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Original Articles

Bisexual Aging and Cultural Competency Training: Responses to Five Common Misconceptions

 

ABSTRACT

Bisexual cultural competency training is one important method of improving the services received by bisexual older adults. These trainings aim to give providers the knowledge and sensitivities they require to treat bisexual older adults with respect and to create environments where bisexual people feel comfortable being open about their identities, relationships, and life histories. This article is a primer intended for anyone who formally or informally educates aging and LGBT service providers on the unique cultures, needs, and resiliencies of bisexual older adults.

Notes

1. I unpack this claim in detail below; for a recent overview of issues facing the bisexual community, see Movement Advancement Project et al. (Citation2014). For information on the discomfort bisexual people report within the LGBT community, see Pew Research Center (2013). For a detailed explanation of the ageism found within the LGBT community, as well as health and economic disparities facing the LGBT community, see Grant (Citation2009).

2. Many resources advocate for bisexual cultural competency training. See, for example, Movement Advancement Project et al. (Citation2014). For an excellent analysis of what constitutes culturally competent care, see Fredriksen-Goldsen, Hoy-Ellis, Goldsen, Emlet, and Hooyman (2014). For an analysis of the effectiveness of one cultural competency training curriculum see Johnston and Meyer (Citation2014).

3. These assumptions and misconceptions are placed in quotation marks, but they are not direct quotations. I am paraphrasing the kinds of comments I hear on a routine basis. Many of these assumptions are not specific to older adults and may pertain to the lives of bisexual people of all ages, but my answers will focus on how these assumptions intersect with aging and aging issues.

4. I will note that transgender people seeking medical services are still diagnosed with gender dysphoria and often cannot access necessary medical treatment absent this official diagnosis. This means that it is difficult for transgender people to engage with medical professionals without having their transgender identity diagnosed and treated as a medical disorder.

5. Seventeen percent of heterosexual adults reported delaying accessing health care, compared with 29% of LGB people, and 30% of transgender respondents (Movement Advancement Project, Citation2010; Services and Advocacy for GLBT Elders, 2010).

6. “Forty-three percent of LGBT older people who are single and 40% of LGBT older people in their 60s and 70s say their healthcare providers don't know their sexual orientations. Two thirds of transgender adults (65%) feel that there will be limited access to healthcare as they grow older” (Espinoza, Citation2014, p. 8).

7. I also recommend the film Gen Silent (2010), a documentary exploring the lives of several LGBT identified older adults in the Boston area.

8. The same point can be made by asking participants to describe what they did over the weekend while omitting any information that would reveal their sexual orientation or key relationships. Participants are often impressed by the sheer number of names and pronouns that need to be either changed or omitted from their stories if they are to hide their sexual orientation.

9. My evidence for this is anecdotal and taken from my own work in both university settings and among older adults.

10. For an excellent discussion of the impact of microaggressions on the epistemic health of bisexual women see Bostwick and Hequembourg (2014). This article is particularly useful for explaining how not being taken seriously or otherwise having the worth of one's bisexuality questioned is an epistemological problem that has serious psychological ramifications for bisexual people.

Additional information

Notes on contributors

Tim R. Johnston

Tim R. Johnston received his PhD in philosophy from SUNY Stony Brook. His research focuses on feminist and queer theory, contemporary French philosophy (specifically Bergson), LGBT aging, and biomedical ethics. He is the Assistant Director of Training and Social Enterprise for SAGE's National Resource Center on LGBT Aging, where he is responsible for coordinating nationwide training about the needs of LGBT older adults for aging providers and LGBT organizations, developing training curricula, and tracking training outcomes and evaluations.

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