372 The Professional Counselor | Volume 11, Issue 3 of intersecting forms of oppression. In fact, a study by Kim et al. (2017) documented that African American LGBT elders faced higher rates of lifetime discrimination, which adversely affected their physical and mental health. Similarly, incidents that contribute to the lack of identity affirmation, community networks, and social support exacerbate a number of health disparities and adverse outcomes of mental health (Fredriksen-Goldsen et al., 2013; Seelman et al., 2017; Woody, 2014, 2015). Consistent with patterns in health disparities research, oppression tends to serve as a catalyst for higher prevalence of suicidality among older LGBTQ+ adults of color (Choi & Meyer, 2016; Meyer, 2014, 2016). In fact, Fullen and colleagues (2018) noted that internalized ageism can predispose older adults to a myriad of mental health issues, symptoms, and increased rates of suicidal ideation. According to Seelman (2019), the combination of responding to discrimination along with barriers to access can significantly increase the mortality rate for older LGBTQ+ adults of color. Conversely, the preservation of cultural identity (Fullen, 2016) and identity affirmation (Fredriksen-Goldsen et al., 2017; Howard et al., 2019; Kim et al., 2017) buffers the effects of oppression and encourages older LGBTQ+ adults of color to seek help and health care. Older LGBTQ+ adults of color also face disproportionate access to resources, especially adequate and LGBTQ-affirming health care services (Hinrichs & Donaldson, 2017; Kimmel, 2014). Among the variety of health conditions tied to the aging process, the risk of HIV increases for older LGBTQ+ adults of color as a result of psychosocial factors, such as poverty, stigma, marginalization, and lack of education (Bower et al., 2021; Jones et al., 2018; Karpiak & Brennan-Ing, 2016; Yarns et al., 2016). Many of these barriers can be traced to the marginalization attached to ageism, classism, racism, genderism, and heterosexism (Brennan-Ing et al., 2014; Robinson-Wood & Weber, 2016). During this stage, older LGBTQ+ adults of color face drastic changes to mental health based on cumulative interactions with societal stigma and internalized heterosexism and genderism (Correro & Nielson, 2020; Yarns et al., 2016). Consistently responding to discrimination can eventually culminate in a variety of mental health symptoms (e.g., anxiety, depression) or mental exhaustion (FredriksenGoldsen, 2014; Fredriksen-Goldsen et al., 2013). Social Isolation, Grief, and Loss Compounded with multiple overlapping forms of oppression, older LGBTQ+ adults of color can have a multifaceted experience of social isolation and loss as they transition into the stages of older adulthood (Dzierzewski, 2014). Although older adults generally experience grief and loss as part of the transition in aging (Chaney & Whitman, 2020; Kampfe, 2015), these experiences are heightened for older LGBTQ+ adults of color as an outcome of navigating racism, heterosexism, and genderism (Bockting et al., 2016; Woody, 2014, 2015). The loss of family, friends, social networks, and intimate partners for older LGBTQ+ adults of color can converge with an overall lack of affirmation and heighten experiences of racial, sexual, and gender discrimination (Seelman et al., 2017). Instances of isolation and loss are pervasive because of the confluence of racism and heterosexism converging in this stage of the life span (Woody, 2015). Woody’s (2015) study noted that older African American lesbian women cited the proliferation of racism as a more prominent issue than their experiences with other forms of oppression (e.g., heterosexism). Compounding these losses, barriers to housing and the likelihood of eviction for older LGBTQ+ adults of color can amplify feelings of displacement from communities and society (Brennan-Ing et al., 2014; Robinson-Wood & Weber, 2016). Additionally, older LGBTQ+ adults of color consistently contend with coming out across the life span (Hinrichs & Donaldson, 2017; Mabey, 2011). Experiences of coming out and self-disclosure of these social identities can be complex because of the loss of connections, fear of rejection, and incivility from
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