蜂蜜是怎么来的:同性恋、双性恋以及变性老人更艰难的老年

同性恋者、双性恋者、以及跨性别者（LGBT）的老化和健康问题常常被各种服务、政策以及研究所忽略。根据在这些社区进行的第一个关于老化和健康问题的研究，这些老年人们面临着更高比例的残疾、身体和精神痛苦以及难以获得一些服务。  

The study, led by Karen Fredriksen-Goldsen and colleagues at the University of Washington's School of Social Work, indicates that prevention and intervention strategies must be developed to address the unique needs of these seniors, whose numbers are expected to double to more than 4 million by 2030. 

华盛顿社会工作学院（University of Washington's School of Social Work）的Karen Fredriksen-Goldsen以及他的同事发起了该项研究。研究指出，针对此类老年人的问题的预防及干预措施必须得到研究，因为该类老年人的数目在预计会在2030年翻番到超过四百万。

"The higher rates of aging and health disparities among lesbian, gay, bisexual, and transgender older adults is a major concern for public health," said Fredriksen-Goldsen, a UW professor of social work and director of UW's Institute for Multigenerational Health. "The health disparities reflect the historical and social context of their lives, and the serious adversity they have encountered can jeopardize their health and willingness to seek services in old age." 

She presented some of the study's key findings last week during a congressional briefing. 

在上周的国会简报上，她展示了该研究的一些主要发现。

The study highlights how these adults have unique circumstances, such as fear of discrimination and often the lack of children to help them. Senior housing, transportation, legal services, support groups and social events were the most commonly cited services needed in the LGBT community, according to the study.  

该研究强调了这些成年人的独特的生存环境，比如他们害怕歧视，以及通常没有子女来帮助他们。研究表明，老年人家政服务、搬运、法律服务、支援小组和社交活动是这些LGBT群体中最需要的服务。  

Fredriksen-Goldsen and her co-authors surveyed 2,560 lesbian, gay, bisexual and transgender adults aged 50-95 across the United States. The researchers found that the study participants had greater rates of disability, depression and loneliness and increased likeliness to smoke and binge-drink compared with heterosexuals of similar ages.  

Fredriksen-Goldsen和她的合作作者们调查了全美50到95岁之间的2560个女同性恋者、男同性恋者、双性恋者以及变性者。调查发现，相较于同样年龄的异性恋者，这些参与者们有更高比例的残障、抑郁、孤独以及更高可能性的抽烟和酗酒。  

Those seniors are also at greater risk for social isolation, which is "linked to poor mental and physical health, cognitive impairment, chronic illness and premature death," Fredriksen-Goldsen said. Study participants were more likely to live alone and less likely to be partnered or married than heterosexuals, which may result in less social support and financial security as they age. 

这些老年人有更有可能被社会孤立。Fredriksen-Goldsen说道，“这是因为糟糕的身体和精神健康状态、认知障碍、慢性病和过早的死亡。”相较于异性恋者，研究参与者们更有可能一个人生活，并且不那么可能有伴侣或者配偶。这可能导致伴随他们年老，他们有更少的社会支持和财产保障。

Histories of victimization and discrimination because of sexual orientation or gender identity also contribute to poor health. The study showed that 80 percent had been victimized at least once during their lifetimes, including verbal and physical assaults, threats of physical violence and being "outed," and damaged property. Twenty-one percent of respondents said they were fired from a job because of their perceived sexual orientation or gender identity. Nearly four out of 10 had considered suicide at some point. 

性取向和性身份带来的受害和受歧视的历史同样导致了糟糕的健康状况。调查显示，他们一生中，80%的人至少受害一次，包括语言或身体上的侵犯，武力威胁，被孤立，或者财产损失。21%的调查回应者表示，由于他们性取向和性身份，他们遭到辞退。十个人中就将近四人曾不同程度的考虑过自杀。

Twenty-one percent of those surveyed did not tell their doctors about their sexual orientation or gender identity out of fear of receiving inferior health care or being turned away for services, which 13 percent of respondents had endured. As one respondent, a 67-year-old gay man, put it, "I was advised by my primary care doctor to not get my HIV tested there, but rather do it anonymously, because he knew they were discriminating." 

21%的受调查者没有告诉他们的医生他们的性取向和性身份，因为害怕得到次等的医护或者直接被拒绝服务，13%的人就碰到了这种情况。其中一个67岁的男同性恋者说道，“我的主治医师建议我，不要在他们那里进行HIV检测，而要进行匿名检测，因为他知道他们会歧视。”

Lack of openness about sexuality "prevents discussions about sexual health, risk of breast or prostate cancer, hepatitis, HIV risk, hormone therapy or other risk factors," Fredriksen-Goldsen said. 

对于性方面缺乏足够的开放度，“会阻碍关于性健康，乳腺癌和前列腺癌的危险、肝炎、HIV的危险、荷尔蒙治疗或者其他危险因素的讨论”，Fredriksen-Goldsen说道。

The good news? "LGBT older adults are resilient and living their lives and building their communities," Fredriksen-Goldsen said. Of the study's respondents, 91 percent reported using wellness activities such as meditation and 82 percent said they regularly exercised. Nearly all - 90 percent - felt good about belonging to their communities. And 38 percent stated that they attended spiritual or religious services, indicating a promising social outlet. 

好消息呢？“LGBT老年人一般比较达观，过着他们的生活，并形成他们的群体”，Fredriksen-Goldsen说道。在回应者中，91%的人进行一些好的活动，比如冥想；82%的人说他们定期运动。几乎所有人（90%）对于他们属于这个群体而感觉良好。38%的人表示他们参加精神或者宗教服务，这指示了一个有前途的社交宣泄途径。

Social connections are key, the study noted because, unlike their heterosexual counterparts, most lesbian, gay, bisexual and transgender seniors rely heavily on partners and friends of similar age to provide assistance as they age. While social ties are critical, there may be limits to the ability of those older adults to "provide care over the long-term, especially if decision-making is required for the older adult receiving care," Fredriksen-Goldsen said.

研究强调，社会联系是至关重要的点。因为不像那些异性恋者，大多数同性恋、双性恋以及变性老人，随着他们年老，他们很大程度上依赖相近年龄的伴侣、朋友来提供帮助。尽管社会联系是至关重要的，这些老年人能提供服务的能力也是有限的。这些服务包括“长期照顾、尤其是缺乏做决定的能力的被照顾者”，Fredriksen-Goldsen说。