1. 1
Sexual orientation is a person’s sexual identity in relations to which gender that they are
attracted to. The U.S. Census that is sent out to people does not ask the question on sexual
orientation and gender identity. The amount of people that identified themselves to be either gay
or lesbian is estimated to be around eight percent of the total population, with a smaller percent
of the elderly that identify as this. There are a small number of articles that focus on LGBT
elderly population addressing their sexuality. MEDLINE did a search in 2002 and showed that
only 0.1 percent of the 3.8 million articles that were published showed any information on elders
in their sexuality preferences. AARP in 2004 conducted a national survey with people over the
age of 70 having been with the same sex partners. Five percent of men and one percent of
women stated that they have been with the same sex within their life time. It is also important to
note that this is under reported for people 65 years and old because of the beliefs that families
had that homosexuality is wrong. In LGBT older adults there are stereotypical views that should
be taken in consideration and some recommendations for people working with LGBT.
Stereotypical views of LGBT are very important for health and social care workers to be
sensitive and watch out for when working with people in homosexual relationships. Some LGBT
people hear a life time of discrimination about their sexuality, but also may face an atmosphere
of silence about their sexuality and intimacy. Homosexual relationships bonding are similar to
that of heterosexual relationships. Relationships can range from monogamous life partners to
nonmonogamous primary type relationships, or they could be serial monogamy and episodic
liaisons. No matter what type of relationship, homosexual or heterosexual, life partner confront
some of the same issues. Some of these issues that lifelong couples can face include loss of
sexual interests due to chronic disease, or fears of loss of sexuality, and death, or illness of a
sexual partner. Even though there is not much difference in reports of relationships patterns

2. 2
between homosexuals and heterosexuals, there have been reported high levels of life
satisfactions, if they are happily partnered with one another. The high satisfaction is also shown
with strong social support, strong family and friend support, and positive source identity.
Lesbians in late adulthood, tend to practice serial monogamy throughout their life time,
and are usually closeted about their sexual orientation. For many of the current older adult
lesbians stated that they first became involved with their lesbian relationship in midlife, and that
nearly 50 percent of them had been married at some point in their lifetime. Over 75 percent of
lesbians have reported that they have had heterosexual intercourse at some point in their life.
Even though lesbians tend to be closeted about their sexual orientation throughout their lifetime,
most usually report that they have high levels of sexual satisfactions and positive self-image as
they age. Heterosexual women tend to report more than homosexual women, fears in changes in
physical appearance, loneliness, and isolation as they age. This could be because of the networks
of strong friendships, or the flexibility in gender roles that allow people to adjust differently to
socially constructed beliefs of aging. Lesbians tend stay attracted to their same age group and
stay sexually active as they age.
Gay men tend to be in long term relationships or not be in a relationship at all. The
average length of a long term gay relationship is 10 years. Gay men start to have more partners
with age and peak at between ages of 46 to 55. Most gay men are satisfied with their life long
partners, and report being sexually active. Sexual activity may start to decrease after the age 60
because of cautiousness, illness, or death. Unlike lesbians, gay men tend worry about growing
old. Looking fit, staying youthful, and “not looking your age” is what older gay men look for in a
partner. Despite their sense of staying young, most gay men still report having a positive sense of

3. 3
self-esteem, contentment, and well-being. Compared to older heterosexual men, older
homosexual men have closer friendships later in life.
There are many differences when looking at gay men today and looking at the older adult
gay men. When looking at older gay men, compared to today’s gay men, they tend to have a fear
of exposing their sexuality, they tend to try and hide their sexual orientation from other people.
The people in the community such as employers, co-workers, friends, and family maybe less
accepting to one’s sexual orientation. The sexual preference that someone has maybe seen as
outside of their control or that something maybe wrong with them. Another concern within the
older gay population is HIV/AIDS. This is a concern because many older men engage in
unprotect sex. Education is an important factor in prevention of HIV/AIDS and safe sex. Older
gay men are less likely to use HIV/AIDS support groups to help with emotional and mental
support, than are younger gay men.
There are some recommendations that might help future staff when working with LGBT
elders. The staff should address issues with a nonjudgmental and respectful manner. They
should be comfortable being able to talk about gay and lesbians and their relationships that they
may have. Professionals should check on what assumptions that they may have and what
language that they are using toward their clients. They also should know what resources that are
available in their area, whether they are local or national gay organizations, or what the typical
culture is in that area. Finally, they should have a positive view of sexual activity for aging gay,
lesbian, and bisexuals.

4. 4
Professionals should always keep a positive and open mind when working with the older
LGBT population. Whether a person’s sexual orientation is to be heterosexual or homosexual
should make no difference in the way that someone works with them.
As women get older there seems to be changes that happen with their bodies that are left
unexplained. Some women know that these things are going to happen when they get older but
do not really understand what they are. There are a growing number of women in the age group
45 to 54. Who are at where there is a higher chance of having menopause. When women get
older some things start happening to them including, climacteric, hot flashes and other common
conditions.
When women reach a certain age they start to lose their ability to reproduce, this is called
climacteric. Climacteric takes place in three different phases, perimenopause, menopause, and
postmenopause. The first phase perimenopause, which can also be called menopausal transition,
is where there is a decline in the ovarian function. When there is no ovarian function, there is an
end in the production of the eggs and a decrease in estrogen. This can have an influence on the
monthly menstrual cycle, or may even stop the cycle. This cycle can occur for 10 years or more
until it reaches the next phase. Some of the symptoms that have been discovered just recently
include hot flash in the head area and upper body, sleep trouble, irritability, concentration
problems, mood swings, and migraines. The second phase is menopause which is a period in a
women’s life where there is a gradual cessation of the menstrual cycle. This also can include
irregular menstrual cycles and menses that are related to the loss of ovarian functioning. The last
phase, postmenopause, is said to occur when there has been no menstrual period for 12 months.
The average age for this phase is 40 to 51 years old, but can start earlier if a person is a smoker.
Some of the physiological changes that happen to women due to the decrease in estrogen levels

5. 5
include hot flashes, urinary tract changes, urogenital atrophy, painful intercourse and
osteoporosis.
Hot flashes are something that many women may encounter when they get older. Hot
flashes are caused by vasomotor instability when and the nerve over responds to it. All of this
happens because the hormone levels in the body are changing. The part of the brain that this
takes place in is the hypothalamus. The hypothalamus causes the blood vessels to dilate and
constrict, which makes the blood rush to the skins surface, making it look red. This often makes
a women feel hot and sweaty. This hormone change and hot flashes can interrupt sleep during
the night leading to sleep deprivation, though not all women are impacted by this way. When
comparing different races of women, Caucasian women reported having more hot flashes and
insomnia than Latina and Asian women.
Urogenital atrophy is another change in aging that women may experience. Urogenital
atrophy refers to the ability to lubricate the vagina and the reduction in the elasticity of the
vagina. This tends to happen 5 years after menopause begins. This is where the vagina become
drier, and the cell walls become thinner, and the amounts of lubricants during sexual arousal are
reduced. The quality of orgasm is not affected by this even though there are not lubricants.
Urogenital atrophy is one of the more frequent complaints that women have and does have. It has
been known to have an impact on their sexual activity and has resulted in a decline. There are
ways to help with urogenital atrophy including regular sexual activity, masturbation, muscle
toning, and vaginal lubricating. Hormone replacement therapy is another way to deal with hot
flashes and vaginal atrophy. This can also be combined with the use of estrogen alone or with
progestin. This restores the women’s hormones levels back to where they were before. There are
many risk factors that can go along with using the hormone replacement therapy including breast

6. 6
cancer, heart attacks, and strokes, which has turned many women away from this option. Some
hormone replacement therapy alternatives including many different herbal remedies and drugs
that have already been proven to treat other conditions and may also help reduce hot flashes.
Some nonmedical strategies that can help to relieve hot flashes include drinking cold water or
juice when hot flashes start coming on, wearing breathable clothing, and sleeping in a cool area.
Some of the things to try and avoid hot flashes include spicy foods, alcohol, and caffeine.
Menopause is viewed as a time status and respect for women in some non-Western cultures and a
growing number of women view menopause as a positive transition, rather than a loss of fertility
or a cause of depression.
Older women’s capability to have an orgasm may be slowed down, but is not impaired
with age. Preorgasmic plateau phase, where sexual tension is heightened, is extended in time.
The older women’s orgasms tend to be less intense, more spasmodic, and more rapid than they
use to be. Heterosexual or homosexual, young or old, does not affect the levels of sexual tension,
initiated or clitoral stimulation. Lesbian partners are more likely to have whole body stimulation
than would heterosexual couples when focusing on an orgasm. Couples who reported to have
good sex lives tended to be happier in general. For men and women who are having sexual
dysfunctions they are turning to sexupharmaceuticals or medications to help men and women
have sex. NSHAP conducted a survey and found that one percent of women and 14 percent of
men had taken medication or supplements to improve their sexual functioning within the last
year. One of the widely known medications for men is Viagra.
As women get older there seems to be changes that happen with their bodies that are left
unexplained. Some women know that these things are going to happen when they get older but
do not really understand what they are. When women get older some things start happening to

7. 7
them including, climacteric, hot flashes and other common conditions. Knowing these conditions
can help many women prepare for what is ahead.
What does it Feel Like to be 75, was meant to help about 20 engineers feel the aches,
pains and, limitations of an average 75-year-old so that they could design better products for
them. They produced a suit that would mimic the losses that a person would experience as they
age. They made goggles that were yellow that made it seem like the person had limited depth
perception. There was limited movement that the person was able to make because of the suits
stretch rubber bands that were connected from the waist to the feet. To try and mimic balance of
the older adult they used crocs sandals with bits of rubber foam taped to the bottom of them,
almost making it impossible for someone to stand up straight and keep their balance. Many
things were more difficult than they thought there were going to be, making their goal for people
to try her suit to feel more empathy for seniors.