Background and Purpose
Little is known about the impact of life stressors and social support on the psychological well-being of lesbians, gay, bisexual and transgender (LGBT) older adults. Since LGBT older adults experience heightened life stressors such as discrimination and stigma, they may have higher risks of poor mental health (Meyer, 2003). As previous studies suggest, diminished social network size and increased feeling of isolation among older adults are additional factors impacting on their poor mental health (Heikkinen and Kauppinen, 2004). Nevertheless, LGBT older adults may maintain social support relationships with close acquaintances, and such existing relationships may play a protective factor on their psychological well-being (Fiori, Antonucci, & Cortina, 2006). Understanding the role of such multidimensional factors as they impact psychological well-being among LGBT older adults is important to improve overall quality of life among these older adults. This study investigates how and to what extent life stressors and social support predict psychological well-being of lesbians, gay, bisexual and transgender older adults.
Analyses used data from the first national research project addressing the health of LGBT older adults. The study participants were recruited with utilizing the mailing lists of eleven LGBT aging service agencies. The total sample size was 2,560. We conducted a hierarchical logistic regression to evaluate the unique contributions of life stressors (the number of life-time discrimination and internalized stigma) and social support (social network size, availability of social support, and perceived isolation) in explaining variability in depression. The dependent variable was measured with CESD-10 and was dichotomized with a cut off of 10. All the analyses controlled for age, gender, income, education, and living arrangement.
The average age was 66. More than half of the respondents (63%) were male. Majority was highly educated (73%). About 85% were white, and 55% were living alone. One third had depression symptoms. Bivariate analyses demonstrate that discrimination, internalized stigma, the availability of social support, social network size, and perceived isolation were significantly correlated with depression. In the first model of explaining the impact of life stressors on depression, both discrimination (AOR=1.30; p<.001) and internalized stigma (AOR=1.96; p<.001) significantly predicted depression. In the final model, where the availability of social support, social network size, and isolation were added, the availability of social support (AOR=0.66; p<.001) and isolation (AOR=4.05; p<.001) in addition to life stressors had unique contributions to explaining the variance in depression (pseudo R2=0.23). Social network size was not a significant predictor of depression.
Conclusions and Implications
Many LGBT older adults have symptoms of depression, and the symptoms are associated with their life stressors and the lack of social support. Interventions need to be developed at the macro level to counter discrimination as well as at the micro level to alleviate internalized stigma. The findings also suggest that fostering higher quality of social support and reducing feeling of isolation will likely improve the psychological well-being among LGBT older adults.