National
New report outlines problems faced by LGBTQ+ nursing home residents
Authors recommend supportive policies, training for nation’s 15,000 facilities
A recently published academic journal article by two University of Indiana researchers reports on problems faced by LGBTQ+ older adults living in the nation’s nursing homes and recommends actions nursing homes should take to ensure LGBTQ+ residents are treated equitably and without bias.
The article, entitled “Postacute Care and Long-Term Care for LGBTQ+ Older Adults,” was published Nov. 9 in the peer reviewed journal Clinics In Geriatric Medicine. It is co-authored by geriatric physician Jennifer L. Carnahan, a research scientist with the Regenstrief Institute, which is affiliated with Indiana University’s Center for Aging Research and Andrew C. Picket, an elder care researcher and assistant professor at Indiana University’s School of Public Health in Bloomington. Carnahan also serves as an assistant professor of medicine at the Indiana University School of Medicine.
“Cultivating an inclusive and LGBTQ+ culturally competent nursing home culture means that all staff and clinicians should receive training specific to working with this group and time should be allocated for this to reduce staff burden,” the article states.
It points out that while some older LGBTQ+ adults fear being forced into the closet while in a nursing home, “they also simultaneously fear unwanted disclosure of their sexual orientation or gender identity status, and their autonomy should be respected either way.”
The article says there are more than 15,000 nursing homes in the U.S. that provide rehabilitative and skilled nursing care to mostly older adults. It notes that nursing home residents fall into two distinct groups–post-acute care residents who often can return to their own home after recovering from an illness or injury; and long-term care residents who are no longer able to care for themselves. It says that among the long-term care residents in nursing homes, about 50% are living with dementia or another type of cognitive impairment.
According to the article, LGBTQ+ older adults “at a minimum have the same risk of dementia as the general U.S. population, and dementia increases the risk of nursing home admission.”
Among the article’s recommendations is that when new residents are being admitted to a nursing home, whether for short term or long term, “standard practice should be to ask sexual orientation and gender identity questions of every new resident along with other demographic identifiers.” Doing this “normalizes sexual and gender minority status” and can also “help to reduce the invisibility and health disparities” that LGBTQ+ nursing home residents experience.
“For transgender individuals, the personal care received in nursing homes can be supportive, as intended, or traumatic,” the article states. When nursing home staff provide assistance to transgender persons unable to care for themselves, “such as toileting or bathing, they may become newly aware of a resident’s transgender status,” the article says, adding, “If staff are not prepared for such an unintentional outing and how to react in a supportive manner, they may demonstrate microaggressions.” That type of biased reaction can be psychologically harmful for a transgender resident, the report states.
“We think about younger LGBTQ+ individuals and the challenges and risks of their lifestyles, but older adults in this population are often forgotten,” co-author Carnahan said in a statement. “They’ve experienced many health disparities. As these accumulate over a lifetime, we see the potential long-term ill effects of being from a marginalized population,” she says in the statement.
“More and more LGBTQ+ older adults are comfortable being out with their providers, while many living in nursing homes fear unwanted disclosure of their sexual orientation or gender identity status,” Carnahan says. “Their autonomy should be respected either way so they can age in an environment where they feel safe, where they feel comfortable and where they are able to live with dignity.”
The article points to a 2018 survey conducted by AARP, which advocates for people over the age of 50, that found most LGBTQ+ older adults, when considering entering a nursing home, “anticipate neglect, abuse, refusal of services, harassment, and being forced back into the closet.”
The article says this fear of abuse and stigmatization may be related to older LGBTQ+ adults’ experiencing anti-LGBTQ+ bias in their younger years.
“Health care workers across disciplines are not well trained in care for LGBTQ+ older adults,” the article says. “Stereotypes and inadequate knowledge of the LGBTQ+ population are not uncommon among those who care for older adults,” it says. And it says LGBTQ+ residents in nursing homes may also face stigmatization from other residents.
“Training programs that engage nursing home staff in LGBTQ+ cultural competency can remediate staff knowledge and ensure more equitable care,” the article stresses.
In addition to calling for better training, the article includes several other recommendations, including providing legal advice to LGBTQ+ nursing home residents on how best to assign the legal authority to make decisions about their care if they become incapacitated and unable to make those decisions for themselves.
Carnahan said in an interview with the Blade that obtaining legal advice about designating a trusted surrogate to make medical decisions for them if they are no longer able to do that is especially important for LGBTQ+ nursing home residents. In at least some cases, LGBTQ+ people are estranged from their biological families and may have chosen families, Carnahan points out. Without having assigned legal health care power of attorney to someone of their choosing, under the laws of most states, the biological family becomes the entity that a nursing home will go to in making these health-related decisions for all residents, including LGBTQ residents.
The article also provides a list of LGBTQ+-related resources for nursing homes and LGBTQ+ older adults considering entering a nursing home. Among the resources on this list is the Long-Term Care Equality Index prepared by the LGBTQ+ organizations Human Rights Campaign and SAGE, an LGBTQ+ elders advocacy organization. The Index is a document that identifies LGBTQ+-supportive facilities, including residential facilities and nursing homes.
SAGE, based in New York City, arranges for LGBTQ+-supportive training for older adult residential facilities across the country and designates facilities that SAGE believes are LGBTQ+ supportive as “SAGECare credentialed” facilities, which are listed in the Long-Term Care Equality Index.
“It is the case now that in almost all states there are one or more elder care facilities that have been trained throughout our SAGECare program,” SAGE CEO Michael Adams said in a recent interview. “But it’s nowhere near where it needs to be,” he said. “It needs to be that there are welcoming elder care facilities in every single community in this country” for LGBTQ+ elders.
The article by elder care researchers Carnahan and Picket reaffirms Adams’s claim that most U.S. nursing homes don’t have the type of LGBTQ+ supportive credentials advocated in the SAGECare program. The two stress in their article the need for all nursing homes to take steps to train their staff on LGBTQ competency issues.
“Yes, that’s what I would like to see,” Carnahan told the Blade. “I would like more nursing homes and assisted living and even senior communities to embrace cultural competency and embrace the SAGE designation,” she said.
Carnahan said a common impediment to nursing homes providing LGBTQ+-related training is it is sometimes difficult to set aside the time to do that because of the busy and often stressful work involved in operating a nursing home. “Working in a nursing home is very hard work. I’ve done it,” she said.
“What leadership really needs to do is to say this is important enough to me that I’m going to set aside a couple of hours where you don’t have critical duties and they just want you to participate in this cultural competency training,” Carnahan concludes. “And that’s what really needs to happen.”
The journal Clinics In Geriatric Medicine has a policy of not releasing articles it publishes to the public who are not paid subscribers to the journal until one year after an article has been published. Additional information about the topic of LGBTQ+ nursing home residents can be found on these sites from the Regenstrief Institute:
regenstrief.org/article/culturally-inclusive-care-lgbtq-nursing-home-residents/
regenstrief.org/article/carnahan-inclusive-long-term-care-video
U.S. Supreme Court
Activists rally for Andry Hernández Romero in front of Supreme Court
Gay asylum seeker ‘forcibly deported’ to El Salvador, described as political prisoner
More than 200 people gathered in front of the U.S. Supreme Court on Friday and demanded the Trump-Vance administration return to the U.S. a gay Venezuelan asylum seeker who it “forcibly disappeared” to El Salvador.
Lindsay Toczylowski, president of the Immigrant Defenders Law Center, a Los Angeles-based organization that represents Andry Hernández Romero, is among those who spoke alongside U.S. Rep. Mark Takano (D-Calif.) and Human Rights Campaign Campaigns and Communications Vice President Jonathan Lovitz. Sarah Longwell of the Bulwark, Pod Save America’s Jon Lovett, and Tim Miller are among those who also participated in the rally.
“Andry is a son, a brother. He’s an actor, a makeup artist,” said Toczylowski. “He is a gay man who fled Venezuela because it was not safe for him to live there as his authentic self.”
(Video by Michael K. Lavers)
The White House on Feb. 20 designated Tren de Aragua, a Venezuelan gang, as an “international terrorist organization.”
President Donald Trump on March 15 invoked the Alien Enemies Act of 1798, which the Associated Press notes allows the U.S. to deport “noncitizens without any legal recourse.” The Trump-Vance administration subsequently “forcibly removed” Hernández and hundreds of other Venezuelans to El Salvador.
Toczylowski said she believes Hernández remains at El Salvador’s Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT. Toczylowski also disputed claims that Hernández is a Tren de Aragua member.
“Andry fled persecution in Venezuela and came to the U.S. to seek protection. He has no criminal history. He is not a member of the Tren de Aragua gang. Yet because of his crown tattoos, we believe at this moment that he sits in a torture prison, a gulag, in El Salvador,” said Toczylowski. “I say we believe because we have not had any proof of life for him since the day he was put on a U.S. government-funded plane and forcibly disappeared to El Salvador.”
“Andry is not alone,” she added.
Takano noted the federal government sent his parents, grandparents, and other Japanese Americans to internment camps during World War II under the Alien Enemies Act. The gay California Democrat also described Hernández as “a political prisoner, denied basic rights under a law that should have stayed in the past.”
“He is not a case number,” said Takano. “He is a person.”
Hernández had been pursuing his asylum case while at the Otay Mesa Detention Center in San Diego.
A hearing had been scheduled to take place on May 30, but an immigration judge the day before dismissed his case. Immigrant Defenders Law Center has said it will appeal the decision to the Board of Immigration Appeals, which the Justice Department oversees.
“We will not stop fighting for Andry, and I know neither will you,” said Toczylowski.
Friday’s rally took place hours after Attorney General Pam Bondi said Kilmar Abrego Garcia, a Maryland man who the Trump-Vance administration wrongfully deported to El Salvador, had returned to the U.S. Abrego will face federal human trafficking charges in Tennessee.
National
A husband’s story: Michael Carroll reflects on life with Edmund White
Iconic author died this week; ‘no sunnier human in the world’
Unlike most gay men of my generation, I’ve only been to Fire Island twice. Even so, the memory of my first visit has never left me. The scenery was lovely, and the boys were sublime — but what stood out wasn’t the beach or the parties. It was a quiet afternoon spent sipping gin and tonics in a mid-century modern cottage tucked away from the sand and sun.
Despite Fire Island’s reputation for hedonism, our meeting was more accident than escapade. Michael Carroll — a Facebook friend I’d chatted with but never met — mentioned that he and his husband, Ed, would be there that weekend, too. We agreed to meet for a drink. On a whim, I checked his profile and froze. Ed was author Edmund White.
I packed a signed copy of Carroll’s “Little Reef” and a dog-eared hardback of “A Boy’s Own Story,” its spine nearly broken from rereads. I was excited to meet both men and talk about writing, even briefly.
Yesterday, I woke to the news that Ed had passed away. Ironically, my first thought was of Michael.
This week, tributes to Edmund White are everywhere — rightly celebrating his towering legacy as a novelist, essayist, and cultural icon. I’ve read all of his books, and I could never do justice to the scope of a career that defined and chronicled queer life for more than half a century. I’ll leave that to better-prepared journalists.
But in those many memorials, I’ve noticed something missing. When Michael Carroll is mentioned, it’s usually just a passing reference: “White’s partner of thirty years, twenty-five years his junior.” And yet, in the brief time I spent with this couple on Fire Island, it was clear to me that Michael was more than a footnote — he was Ed’s anchor, editor, companion, and champion. He was the one who knew his husband best.
They met in 1995 after Michael wrote Ed a fan letter to tell him he was coming to Paris. “He’d lost the great love of his life a year before,” Michael told me. “In one way, I filled a space. Understand, I worshiped this man and still do.”
When I asked whether there was a version of Ed only he knew, Michael answered without hesitation: “No sunnier human in the world, obvious to us and to people who’ve only just or never met him. No dark side. Psychology had helped erase that, I think, or buffed it smooth.”
Despite the age difference and divergent career arcs, their relationship was intellectually and emotionally symbiotic. “He made me want to be elegant and brainy; I didn’t quite reach that, so it led me to a slightly pastel minimalism,” Michael said. “He made me question my received ideas. He set me free to have sex with whoever I wanted. He vouchsafed my moods when they didn’t wobble off axis. Ultimately, I encouraged him to write more minimalistically, keep up the emotional complexity, and sleep with anyone he wanted to — partly because I wanted to do that too.”
Fully open, it was a committed relationship that defied conventional categories. Ed once described it as “probably like an 18th-century marriage in France.” Michael elaborated: “It means marriage with strong emotion — or at least a tolerance for one another — but no sex; sex with others. I think.”
That freedom, though, was always anchored in deep devotion and care — and a mutual understanding that went far beyond art, philosophy, or sex. “He believed in freedom and desire,” Michael said, “and the two’s relationship.”
When I asked what all the essays and articles hadn’t yet captured, Michael paused. “Maybe that his writing was tightly knotted, but that his true personality was vulnerable, and that he had the defense mechanisms of cheer and optimism to conceal that vulnerability. But it was in his eyes.”
The moment that captured who Ed was to him came at the end. “When he was dying, his second-to-last sentence (garbled then repeated) was, ‘Don’t forget to pay Merci,’ the cleaning lady coming the next day. We had had a rough day, and I was popping off like a coach or dad about getting angry at his weakness and pushing through it. He took it almost like a pack mule.”
Edmund White’s work shaped generations — it gave us language for desire, shame, wit, and liberation. But what lingers just as powerfully is the extraordinary life Ed lived with a man who saw him not only as a literary giant but as a real person: sunny, complex, vulnerable, generous.
In the end, Ed’s final words to his husband weren’t about his books or his legacy. They were about care, decency, and love. “You’re good,” he told Michael—a benediction, a farewell, maybe even a thank-you.
And now, as the world celebrates the prolific writer and cultural icon Edmund White, it feels just as important to remember the man and the person who knew him best. Not just the story but the characters who stayed to see it through to the end.
District of Columbia
In town for WorldPride? Take a D.C. LGBTQ walking tour
Scenes of protest, celebration, and mourning
As Washington welcomes the world for WorldPride, it’s essential to honor the city’s deep-rooted LGBTQ history—an integral part of the broader story of the nation’s capital. The following locations have served as cornerstones of queer life and activism in D.C., shaping both local and national movements for LGBTQ rights. So take a walk around “the gayest city in America” and check out these sites.
DUPONT CIRCLE AREA
Dupont Circle
Central hub of LGBTQ life since the early 20th century, hosting Pride parades, Dyke Marches, and cruising culture. A long-standing site of protests and celebrations.
Washington Hilton – 1919 Connecticut Ave NW
Hosted D.C.’s first major hotel drag event in 1968 and the iconic Miss Adams Morgan Pageant. Protested in 1978 during Anita Bryant’s appearance.
Lesbian Avengers – 1426 21st St NW
Formed in 1992, the group empowered lesbians through bold direct actions. They met in Dupont Circle and launched the city’s first Dyke March.
Lambda Rising Bookstore (former) – 1724 20th Street NW
D.C.’s first LGBTQ bookstore and the birthplace of the city’s inaugural Pride celebration in 1975.
Women In The Life (former office) – 1623 Connecticut Ave NW
Founded in 1993 by Sheila Alexander-Reid as a safe space and support network for lesbians of color.
17th Street NW Corridor – Between P & R Streets NW
Core of the LGBTQ business district, home to the annual High Heel Race in October and the June Block Party celebrating the origins of D.C. Pride.
CAPITOL HILL / SOUTHEAST
Tracks (former) – 80 M St SE
Once D.C.’s largest gay club, famous for inclusive parties, RuPaul shows, and foam nights from 1984 to 2000.
Ziegfeld’s / The Other Side – 1345 Half Street SE
Legendary drag venue since 1978, hosting famed performers like Ella Fitzgerald.
Club 55 / Waaay Off Broadway – 55 K Street SE
Converted theater central to D.C.’s early drag and Academy pageant scenes.
Congressional Cemetery – 1801 E Street SE
Resting place of LGBTQ figures like Sgt. Leonard Matlovich and Peter Doyle. Offers queer history tours.
Mr. Henry’s – 601 Pennsylvania Ave SE
LGBTQ-friendly bar since 1966 and the launching stage for Roberta Flack’s career.
The Furies Collective House – 219 11th Street SE
Home to a 1970s lesbian feminist collective that published “The Furies.” Members included Rita Mae Brown.
ARCHIVES / PENN QUARTER
Archives Metro & Center Market Site – 7th St & Pennsylvania Ave NW
Where Walt Whitman met Peter Doyle in 1865, commemorated by a sculpture linking Whitman and poet Fernando Pessoa.
COLUMBIA HEIGHTS / PETWORTH
Palm Ballroom (former) – 4211 9th Street NW
Mid-20th century venue for Black drag balls and LGBTQ events during segregation.
NATIONAL MALL AREA
National Mall / Washington Monument Grounds
Historic site of LGBTQ activism and remembrance, including the 1987 display of the AIDS Memorial Quilt and a mass same-sex wedding. Hosted major civil rights marches in 1979, 1987, and 1993.
NORTHWEST DC
Dr. Franklin E. Kameny House – 5020 Cathedral Ave NW
Home of gay rights pioneer Frank Kameny and the Mattachine Society of Washington; now a national landmark.
LAFAYETTE SQUARE / WHITE HOUSE
Lafayette Park – Pennsylvania Ave & 16th St NW
Historic gay cruising area and epicenter of government surveillance during the Lavender Scare.
Data from: SSecret City by James Kirchick, The Deviant’s War by Frank Kameny, Brett Beemyn, The Rainbow History Project, NPS Archives, Washington Blade Archives.
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