimination-protections-for-lgbtq-renters.html\">\n                        Housing Protections for LGBTQ+ Renters\n                    <\/a>\n                <\/li>\n                                                <li class=\"fl-list-item fl-flex\">\n                    <i class=\"fa fa-angle-right medium\" aria-hidden=\"true\"><\/i>\n                    <a class=\"fl-list-item-link\" href=\"https:\/\/www.findlaw.com\/lgbtq-law\/lgbtq-older-adult\/advance-planning-advocacy-tools-and-estate-planning-basics-for-l.html\">\n                        Advance Planning Tools for LGBTQ+ Older Adults\n                    <\/a>\n                <\/li>\n                        <\/ul>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>FindLaw discusses laws impacting LGBTQ+ older adults and their ability to age with dignity, access affirming healthcare and senior services, and prevent elder abuse.<\/p>\n","protected":false},"author":41135,"featured_media":0,"parent":354802,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"app\/Http\/Controllers\/Templates\/ArticleWithBreadcrumbsController.php","meta":{"_acf_changed":false,"_stopmodifiedupdate":true,"_modified_date":"","_autodraft_ids":[],"_cloudinary_featured_overwrite":false,"_sb_is_suggestion_mode":false,"_sb_show_suggestion_boards":false,"_sb_show_comment_boards":false,"_sb_suggestion_history":"","_sb_update_block_changes":"","_is_real_time_mode":false,"_realtime_collaborators":"","footnotes":"","cf_checklist_status":["SEO Title Length","Alt Text for All Images","Category Assigned","External 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