The abuse and mistreatment of LGBTIQA+ older people

About this project

The abuse and mistreatment of older people is a serious social, human rights, health and justice issue in Australia. ‘Abuse and mistreatment of older people’ is defined for research purposes as:

A single or repeated act or failure to act, including threats, that results in harm or distress to an older person. These occur where there is an expectation of trust and/or where there is a power imbalance between the party responsible and the older person (Kaspiew et al., 2019, pp 4 & 16).

The National Elder Abuse Prevalence Study (National Prevalence Study) 2021 was the first study to provide comprehensive data on the nature and prevalence of abuse of older people in the general population in Australia. It identified 5 types of abuse and mistreatment: psychological abuse, neglect, financial abuse, physical abuse and sexual abuse.

Following the National Prevalence Study, it was clear that more targeted research was needed to better understand the forms of abuse and mistreatment specifically experienced by lesbian, gay, bisexual, transgender, intersex, queer and/or asexual (LGBTIQA+) older people. 

This project, commissioned by the Attorney-General’s Department, aims to address this gap and improve understanding of:

• the types of abuse and mistreatment experienced by LGBTIQA+ older people
• the drivers and context for this abuse and mistreatment
• who experiences this abuse and mistreatment and its effects on them
• who is abusing or mistreating LGBTIQA+ older people
• help seeking and protective behaviours of LGBTIQA+ older people
• experiences of service responses by LGBTIQA+ older people.

In addition to the 5 types of abuse and mistreatment identified in the National Prevalence Study, this project also includes discrimination as an additional sixth type of abuse and mistreatment.

Due to differences in design and methodology, findings from the current study and the National Prevalence Study are not directly comparable. Nevertheless, in most cases, the same or similar survey items have been used in both studies, and the National Prevalence Study results help to place the current findings in the context of the experiences of the wider Australian population.

What did this research project involve?

This research project involved:

• two concurrent national surveys (n = 335) of both younger (18–64 years; 18–49 years for Aboriginal and Torres Strait Islander) LGBTIQA+ people and older (65 years+; 50 years+ for Aboriginal and Torres Strait Islander) LGBTIQA+ people
• focus groups (9 in total with n = 32 participants) and interviews (n = 10) with LGBTIQA+ older people
• a desktop review of relevant research literature conducted in Australia and overseas prior to this study.

Forms of abuse and mistreatment experienced by LGBTIQA+ older people

LGBTIQA+ older people reported higher rates of abuse and mistreatment (21%–27%) than the 15% of people aged 65 years or older in the general population, when focusing on the 5 abuse types identified by the National Prevalence Study.

More than one-in-three (36%) LGBTIQA+ older people reported experiencing at least 1 of the 6 identified types of abuse and mistreatment in the 12 months preceding the survey.

The most common forms were:

• psychological/emotional abuse (23%)
• discrimination (17%)
• financial abuse (9%).

30% of LGBTIQA+ younger survey participants reported they had observed or were concerned about abuse and mistreatment of an LGBTIQA+ older person they knew.

Psychological/emotional abuse and financial abuse were reported in higher proportions by LGBTIQA+ older people compared to participants in the National Prevalence Study.

LGBTIQA+ older people commonly experience multiple forms of abuse and mistreatment to a substantially higher degree than participants in the National Prevalence Study (11% cf. 4%).

Although the data indicates non-LGBTIQA+ people more commonly engaged in abuse or mistreatment of LGBTIQA+ older people (69%), some gay, lesbian and transgender and/or gender diverse older people identified abuse and mistreatment from other LGBTIQA+ people (20%). 

• Some transgender and/or gender diverse older people described experiencing psychological abuse and discrimination from some LGBTIQA+ people and organisations based on a range of reasons, including age, disability and/or transphobia.
• Some lesbian participants described not being permitted to advocate for and seek cisgender women-only spaces, as a form of abuse and mistreatment; while some other LGBTIQA+ participants identified this behaviour as discriminatory against transgender and/or gender diverse women.

Some participants also identified systemic abuse across their life course, including:

• unequal access to services or the absence of support to access services
• heteronormative interactions with government and health care
• government and social services that do not accommodate the health and medical needs of transgender and/or gender diverse people and the health, service and medical needs of older lesbian women and some older gay men, including those with HIV.

Societal and community factors in the drivers and context of abuse and mistreatment of LGBTIQA+ older people

Participants identified several societal factors contributing to abuse, including:

• ageist and abuse-condoning attitudes
• changes in social norms
• cultural and religious beliefs that may not be accepting of LGBTIQA+ people
• bias and stereotyping in the Australian community (including within LGBTIQA+ communities). 

Assumptions about older people’s perceived vulnerability and how their resources should be used were also identified as contributing to abuse and mistreatment of older people.

Factors identified as compounding the experience of abuse and mistreatment of LGBTIQA+ older people include:

• not having a stable income or secure place to live
• isolation (including over the life course)
• disability and cognitive decline.

Compared to participants in the National Prevalence Study, a greater proportion of LGBTIQA+ survey participants perceived abuse and mistreatment as both common and ignored in society.

Psychological abuse, neglect and sexual abuse were more strongly identified by LGBTIQA+ participants in this project than in the National Prevalence Study, while reports of physical and financial abuse were similar across both studies.

Individual and relationship factors for people who abuse and mistreat LGBTIQA+ older people

Survey participants identified both men and women equally (43%) as engaging in abuse and mistreatment of LGBTIQA+ older people.

Men were more likely to be identified as engaging in financial and emotional abuse, while women were more likely to be identified as engaging in discrimination.

Just over two-thirds (69%) of people engaging in abuse or mistreatment were identified as being heterosexual, 16% as gay, lesbian or homosexual, with a further 4% as bisexual or pansexual.

The data indicate that abuse or mistreatment of LGBTIQA+ older people was undertaken by people across the age groups, with those aged 35–44 and 45–54 years more likely to be reported as engaging in abuse or mistreatment (18% and 22% respectively).

There were no clear patterns in the relationships with people using abuse or mistreatment – however, the most commonly reported were siblings (8%) and LGBTIQA+ and non-LGBTIQA+ friends (8% respectively), followed by partners or spouses (6%), children-in-law (6%), neighbours (6%), children (4%) and stepchildren (2%), and professionals or service providers (2%–4%).

Just over half (51%) of LGBTIQA+ survey participants who reported experiencing abuse or mistreatment indicated that those engaging in such behaviour had one or more personal issue. Often there were co-occurring issues. These included:

• mental health (most common)
• alcohol and drugs
• gambling or financial hardship
• physical health.

Individual and relationship factors for people who experience abuse and mistreatment and its effects

The highest rate of reported abuse and mistreatment was among participants aged 71 years or older (44%), particularly for financial abuse, sexual abuse and neglect.

There was no statistically significant difference in the experience of abuse or mistreatment between women (37%) and men (33%), although women were more likely to report experiencing neglect.

Transgender and/or gender diverse people were more likely to report experiences of abuse or mistreatment (67% cf. 31%).

• Discrimination was reported as especially prevalent for those who identify as transgender and/or gender diverse.

• LGBTIQA+ participants who reported living with disability were more likely to experience abuse or mistreatment, particularly financial abuse and neglect.
• Relationship status also played a role, with most participants who reported experiencing at least one form of abuse or mistreatment being separated, divorced, widowed or currently single but previously married or in a de facto relationship.

• Experiences of abuse varied by sexuality, with gay men more likely to report financial or emotional abuse and bisexual people more likely to report experiences of physical abuse, neglect and discrimination.
• There were no apparent differences in rates of experiencing abuse or mistreatment by geographical remoteness.

The reported effects of abuse and mistreatment were far-reaching and devastating. Participants reported isolation, disconnection from social and family relationships and adverse health and wellbeing outcomes including physical health issues, mental ill-health and post-traumatic stress disorder (PTSD).

Financial hardship and reduced life satisfaction were also identified. Many expressed the distressing need to conceal sexuality and gender, including to service providers and professionals.

Seeking help and barriers to seeking help

Most (90%) of those aged 65 years or older reported confidence in identifying the signs of abuse and mistreatment. This was significantly higher than among people aged 49 years or younger (64%).

However, the research shows there are challenges in identifying abuse and mistreatment and in seeking help.

• Just under half of LGBTIQA+ older people who reported experiencing abuse or mistreatment sought help, which is higher than for older people in the National Prevalence Study.
• Help was most commonly sought when financial abuse was experienced.

Even when LGBTIQA+ participants who reported experiencing abuse or mistreatment did not seek help, more than three-quarters (77%) still took at least one form of action to stop this abuse. This was most commonly breaking contact with the person engaging in the abuse or mistreatment.

More than one-quarter (28%) of LGBTIQA+ younger participants expressed concerns about experiencing abuse and mistreatment when they are older. Non-binary participants had higher rates of concern than men and women. Age group differences were not statistically significant, though participants 50 years+ reported greater levels of concern.

Improving service responses and education and awareness

Survey participants highlighted several key strategies to improve service responses, education and awareness. These included:

• building collaborative partnerships between specialist elder abuse services, LGBTIQA+ services and other organisations
• establishing mentoring and support programs
• expanding community visitor schemes, where LGBTIQA+ people connect with isolated or at risk LGBTIQA+ older people.

The research findings reinforced the need for:

• dedicated services for LGBTIQA+ older people, with staff trained in the specific issues they face
• LGBTIQA+ employee representation to help service users feel safe and understood
• holistic service provision with different services and agencies working closely together
• greater financial and geographical accessibility of services
• increased visibility of older people within LGBTIQA+ groups
• improved education for professionals, the general public and LGBTIQA+ people themselves.