Researching Older Gay Male Identities, Welfare Needs and Service-use Experiences

Researching Older Gay Male Identities, Welfare Needs and Service-use Experiences Dr Adrian Lee, University of York Email: aml106@york.ac.uk 1

Outline • The Research • Older and Gay Identities • Historical Contexts • Disclosure of Sexuality and Partnerships • Health Service Experiences • Future Care Needs and Preferences 2

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’. 3

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

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 Mortality 5

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. 6

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... 7

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. 8

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. 9

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. 10

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. 11

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. 12

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. 13

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. 14

Researching Older Gay Male Identities, Welfare Needs and Service-use Experiences