Top-Ten-Tips

TEN TOP TIPSFOR BECOMING MORE LGBT INCLUSIVEfor services and organisations working with older peopleLGBT AGE CAPACITY BUILDING PROJECTLGBT Health and Wellbeing

ContentsIntroduction 21. Make sure LGBT people are visibly welcomed 42. Avoid assumptions 53. Ensure that staff receive LGBT awareness training 74. Make sure that LGBT people’s safety and privacy is protected 85. Create a Safe Space policy 96. Engage with and respect LGBT people’s chosen families 117. Monitor gender and sexual orientation across the organisation 128. Link up with the LGBT communities in your local area 139. Make sure your systems and procedures are LGBT inclusive 1410. Remember that not all LGBT people are the same 15BONUS TIP: Keep up to date with issues, research, and good practice 17Useful resources and research 18Glossary 21About LGBT Health and WellbeingLGBT Health and Wellbeing creates andpromotes opportunities to improve andequalise the social, emotional, physical andmental health and wellbeing of lesbian, gay,bisexual and transgender people in Scotland,through a programme of activities, events,courses and community groups.This resource has been developed inconsultation with older LGBT people.The poetry, prose, and images in thisbooklet have been generously sharedby LGBT people who took part in our‘Lifelines’ intergenerationalstorytelling project.Page | 1

IntroductionWhat does it mean to be inclusive of LGBTpeople? How can you make sure that LGBTpeople feel actively welcomed? Why is itimportant to go beyond ‘treating everyone thesame’? How can your organisation provide thebest service possible to older LGBT people?Attitudes towards LGBT people have changeda great deal in recent times: the Equality Act(which requires public services to consider theneeds of LGBT people and tackle inequalityand discrimination) and Equal Marriagerepresent huge legal landmarks, anddiscrimination against LGBT people isincreasingly unacceptable in society.However, LGBT people still regularly faceprejudice, harassment and hate crime. OlderLGBT people in particular have dealt withserious discrimination throughout their lives(take a look at the timeline below to get anidea of some of the challenges they havefaced). As a result, many older LGBT peoplefear or expect prejudice from the peoplearound them – including professionals. Thismakes accessing services difficult; they arealso less likely to access preventative support,getting help only when the situation becomesa crisis – sometimes leading to permanentharm which could have been avoided.IsolationElspethThis piece reflects my fears of growingolder, my fears of isolation, bereavementand loss, and my experiences of thesepowerful experiences in the past.Imagine you are 65…If you’re a gayman, it was illegalfor you to have asexual relationshipuntil you were 31.1992If you are transgender,you didn’t have a legalright to have yourgender recognised untilyou were 54.present1980If you are lesbian orgay, your identity wasclassified as a mentaldisorder by the WorldHealth Organisationuntil you were 51.2003If you’re bisexual, as well asexperiencing the strugglesmentioned here around yoursame-sex relationships, youridentity has always beencalled into question as‘confusion’ or ‘a phase’.Page | 2

Many LGBT people who do access services hide theiridentities to protect themselves from discrimination. Forthose receiving care in their own home, this might meanhiding photographs and other things that would suggestthat they are LGBT; those moving into residential caremight hide their identity completely. For transgenderpeople, personal care may be particularly worrying iftheir body gives away their transgender status.Discrimination, and the fear of it, also contributes tosocial isolation, creating a barrier to mainstream socialopportunities – especially as their peers are more likely tohave negative views about LGBT people than the generalpopulation. Meanwhile, LGBT communities are oftenyouth-orientated and can feel inaccessible to olderpeople.Many LGBT people have experienced rejection from theirfamilies, which also contributes to isolation and a reducedsupport network. LGBT people often create their own,non-traditional families and forms of support; however,these can go unrecognised by those who provide formalcare. In addition, these networks are more likely to beformed of people who are ageing together, and may findit harder to look after each other as they get older.Even where there is not outright prejudice, LGBT peopleare often invisible, or seen as a deviation from the norm.Within services, ‘treating everyone the same’ often inpractice means treating everyone as heterosexual and/orcisgender (see glossary), which can be difficult for LGBTpeople who have to correct assumptions all the time as aresult.These days, many professionals are keen to make surethat they are inclusive and welcoming. But it’s somethingwhich hasn’t always been talked about, and often it canbe difficult to know where to start. This resource will giveyou some practical strategies for becoming moreinclusive, explaining the reasoning behind them along theway. It can be used with the LGBT Age Audit Tool to helpyou assess how your organisation is doing, and come upwith ways to improve. It is designed to help you go beyondtolerance to promote acceptance and active inclusion,embracing LGBT people for who they are and providingthe best care and support possible to them.SupportIs a timely touch on the armIt’s a smileIt’s a hugor a wordIt’s Marks and Spencers’ knickersOr tights or a girdleIt’s a helping hand over anunexpected hurdle.It grows from empathy, sympathy,love and compassion.It’s politicalIt’s essentialIt comes from peers, friends andfamilyFrom Stonewall to AmnestyIt’s unityIt’s you and meIt’s an act of loveIt’s an act of kindnessIt’s what should beIt’s what could beIt’s acceptanceIt’s hopeIt’s possibility.There is aglossary at the back ofthe booklet to explainany unfamiliar terms,plus a list of usefulresources for furtherinformation.Sally FoxFor more information, please contactKatherine, the LGBT Age CapacityBuilding Development Worker, on0131 652 3284 /katherine@lgbthealth.org.ukPage | 3

1. Make sure LGBT people are visibly welcomedWHY?LGBT people feel safer andmore confident in accessingservices if it is clear that theyare welcome.Many older LGBT people haveexperienced serious andongoing prejudice anddiscrimination throughout theirlives, from family, co-workers,peers – and often services.As a result of this, older LGBTpeople often assume that theywill face prejudice fromservices unless it is provedotherwise.It can be a huge relief to findout that fears about anorganisation were unfounded!Make sure your promotional materialsinclude LGBT people – in the pictures you use,as well as words.Have posters and flyers for LGBT-specificservices on noticeboards etc. in public areas.Signpost to LGBT organisations on your website.Use the LGBT Age Audit Tool to assess howyou are doing, and display the certificationafter completion.Display a statement of inclusivity in publicareas. Let people know that discriminationwill not be tolerated in your services.Display a Safe Space policy (see tip 5)which references LGBT people.Celebrate events such as LGBT HistoryMonth and Pride.Older LGBT peopleare 5 times lesslikely to useservices for olderpeople than theirpeers (ILC, 2008)The Invisible WomanSiân LovellPage | 4

2. Avoid assumptionsWHY?Avoiding making assumptionsabout people’s genderand/or sexual orientationmakes it much easier forthem to come out to you.It is important to make iteasy for people to talk abouttheir identity if they needto, so that they are able tellyou details about themselveswhich are relevant to theircare, e.g. discussing the roleof their same sex partner, ortrans-specific healthcare.It makes LGBT people feelsafer and more welcome,even if they choose not tocome out to you.It can be difficult and tiringto correct other people’sassumptions, particularlywhen you are in a vulnerableposition and/or need helpwith something unrelated toyour sexual orientation orgender.It helps to make clear toheterosexual and cisgenderpeople who use your servicesthat there may be LGBTpeople around, and that theorganisation is welcoming ofthem. This can help tochallenge prejudice amongstpeople using the service.Ask open questions and use gender neutrallanguage, e.g “do you live with anyone?”instead of “do you live with your husband/wife?”You might also use words like “partner”.Use gender neutral language about past andpotential relationships too - don’t assume that ifsomeone is in a mixed-sex relationship, they havenever been/never will be in a same-sexrelationship (or vice versa).Try not to make assumptions about people’sbodies. Someone’s gender identity doesn’tnecessarily tell you what their body is like.Listen to what words people use to describethemselves, and use those words. The exceptionis reclaimed slurs, such as ‘dyke’ or ‘tranny’.Avoid labelling people - describe relationshipsas ‘mixed sex’ and ‘same sex’ – rather than‘gay’ and ‘straight’.If you’re not sure about someone’spronoun, just respectfully ask.Be honest about gaps in your knowledge – admitthat you’re not sure what they mean and ask ifthey would be willing to explain a bit more. Bepatient if they find it difficult to explain.Don’t assume you know someone’s sexualorientation based on their gender identity– a trans person could be heterosexual,gay, bisexual, or something else.Don’t assume you know someone’s sexualorientation or gender identity based onhow they look.Page | 5

This Wish Tree holds a range of things that older LGBT people would like from support services.Avoiding assumptions is a very strong theme:“For everyone from allwalks of life to feel safe,supported and lovedliving every part ofthemselves openly andhonestly.”“I wish that services wouldn’toperate with a really narrowidea of what it means to be awoman – talking about ‘ladies’and assuming that because weare ‘ladies’ we have a specific,traditional range of interests.”“I wish that everyonewas allowed to bewho they are,however ‘different’that may be.”“To be visible.”“Acknowledgingthe past, notignoring it.”“I want to be seenfor all parts of whoI am, and forcare/treatment Ireceive to take thisinto account.”Page | 6

3. Ensure that staff receive LGBT awareness trainingTraining gives staff theconfidence to be proactive inaddressing the issues that LGBTpeople face.It helps staff to provide personcentredcare.Staff often want to be moreLGBT inclusive but are worriedabout saying the wrong thing.It sends the message thatprejudice is not acceptableamong staff members.LGBT staff members will alsofeel safer.WHY?Make LGBT awareness part of the standardinduction for new staff.Hold refresher training for existing staff atregular intervals, making sure to keep up to datewith developments in language and issues.Make it clear at the recruitment stage that staffwill be expected to engage with LGBT issues,and prejudice will not be tolerated.Make it clear that LGBT status isconfidential information in yourconfidentiality training and policy.Ensure that training includes trans andbisexual identities, as well as lesbian andgay ones.It Began With a Big BangI created a big bang in my mind,My life and thoughts have totally changed.Out of the blackness,out of the exploding starlightmy mind transformed.Lo and behold I saw my bodyrecreated into a living, healthy being.Free of gender, free of ageing.It’s full of spiritual thought and ideas.My inspired ideas are boundless.Energy re-explodes in a gapless mind.I looked at my body and for once in my lifeI was very pleased.Training sessions should be a safe andsupported space for staff and volunteersto challenge their own prejudiceswithout feeling they may be judged.Make sure that staff at all levelsreceive training, from seniormanagers to front line workers.Make sure that external and sessional staff(e.g. interpreters, people runningworkshops and activities, etc.) are aware ofthe expectations around LGBT inclusion.Remember to communicate this to peoplewho use your services.Nicky L. StonesPage | 7

4. Make sure that LGBT people’ssafety and privacy is protectedWHY?Provide some gender neutral toilets.LGBT people often fear being‘outed’ without their consent.Being clear that LGBT statuswill be treated as confidentialwill make it easier to comeout to staff.Being clear about theprocesses for dealing withdiscrimination will make LGBTpeople feel more confidentthat it will not gounchallenged.This may also help toencourage more positiveattitudes among people whouse the services, and will helpstaff to challengediscriminatory attitude whenthey do occur.Many trans people feel unsafein public toilets as they mayworry that they will bequestioned about their gender.It is a criminal offence toreveal someone’s transgenderstatus without their consent(Gender Recognition Act, 2004)Make clear and visible statements that LGBT status willbe treated as confidential.Remember that people may not come out toyou – and that is their choice.If you signpost to other organisations, get a sense ofhow LGBT inclusive they are. If they are notinclusive, you can signpost them to support that willhelp them improve. Depending on the situation, youmay need to stop referring people to them until theyshow improvement – let them know why you havestopped to encourage them to address the issues.If you run LGBT-specific groups, hold some of themoutside of your main space or somewhere more private,so that people can join in without outing themselves.Make sure that your complaints procedure dealsexplicitly with discrimination, and that it is clear, visible,and easy to use. Support the person complaining throughthe process and keep them informed about outcomes.Have a way for people to make anonymouscomments/complaints, so that they do not haveto out themselves to report discrimination.If someone needs help filling in forms, make surethat they are able to do this in private, with someonethey feel comfortable with.76% of lesbian, gayand bisexual peopleare not confident theywould be treated withdignity and respect ina care home setting(Stonewall, 2011)Develop a way for staff to whistle-blow ifthey encounter discrimination.Don’t ask questions just to satisfy your curiosity – forinstance, never ask a trans person if they have hadgenital surgery unless you need to know for relevant,medical reasons. If in doubt, ask yourself if you wouldever ask a non-LGBT person the same question.Page | 8

5. Create a Safe Space PolicyWHY?A Safe Space Policy sets outthe expectations of peopleusing and staffing a service.It forms an agreement forhow people treat each otherin the space/service.The aim is to make the spacea good place for everyone,regardless of identity orbackground.LGBT people feel moreconfident in knowing thatstaff will challenge behaviourthat makes them feelsunsafe.Staff are able to refer backto the policy in challengingdiscriminatory behaviour,which helps increase theirconfidence in doing so.Ensure staff know how to uphold the Safe SpacePolicy, including challenging people who use theservices and colleagues who breach it.When talking about the policy to deal with atricky situation, remember to speak about thebehaviour rather than the person, making surethat while people who breach it are asked totake responsibility for their actions, they are notcharacterised as bad people.Consider working with people who use the servicesand staff to come up with a policy together,making sure to include LGBT people and peoplefrom other equality strands in the discussion.Display the policyprominently and discussthe expectations it setsout with people who areusing the service for thefirst time.81% oftransgenderpeople avoidcertain situationsdue to fear (STA,2008)Soul PartyI wish,that when I'm oldI will rock back,history rolling down my spinein ever shifting colors.Lucent paths mapping us togetherin rhythms of joy and blues.Deep in the darkness of my soul,there is a partywhere everyone is invited.Aino LeskinenPage | 9

An example of a safe space policyPage | 10

6. Engage with and respectLGBT people’s chosen familiesOlder LGBT peoplemay have experiencedrejection from theirbiological families, andso may not havetraditional networks ofsupport.WHY?They are also lesslikely to have children,and more likely to livealone.Because of this, olderLGBT people’s supportnetworks are oftenbased on chosenfamily: close friendswho play an importantrole in their lives.LGBT people are4 ½ times morelikely not to havechildren (ILC, 2008)Involve LGBT people’s families in the same way thatyou would involve anyone’s family. This may includefriends as well as same-sex partners; listen to whatthey say about their networks and go from there.Don’t assume that LGBT people have children to supportthem – but equally, don’t assume that they do not!LGBT people may not be out to all of their family. Treattheir LGBT status as confidential when speaking tofamily unless you have asked if it’s ok to reference it.Remember that even if someone is in a same-sexrelationship, they may have a history which includesmixed-sex relationships – perhaps because they arebisexual, or came out later in life, or simply becausetheir sexual orientation has changed or is fluid.Work with individuals’ chosen family to ensure that LGBTpeople who have less capacity (e.g. those with dementia orwho are in hospital) are still able to be themselves as muchas possible – for instance, dressing in their own clothes,ensuring that the right pronoun/name is used, etc.Photography by Daisy SwainPage | 11

7. Monitor gender and sexual orientationacross the organisationWHY?It’s important to keep track ofdemographics to ensure that youare reaching LGBT peopleeffectively.At least 5-7% of the populationare LGBT; it’s a good idea toaim for this proportion withinyour service.Asking monitoring questionsgives LGBT people a chance totell you about their identity ifthey want to, allowing you toprovide a more person-centredservice right from the start.People are much more likely toanswer questions if they knowwhy they are being asked.Transparency can help to buildtrust.Separate gender, transgender status, andsexual orientation into different questions(see picture below).Ask ‘do you or have you ever identified astransgender?’. Some people see trans as part oftheir medical history, rather than part of theiridentity.Make it clear why you are collecting theinformation and what you will be using it for.Include an ‘other’ and ‘prefer not tosay’ option in each question.Include ‘questioning’ as an option – many peoplecome out in later life as their circumstanceschange and may not have picked a label.Monitor LGBT status among staff andvolunteers.Make it clear that LGBT status will be keptconfidential and/or anonymous and will notdisadvantage anyone.An example of good monitoring questions.Page | 12

8. Link up with LGBTcommunities in your local areaWHY?Publicise your service via LGBTpublications and networks.Older LGBT people can feelisolated from the LGBTcommunity, as it can beyouth-orientated and basedaround bars and clubs.This can increase theiroverall isolation.They may find it easier totalk to other LGBT peopleabout their lives. This canbe a valuable source ofsupport.Younger LGBT people whomay not have supportiveelders in their own familiesbenefit from interactingwith older LGBT people,which in turn gives olderLGBT people a sense ofpurpose and belonging.Engaging with the LGBTcommunity sends themessage that your service isLGBT friendly and ensuresthat LGBT people knowabout the options availableto them.Organise an intergenerational event with a localLGBT community group. LGBT Youth Scotland have anumber of youth groups and may be a good place tostart.Consult with older LGBT people on what theythink of your service, and what their needs are.Signpost to LGBT-specific services, groups andactivities. Make sure staff are kept up to date onthe opportunities and services available.When you encounter a tricky situation, ask forhelp. Organisations such as LGBT Health andWellbeing can offer advice and support.Be creative!One residential care home was strugglingwith residents expressing homophobicviews; explaining the situation, theyinvited the local gay men’s choir tocome in to sing carols and have mincepies with the residents. Many residentshad never knowingly met a gay personbefore, and the contact resulted inincreased understanding – and residentschallenging their peers’ homophobiccomments themselves.Page | 13

9. Make sure your systems, policies andprocedures are LGBT inclusiveWHY?Policies and procedures canprovide guidance for staffon what is expected of themin relation to LGBT people,helping them to make suretheir practice is inclusive.Policies and procedures alsomake LGBT people feelmore confident and safer byreassuring them that theywill be treated respectfullyand protected fromdiscrimination.Sometimes systems forrecording data can beinaccurate because theydon’t have comprehensivecategories, for example forgender. Updating them willallow you to get a moreaccurate picture of thepeople you work with, whichwill help you to understandtheir needs.Where you record gender, ensure that there is away of recording genders other than male/female(see tip 7).If it’s relevant, make sure that your system allowstrans people to record their gender accurately andstill receive information relevant to them. Forinstance, trans women should still get remindersabout prostate checks – but make sure that thesereminders are inclusive, and don’t assume thateveryone with a prostate is a man! You may alsowish to send out separate reminders to avoid this.Update relevant policies and procedures toprovide guidance on how they apply to LGBTpeople. This might include: a discussion of LGBTstatus in your confidentiality policy; inclusion ofhow discrimination is dealt with in your complaintsand/or disciplinary procedures.Make clear statements about thesepolicies to all staff and people whouse your services.The Equality Act(2010) requirespublic services toconsider the needs ofLGBT people and totackle inequality anddiscriminationBack up your policies and procedures withhigh-quality staff training to make surethey are supported in carrying them out(see tip 3).Make sure that your employment and recruitmentpolicies promote equality and aim to eliminatediscrimination for LGBT employeesPage | 14

10. Remember that not all LGBT people are the sameLGBT people are as variedas any other part of thepopulation in terms of race,belief, ethnicity, socioeconomicstatus, disability,health, interests,personality…Person-centred care is allabout engaging with peopleas they are. Rememberingthat LGBT people are adiverse group will help youto provide care which livesup to that ideal.LGBT people mayexperience multiplediscrimination – they mayalso be disabled, experiencemental health issues, beBME etc.; this may meanthat they have particularchallenges, e.g.experiencing discriminationwithin their own communityor experiencing doublestigma.LGBT people experiencehealth inequalities,particularly around mentalhealth.WHY?Avoid stereotypes - you can’t tell what someone islike just from their sexuality and/or genderidentity, just as you can’t tell if someone is LGBTjust by looking.Be aware that different cultures have differentattitudes to LGBT people, which can affect people’sengagement with their cultural community. Butdon’t assume that BME people will be offended bydiscussion of LGBT issues.Remember that many LGBT people have had adifficult relationship with religion – but also beaware that many LGBT people are religious.If someone using the service needs an interpreter,remember that LGBT-related terms don’t alwayseasily translate. Also be aware that people may worryabout prejudice from interpreters.While you are thinking about LGBT inclusion, usethe opportunity to think about the other equalitystrands. Lots of this learning will be transferrable!Remember that sexual orientation isn’t all about sex– even if someone is not having a sexual relationship,their L/G/B identity is still important, and they canstill enjoy romance and companionship.LGBT people are 3-4 times more likelyto experiencemental ill health(University ofBrighton, 2007)Don’t assume that just because someoneis older and/or disabled that they are notinterested in sex!Try to have a diverse range of LGBT people in yourpublicity – for instance, not all LGBT people are whiteor able-bodied.Page | 15

A Letter to my Younger SelfDear ElspethLetters to MyselfElspeth MorrisonThis is a letter from your future, where things are currently brightand good. Don’t give up. This pain will pass, this storm will subside.You will not always feel cold and lost. You will come home to yourself. Your road will bemostly uphill but you will manage, one step at a time. Others will be there to hold your hopefor you while you limp along. Your best is good enough, and more than that, it is all you haveto give.I cannot tell you how long your journey to recovery will take: I can only say that quick fixeswon’t work. Neither do absolutes apply to you anymore. Learn to live with shades, not blacksand whites. Try to keep talking, try to keep trusting. No-one means to let you down. Judgethem and yourself with compassion. Above all, hold on to love, it will see you through.A Letter to my Older SelfDear ElspethWow, you’re still here. Well done for that! You’ve made it this far, that’spretty damned impressive. Stopping smoking and drinking was worth itthen? How does it feel being this old? Better than the alternative? Are you still looking into that, orhave things settled a bit more? I hope things are more stable with you. You’ve struggled a lot in thepast, but now this is the time to settle down and relax: to look back on your life and see what youhave achieved, not beat yourself up for what you never got round to doing. Don’t waste the timeyou have left on regrets. Don’t live solely off your memories either, make new memories out of eachprecious moment. Keep mindful and compassionate. These allies have served you well in the pastand will see you through the present into the future. Respond, don’t react. Remember the lessonsyou worked so hard and long to learn, stick with those too. Keep surrounding yourself with thepositive people you have met over the years. Remain honest and respectful for the time you haveleft. Let yourself be remembered for the best you could be, not the worst. Keep loving, keep livingand now it’s your turn to look after Jackie.With love to youEPage | 16

BONUS TIP: Keep up to date with issues,research, and good practiceWHY?Don’t be afraid to ask questions. Build relationshipswith projects and people who can advise you.Services and organisationsare still experimenting tofind out what works to makeservices more accessible toLGBT people. Newopportunities andapproaches are beingdeveloped all the time.As progress is made, newgroups make their voicesheard. For instance,intersex people campaigningfor their inclusion and rightsare starting to gainmomentum.Language changessurprisingly quickly!Make sure staff can ask questions about LGBTissues – perhaps you could have someone who is adesignated go-to person.Make links with other services which are strivingfor inclusivity and learn what’s worked and whathasn’t. Seek out good practice.Designate someone to keep up to date with researchand disseminate it to other staff.Regularly re-assess how you are doing andmake new plans to keep improving. TheLGBT Age Audit Tool is a great way ofdoing this.Most importantly - involve older LGBT people indevelopment and improvement work right from thestart – and keep them involved as the workcontinues.Wish Tree and Worry BoxKeep consulting withLGBT people – and getcreative!Page | 17

Useful resources and researchCount me in Too | Finding from the UK’s largest scale LGBT community needs assessment. Includes areport on older LGBT people’s needs. University of Brighton & Spectrum (2007)http://www.countmeintoo.co.uk/Transgender Experiences in Scotland | Key research findings of the Scottish Transgender Alliancesurvey of transgender people living in Scotland. Scottish Transgender Alliance (2008).http://www.scottishtrans.org/our-work/research/The Equality Network have a range of reports on community engagement, policy and campaigns,intersectional identities (in particular asylum seekers and black/minority ethnic people), andtransgender issues.http://www.equality-network.org/resources/publications/Stonewall Scotland have a range of resources and research available, including reports on communitysafety, employment, health, housing, and including LGBT people in decision-making.http://www.stonewallscotland.org.uk/scotland/what_we_do/2745.aspThe Bisexuality Report: bisexual inclusion in LGBT equality and diversity | A comprehensive report,including recommendations and tips. Barker et al; BiUK, Bisexual Index and Open University (2012)Older LGBT peopleThe Last Outing | Exploring end of life experiences and care needs of older LGBT people. University ofNottingham (2014) http://www.nottingham.ac.uk/nmpresearch/lastouting/home.aspx“We don’t have any of those people here” | Retirement Accommodation and Aged Care Issues forNon-Heterosexual Populations. GRAI (2010)http://grai.org.au/wordpress/wp-content/uploads/2010/07/We-dont-have-any-of-those-peoplehere.pdfOpen Doors London have a variety of useful resources and research available. They provide a range ofLGBT people over 50 in London.http://openingdoorslondon.org.uk/odl-resources/Don’t look back? | Improving health and social care service delivery for older LGB users. Ward et al;Equality and Human Rights Commission (2010)http://www.equalityhumanrights.com/sites/default/files/documents/research/dont_look_back_improving_health_and_social_care.pdfThe International Longevity Centre (ILC) has a series of policy briefs on the needs of older LGBTpeople.http://www.ilcuk.org.uk/index.php/publications/publication_details/older_gay_lesbian_and_bisexual_people_in_the_uk_policy_brief_seriesPage | 18

Perspectives on ageing: lesbians, gay men and bisexuals | Interviews with older LGB people abouttheir experiences of ageing. Knocker; Joseph Rowntree Foundation (2012)http://www.jrf.org.uk/publications/perspectives-ageing-lesbians-gay-men-bisexualsLesbian, gay, bisexual or transgender: planning for later life | Age UK (2013)http://www.ageuk.org.uk/Documents/EN-GB/Informationguides/AgeUKIG02_Lesbian_gay_or_bisexual_inf.pdf?dtrk=trueTransgender Issues in Later Life | Age UK (2011)http://www.ageuk.org.uk/brandpartnerglobal/eastlondonvpp/documents/fs16_transgender_issues_in_later_life_fcs.pdfBereavement: A guide for Transsexual, Transgender people and their loved ones | NHS &Department of Health (2007)www.gires.org.uk/assets/DOH-Assets/pdf/doh-bereavement.pdfStonewall have several resources aimed at organisations working with older people, including asubstantial piece of quantitative research (Lesbian, Gay and Bisexual People in Later Life).http://www.stonewall.org.uk/what_we_do/research_and_policy/sexual_orientation__equality_strands/8025.aspThe Rainbow Project have produced two sets of practical guidelines specific to care settings.http://www.rainbow-project.org/resources/resources-for-professionalsStonewall celebrated their 25 th birthday with a publication of 25 stories from older LGBT peoplehttp://www.stonewall.org.uk/media/current_releases/10243.aspDementiaDementia Doesn’t Discriminate | Information for LGB&T people and their friends, partners andfamilies. Equity Partnership (2014)http://www.futureyears.org.uk/uploads/files/Dementia%20leaflet.pdfSupporting lesbian, gay and bisexual people with dementia | Alzheimer’s Society (2012)http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1100Moving into a care home – advice for lesbian, gay and bisexual people | Alzheimer’s Society (2012)http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=2131Mental HealthTrans Mental Health Study | Largest UK study of trans mental health. McNeil, J. et al. (2012).http://www.scottishtrans.org/our-work/research/Page | 19

There’s More to Me | Report on lesbian, gay and bisexual people’s beliefs, attitudes and experiencesof mental health. Glasgow Anti-Stigma Partnership (2010)http://www.samh.org.uk/media/1154/SAMH_LGB_Report_FINAL.pdfSupporting LGBT Lives: A study of mental health and wellbeing | Commissioned by Gay and LesbianEquality Network (GLEN) and Belong to Youth Project. Maylock, A. et al. (2008)http://www.nosp.ie/lgbt_lives_dec_2008.pdfHealth and WellbeingTowards a Healthier LGBT Scotland | INCLUSION Project Working for Lesbian, Gay, Bisexual andTransgender Health. Stonewall Scotland and NHS Health Scotland (2003)www.show.scot.nhs.uk/publications/Stonewallopt3.pdfThe Terrance Higgins Trust provide sexual and physical health advice. Their sexual health guides fortrans men and women are particularly useful:http://www.tht.org.uk/sexual-health/Sex,-reproduction-and-gender/Transwomenhttp://www.tht.org.uk/sexual-health/Sex,-reproduction-and-gender/TransmenA national study of ageing and HIV (50 Plus) | Power et al, Joseph Rowntree Foundation (2010)http://www.jrf.org.uk/sites/files/jrf/living-with-HIV-full.pdfPage | 20

GlossaryThis glossary includes the definitions of the terms used in this booklet, along with some otheruseful terms. It’s important to bear in mind that a lot of these words refer to personal identities, sothey can mean different things to different people. Use these definitions as a starting point forunderstanding and discussion – and most importantly, listen to what people say about themselves.Words marked as adjectives (adj) should not be used as nouns, e.g. ‘a transgender person’ NOT ‘atransgender’.Biphobia: refers to the hatred or fear of bisexual people. Discrimination based on a person’s bisexualidentity.Bisexual (adj): a person who is emotionally and sexually attracted to both men and women.Cisgender (adj) (abbreviation: cis): refers to a whole range of people who find their gender identityor gender expression matches the gender assumptions made by others about them when they wereborn. The term was created to challenge the assumption that cisgender people (as opposed totransgender people) are always the standard in discussions about gender and sex. It is not a derogatoryterm.Coming out: coming out is the lifelong process of telling other people that you are LGBT. Being outed ishaving someone else reveal you as lesbian, gay, bisexual, or transgender, usually without your consent.Crossdressing (adj) / Transvestite: people who dress, either occasionally or more regularly, in clothesassociated with the opposite gender, as defined by socially accepted norms. Crossdressing people aregenerally happy with the gender they were labelled at birth and usually do not want to permanentlyalter the physical characteristics of their bodies or change their legal gender.Gay (adj): a person who is attracted only to members of the same sex. Attraction is emotional as wellas physical and not always based on sexual activity.Gender identity: a person's inner sense of self as male, female or somewhere in between. Most peopledevelop a gender identity that corresponds to other’s expectations of their biological sex but some donot.Heterosexism: the belief that heterosexuality represents a standard, and that all other sexualorientations, if acknowledged at all, are merely a deviation from this. Heterosexist statements arestatements that assume all people are straight or that fail to recognise the variety of sexualorientations that exist.Heterosexual (adj) (colloquially: straight): a person who is only sexually attracted to persons of theopposite sex.Homophobia: hatred or fear of gay/lesbian people. Discrimination based on a person’s gay/lesbianidentity.Homosexual (adj): a medical word for a person who is attracted to someone with the same gender thatthey have. This is considered an offensive/stigmatising term by many members of the LGBT community,and is often used incorrectly in place of “lesbian” or “gay”. However, some people, especially oldergay men, use the term to describe their identity in a neutral or positive way.Page | 21

Intersex (adj): this is a term used to describe people born with biological sex characteristics (such astheir external genitals, internal reproductive system or chromosomes) that are medically detectable asdiffering from what is considered clearly male or female.Lesbian/Gay Woman: a woman who is emotionally and/or sexually attracted to other women.Attraction is emotional as well as physical and not always based on sexual activity.LGBT: Lesbian, Gay, Bisexual, Transgender.Non Binary Gender: refers to people who identify their gender as not conforming to the traditionalwestern model of gender as binary. They may identify their non-binary gender as a combination ofaspects of men and women or alternatively as being neither men nor women. Examples of labels peoplemay use to describe their non-binary gender include Androgyne / Polygender / Genderqueer; somepeople who may use no label at all.Questioning (adj): a person who is questioning their sexual orientation and/or gender identity. Thisdoes not necessarily make them confused.Sexual orientation: the type of sexual, romantic, physical, and/or spiritual attraction one feels forothers, often labelled based on the gender relationship between the person and the people they areattracted to.Transgender/trans (adj): an umbrella term for a range of people whose gender identity or genderexpression differs in some way from the gender assumptions made by others about them when theywere born. Including: transsexual people, people with a non-binary gender, crossdressing/transvestitepeople, intersex people, and others.Transphobia: refers to the hatred or fear of transgender people. Discrimination based on a person’stransgender identity.Transsexual (adj): a term used to describe people who consistently self-identify as the oppositegender from the gender they were labelled at birth. Depending on the range of options and informationavailable to them during their life, most transsexual people try to find a way to transition to live fullyin the gender that they self-identify as. Transitioning is also known as gender reassignment. Many, butnot all, transsexual people take hormones and some also have surgery to make their physical bodiesmatch their gender identity better.Page | 22

Other resources are available on our website, including: An easy to use Audit Tool “Are we being served?”, a short film about theexperiences of older LGBT people Signposting optionshttp://www.lgbthealth.org.uk/services-support/lgbt-age/LGBT Health and Wellbeing, 9 Howe Street, Edinburgh, EH3 6TElgbtage@lgbthealth.org.uk / 0131 523 1100www.lgbthealth.org.ukPage | 23