A study on internal/external homophobia and the impact on long-term health outcomes : the effect on gay, lesbian, bisexual, and transgender edlers in health care and their decision to disclosed their sexual orientation to healthcare providers.

Date of Award


Document Type



Caspersen School of Graduate Studies

Degree Name

Doctor of Medical Humanities


An ever increasing body of literature finds a connection between strong social support and the optimum physical and mental health in the aging population. Largely unexamined, however, are the impact and the meaning of the aging process on Gay and Lesbian elders'. This midlife cohort of "Baby Boomers" stands to be the first group of homosexuals who have lived a politically open life. This group's lifelong impact on social, political, and economic strides however, comes into conflict within the heterocentric framework of American culture and specifically on aging research. Historically, this group remained hidden without adequate social or material support. The exclusion of GLBT elders from gerontological theory has rendered them invisible and has silenced their unique experiences. The purpose of this dissertation is to examine the concerns and fears of the aging Gay, Lesbian, Bisexual, and Transgender (GLBT) population. Specifically, it will focus on anti-GLBT attitudes among healthcare providers--just at the time of life when the GLBT patient's healthcare needs are growing. This research will examine if and how these fears have the potential to drive GLBT individuals who have been "out" most of their lives back into the closet, thereby depriving them of the benefits necessary for optimal physical and mental health. In addition, the research will investigate healthcare provider attitudes in order to determine if homophobia and fears of anti-GLBT bias has an effect on GLBT elders seeking health care services. A working hypothesis is that whether or not the research finds anti-GLBT bias among healthcare providers, the fear of that bias nonetheless affects the aging GLBT population's sense of well-being and may limit their full access to appropriate healthcare or social services. The very process of ageing is exponentially detrimental if the individual withholds or withdraws from the physician/patient relationship. This returning to the closet and the social changes in aging may profoundly affect their willingness to access appropriate care. This impact could grievously impact an individual's quality of life thereby affecting their health outcome, additionally, their sense of well being could be undermined and exacerbated by the heterocentric institutions.