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Researching Older Gay Male Identities,

Welfare Needs and Service-use

Experiences

Dr Adrian Lee, University of York Email: aml106@york.ac.uk

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Outline

The Research

Older and Gay Identities

Historical Contexts

Disclosure of Sexuality and

Partnerships

Health Service Experiences

Future Care Needs and

Preferences

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The Research Participants

Semi-structured, in-depth interviews in 2003 with 15 self

identifying Older Gay Men (OGM).

Participants aged 57-84 (mean 66.6) years.

Majority from Yorkshire.

Many lived in semi-rural to remote-rural locations.

Diverse employment backgrounds.

2/3s single, 1/3 living in a partnership.

Largely minimal physical contact with gay communities.

A financially comfortable/ very comfortable. However, 4

men were ‘just about getting by’/ ‘finding it difficult’.

4

Older and Gay Identities

Historical contexts influenced how men identified

in terms of sexuality.

It is important to understand why some (did not)

prefer(red) to identify as gay/ homosexual/ queer.

Gay often related to an identity and lifestyle that

was not there’s – was younger.

Embracing a ‘gay’ lifestyle gave some a new lease

of life.

Sexual identities had affected family relationships

for some, reducing support networks and familial

interactions. 4

5

Older and Gay Identities

Whether identifying as ‘old’ or not, some experienced

ageism on the scene, or felt liberation and progressive

social attitudes had passed them by.

Others had rich social and sexual lives with peers or

men different in age.

Age was clearly a state of mind, but one with key

influences:

Body Contextual

Generational Mortality5

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Historical Contexts

Military service and the need for secrecy.

Mental illness.

Sexuality as a mental illness.

Working in caring professions.

Legal issues.

Partnerships, engagements and

marriage.

HIV/AIDS epidemic and fears.

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P9 (63): The police got involved and they threatened

to charge me with buggery and other fairly obnoxious

offences... My step-father threatened to have me put

away in a mental hospital for the rest of my life.

Then I decided to book myself in to this hospital in

London... I signed a consent form and he [doctor]

wired me up and he showed me these pictures and

every time I saw somebody I fancied I had to indicate

it and I was given a sharp shock...

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Disclosure of Sexuality/ Partnerships

This happened in different ways or not at all:

Passively

Assuming the GP knew, but not clarifying it one way or

the other.

Prompted Active

P12 (69) I asked him ‘is there any chance of you giving

me Viagra? To sort of build up me sex life’...He said

‘you’re not telling me you’re gay are ya?’ I said ‘yeah’, he

said’ I thought so.’

Unprompted Active

Coming out as a couple to a new GP when registering.

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Disclosure of Sexuality/ Partnerships

Assumptions played a key, but problematic role.

P1: Yes I have read about it [HIV/AIDS] of course,

you know and I have read quite a bit about it really.

And I think its, you don’t want to, alright I have

apparently a very rigorous immune system…

R: So you feel that the precautions that you currently

take, you manage those risks fine.

P1: Yes.

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Problems of Non-disclosure

A lack of space to discuss safer-sex.

A lack of consideration for partnerships or how

friends might be involved in care.

Fear of confidentiality being broken

Small-town gossip

Large health centres.

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Health Service Experiences

P14 (64) ...for the first time in my life, because I’d just had

my heart attack, I had a seventy mile journey there, we were

together… and I was admitted to hospital, and there was this

young doctor there and she was asking me questions, but

you must respect I had two hours to getting sorted out, and I

felt pretty lousy.

I don’t know whether she said ‘are you gay?’ or what, but I

couldn’t see the other side of me saying ‘yes’ and dealing

with the questions that might come, or feeling under

pressure, I felt so ill.

It came out, it wasn’t deliberate, I wasn’t expecting it, I said

‘no’. There was the feeling that, you know, at the end of the

day, there are people who, I mean I have seen it in the

hospital where I’ve taken action on it from time to time.

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Health Service Experiences

P2 (67) On my blood tests he put ‘known homosexual’

and I thought ‘why have you done that if you think I’m a

biohazard you should just stamp it biohazard, why is it

important for all your staff to know that I’m homosexual?’

R: Did he explain himself?

P2: He said he was very sorry, he didn’t realise that he

was being homophobic… I thought an apology wasn’t

enough so I reported him… And they [hospital

administration] said that they were going to look at all

their policies… I thought I should really make a statement

so that the other doctors don’t do it to other gay men… I

was quite pleased that I had the bottle to confront him.

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Future Care Needs

What was important to participants:

A good bed-side manner and

communication.

The ability to discuss sexual orientation,

signs of acceptance and valuing diversity.

Recognition of partners and domestic

circumstances.

High standards.

Choice.

Gay-friendly or gay carers.

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In Summary

A need for understanding histories to understand the

present.

OGM’s identities are complex and nuanced.

There has been unfair treatment and lack of

confidence to come out.

Good practice examples go a long way and can be

easy and cheap to implement.

Staff training, monitoring, enforcing and promoting

equality policies can help staff and service-users.

A need to provide choice and flexibility of service

provision.