Protecting LGBTQ people from the health risks of social isolation

The ways in which Donald M. Bell and his Chicago neighbors relate to each other are as simple as they are significant.

“We have certain rituals that bring certain groups of people together,” said Bell, 73. Sometimes they get together to watch “Jeopardy!” in the common room of their senior housing unit. Other times they prepare meals for each other because cooking for one can be difficult, but sharing is easy.

They look after each other’s pets and accompany each other to doctor’s appointments and check on their neighbors after medical procedures — like the triple bypass surgery Bell had about six years ago.

Such actions are healthy for anyone at any age. But as residents of the city’s first LGBTQ-friendly senior housing, Bell and his neighbors had to overcome years of obstacles to build those bonds.

“We’re trying to show each other that we matter after a lifetime of being told, ‘You don’t matter,'” Bell said.

Social connections can help protect health, research shows. But the lack of such connections — social isolation — is associated with an increased risk of premature death from all causes, according to a 2020 report by the National Academies of Sciences, Engineering, and Medicine. And poor social relationships are associated with an increased risk of coronary heart disease and stroke.

“We are social animals,” said Dr. Benji Laniakea, an assistant professor in the LGBTQ+ Clinical Program at Stanford University School of Medicine in Palo Alto, California. “We are built to be together, to be able to talk to each other, to communicate with each other, to be with each other.”

But LGBTQ people are more likely to say they are lonely, studies show. Several factors put older LGBTQ people at higher risk of isolation, Laniakea said. Many have been shunned by their biological families or lost friends to AIDS. And societal discrimination may have hindered your chances of meeting a life partner.

According to LGBTQ+ advocacy and senior services organization SAGE, older LGBT people are more likely to be single and live alone and less likely to have children than their heterosexual peers, depriving them of a potential source of cares. And many fear discrimination when seeking help. “Some of our LGBTQ+ adults have had to go back into the closet to receive care in a care facility,” Laniakea said.

But social isolation is not just a problem for the elderly. Young people depend on many different support systems — family, schools, clubs, religious organizations — to shape their sense of self-worth, said Jonathan Garcia, an associate professor at Oregon State University in Corvallis, where he is director of the Department of Youth and Young Adults core of the Hallie E. Ford Center for Healthy Children and Families.

For LGBTQ teens, these potential safe spaces can become sources of rejection, bullying, and the repeated message that they don’t belong. “So they don’t feel like they can get the support they need in the places where they need it the most,” Garcia said.

Social isolation among LGBTQ youth is associated with problems such as depression, substance abuse, and suicide attempts. Garcia led a review of the effects of social isolation and connectedness in LGBTQ youth that was published in 2019 in Global Public Health. He said the problem can be compounded for youth who are also members of marginalized racial or ethnic groups, who may feel isolated from families and religious institutions because of their orientation and be excluded from LGBTQ groups when they experience racism.

The COVID-19 pandemic has exacerbated many problems with isolation, Laniakea said. Adults who were just coming out were cut off from opportunities to connect with the LGBTQ world, while “for LGBTQ youth, especially those who might not be out with their families, it meant effectively going back into the closet.”

LGBTQ people have always had to find ways to build community, Laniakea said. The most famous historical event of the gay rights era, the Stonewall uprising of 1969, was about the right to assemble without being harassed by the police. And there is a strong tradition of forming a “chosen family” among people who may have been cut off from those who raised them. “Those bonds that are found in someone who really sees you for who you are can sometimes be just as strong as biological family,” Laniakea said.

Being around welcoming people can be critical to health, Laniakea said, providing understanding, a stress-relieving refuge from personal grudges and anti-LGBT rhetoric. Affirmative people can send a message that “you are valid, that your gender and your lifestyle are reasonable, that you are not hurting anyone by existing in a way that is true to yourself.”

Garcia, who led research for a community-building program among Latino LGBTQ youth, said society as a whole has a responsibility to address the causes of loneliness.

“Social isolation is not the result of personal failure,” he said. “It’s not just an individual experience. This is the result of this systemic oppression.

Volunteering can be a way to both meet people and build community, Garcia and Laniakea suggested. “That in itself allows people to become useful and serve the community,” Garcia said. “It addresses the isolation, but it also addresses some systemic issues.”

People who want to be LGBTQ allies can help by supporting gender and sexuality alliance networks (formerly known as gay-gay alliances) and things like school anti-bullying policies that have been shown to reduce harm from social isolation and the risk of suicide attempts.

An ally can also accompany someone to an LGBTQ community group, Laniakea said, “because going anywhere alone can be really daunting for the first time, no matter what your age.”

Bell — who identifies as gay or bisexual, as well as being a father of two and a third-generation Chicagoan of African, Native and Scots-Irish heritage — has a community built into Town Hall Apartments, an LGBTQ-friendly complex. set up in a renovated police station not far from Wrigley Field.

He realizes that having room for a few dozen people in a city where tens of thousands identify as LGBTQ is far from a solution. But he is grateful for it.

Residents look out for each other, he said, “with the recognition that it’s essential.”

Born in 1949, he lived through an era when “there were no places outside and no safe places. There are no places like this,” where he and his friends can share a joke without having to explain the context, or just let their guard down and be themselves. A place, he said, where “they tell you you matter.”

If you have questions or comments about this American Heart Association news release, please email [email protected]

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