More Senior Living Communities Commit to LGBTQ+ Inclusion in Discrimination Policies

The number of senior living communities that include gender identity and sexual orientation in their anti-discrimination policy shot up in 2022 — but there is still plenty of progress yet to be made.

This is according to the 2023 Long Term Care Equality Index (LEI) which included results from 200 long-term care communities across 34 states. It was conducted by the Human Rights Campaign (HRC) and SAGE, an LGBTQ+-focused organization for the senior housing sector.

The survey, released Wednesday, included communities that house more than 23,000 residents and employ more than 17,000 employees. The vast majority of participating communities had assisted living (84%) and/or memory care (83%) levels while 69% had independent living units.


In a 2021 survey, just 35% of communities that responded reported having a non-discrimination policy that included both gender and orientation-specific language. That number shot up to 90% in the latest survey, according to HRC Director of Health and Aging Tary Hanneman.

LGBTQ+ older adults can experience stigmatization, lack of identity-affirming treatment and discrimination and violence that can lead to avoiding necessary services, chronic stress and increased social isolation, according to the survey’s authors.

However, very few communities in the index reported including abuse and neglect policies that explicitly protect LGBTQ+ residents (5%) or policies that outline any procedures that are in place to address bias/insensitive incidents (7%).


And while 89% of respondents said they asked residents their chosen names on intake forms, just over half asked about sexuality or gender identity; and just 11% asked about incoming residents’ pronouns.

The latest survey’s results are a “step in the right direction,” but there are stil areas of much-needed improvement for the industry, according to Hanneman.

“We have found that many communities think they are good to go on LGBTQ+ issues because they have taken a training or because they are in a state that has a long-term care LGBTQ+ Bill of Rights,” she said. “But they haven’t taken the next step and changed their policies or done other things to be inclusive.”

The LEI was modeled after another HRC index survey called the Healthcare Quality Index, Hanneman told Senior Housing News.

“The 2022 Healthcare Quality Index had more than 900 participating healthcare facilities after just 78 when it first started in 2007,” Hanneman said.

Recent events also underscore the need for updated policies and advocacy for this segment of the population. For example, an affordable senior housing community for LGBTQ seniors in Boston was vandalized with homophobic hate speech earlier this year; and in Maine, a 79-year-old transgender woman sued after being rejected from a senior housing community. The community and the woman later reached a settlement.

The majority of communities in the latest LEI survey understand the growing need of inclusive senior living, with 77% of respondents reporting that they engage in LGBTQ+ marketing and 84% participating in local events and initiatives that support the LGBTQ+ community.

And looking ahead, Hanneman said she hopes to attract responses from “as many senior living communities as possible from all 50 states” in coming surveys.

“While we have a long way to go, we commend the 200 participants this year and look forward to working with greater numbers of senior living communities in the future,” she said.

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