Bill Hall, 71, has been fighting for his life for 38 years. These days, he鈥檚 feeling worn out.
Hall contracted HIV, the virus that can cause AIDS, in 1986. Since then, he鈥檚 battled depression, heart disease, diabetes, non-Hodgkin lymphoma, kidney cancer, and prostate cancer. This past year, Hall has been hospitalized five times with dangerous infections and life-threatening internal bleeding.
But that鈥檚 only part of what Hall, a gay man, has dealt with. Hall was born into the Tlingit tribe in a small fishing village in Alaska. He was separated from his family at age 9 and sent to a government boarding school. There, he told me, he endured years of bullying and sexual abuse that 鈥渒illed my spirit.鈥
Because of the trauma, Hall said, he鈥檚 never been able to form an intimate relationship. He contracted HIV from anonymous sex at bath houses he used to visit. He lives alone in Seattle and has been on his own throughout his adult life.
鈥淚t鈥檚 really difficult to maintain a positive attitude when you鈥檙e going through so much,鈥 said Hall, who works with Native American community organizations. 鈥淵ou become mentally exhausted.鈥
It’s a sentiment shared by many older LGBTQ+ adults 鈥 most of whom, like Hall, are trying to manage on their own.
Of the 3 million Americans over age 50 who identify as gay, bisexual, or transgender, about twice as many are single and living alone when compared with their heterosexual counterparts, according to the National Resource Center on LGBTQ+ Aging.
This slice of the older population is expanding rapidly. By 2030, the number of LGBTQ+ seniors is expected to double. Many won鈥檛 have partners and most won鈥檛 have children or grandchildren to help care for them, indicates.
They face a daunting array of problems, including higher-than-usual rates of anxiety and depression, chronic stress, disability, and chronic illnesses such as heart disease, according to numerous research studies. High rates of smoking, alcohol use, and drug use 鈥 all ways people try to cope with stress 鈥 contribute to poor health.
Keep in mind, this generation grew up at a time when every state outlawed same-sex relations and when the American Psychiatric Association identified homosexuality as a psychiatric disorder. Many were rejected by their families and their churches when they came out. Then, they endured the horrifying impact of the AIDS crisis.
鈥淒ozens of people were dying every day,鈥 Hall said. 鈥淵our life becomes going to support groups, going to visit friends in the hospital, going to funerals.鈥
It鈥檚 no wonder that LGBTQ+ seniors often withdraw socially and experience isolation more commonly than other older adults. 鈥淭here was too much grief, too much anger, too much trauma 鈥 too many people were dying,鈥 said Vincent Crisostomo, director of aging services for the San Francisco AIDS Foundation. 鈥淚t was just too much to bear.鈥
In an AARP survey of 2,200 LGBTQ+ adults 45 or older this year, 48% said they felt isolated from others and 45% reported lacking companionship. Almost 80% reported being concerned about having adequate social support as they grow older.
Embracing aging isn鈥檛 easy for anyone, but it can be especially difficult for LGBTQ+ seniors who are long-term HIV survivors like Hall.
Of 1.2 million people in the United States, about half are over age 50. By 2030, that鈥檚 estimated to rise to 70%.
Christopher Christensen, 72, of Palm Springs, California, has been HIV-positive since May 1981 and is deeply involved with local organizations serving HIV survivors. 鈥淎 lot of people living with HIV never thought they鈥檇 grow old 鈥 or planned for it 鈥 because they thought they would die quickly,鈥 Christensen said.
Jeff Berry is executive director of the , an alliance of long-term HIV survivors. 鈥淗ere people are who survived the AIDS epidemic, and all these years later their health issues are getting worse and they鈥檙e losing their peers again,鈥 Berry said. 鈥淎nd it鈥檚 triggering this post-traumatic stress that鈥檚 been underlying for many, many years. Yes, it鈥檚 part of getting older. But it鈥檚 very, very hard.鈥
Being on their own, without people who understand how the past is informing current challenges, can magnify those difficulties.
鈥淣ot having access to supports and services that are both LGBTQ-friendly and age-friendly is a real hardship for many,鈥 said Christina DaCosta, chief experience officer at , the nation鈥檚 largest and oldest organization for older LGBTQ+ adults.
Diedra Nottingham, a 74-year-old gay woman, lives alone in a one-bedroom apartment in Stonewall House, an LGBTQ+-friendly elder housing complex in New York City. 鈥淚 just don鈥檛 trust people,鈥 she said. 鈥淎nd I don鈥檛 want to get hurt, either, by the way people attack gay people.鈥
When I first spoke to Nottingham in 2022, she described a post-traumatic-stress-type reaction to so many people dying of covid-19 and the fear of becoming infected. This was a common reaction among older people who are gay, bisexual, or transgender and who bear psychological scars from the AIDS epidemic.
Nottingham was kicked out of her house by her mother at age 14 and spent the next four years on the streets. The only sibling she talks with regularly lives across the country in Seattle. Four partners whom she鈥檇 remained close with died in short order in 1999 and 2000, and her last partner passed away in 2003.
When I talked to her in September, Nottingham said she was benefiting from weekly therapy sessions and time spent with a volunteer 鈥渇riendly visitor鈥 arranged by SAGE. Yet she acknowledged: 鈥淚 don鈥檛 like being by myself all the time the way I am. I鈥檓 lonely.鈥
Donald Bell, a 74-year-old gay Black man who is co-chair of the Illinois Commission on LGBTQ Aging, lives alone in a studio apartment in subsidized LGBTQ+-friendly senior housing in Chicago. He spent 30 years caring for two elderly parents who had serious health issues, while he was also a single father, raising two sons he adopted from a niece.
Bell has very little money, he said, because he left work as a higher-education administrator to care for his parents. 鈥淭he cost of health care bankrupted us,鈥 he said. (According to SAGE, one-third of older LGBTQ+ adults live at or below 200% of the federal poverty level.) He has hypertension, diabetes, heart disease, and nerve damage in his feet. These days, he walks with a cane.
To his great regret, Bell told me, he鈥檚 never had a long-term relationship. But he has several good friends in his building and in the city.
鈥淥f course I experience loneliness,鈥 Bell said when we spoke in June. 鈥淏ut the fact that I am a Black man who has lived to 74, that I have not been destroyed, that I have the sanctity of my own life and my own person is a victory and something for which I am grateful.鈥
Now he wants to be a model to younger gay men and accept aging rather than feeling stuck in the past. 鈥淢y past is over,鈥 Bell said, 鈥渁nd I must move on.鈥
