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“A lot of the common themes that we see in ageing research are amplified for 2SLGBTQIA+ folks”

A Q&A with NIA Diversity and Ageing Research Fellow Ashley Flanagan

November 15 2022

Ashley Flanagan is a Diversity and Ageing Research Fellow at the National Institute on Ageing. Her research focuses on 2SLGBTQIA+ ageing and old age with the goal of advancing comprehensive health and wellness policy, programs and services for older adults with diverse gender and sexual identities. She co-authored the NIA’s recent report on 2SLGBTQIA+ older adults living with dementia and their caregivers, in partnership with Egale.  

This interview was originally published by the National Institute on Ageing and has been lightly edited for length and clarity.  

Q: What do you think are some of the most important issues around the 2SLGBTQIA+ community and ageing? 

A: I think one of the biggest hurdles we’re coming up against, and starting to overcome, is just the fact that a lot of people don’t realize that 2SLGBTQIA+ folks get older. Because when we think about Two Spirit, queer and trans communities, the first thought is usually young adults, and I think a lot of our focus does definitely need to be there. But I think we need to also broaden our scope, and number one, just advocate that there are folks who are older and also identify as 2SLGBTQIA+.  

And then once we get past that, I think the field is pretty wide open. There’s a lot of concerns that I’ve learned about through conversations with folks around long-term care, home care, ageing care services in general. A lot of uncertainty and fear around dementia, which was definitely reinforced in the work that we did with Egale, and starting to kind of chip away at that. Whether we’re talking about social isolation, or we’re talking about access to care and whatnot, I think a lot of the common themes that we see in ageing research are amplified within the experiences of Two Spirit, queer and trans older adults.  

Q: Why is it important to consider 2SLGBTQIA+ people who are ageing separately from the broader community? 

A: I think it all comes back to the histories that folks are carrying with them as they age. This current generation of Two Spirit, queer and trans older folks are the first to live openly in some way or fashion with diverse sexual orientations and/or gender identities in old age – which brings with it histories of discrimination, of harassment, of the advocacy that they’ve done throughout their lives, and the successes and challenges that they’ve seen throughout that process. One of the things that we need to recognize as 2SLGBTQIA+ older folks age — that their experiences may be different in a way that requires specific consideration when we’re interacting with 2SLGBTQIA+ folks. It’s not only these histories, but the way that these histories impact the perceptions they have of healthcare services, social services and programming. It definitely brings another layer into the experience of ageing.  

Q: Can you share a little bit more about why this work is meaningful to you? 

A: I think for me, as a queer person, what really sparked my interest was that I’d been working, doing research within ageing studies but my focus historically had been on caring experiences and within the dementia realm, more broadly. It wasn’t until I saw a documentary about ageing as a lesbian that it occurred to me that I might need some support and what that could look like. So, the impetus was, on a personal level, trying to make ageing care better for myself and my peers as we aged.  

But then as I got chatting with folks and hearing their experiences, I was hearing about the joys that were associated with growing older and also the fears that they had. That was just the fuel that kind of lit the fire and changed the course of my Masters and my PhD work. And, now, any time that I have a conversation with somebody about ageing or about their day-to-day lives, it’s just another point that reinvigorates and drives me forward. So that’s what keeps me going! 

Q: Last month, the NIA released a report that you co-authored with Egale on 2SLGBTQIA+ folks living with dementia and their caregivers. What are some of the main findings in that report? 

A: Broadly, it’s calling for moving past individual-focused solutions that place the onus for finding support on people living with dementia and carers, and taking a systems-level approach. So that is, integrating dementia-care programs with conversations around sexual and gender identity, and how that creates a new or a slightly different or unique experience of living with dementia and also caring for people living with dementia. And then vice versa — bringing conversations about caring and dementia into programming that is 2SLGBTQIA+ focused, and breaking down the way that things have been siloed historically. 

Another thing that has come out of our research is the need to expand our recognition of who carers are. It’s not only spouses or children, immediate children or biological family. It expands into a neighbourhood approach, it expands into chosen or found family, it expands into friends and acquaintances. There’s a wider net of support that I think is important to acknowledge when we think about supporting carers and supporting the different caring relationships.  

Q: Can you talk a little bit more about the issue of the two communities being siloed, and why you think that is? 

A: I think it goes back to that lack of recognition, or lack of awareness, that Two Spirit, queer and trans folks are getting older, and also being among the first generation that are open and sharing aspects of themselves that historically they haven’t shared with healthcare and social service providers. And because of that, within spaces of dementia care, there isn’t necessarily the recognition that, number one, Two Spirit, queer and trans folks are accessing their services. So, there isn’t that awareness. And then embedded within that, and maybe reinforcing it a little bit, is the perspective that, “Oh, we’re inclusive, everybody gets treated the same. It doesn’t matter who you are, it doesn’t matter your identities, because we’re treating everybody the same, everybody gets access to the same services.” And that’s not recognizing those histories that folks are bringing with them into spaces.  

And then I think, on the other hand, within Two Spirit, queer and trans communities, there is often a lot of ageism that happens within the broader community, there’s a lot of ableism that happens within the community. There’s a very youth-centric perspective, where the emphasis is on maintaining your youth and your beauty, and not necessarily acknowledging or recognizing anybody that kind of moves beyond that perception, and is getting older, within those spaces. So, conversations about issues related to ageing don’t happen because it’s an out of sight, out of mind kind of thing, not wanting to deal with it.  

That being said, in recent years we’re seeing a lot more “Ageing with Pride” communities and groups popping up, and conversations are starting to happen in little pockets, which I think is fantastic. But what we heard in our research is that these groups are more social. They’re not necessarily about talking about the challenges faced in ageing, it’s more about building a community — which is definitely necessary. But folks want to see more depth to the conversations that are happening within these spaces as well.  

Q: What are you working on now? 

A: We are starting to work out how to best work with Two Spirit, queer and trans folks who are living in rural and small-town communities and gaining more perspectives and understandings of what it’s like to be situated there, because a lot of the folks that we’ve heard from — whether it was through the work that we did with Egale or any of the other projects — we’ve been chatting with folks that are located in more urban areas. And based off of what we know, the urban-rural divide has an impact when it comes to ageing, generally. And as someone who lives in a rural community, I think that working to bridge that gap would be a really, really worthwhile and much needed perspective when it comes to Two Spirit, queer and trans knowledges of ageing.  

Q: What are some things that people should think about doing if they want to support 2SLGBTQIA+ older adults? 

A: I think the biggest thing, and probably the easiest thing, that folks can do is do their research. I’ve been talking a lot about histories and what folks are bringing with them into ageing — I think the first step they can do is familiarize one’s self with those histories, with what Pride Month means, why it’s in June, what it means for 2SLGBTQIA+ folks, and how they are part of that history whether they realized it or not. And then as they’re learning, reflect on the assumptions and the potential biases that they were carrying throughout that time, and up until present day. Egale’s e-learning modules are a great resource for folx. 

And then another relatively easy thing that folks can do is just to be mindful of the language that they’re using when they’re speaking with folks. For example, making a habit of using affirming language, using gender-neutral language until you know, or someone shares with you, their pronouns and those aspects of their identity. And to take that action, in the first instance, when introducing yourself — use your own pronouns and open the conversation for folks to reciprocate that.  

And then within organizations, you can assess where your policies and procedures are at, but that’s not quite as easy. But you can work in your day-to-day on that personal level and that will definitely have ripple effects.