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Mental Health Counseling of LGBT Elders

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Handbook of LGBT Elders

Abstract

This chapter discusses the complexity of mental health among older lesbian, gay, bisexual, and transgender (LGBT) individuals. Mental health issues for LGBT older adults can potentially involve the long-term impact of stigma and discrimination, and the changing view of sexual orientation and gender identity as pathology to non-pathology. This chapter will address both the risk and protective factors that are relevant to mental health counseling of LGBT older individuals, will discuss the history of research and practice related to mental health, and will provide recommendations for creating culturally competent evidence-based training programs for mental health service providers working with LGBT older adults. As well, the chapter provides an overview of specific issues relevant to the LGBT community including depression and anxiety and body image concerns. Interdisciplinary perspectives to service delivery for LGBT older adults are highlighted.

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Author information

Authors and Affiliations

  1. Virginia Commonwealth University, Richmond, USA

    Tracey L. Gendron, Terrie Pendleton & John T. White

Authors
  1. Tracey L. Gendron
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  2. Terrie Pendleton
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  3. John T. White
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Corresponding author

Correspondence to Tracey L. Gendron .

Editor information

Editors and Affiliations

  1. University of Kentucky, Lexington, Kentucky, USA

    Debra A. Harley

  2. University of Kentucky, Lexington, Kentucky, USA

    Pamela B. Teaster

Appendices

Learning Exercises for Knowledge Gain

  1. 1.

    According to minority stress theory, LGBT individuals face disparities in health outcomes, which are explained by stressors induced by discrimination and victimization (Meyer 2003). How does minority stress theory specifically relate to an LGBT older adult? How does minority stress theory relate to LGBT older adults seeking mental health services?

  2. 2.

    Identify 5 barriers for LGBT older adults that may prevent them from accessing mental health services.

  3. 3.

    Describe 5 essential components of culturally competent training for mental health providers working with older LGBT clients.

  4. 4.

    Why is body image and eating particularly prevalent among gay men? How does the view of aging within the LGBT community impact body image and eating disorders?

Multiple-Choice Questions

  1. 1.

    Which of the following is a cause of depression and anxiety in LGBT elders?

    1. (a)

      Low self-esteem

    2. (b)

      Isolation

    3. (c)

      Denial of true self

    4. (d)

      All of the above

  2. 2.

    George is a 75-year-old gay man who never came out with his family and friends. Which of the following would he likely be at an increased risk for?

    1. (a)

      GAD

    2. (b)

      Higher blood pressure

    3. (c)

      High cholesterol

    4. (d)

      A personality disorder

  3. 3.

    A welcoming environment would include all of the following except

    1. (a)

      An inclusive gender section (i.e., male, female, transgender)

    2. (b)

      A non-discriminatory policy

    3. (c)

      Male- and female-only restrooms

    4. (d)

      Courteous, respectful staff

  4. 4.

    Which of the following is a barrier to service utilization?

    1. (a)

      Open and honest communication

    2. (b)

      Fear of discrimination

    3. (c)

      Professional’s knowledge of the LGBT community

    4. (d)

      Nonjudgmental, safe space that includes messages of inclusiveness

  5. 5.

    Which of the following is true regarding counselor competency?

    1. (a)

      It requires understanding of the sexual minority experience

    2. (b)

      Becoming a culturally competent mental health provider requires taking a psychoanalytic approach

    3. (c)

      Training and education on LGBT aging issues is important for promoting counselor competency

    4. (d)

      Both A & C

  6. 6.

    Counselor competency in LGBT elder issues requires that the counselor understands

    1. (a)

      Social and historical context presented by the client

    2. (b)

      Knowledge of the client’s views on fashion

    3. (c)

      Understanding of the intersectionality between LGBT issues, race, ethnicity, and aging.

    4. (d)

      Both A & D

  7. 7.

    Transphobia is

    1. (a)

      A lack of understanding of the psychology of the transgender individual

    2. (b)

      A feeling of unease toward those who identify as transgender

    3. (c)

      A clinical terminology no longer used to describe men who dress as women

    4. (d)

      The fear of people who are bisexual

  8. 8.

    Transgender individuals often experience discrimination in the form of

    1. (a)

      Employment discrimination

    2. (b)

      Physical abuse

    3. (c)

      Verbal harassment

    4. (d)

      All of the above

  9. 9.

    What are the factors that can negatively impact the mental health of LGBT older adults?

    1. (a)

      Self-imposed or societal isolation

    2. (b)

      A pattern of out-of-control sexual behavior

    3. (c)

      Ageism

    4. (d)

      Both A & C

  10. 10.

    Research has demonstrated that good mental health outcomes were indicated for LGBT individuals

    1. (a)

      Who had lifetime partners

    2. (b)

      Had an active religious affiliation

    3. (c)

      Who were out about their sexual orientation or gender identify

    4. (d)

      Both A & C

Key

  1. 1.

    (D)

  2. 2.

    (A)

  3. 3.

    (C)

  4. 4.

    (B)

  5. 5.

    (D)

  6. 6.

    (D)

  7. 7.

    (B)

  8. 8.

    (D)

  9. 9.

    (D)

  10. 10.

    (C)

Field-Based Experiential Assignments

  1. 1.

    Interview a mental health practitioner that specializes in working with LGBT clients. What did you learn about addressing the psychological/mental health needs of LGBT elders? What advice were you given about how to be a culturally competent provider?

  2. 2.

    Attend training on a mental health topic for LGBT older adults. The training can be facilitated by a local LGBT organization or a national LGBT organization such as Services and Advocacy with Gay, Lesbian, Bisexual and Transgender Elders (SAGE) or another institute providing education and training to the community.

  3. 3.

    Volunteer with the local LGBT Community Center in your area to become more familiar with LGBT community needs and resources and specifically to investigate the community needs of the aging LGBT population.

Resources

  1. 1.

    National Alliance on Mental Illness. http://www.nami.org/Content/NavigationMenu/Find_Support/Multicultural_Support/Resources/GLBT_Resources.htm

  2. 2.

    LGBT Aging Resources Issues Clearinghouse (part of the American Society on Aging) http://asaging.org/lgbt_aging_resources_clearinghouse

  3. 3.

    National Resource Center on LGBT aging http://www.lgbtagingcenter.org/

  4. 4.

    The Pride Institute http://pride-institute.com/

  5. 5.

    National LGBT Health Education Center at the Fenway Institute www.lgbthealtheducation.org

  6. 6.

    Project HEALTH—A program of Lyon-Martin Health Services and the Transgender Law Center www.project-health.org

  7. 7.

    SAMHSA Top Health Issues for LGBT Populations Information and Resource Toolkit http://store.samhsa.gov/product/Top-Health-Issues-for-LGBT-Populations/SMA12-4684.

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Gendron, T.L., Pendleton, T., White, J.T. (2016). Mental Health Counseling of LGBT Elders. In: Harley, D., Teaster, P. (eds) Handbook of LGBT Elders. Springer, Cham. https://doi.org/10.1007/978-3-319-03623-6_23

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  • DOI: https://doi.org/10.1007/978-3-319-03623-6_23

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