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The 2011 Institute of Medicine (IOM) report, Health of LGBT People: Building a Foundation for Better Understanding, highlighted both the health disparities and diversity of the lesbian, gay, bisexual, and transgender (LGBT) population.

This chapter describes specific health concerns related to LGBT aging and the impact of historical context and institutional and social stigma on medical, psychological, and social outcomes that confer both vulnerability and resilience. A heightened awareness of these disparities and the heterogeneity of the population can allow for optimal and culturally appropriate care to all older LGBT patients.


Table 73–1 defines terms used to define sexual and gender minorities. In general, sexual orientation describes a person’s emotional and/or physical attraction to people of the same and/or different gender. Most identify as lesbian, gay, bisexual, or heterosexual. However, it is also important to appreciate how factors including life course and historical context affect the diversity of gender identity and expression, in addition to sexual orientation. Older generations in particular often felt the need to hide their sexual orientation or conform to their gender of birth to avoid rejection and discrimination, thus “staying in the closet,” and giving rise to a mix of diverse family structures.

Table 73–1.Terms and definitions for gender and sexual minorities.

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