(gentle melancholic music) - Loneliness and isolation is a huge problem for everyone at our age, really.

- As soon as the provider walked into the room and found out that the patient was transgender, he threw up his hands and said, I'm sorry, I'm not gonna be able to see you today and walked out of the room.

- My spouse was diagnosed with glioblastoma and we went to the hospital one day and they gave him eight months to live.

Thank God we were married because his family could have zoomed in and said, okay, you're out.

- A lot of assisted living facilities are run by private organizations that are often hostile to the LGBTQ community.

Will our partners be recognized, will our identities and our names be recognized?

- Some choose to come out and some are not sure how much acceptance they're gonna have, and so they choose to keep that to their self.

- [Narrator] Major funding for Aging Matters is provided by the West End Home Foundation, enriching the lives of older adults through grant making, advocacy, and community collaboration.

The Jeanette Travis Foundation, dedicated to improving the health and wellbeing of the Middle Tennessee community.

The HCA Healthcare Foundation on behalf of TriStar Health.

Cigna, together all the way.

Additional funding provided by Jackson National Life Insurance Company, the Community Foundation of Middle Tennessee, and by members of NPT, thank you.

(bright music) - I would say I give my community at home about a seven or a six out of 10 for how progressive it is.

- I'd probably give it about a seven.

- Probably be about a six.

- I would give it an an eight because it's evolving.

- I would give my community, honestly, a four or a five.

- I'd give our community and our city a rating of eight.

- There is a lack of progression surrounding any like actual substantial change for people who are gender diverse.

As someone who's non-binary, I really think that some of the, oh, what are your pronouns, is kind of like a superficial level to actually respecting someone's gender identity.

- There are no explicit workplace or housing protections for LGBTQI folks, except for a shaky SCOTUS decision that we now see can be reversed.

- I think there has been a significant progress, not only in legal and civil protections, but also, I think, a culture change.

- We have just recently started having our own pride and we recently having meet up meetings.

So it's an evolving situation there because it's a growing community.

- Younger people haven't had the experience that I've had and they don't understand how far we've come 'cause they don't know where we came from.

The AIDS crisis, the AIDS death.

I don't think people can understand how many people I lost.

And I had thought my friends here, I had thought that they would be around me and I'd be around them as we got older, but they're not there anymore.

As I've gotten older, I've begun to realize it more and more that there really isn't anybody there for me anymore.

There are people out there who are my friends, of course I'm not friendless, but in terms of real friends, people with whom I was gonna grow old and people who be available to go out for dinner or go out for coffee, go out for drinks or something.

They're not there anymore.

- I am the retired CEO for Nashville Cares.

I'm also a long term survivor living with HIV.

One of the reasons for isolation for some of us is that we've lost most of our support network who are also people living with HIV who have subsequently died from AIDS.

And that's one of the experiences, especially of long term survivors, in terms of the number of people that they have known and cared for who have passed away.

It's called the Reunion Project who are an organization of long term survivors who try to provide resources and link people to resources that increase what's, you know, what we call people's resiliency, provide them with strategies for cutting down on isolation, and linking with others in their communities.

And that's really an important resource, I think.

- Well, I am a widower and I have no family in Nashville.

I can vouch for the fact that it's very isolating because, where do I go?

I have no place to go.

If I don't go to a gay bar, where am I gonna go?

I mean, I'm not going to go to a gay bar to meet people.

So thank God for the lunch, the meetups, and the pride and those things.

Without that, I wouldn't have any contact with anybody.

There's no way.

- Aging in general is a challenge, you know, so having community, continuing to have community is a challenge.

So there are lots of gay bars.

Would like to have a place that's not alcohol related for folks, for especially elder folks.

We do need, I really feel like we need a place where gay folks can come together.

- And I think that loneliness and isolation is a huge problem for everyone at our age, really.

You know, we have a Facebook group of old gay men in Nashville.

There's about 60 of us in that group right now.

And we've met a number of times and gone and done things.

We're going to the farmer's market, meeting at the farmer's market this Saturday.

But we went to Cheekwood a couple of weeks ago, been doing the gospel drag show.

Listen, if you'd never seen a drag queen perform Mahalia Jackson, you owe it to yourself.

You really do.

We started out just doing some video chats, you know, there might be six or seven of us just to kind of get to know each other a little bit.

So then when we really did meet in person for the first time, we all kind of knew each other already.

That group, I just started it.

That's really been nothing but a positive experience that really has given me, really, exactly what I needed.

You know, it's not often that something just turns out perfectly like that, but it really has.

And I would really encourage anyone who's sitting home, thinking, I'd like to have somebody talk to besides this dog, you know, to get out, or to get on Facebook and start yourself a group, you know, a local group.

I know it's worked well for me, really has.

- There's really not anybody in my life right now that was in my life two years ago.

I've got several acquaintances, but there's some of my childhood friends and my family are all, have all backed away, become conveniently busy.

Some are a little more blatant than others.

Some have actually blocked me off of Facebook and everything.

And others just kind of pulled away and just don't say anything anymore.

- The Vanderbilt University Social Networks Aging and Policy Study, which we call VUSNAPS, is about this idea that negative life experiences like discrimination, harassment, and violence that LGBTQ people experience in their lifetime have effects on health.

And one of the questions that we ask folks is whether they have an LGBTQ affirming health provider and about half say yes and about half say no.

And so when you have an LGBTQ affirming provider, you're more likely to go for a routine checkup.

You're more likely to have had a colorectal cancer screening.

So we are able to show that having those providers matters and makes a difference in terms of what kind of care folks are getting in terms of preventative care.

- Good afternoon.

Thank you for calling the Vanderbilt Program for LGBTQ Health.

This is Del, how may I help you?

A few months ago, I got a call from a lesbian couple.

They hadn't lived in the area long, was a rural area, and one of the partners was transgender and she was experiencing some facial pain that got worse over the course of several days.

So they did a cursory Google search, found a place to go and get an initial evaluation.

And as soon as the provider walked into the room and found out that the patient was transgender, he threw up his hands and said, I'm sorry, I'm not gonna be able to see you today and walked out of the room.

Now, I can't imagine what that experience must have been like for that patient, but there were so many barriers along the way that I think that cisgender people absolutely take for granted.

And again, we know that trans patients will delay care because of instances like that.

- Getting older, anything can happen.

Anything can, well, anything can happen to any of us, but as you get older, you realize the time is squeezing.

Having moved to Nashville, I have a doctor here who I like, but I've said to my wife, I don't know what hospital to go to.

I don't know if Vanderbilt or St. Thomas or whatever is the best hospital for an old trans person.

You know, you take off my clothes and I'm there and you know who I am.

And I don't wanna presume this, but maybe I am.

I think it's harder for a trans person than it is a gay person because we are physically, most of us, altered in some way that you can tell immediately.

♪ Don't take me over the gender line ♪ - The Trans-Buddy program is a unique homegrown patient navigator program that was designed by one of our colleagues who was also transgender.

He developed some training that would empower volunteers to be able to take care of trans patients going to any kind of healthcare visit.

And it's just really a great program.

It's the first of its kind in the country.

And we get calls from all across the nation from other programs who have heard about Trans-Buddy and would like to replicate it.

- I love the Trans-Buddy program.

I love being on the front end of watching the trans person evolve.

And I remember that first day, because I remember when I went to see my endocrinologist the first time, I remember I walked in, I remember she smiled and shook my hand.

I remember I cried the whole time.

And then she said, I'll send out your prescription.

And so I was just so emotional, just so like, like this is my birthday, I'm gonna start really taking estrogen and things are gonna go my way and I'm gonna get to be me, that I was so overcome.

And to be with somebody and be there with them and say, write down notes for 'em and say, okay, honey, everything went great.

I'm very privileged that I'm mostly passable and not all trans folks are, especially in the beginning.

And so some physicians may call a trans woman sir, or a trans man ma'am and we're so scared in the beginning, we just let it happen.

But if somebody like me can be there to say, hey, it's ma'am or it's sir.

Then that kind of puts the physician sort of on notice in a nice way.

- Patient navigation services, that's one of the places that our program was founded on.

And so we have a phone line and an email address that LGBTQ patients can contact us, tell us who they are, and what's going on with them.

And then we can recommend providers, whether it's at Vanderbilt or not.

We judge that our job is to connect people to healthcare services.

And so we're constantly building out a repository of affirming services throughout the region.

(gentle piano music) - My life did not go the way we planned.

My spouse was diagnosed with glioblastoma.

And we went to the hospital one day and they gave him eight months to live.

So the scenario was, thank God we were married because his family could have zoomed into St. Louis where we were and said, okay, you're out.

But I had the marriage certificate in my hand and they did not, they didn't even attempt to do it.

So that definitely protected us.

And plus I wouldn't even been able to go in the room.

They wouldn't have shared information with me had we not been married.

- I've had friends who, you know, when their partner passed away, the parents swooped in and they couldn't see 'em, they weren't able to go in the hospital room.

You know, if the partner's name was on, say, the house or the apartment, you know, all that goes to the family if there's nothing written down, and that partner's just left, you know, with nothing.

Or they don't have, you know, the right to come in the hospital room, you know, when you're sick.

And so my main concern would be that my partner, that she doesn't have anyone to fight, I wanna make sure that she gets the insurance.

I wanna make sure that she can be in, you know, the room, you know, if I'm dying.

- It's one thing to get married.

It's another thing to have it recognized and respected.

So when I got married, I didn't go woohoo and go up and down the halls of work saying I just got married because there could be repercussions for that.

- So much of our society is based on being married.

Social security benefits, health insurance coverage, death benefits.

In 1996, I overturned the sodomy law here that criminalized private, consensual, same sex sexual behavior.

It criminalized acts, but if the exact same acts were entered into by one of the same parties, but then with somebody of the opposite sex, not the same sex, it wouldn't be illegal, which is just totally irrational.

And so I challenged that on my own without an organization, but that was pretty significant because in parenting cases, custody cases, the other side would bring up, well, your honor, she's a criminal, you know, because of the criminal statute.

So getting rid of that was really important.

- We're seeing these laws being passed to test, some of these past rulings on the sodomy and on marriage and on employment rights in the workplace.

And so they're trying to, you know, chip away at those gains, we've made real significant gains in all of those areas, but we are very concerned that the courts could reverse these current gains and could send us back into a new dark ages.

- LGBTQ+ older adults have faced a lifetime of discrimination, especially in employment.

And this has led to many of our LGBTQ older adults being at the 200% poverty level or below.

And, you know, this is really a concern for LGBTQ older adults as they think about their own aging, their retirement savings, and social security earnings.

And they're far less likely to feel secure in their retirement years as compared to non LGBTQ+ older adults.

- My wife and I just celebrated our 34th anniversary together and we have been able to form a community.

And so now as we enter into a new phase in our lives, as we kind of ink up into the early sixties, we're like, you know, what are we doing to plan our retirement?

Where can we be, what can we do?

And then looking around at different retirement communities that may or may not be something we do in our future, we recognize that there's not a whole lot of places that we can go that welcome us as a long term lesbian married couple in their environments.

And so we've had to go as far as New Mexico to be able to find communities that we might feel comfortable in.

And I'm not sure that within the next 15 years that I'm gonna see that in the state of Tennessee.

That's unfortunate, and I'm hoping that there'll be a systematic change so that we don't have to leave the state in order to retire comfortably.

- A lot of assisted living facilities are run by private organizations, religious organizations that are often hostile to the LGBTQ community.

Will our partners be recognized, will our identities and our names be recognized?

And so those are real concerns.

We may not have children or our blood families have turned their backs on us and ostracized us, so we are more at risk than other communities, and a lot of us are worried.

I do know that there are some places, some of the bigger cities do have resources, but currently we don't here in Nashville and Middle Tennessee.

- Even if the places might be accepting of us and maybe that'll happen over the next few years, we'd be the only gay people in the entire place.

How much fun's that gonna be?

Yeah, I have friends who say, oh, don't worry, we'll take care of you.

Eh, maybe, you know, I don't mistrust them, but they all have husbands now and they're all coupled up that way and I'm not.

You know, and I don't have all the money in the world either.

And I worry about my future financially, too.

It's just, that's where it is.

I'm pretty disturbed about it.

- There really needs to be some LGBT community for elder care.

I'm hearing some stories of a lot of older LGBT folks that are getting some, not necessarily really hard hate, but they're not really fully accepted either.

- There's been lawsuits that some of the LGBT legal groups have done about nursing homes or assisted living facilities offering a place to somebody.

And then when they find out it's a same sex couple, withdrawing it, just discriminating.

And, you know, we say like, marriage equality is so great and it fixed everything, but it didn't.

And of course you're more vulnerable in everything when you're older and have fewer options.

So that's something, and it's especially bad for trans people.

- I mean, I have heard horror stories.

I have friends who have worked in nursing homes and who have been hospice nurses and so on and so forth who have encountered abuse to trans people, older trans people.

We hope that that's changing, but in today's world, it's not, I'm not that hopeful sometimes.

- I mean, I'd hope to die at home, but, you know, if I do end up being put away, you know, in a home or somewhere, it would be nice to know that even if those people know, you know, that I'm LGBT, that I'll still be welcome, I'll still be treated fairly.

And at that time, I hope it's a while, but you know, at that time period that I have the right to be treated and somebody will stand up.

- One of the things that concerns me as a pastor is to be able to provide pastoral care.

And so to be able to talk about end of life issues and fears where your faith walk and your journey are concerned.

And so one of the challenges of pastoring in this part of the country where homophobia, transphobia is so prevalent is trying to find those folks.

If they are out to their family, but they are living in a senior center or a assisted living facility that is not affirming of LGBTQ people, then they are at risk of elder abuse which is like next level.

We're just not even talking about medical elder abuse.

We're talking about in addition to, on top of which already exists.

- SAGE has found that 48% of LGBTQ households have experienced adverse treatment when seeking housing, especially senior housing and affordable housing.

And these rates of adverse reaction and discrimination are even higher for our trans older adults within the community.

As a result, SAGE started the SAGE National LGBTQ+ Housing Initiative.

And this program is really designed to help increase the availability of LGBTQ+ affordable housing in communities across the country.

We also have a resource map on our website at SAGEUSA.org that allows people to go in and search for LGBTQ+ affordable housing in their communities.

And so this is some of the work that we're doing at SAGE to help ensure that LGBTQ+ older adults can age in their communities.

- A lot of people go home on Thanksgiving and Christmas with their roommate or their friend from college or somebody like that.

And sometimes their friend from college has been their roommate for the last 20 years.

That's just how it is with a lot of LGBT families.

They just, some choose to come out and some are not sure how much acceptance they're gonna have, and so they choose to keep that to their self.

- If no one has ever come out to you as gay, I'd invite you to be open to the possibility that you might be sending out this signal that you're not a safe place to hear that story.

- I cried real tears on both the days that gay marriage was legalized in this country and that Don't Ask Don't Tell was repealed and gay people could serve in the military.

I very well may get emotional about it right now, talking about it.

I mean, it was a huge, huge thing because some people go in to the military like I did, out of a real sense of duty, an obligation, that you feel like you want to do something for your country.

I graduated from high school in 1976.

At that time, they just asked you, you know, have you ever had sex with a man?

No, never, but the sad part of that is, you know, you get stationed on the ship with 140 guys.

You work with them, you sleep with them, eat and drink.

You smell their smelly boots and their BO, and there is nothing romantic about that, now is there?

These are guys who are like your brothers.

On one of these nights out, my buddy Bill and I met these two really sweet young ladies in Erie, Pennsylvania.

And I told that young woman that I was gay.

And she didn't deliberately out me, she told her friend and her friend told Bill and my poor buddy Bill just felt betrayed that I didn't trust him enough.

You know, it's hard, it's a hard thing.

- I'm here to be an advocate and an example that we can live our lives in spite of our differences and in spite of the challenges that are in front of us.

And I have to remind myself sometimes how lucky I really am and how so many people, trans people, trans women, trans men too, are not supported.

Non-binary people, all of the spectrum of LGBTQIA+, not everybody has the support that I have.

- And I think it's important that we have this documentary so that people out there are aware that we're out there.

At least you knew about us.

(gentle music) - [Narrator] Major funding for Aging Matters is provided by the West End Home Foundation, enriching the lives of older adults through grant making, advocacy, and community collaboration.

The Jeanette Travis Foundation, dedicated to improving the health and wellbeing of the Middle Tennessee community.

The HCA Healthcare Foundation on behalf of TriStar Health.

Cigna, together all the way.

Additional funding provided by Jackson National Life Insurance Company, the Community Foundation of Middle Tennessee, and by members of NPT, thank you.

(bright music)