Silent voices, hidden lives: carving out narrative space for LGBT+ elders in the medical curriculum
Dr Stevie AgiusZoom
How can the medical humanities be harnessed to capture and convey the narratives of older (50+) LGBT+ adults in the UK, many of whom will have endured extraordinary discrimination and homophobia/transphobia during their life course, encompassing the pre-Wolfenden era, AIDS, Clause 28 and countless other assaults on their physical and mental well-being. Whilst great strides have been made in some countries to provide legal protection and equality for LGBT+ people, older adults carry a particular legacy with them. To know and understand that legacy through the use of art, literature and film may allow for greater understanding and compassionate care of this minority group.
Older LGBT+ adults experience significant health disparities related to ageing, with an increased risk of disability, poor mental health, smoking, and higher alcohol consumption than their heterosexual counterparts. They are more than twice as likely to live alone, to be single and to be without children: they are consequently much more likely to have a ‘chosen family’ of friends. Chosen support networks can be endangered by ageing and illness, however, and research points to a concerned LGBT+ patient population that faces unknown future support systems.
Students entering medical schools have a diverse range of socio-cultural backgrounds. Undergraduate medical education represents the first opportunity for medical educators to ensure that all future doctors have the same foundational understanding of sexuality and gender. Medical students should receive greater instruction on the social and healthcare-related experiences of older LGBT+ patients. At present, very few medical schools include such provision in their curricula. There are many opportunities for inclusion of such content into medical school curricula. This study explores how the medical humanities may provide a vital source of understanding for the LGBT+ elder experience, giving voice to silence and shedding light on hidden lives in pursuit of culturally competent care and combat healthcare inequalities.