New York
320,127
Florida
271,554
Texas
241,356
California
237,924
Georgia
236,463
North Carolina
210,772
Illinois
190,521
Maryland
166,186
In a study of self-rated health status in 2010–2012, 62 % of older African-American men and 61 % of women reported “good,” “very good,” or “excellent” health status compared to 78 % for White older men and 80 % for women. Positive health evaluations decline with age, with 67 % of African-American men ages 65–74 reporting “good,” “very good,” or “excellent” health compared with 52 % among those aged 85 or older. Similarly, 65 % of African-American women ages 65–74 reported “good” to “excellent” health, with 58 % at ages 85 or older (Administration for Community Living 2012). African-Americans have a disproportionately higher rate of chronic illnesses and lower survival rates. The most frequently occurring health issues among African-Americans include AIDS/HIV, asthma, cancer, diabetes, heart disease, hypertension, obesity, and stroke (Centers for Disease Control 2013). In addition, African-Americans have higher rates of HIV and AIDS, many of whom were infected at a younger age and who are now living longer (Baker and Krehely 2012). A combination of health inequities and financial and cultural barriers to receiving health care in later life negatively affects the health of African-American older adults. Table 6.2 compares the most frequently occurring conditions among older African-Americans compared to all other older persons. In comparison to White elders, Black elders have severe limitations in daily tasks requiring assistance with housework, personal care, and preparing meals. The life expectancy for Blacks, at any age, tends to be lower than that for Whites. In 2010, a 65-year-old African-American male was expected to live another 15.9 years, compared with 17.7 for White males, and a Black female at age 65 was expected to live another 19.3 years, a full year less than a White woman. Comparatively, Latino males (additional 18.8 years) and Latina females (additional 22 years) are expected to liver longer than Black or White males and females (National Center for Health Statistics 2013). Interestingly, these data do not disaggregate outcomes for LGBT persons. The leading causes of death for all African-Americans are in Table 6.3.
Table 6.2
Frequently occurring health conditions of older African-Americans
African-Americans | All older persons (%) |
|---|---|
Hypertension (85 %) | 72 |
Diagnosed arthritis (52 %) | 50 |
Heart disease (26 %) | 30 |
Diagnosed diabetes (40 %) | 20 |
Cancer (17 %) | 24 |
Table 6.3
Leading causes of death for African-Americans
Heart disease |
Cancer |
Stroke |
Diabetes |
Unintentional injuries |
Nephritis, nephrotic syndrome and nephrosis |
Chronic lower respiratory disease |
Homicide |
Septicemia |
Alzheimer’s disease |
African-American LGBT elders face challenges similar to those in both the African-American and the older adult populations as a whole. Collectively, more than 68 % of African-American elders are poor, marginally poor, or economically vulnerable, are more than one and a half times as likely as White elders to live below the poverty line, and more than one in four African-American elders have incomes that fall below the poverty line. Some gender disparity exists among older African-American women and men with regard to living arrangement. More older African-American women are vulnerable to social isolation and economic hardship, with nearly 40 % of women ages 65 and older living alone compared to 19 % of men (Administration on Aging, n.d.). The circumstances of older LGBT African-Americans are difficult to discern and separate from the Black population at large because of their covert existence in the Black community (Harley et al. 2014). Many years of living, secretive or closeted lives often lead to a heightened sense of isolation for Black LGBT elders. Yet, as a separate group, less is known about unique challenges faced by African-American transgender persons or those who identify as queer, even though they were intricately involved in the Civil Rights Movement of the 1960s and have been active contributors to history (Roberts 2012). One of the earliest documented cases of an African-American transgender person is that of Lucy Hicks Anderson who was born in Waddy, Kentucky, in 1886, as Tobias Lawson. See Discussion Box 6.1 for information on Anderson and on Carlett Angianlee Brown, who was scheduled to become the first African-American to have sex reassignment surgery (SRS).
Discussion Box 6.1: Historical Transgender African-Americans
Lucy Hicks Anderson (1886–1954): Born in Waddy, Kentucky, as Toias Lawson. When Lawson entered school she insisted on wearing dresses and began calling herself Lucy. Upon the advice of a physician, Lawson’s mother raised her as a girl. After leaving school at age 15, Lucy worked as a domestic. She eventually married and then moved to California. After a divorce in 1929, she remarried in 1944 to a soldier. Eventually, when the Ventura County district attorney discovered that Lucy was biologically male, he decided to try her for perjury. Lucy was convicted of perjury and placed on probation for 10 years. Later, the federal government prosecuted Lucy and her husband for fraud for receiving allotment checks as the wife of a member of the US Army. After her release from prison, she lived the remainder of her life in Los Angeles (http://www.blackpast.org/aaw/anderson-lucy-hicks-1886-1954).
Carlett Angianlee Brown (1927): She was born as Charles Robert Brown. In 1953, Carlett was a 26-year-old female illusionist and shake dancer from Pittsburgh. She had served in the Navy, during which time she was examined for an issue with recurring monthly bleeding through her rectal area. The medical exam revealed that she was intersex and had some female sex organs. She declined to have surgery to remove the female organs and opted for SRS instead. Her plan was to get marry after completing SRS. In order to do so, Carlett had to renounce her US citizenship because laws in countries where the surgery could be performed did not allow foreign nationals to obtain SRS. Her US passport was issued with her name as Carlett Angianlee. On July 9th, she was arrested for cross-dressing. She postponed her departure to get a feminizing face-lift in New York in August. Eventually, she was ordered not to leave the USA until $1200 in back taxes were paid. Unable to make payment, she worked as a cook at Iowa State’s Pi Kappa frat house to earn money. Additional information regarding her final outcome is not found. If Carlett is still alive, she will be into her mid- to late 1970s (http://www.racialicious.com/2009/07/15/the-story-of-carlett-brown/).
Discussion Questions:
1.
What sociopolitical issues are in play for Anderson and for Brown?
2.
Compare and contrast the challenges facing transgender African-Americans in the 1940s, 1950s, and today.
3.
How accepting was the Black community of transgender persons within the community? Civil Rights Movement?
4.
Have the attitudes of the Black community changed toward transgendered persons?
5.
In what ways can the Black community promote advocacy and equality for Black transgendered persons?
In 2007, a national survey of transgender and nonconforming gender populations was conducted by Trans Equality to determine discrimination experiences (www.transequality.org/PDFs/BlackTransFactsheetFINAL_090811.pdf). Of the 6456 respondents, 381 were Black or Black multiracial. While the focus of the survey was on anti-transgender bias, the results also show the complex interactions of bias with race and socioeconomic status. The survey did not identify those experiences by age. Nevertheless, “the combination of anti-transgender bias and persistent, structural and individual racism was especially devastating for Black transgender people and other people of color” (p. 1). Black transgender persons live in extreme poverty with 34 % reporting a household income of less than $10,000 per year. These data indicate that for Black transgender persons, this is more than twice the rate for transgender people of all races (15 %), four times the general Black population rate (9 %), and over eight times the general US population rate (4 %). In addition, more than half of Black respondents were HIV positive. Although African-Americans have a significantly lower suicide rate than other racial groups, nearly 49 % of Black transgender persons indicated they had attempted suicide at some point. On a more positive note, the study found that those who were “out” to their families found acceptance at a higher rate than the overall sample of transgender respondents.
Research and Practice
The National Alliance on Mental Illness (2007) acknowledges that to date, most research on LGBT populations has been done with predominately White samples and the mental health (MH) concerns and needs of LGBT of color are still largely unknown and vastly understudied. In addition, health disparities and disabilities among African-Americans are higher than their White counterparts, with women experiencing early onset of disease and disability and increased mortality (Jones 2009; Lekan 2009). LGBT older adults and LGBT elders of color deal with significant health disparities across domains related to physical and mental health, including chronic conditions and HIV/AIDS, depression, suicide, and substance abuse (Administration on Aging , 2013; Fredriksen-Goldsen et al. 2011; Institute of Medicine, 2011).
The long-term financial stability of many LGBT elders of color is shaped by employment discrimination. Many LGBT elders of color are concentrated in employment sectors with low wages, no labor unions or few labor protections, routine discrimination, and limited health and savings options. Economic security is core to the health and well-being of LGBT elders of color (Auldridge and Espinoza 2013).
Lekan (2009) emphasizes that African-American women experience more stress and health disadvantages than their White counterparts because of the interaction and multiplicative effects of race, gender, socioeconomic status, and age. Although there is a growing body of research about health concerns among African-American women in general, there exists a dearth of information on African-American lesbians (Dibble et al. 2012). Similarly, African-American gay men are rarely researched outside of a focus on HIV/AIDS. African-American transgender persons also experience many health and socioeconomic challenges including substance abuse, HIV infection, difficulty in obtaining housing and employment, and reliance on commercial sex work for survival (Clements-Nolle et al. 2001; Wilkinson, nd). Understanding bisexual Black women and men within the context of culture and community is difficult because they experience isolation from heterosexual as well as lesbian and gay communities, which may affect aspects of identity development, internalized binegativity, and access to social and psychological resources (Isarel 2007). While LGBT people of color experience the worst outcomes and receive the least institutional attention, the aging concerns of LGBT of color are virtually absent in national policy discussions on aging health and economic security (Auldridge and Espinoza 2013). Because of the limited research on LGBT elders of color, there is reliance on the literature concerning LGBT elders in general, from which information is glean about African-American LGBT elders. However, additive research for African-American LGBT should be avoided because it does not equal research applicable to this group (Bowleg 2008). As author of this chapter, I suggest that additive research may offer some comparative insight; however, should at least approached with caution.
In advancing the research of LGBT persons of African descent, Lewis and Marshall (2012) offer several considerations. First, research on Black LGBT populations should not attempt to separate the various aspects of the individual’s identities into mutually exclusive categories and expect to understand their experiences. Second, research must incorporate questions of the participants that do not force them to respond to items as to which identity is more important, which identity causes more stress, or rank identities in order of concern on a daily basis. Questions such as these assume an additive value to the multiple identities, and further marginalizing as opposed to an intersecting relationship among the identities (Bowleg 2008; Lewis and Marshall). According to Wheeler (2003), researchers must realize that the intersecting identities of sexual orientation, gender, race, and ethnicity are more likely to be geometric rather than additive. Finally, Afrocentric theorizing, which has “secured its own identity among dominant Eurocentric thought” (p. 13), must stop being neglectful of prevalent sexual realities in African-American culture.
All too often, research methodologies on African-Americans and Black LGBT populations involve a comparison to White LGBT groups, with whom they share few similarities beyond sexual orientation and gender identity. Moreover, most studies on sexual minorities do not include sufficient numbers of African-American or Black participants to perform adequate or sophisticated statistical analyses. In addition, research on LGBT African-Americans focuses on urban populations and ignores those in rural setting or smaller cities (Deblaere et al. 2010). For additional information on LGBT persons in rural settings, the reader is referred to Chap. 25 in this text. LGBT persons in urban areas have the privilege of anonymity, access to more services and supports, and the opportunity to belong to an LGBT community. The language used in many research studies present another barrier to instrumentation design. Much of the terminology that is used is characteristics of the White LGBT community (e.g., “out”), which involves identification by labels, whereas in Black culture, the approach is more a use of descriptions. Researchers will need to develop measures that are consistent with indigenous structures in the Black community. Finally, limited research exists that examines African-American LGBT issues and concerns across the life span (Harley et al. 2013).
Cultural Capital
The African-American community is known as a collective society that provides support and refuge to its people. The cultural characteristics of the community consist of strong kinship bonds, valuing education, strong religious orientation, high achievement orientation, strong work ethic, self-reliance, and adaptability of family roles (Brown Wright and Fernander 2005). Table 6.4 consists of value characteristics of the African-American community. Homosexuality and nonconforming sexual identity are largely considered incompatible with values in the Black community. Lewis and Marshall (2012) suggest factors that may influence the attitudes and perceptions among Black people about LGBT persons of African descent, including racism and ancestral baggage (i.e., rejection by some in their own race in an attempt to project noticeable “normal” Blackness), a lack of promotion of historically accurate information on diverse Black sexuality, and selective attention bias regarding interpretations of specific biblical scriptures. Some evidence suggests that more ambivalence, tolerance, and acceptance have emerged in African-American families for LGBT family members (Hunter 2005). Hunter suggests that family instructions such as “be silent and invisible” may allow the family to accept a LGBT member without having to deal with his or her sexual orientation and the issues associated with it. In fact, the lack of disclosure increases acceptance of their sexual orientation for older LGBT Black persons. However, the circumstances for African-American LGBT elders are difficult to discern and separate from the general Black population because of their cover existence in the Black community.
Table 6.4
Value characteristics of the African-American Community
Self-reliant |
Oral traditions |
Strong work ethic |
Unity and cooperation |
Flexibility in family roles |
Present-time orientation |
Firm child-rearing practices |
Educations as a means of self-help |
Strong work and achievement ethic |
Strong spiritual and religious values |
Respect for elders and authority figures |
Collateral interpersonal relations are highly valued |
Giving people status as a function of age and position |
Strong kinship bonds with family, extended family, and friends |
“Strong Black Woman” (pride in racial identity, self-reliance, capability in handling challenges) |
Nonverbal communication patterns (body movement, postures, gestures, facial expressions) |
Although African-American culture may be inclusive of other Black families and communities, it is a misnomer to assume that it is representative of those other diverse Black groups. There is no one description that can accommodate the various identities, behaviors, and perceptions among African-Americans (Wilson 2005). Similarly, the terms used in the African diaspora are different, with some being highly derogatory (Lewis and Marshall 2012). LGBT issues of people of color play out differently in families and communities of different backgrounds, yet many communities of color share cultural bias against homosexuality and gender nonconformity (Somjen 2009). The way in which an individual expresses his or her gender and/or sexuality may be defined by cultural values such as whether the culture focuses on the individual or the group; the level of acceptance in talking about sexuality; the degree of separation of public and private domain; the social organization and definitions of gender; the role of religion within their own culture; and the degree of assimilation into the dominate society (Rust 1996). LGBT persons of color, regardless of age, share the common experience of being a minority within a minority, which may contribute to an increased vulnerability to psychosocial issues.
African-American and Black LGBT persons have always been part of the Black community. The roles and impact of LGBT persons in the Black community was in part demonstrated through involvement in the Civil Rights Movement. On April 1, 1998, in the Chicago Tribune, Coretta Scott King acknowledged the role of sexual minorities stating, “gay and lesbians stood up for civil rights in Montgomery, Selma, in Albany, Georgia and St. Augustine, FL., and many other campaigns of the Civil Rights Movement. Many of these courageous men and women were fighting for my freedom at a time when they could find few voices for their own, and I salute their contributions.” Although the rate of homophobia and heterosexism is high in the Black community, especially in the Black Church (which is discussed later in this chapter), most African-American LGBT persons indicate that they still find more support and refuge in the Black community, especially against the tyranny of racism in the White gay community (Boykin 1996; Green 1994; Savage and Harley 2005). For African-American LGBT people, there is “a perceived link that connects its members regardless of other differences that might also exist” (Moore 2010, p. 17). In fact, some researchers suggest that African-American lesbians, having learned to handle their ethnic minority status, have developed a great deal of resilience and personal strength and may be better equipped to also handle their status as a sexual minority (Cooper-Lewter 2007; Dibble et al. 2012; Hall and Fine 2005). Yet, gender discrimination is not equal for LGBT persons in the Black community. Lesbians often face disproportionately more ridicule in the Black community, and based on their multiple subordinate-group identities, Black lesbians have “intersectional invisibility: as targets of sexism, heterosexism, homophobia, and racism within the dominant culture and the Black community” (Purdie-Vaugns and Eibach 2008, p. 377).
Views Held About Elders. From a cultural perspective, elderly African-Americans are revered and entitled to respect within the African-American community, and a position of age carries with it a high level of cultural capital (Harley et al. 2014). Ageism is not a prevalent characteristic in the Black community; however, it is in the gay community, especially with regard to physical attractiveness. However, the reader should be aware of some generational changes within the Black community about attitudes and behaviors toward their elders. For example, elders in the Black community are increasingly targets of violence and crime, mistreatment, and assault. This shift in attitudes toward African-American elders must be placed within a culturally sensitive context and considered alongside culturally specific risk factors (Teaster et al. 2014). For example, in the African-American community, a single incidence of yelling or hitting an elder is not viewed as elder abuse, whereas physical abuse is extreme abusive behavior. Extreme abusive behavior toward elders is considered as unacceptable in the Black community (Tauriac and Scruggs 2006).
African-American elders hold the distinction of being the family historian. The elders continue the oral tradition of passing on cultural meaning, legacy, and knowledge. Within the Black community, elders are not referred to as old, but as wise, illustrating that they have reached the “age of wisdom.” Although aging is associated with lived experience, chronological age is not the only criterion for ascension into the “age of wisdom.” The experience that one has accumulated allows one, especially women to gain this wisdom. Experience may include emotional and spiritual support, information, advice, and service. Old age for Black women is a matter of the functions they carry out (e.g., teaching values, convening the family on certain occasions, religious role model). Thus, wise women gain prestige and power, and important matters are brought to them (Brown Wright and Fernander 2005; Peterson 1990). Peterson summarized the important role of older Black women in the family and church, “they move beyond the potential constraints of class, money and blood relationships to reinforce cultural values of the importance of children, the significance of fictive kin, the problem of clinging to possessions and the wisdom derived from lived experience” (p. 227). Given that the family and church are considered to be the two most important institutions in the Black community and a high degree of respect for elders, the question is raised, what is the role of LGBT elders within these institutions? Deutsch (2006) suggests that through civilized oppression (the experience of repeated, widespread, systematic injustice), Black LGBT persons receive unequal treatment, are relegated to invisibility, and are silenced, condemned, shamed, and forbidden from participation in activities afforded to heterosexual couples.
Acculturation and Assimilation Issues. Numerous definitions of acculturation exist to explain the multifaceted ways in which changes occur at the group and individual level. Riva (2010) offers the definition of acculturation as “a dynamic process of change that individuals undergo as they interact with and adapt to a new or different cultural environment; it is an interactive process that occurs along different life domains at different rates of change” (p. 331). Inherent in the practice of acculturation is the concept of inequality and the lack of mutual respect that the dominant culture tends to project, consciously or unconsciously, on racial minorities (Wilson 2005). Assimilation is viewed more as voluntary aspiration to identify and integrate with and adapt to the ways of the dominant, Anglo-Saxon mainstream. The intent of presenting information on acculturation and assimilation is not to debate if Black LGBT elders are one or the other, but rather to illustrate that acculturation and assimilation involve changes in both values and behaviors related to identity (Schwartz et al. 2007). Cultural identity is the sense of belonging that one derives from membership in groups that provide knowledge, beliefs, values, traditions, attitudes, and ways of life (Jameson 2007). Although acculturation and cultural identity are not totally uncorrelated, an individual who is highly acculturated can have a high level of ethnic identity or a low level of ethnic identify (Moore et al. 2010). It is important to point out that race and culture are not synonymous.
For Black people in America, the assimilation model is most useful for understanding voluntary immigrants, not native-born Black who entered the USA involuntarily who were selectively incorporated through enslavement, coercion, and Jim Crow laws (Lacy 2004). Wamwara-Mbugua et al. (2006) contend “the experience of Black immigrants in the United States is different from that of other non-white groups because of the existence of a large African-American population and the complexities of race relations” (p. 428). Black immigrants may conform more to segmented assimilation (Portes and Zhou 1993) in which they take three paths of adaptation: (1) the White middle class, (2) identify with the Black underclass, and (3) carve out a path by deliberately retaining the culture and values of their immigrant community. Frequently, older Black immigrants and subsequently generations take the third path, relying on their ethnic communities for social capital, employment leads, and relief from discrimination. Segmented assimilation allows the individual to maintain an ethnic identity as an invaluable resource (Lacy).
The question of whether Black LGBT elders more acculturated because of their sexual orientation and gender identity is not known. The extent to which Black LGBT elders are acculturated or assimilated has not been studied, and, at best, one can glean from the research on acculturation of African-Americans in general. Furthermore, the reality may be that neither acculturation nor assimilation is the issue, but more one of cultural immersion in which individuals reject mainstream culture and their emotional needs are met exclusively in their ethnic or in the gay community. Where one lives may be a major determinant of cultural immersion. For example, LGBT persons who live in urban areas may immerse themselves in LGBT communities; however, this is not an option available to most LGBT people who must live in many worlds/cultures and communities.
Black Homophobia, Biphobia, Transphobia, and Heterosexism
African-American LGBT elders often face social stigma in the Black community. Historically, the Black community view homosexuality as a characteristic of European culture, and they deny, or at least overlook its existence in their own community. Many in the Black community believe that homosexuality and any form of alternative sexual identity is a strategy to destroy Black people and the Black family, is a moral sin, and goes against the values of the Black community. The Black community values privacy, which is in contrast to the White LGBT community’s value of “coming out.” Strong family and kinship ties stress that marriage and family always come first, and the family may present a united front against the LGBT member or disown him or her, resulting in a loss of the sense of unity that helps the LGBT member form cultural and/or race identity (Savage and Harley 2005). The National Black Justice Coalition (2009) found that while statistically African-Americans are more disapproving of marriage equality for sexual minorities, these attitudes do not arise from simple homophobia; rather, they come from their diverse experiences, opinions, and beliefs and are influenced by factors such as geographic location, age, class, and other markers of differences. Often, this moral disapprobation is linked to the pulpit and rhetoric of the conservative right that suggests that the gay rights movement has appropriated the civil rights philosophy and incorrectly equated racial oppression with oppression based on sexual orientation and gender identity (National Black Justice Coalition). As a historically oppressed group, African-Americans have placed great importance on reproductive sexuality to ensure continue existence of the group in face of racist, genocidal practices by the dominant White group (Greene and Boyd-Franklin 1996). Thus, Black LGBT individuals are seen as a threat to the social structure of the family (Battle and Bennett 2000; Boykin 1996; National Black Justice Coalition 2009).
Research suggests that homophobia is greater in the African-American community than in the European American community (National Black Justice Coalition2009; Savage and Harley 2005; Stanford 2013). The existence of homophobia among Black people in America is largely reflective of the homophobic culture in which we live (Clarke 1999). According to Clark, Black Americans assimilated the Puritan value that sex is for procreation, occurs only between men and women, and is only valid within the confines of heterosexual marriage. The result of this assimilation is that Black people have to live with the contradictions of this restricted sexual system by repressing or closeting any other sexual or erotic feelings or desires. However, the whole African-American community is not homophobic or heterosexist, and the “accusation of homophobia” directed toward the whole Black community is inaccurate (Boykin 1996, p. 185), and studies on the African-American community’s attitudes and perceptions of sexual minorities continue to unfold. Nevertheless, it cannot be denied that the existence of homophobia has always been a reality in Black life (Hooks 2001). Today, the invisibility of homosexuality in the Black community remains prevalent and is synonymous with its own form of “don’t ask,” “don’t tell.” Despite the sometime disapproving attitudes and religious condemnation, the majority of Black LGBT individuals remain in predominantly Black communities and social contexts and negotiate daily with family and community. They remain because they trust in racial solidarity and racial group membership (Moore 2010), which often provide protection from racial discrimination in the larger society.
Religion and Spirituality in the Lives of Black Elders. The Black Church is recognized as the oldest and one of the most influential institutions of the Black community. Both religion and spirituality are vital components of African-American racial and cultural activities (Harley 2005a). Laderman and Leon (2003) suggest that religion supplies perhaps the best vantage point from which to describe the development of African-Americans in relationship to themselves, others, and the larger universe. National research data indicate that approximately 97 % of African-Americans identify some religious affiliation (Pew Center 2006). The church is more than a place of worship and fellowship; it is a place of advocacy, empowerment, personal and psychological support, socialization, emotional outlet, social status, political action, cultural affirmation, and connection to the community (Evans and George 2008; Loue 2014) and is essentially impossible to separate from Black life for most African-American elders. Research Box 6.1 contains a study of older African-Americans’ perception of spirituality and its role in dealing with depression. The amount of support and assistance provided by the Black Church is second only to that provided by the family (Robinson-Wood 2009). In many ways, the Black Church takes on increased significance as a source of support because LGBT seniors, especially gay men, do not have children who can care for them as they age. Within the LGBT population, child rearing is much more common among racial and ethnic minority women (41 % of African-Americans) compared with White LGBT women (28 %) and less so among African-American men (14 %). However, these data include younger average ages of racial and ethnic groups in the USA (Gates and Newport 2012). In fact, lesbians and gay men are twice as likely as their heterosexual counterparts to grow old un-partnered and almost ten times more likely not to have a spouse, child, or other family member to care for them in old age (Albelda et al. 2009).
Research Box 6.1: Depression and Spirituality
Wittink, M. N., Joo, J. H., Lewis, L.M., & Barg, F. K. (2009). Losing faith and using faith: Older African-Americans discuss spirituality, religious activities, and depression. Journal of General Internal Medicine, 24(3), 402–407.
Objective: This study aimed to understand how spirituality might play a role in the way older African-Americans conceptualize and deal with depression in order to inform possible interventions aimed at improving the acceptability and effectiveness of depression treatment.
Method: A cross-sectional qualitative interview design was used with older African-American primary care patients. Forty-seven patients were recruited from primary care practices in Baltimore, DM area, and interviews were conducted in the homes of participants.
Results: Participants in this study held a faith-based explanatory model of depression with a particular emphasis on the cause of depression. Specifically, participants described depression as being due to a “loss of faith,” and faith and spiritual/religious activities were thought to be empowering in the way they can work together with medical treatments to provide the strength for healing to occur.
Conclusion: Older African-Americans are more likely to identify spirituality as important in depression care.
Questions
1.
How are spiritual/religious activities facilitative of depression treatment?
2.
How would you evaluate the extent to which the findings of the research represent insider versus outsider perspective?
3.
What do you see as the limitations to this research methodology for Black LGBT elders?
Although reference is made to “the Black Church,” the church is heterogeneous, non-monolithic, and disparate collective of churches that reflect the diversity of the Black community itself and are diversified by origin, denomination, doctrine, worship culture, spiritual ethos, class, size, and numerous other factors. Yet, Black Churches share a common history and function as a unique role in Black life, which attest to their collective identify as the Black Church (Douglas 2006). The Black Church, with its heterogeneous character, is more monolithic in its attitude toward homosexuality. The Black Church adheres to traditional religious values, which condemn homosexuality and gender nonconformity. Some Black ministers hurl condescending insults in their sermons to express distain toward non-heterosexuals (Ward 2005). African-Americans attend religious services more frequently than Whites and are less supportive of gay rights (Pew Center 2006). According to Douglas (2006), “the Black Church community, even with all of their diversity, the Black Church people are regarded as strikingly similar in their attitudes toward non-heterosexual sexualities. Black Church people are viewed as not simply homophobic but more homophobic than other populations of society” (p. 12). Although the majority of Black people in America regard themselves as Christians, growing numbers are counted among Islamists, Buddhists, Jews, and agnostics (Robinson-Wood 2009).
In a study of Black lesbian spirituality, Betts (2012) found that African-American lesbians continually strive for a sense of spiritual wholeness. While the lesbians in Betts’ study had no difficulty connecting to Black culture, they did report difficulty connecting with their initial religious roots within the churches of their childhood and actively sought alternative spiritual outlets. Other studies suggest that for certain populations of Blacks , perceived religiosity is related to faith healing (Harley 2005b; Mitchem 2002; Lawson and Thomas 2007), and elderly Black women have higher religiosity (e.g., prayer, giving thanks to God, reading the Bible, going to church) than Black men (Taylor et al. 2004). Black people who may not go to church or even have a church home may still pray to the Lord when confronted with difficult times (Boyd-Franklin 2003). Even Black persons who denounce religiosity often note religious ideology as important to their moral beliefs and practices (Dyson 2003; Ward 2005). With the importance placed on religion and spirituality by African-Americans and their disapproval of homosexuality, transgender, and nonconforming gender persons, Black LGBT persons may be denied the sense of community and support afforded to others within the community when the church denies them fellowship. Many LGBT African-Americans often face the same ignorance within the very institution that has for so many been the centerpiece of their community as they face from the larger society (Harley et al. 2014). Because many LGBT persons have encountered condemnation from churches, they often esteem personal faith in a higher power other than their religious institutions, and spirituality maintains their formal connections to religious establishments (Ward 2005). While homonegativity is not unique to Black Churches, it has dire psychosocial consequences for Black LGBT persons (Jeffries et al. 2008).
The presence of homophobia and heterosexism are persistent in the Black Church and Black community as a whole, but not in all Black Churches or all of the Black community. Clark (1983, 1999) warned that the “accusation of homophobia” should not be directed toward the whole African-American community. Nevertheless, the continual stance of many Black Churches to both condemn homosexuality and to deny fellowship to LGBT African-Americans appears to be in direct opposition to the mission of religion to be accepting of all people. Moreover, such opposition contradicts beliefs and values of the Black community as collective and communal (Harley et al. 2014). According to Greene (2000), because of the importance of family, community, and church as buffers against racism and as sources of tangible support, homophobia in the Black community often leaves LGBT persons feeling vulnerable and less likely to reveal their sexual orientation or gender identity.
Intersection of Racial/Ethnic and LGBT Identities
Frequently, Black LGBT persons are challenged to choose between their sexual and racial identities. Black LGBT persons are confronted with a dichotomy of allegiances. Meyer (2010) argues that the intersection of racial/ethnic and LGBT identities contain several basic truths. First, Blacks and other racial/ethnic minorities in the USA do not form a different culture; they are surrounded, contribute to, shape, and are affected by mainstream American culture; thus, the notion of a gay community is not alien to them. Second, many LGBT of color in the USA were raised in the same culture as their White counterparts. Third, among immigrants to the USA, many tend to acculturate and adopt local sociocultural norms. Finally, the gay liberation movement has had a great impact globally on cultures. Although Meyer acknowledges that local cultures matter in the analysis of LGBT populations and that subculture differences and clashes with White American culture exist, a fundamental challenge to these truths is that they fail to account for social and historical contexts in which a myriad of cultural variables affect the lives of elderly African-American LGBT persons. However, this is not to say that elderly Black LGBT persons cannot have several, even seemingly, conflicting identities while maintaining a coherent sense of themselves (Meyer 2010; Singer 2004). In fact, Purdue-Vaughns and Eibach (2008) use the term intersectional invisibility to refer to the failure to fully recognize people with intersecting identities as members of their constituent groups. Because Black LGBT persons do not fit the prototype of their constitute group, they are likely to experience social invisibility (Lewis and Marshall 2012).
Gibson (2009) explored the behavioral and psychological strategies used by lesbians of African descent to negotiate relationships within their families of origin while simultaneously developing and maintaining an affirmative lesbian identity. The results showed that lesbians of African descent negotiated multiple identities of race, sexual orientation, disability, and gender through application of several identity management strategies (e.g., cultivate LGBT community and support systems, educate others about lesbian identity, maintain visibility, and engage in LGBT activism), including ways to manage conflicting loyalties between the community and Black community without any loss of significant relationships and cultural ties.
In a similar study, Moore (2010) examined strategies that Black LGBT people used in Black environments to proclaim a gay identity that is simultaneous with a Black identity. Moore found three distinct features: (a) Black gay protest takes on a particular form when individuals are also trying to maintain solidarity with the racial group despite the treat of distancing that occurs as a result of their sexual minority status, (b) Black sexual minorities who see their self-interests linked to those of other Blacks use cultural references to connect their struggles to historical efforts for Black equality and draw from nationalist symbols and language to frame their political work, and (c) they believe that increasing their visibility in Black spaces will promote a greater understanding of gay sexuality as an identity status that can exist alongside, rather than in competition with race. Conversely, Bates (2010) found African-American lesbians who were once married and bisexual women expressed difficulty assimilating into the African-American community since coming out. Each of these studies focused on young to middle-aged LGBT.
As is the case for any individual or group, the intermingling of identities for older Black LGBT persons represents a degree of integration. Identity models conclude with integration of sexual identity into the personality as a seamless whole, when in reality one’s social circumstances change constantly and dictate priority of awareness and identity importance (Eliason and Schope 2007). For example, depending on what is occurring in society, for Black lesbians, the race may be the priority in the face of discrimination. Yet, in another situation, the murder of sexual minorities may pose greater importance than race. And still, ageism may be the salient factor. The point that Eliason and Schope make is that all people have multiple intersecting identities, and while people seek validation of all parts of their identity and not just one facet, full integration all the time is unrealistic.
Multiple Oppressions. African-American LGBT elders, unlike their younger counterparts who experience their young adult development within a dual identity or bicultural framework, experience their development through three distinct cultural perspectives: race/racism, homo-prejudice, and aging. African-American LGBT persons tend to construct their experiences in two distinct minority environments: (a) a racial minority within the dominant White culture and (b) a sexual minority within the mainstream heterosexual culture (Burlew and Serface 2006). Racial minority status appears to be a significant variable in determining the quality of life of people of color in the USA (Wilson et al. 2001). It is through the intersection oppressions of race and sexual identity that African-American and LGBT persons experience multiple oppressions. On the one hand, they are subjected to racism and oppression from mainstream society, and on the other hand, they face prejudice because of their sexual orientation from mainstream heterosexual society of all races (Burlew and Serface). In addition, African-Americans/Blacks are subjected to “colorism,” a differential treatment based on skin hue, in which individuals with lighter skin color are seen as more intelligent or attractive (Kelly and Greene 2010). A lifetime of discrimination (e.g., racial inequality, anti-LGBT policies) has adversely affected African-American LGBT elders (Francis and Acey 2013).
Related posts:
The Intersection of Identities of LGBT Elders: Race, Age, Sexuality, and Care Network
Asian American and Native Pacific Islander LGBT Elders
American Indian, Alaska Native, and Canadian Aboriginal Two-Spirit/LGBT Elderly
End-of-Life Issues for LGBT Elders
Disabilities and Chronic Illness Among LGBT Elders: Responses of Medicine, Public Health, Rehabilitation, and Social Work
LGBT Elders in Nursing Homes, Long-Term Care Facilities, and Residential Communities
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