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
National
LGBTQ Catholic groups slam Trump over pope criticism
‘Moral truth and compassion always overcome ignorant hate’
LGBTQ Catholic groups have sharply criticized President Donald Trump over his criticisms of Pope Leo XIV.
Leo on April 13 told reporters while traveling to Algeria that he had “no fear of the Trump administration” after the president described him as “weak on crime” and “terrible for foreign policy” in response to his opposition to the Iran war. (Trump on the same day posted to Truth Social an image that appeared to show him as Jesus Christ. He removed it on April 13 amid backlash from religious leaders.)
Vice President JD Vance, who is Catholic, during a Fox News Channel interview on the same day said “in some cases, it would be best for the Vatican to stick to matters of morality, to stick to matters of what’s going on with the Catholic church, and let the president of the United States stick to dictating American public policy.” Vance on April 14 once again discussed Leo during an appearance at a Turning Point USA event in Athens, Ga., saying he should “be careful when he talks about matters of theology.”
Italian Prime Minister Giorgia Meloni; former U.S. Ambassador to the Vatican Miguel Díaz; and Oklahoma City Archbishop Paul Coakley, president of the U.S. Conference of Catholic Bishops, are among those who have criticized Trump over his comments. The president, for his part, has said he will not apologize to Leo.
“The world is being ravaged by a handful of tyrants,” said Leo on Thursday at a cathedral in Bamenda, Cameroon.
Francis DeBernardo is the executive director of New Ways Ministry, a Maryland-based LGBTQ Catholic organization. He told the Washington Blade on Thursday that Trump’s comments about Leo “are one more example of the ridiculous hubris of this leader (Trump) whose entire record shows that he is nothing more than a middle-school bully.”
“LGBTQ+ adults were often bullied as children, and they have learned the lesson that bullies act when they feel frightened or threatened,” said DeBernardo. “But secular power does not threaten the Vicar of Christ, and Pope Leo’s response illustrates this truth perfectly.”
DeBernardo added Trump “is obviously frightened that Pope Leo, an American, has more power and influence than the president on the world stage.”
“Like most Trumpian bullying, this strategy will backfire,” DeBernardo told the Blade. “Moral truth and compassion always overcome ignorant hate. Trump’s actions are not an example of his power, but of his impotence.”
Marianne Duddy-Burke, executive director of DignityUSA, an LGBTQ Catholic organization, echoed DeBernardo.
“He [Trump] has demonstrated throughout both presidencies that he doesn’t understand the basic concepts of any faith system that is founded on the dignity of human beings, the importance of common good,” Duddy-Burke told the Blade on Thursday during a telephone interview. “It’s just appalling.”
Duddy-Burke praised Leo and the American cardinals who have publicly criticized Trump.
“The pope’s popularity — given how much more respect Pope Leo has than the man sitting in the White House — is a blow to his ego,” Duddy-Burke told the Blade. “That seems to be a sore sport for him.”
“It’s such an imperialistic world view,” she added.
Leo ‘is the real peacemaker’
The College of Cardinals last May elected Leo to succeed Pope Francis after his death.
Leo, who was born in Chicago, is the first American pope. He was the bishop of the Diocese of Chiclayo in Peru from 2015-2023.
Francis made him a cardinal in 2023.
Juan Carlos Cruz — a gay Chilean man and clergy sex abuse survivor who Francis appointed to the Pontifical Commission for the Protection of Minors — has traveled to Ukraine several times with Dominican Sister Lucía Caram since Russia launched its war against the country in 2022. Cruz on Thursday responded to Trump’s criticism of Leo in a text message he sent to the Blade from Kyiv, the Ukrainian capital.
“I am in Ukraine under many attacks,” said Cruz. “Trump is an asshole and has zero right to criticize the Pope who is the real peacemaker.”
Tennessee
Charlie Kirk Act advances in Tenn.
Bill would limit protests, protects speakers opposing ‘transgender’ identities
The Tennessee legislature has passed Senate Bill 1741 / House Bill 1476, dubbed the “Charlie Kirk Act,” which, if signed by Republican Gov. Bill Lee, would reshape how public colleges and universities regulate speech on campus.
The measure targets all public higher education institutions and requires them to adopt a “free expression” policy modeled on the University of Chicago’s framework. That framework emphasizes that universities should not shield students from controversial or offensive ideas and requires state schools to formally embrace institutional neutrality — meaning they do not publicly take a stance on political or social issues.
Under the legislation, publicly funded schools cannot disinvite or cancel invited speakers based on their viewpoints or in response to protests from students or faculty. Student organizations, however — like Turning Point USA, an American nonprofit that advocates for conservative politics on high school, college, and university campuses, founded by Charlie Kirk, and often lack widely represented liberal counterparts — would retain broad authority to bring speakers to campus regardless of controversy.
The law includes broad protections for individuals and organizations expressing religious or ideological beliefs, including opposition to abortion, homosexuality, or transgender identity, regardless of whether those views are rooted in religious or secular beliefs. It further prohibits public institutions from retaliating against faculty for protected speech or scholarly work.
The bill, which has been hailed by supporters as an effort to “preserve campus free speech,” ironically also limits protest activity. Shouting down speakers, blocking sightlines, staging disruptive walkouts, or physically preventing entry to events are now considered “substantial interference” under the legislation, making those who engage in such actions subject to discipline.
Some of those disciplinary consequences include probation, suspension, and even expulsion for students, while faculty who protest in ways deemed to violate the policy could face unpaid suspensions and termination after repeated violations.
Supporters of the bill argue it strengthens free expression on campus. State Rep. Gino Bulso (R-Brentwood), the bill’s sponsor, said it reinforces a commitment to “civil and robust” debate at public universities.
“The Charlie Kirk Act creates critical safeguards for students and faculty and renews the idea that our higher education institutions should be centers of intellectual debate,” Bulso told Fox 17. “This legislation honors the legacy of Charlie Kirk by promoting thoughtful engagement and defending religious freedom.”
Critics, including Democratic lawmakers, have raised concerns that the legislation effectively elevates certain ideological viewpoints — particularly those tied to religious objections to LGBTQ identities — while exposing students and faculty to punishment for protest or dissent.
“It’s ironic that this body is talking about free speech when we had professors in Tennessee schools expelled and suspended when they did not mourn the death of Charlie Kirk — when they said that his statements were problematic and that the way he died did not redeem the way he lived,” state Rep. Justin Jones (D-Nashville) told WKRN.
Kirk, the right-wing activist and founder of Turning Point USA, for whom the bill is named, was assassinated in September 2025 at a public event at Utah Valley University. His legacy and rhetoric remain deeply polarizing, particularly among LGBTQ advocates, who have cited his history of anti-LGBTQ statements in opposing his campus appearances.
The bill now heads to Lee’s desk for his signature.
National
Demonstrators disrupt OMB director hearing over PEPFAR
Capitol Police arrested five protesters
A group of protesters interrupted Office of Management and Budget Director Russell Vought during his testimony before Congress on Wednesday.
Vought was at the Cannon House Office Building to give testimony to the House Budget Committee.
Committee Chair Jodey Arrington (R-Texas) began the hearing by touting what he described as economic accomplishments of the Trump-Vance administration’s economic accomplishments. Ranking Member Brendan Boyle (D-Pa.) disputed those claims in his opening statement.
Boyle went on to admonish Vought for not attending a committee hearing in the previous year.
Vought, the “Project 2025” architect, was invited to speak after Arrington and Boyle made their statements.
Shortly after Vought began reading his statement, Housing Works CEO Charles King stood up in the gallery and began shouting, “PEPFAR saves lives: spend the money!”
The U.S. Capitol Police moved quickly to escort King from the room. Other activists began chanting with King as they unfolded signs bearing a picture of Vought’s face and statements such as, “Vought’s cuts kill people with AIDS,” and “Protect PEPFAR from Vought.”
The group of HIV/AIDS activists included independent activists, former U.S. Agency for International Development and PEPFAR staff, members of Health GAP, Housing Works, and the Treatment Action Group. Six activists were escorted from the hearing and the U.S. Capitol Police detained five of them.
The HIV/AIDS treatment activists protested at the hearing in response to the dismantling of global health programs, including PEPFAR, a federally-funded program credited with saving millions of lives from HIV/AIDS, particularly in sub-Saharan Africa.
“Russell Vought is directly responsible for illegally withholding Congressionally appropriated funds for PEPFAR and related global health initiative,” King said in a statement provided to the Washington Blade. “These funding disruptions have already contributed to preventable deaths and threaten to reverse decades of progress in the fight against HIV worldwide. Enough is enough. Congress must ensure Vought stops this deadly sabotage.”
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