Isolation is particularly acute for LGBTQ seniors, Adams said. “They are four times less likely to be parents than older Americans in general. Whereas most older Americans have adult children, they do not. They are twice as likely to grow old living alone without partners or spouses than older Americans in general. Because of discrimination and bias, LGBTQ elders are more likely to be disassociated from their families of origin than older Americans in general.”

“The traditional family structure is missing for many of our folks,” Adams said. “When folks are younger in the LGBTQ community, they deal with that by forming ‘families of choice.’ But there’s a limitation to that when you’re 75, 80, 90, and it’s harder to form such support networks.”

LGBTQ seniors may not feel safe where they reside in private or public housing, or within the residential care system. Adams said some “go back into the closet” in fear of homophobia and mistreatment by neighbors or nursing staff. “You can understand why,” said Adams. “There is a lot of discrimination still going on.”

Even in progressive urban centers like New York City, Adams said, LGBTQ seniors may go to a senior center to build new relationships but experience homophobia from other seniors. “At SAGE, they are embraced for who they are,” he added.