Often, battles over rights take place with a feverish public intensity, as we saw in January when crowds jammed the streets of Washington, D.C., for the Women’s March on Washington — and when attorneys hunkered down at airports to help those left in limbo by President Donald Trump’s travel ban.
At other times, though, these battles are covert, proceeding almost unnoticed.
Consider, for instance, the National Survey of Older Americans Act Participants, which the Department of Health and Human Services administers each year to gather data about older adults who receive services — such as family caregiver support, home-delivered meals, and transportation — under the Older Americans Act. The federal government then uses the survey results to allocate some $2 billion in senior services. Yet a key data point is missing from the 2017 draft: HHS has removed the question inviting respondents to disclose their sexuality.
For many older LGBTQ Americans, this question boils down to life-or-death care.
Since 2014, when groups successfully swayed the Obama administration to include a survey question that would address sexual orientation, service recipients were asked the following: “Which of the following best represents how you think of yourself: lesbian or gay; straight, that is, not lesbian or gay; bisexual; something else; refused; and don’t know.” The benefits of this survey question run deeper than inclusion in the narrowest sense; for many older LGBTQ Americans, this question boils down to life-or-death care.
The NSOAAP culls information on how certain services perform and operates as a roadmap for advocates and policymakers looking to plug gaps where these services fall short. This takes on even greater urgency for LGBTQ seniors, who — compared to many of their heterosexual peers — are disproportionately affected by issues such as financial instability and housing discrimination. For instance, research shows that older lesbian couples face a 9.1 percent poverty rate, and older gay couples face a 4.9 percent poverty rate, in contrast to a 4.6 percent poverty rate among heterosexual couples. Even fear of discrimination shapes the lived realities of older LGBTQ Americans: A national survey shows that only 22 percent of LGBTQ seniors in long-term care facilities felt that they could reveal their LGBTQ identities (also of note: 43 percent reported cases of actual mistreatment).
“It doesn’t matter, frankly, whether LGBT elders are eating chicken or steak or fish in a senior center,” Michael Adams, chief executive officer of Services and Advocacy for LGBT Elders, one of the largest resource networks for LGBTQ seniors in the United States, told the Guardian earlier this month. “What does matter is: Are they eating in a senior center at all? Are they receiving care management services? Are they receiving caregiver support?”
In short, data is crucial. When it comes to social policy, it helps us draw correlations to know when and where problems exist. The challenges beleaguering many older LGBTQ Americans in large part because of their age and sexuality are inherently — and often insidiously — intersectional. Nixing the above survey question would only ensure that a largely overlooked, vulnerable group remains exactly that.
On the one hand, HHS’s anti-LGBTQ move isn’t too surprising. The department, after all, is headed by HHS Secretary Tom Price, who has an inglorious history on LGBTQ rights. All the same, this erasure of LGBTQ seniors shows us once again just how incredibly abnormal and threatening these times are. It also illuminates a real problem for progressives working on policy under an administration that keeps muzzling basic data collection. We can’t look solely at the streets and at airports to see where lives are under threat—we also need numbers.
