[{"@context":"https:\/\/schema.org\/","@type":"NewsArticle","@id":"https:\/\/thehomeground.asia\/destinations\/singapore\/how-ageing-hits-harder-for-the-queer-community\/#NewsArticle","mainEntityOfPage":"https:\/\/thehomeground.asia\/destinations\/singapore\/how-ageing-hits-harder-for-the-queer-community\/","headline":"How ageing hits harder for the queer community","name":"How ageing hits harder for the queer community","description":"In recent years, more programmes and resources have been established to meet the needs of Singapore\u2019s ageing population. These include the Senior Priority Scheme, which improves an individual\u2019s chance of getting a flat, as well as the Silver Support Scheme, which offers quarterly cash payouts to seniors with low lifetime wages and little or no […]","datePublished":"2021-04-28","dateModified":"2022-04-16","author":{"@type":"Person","@id":"https:\/\/thehomeground.asia\/author\/Maisie%20Leong\/#Person","name":"Maisie Leong","url":"https:\/\/thehomeground.asia\/author\/Maisie%20Leong\/","identifier":227,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/4f5c852853ba8ed19bedc5417be7db8166064cfcb8857f5ec40bb516fab94b2d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/4f5c852853ba8ed19bedc5417be7db8166064cfcb8857f5ec40bb516fab94b2d?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"TheHomeGround Asia","logo":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","width":640,"height":640}},"image":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1619513284374_WhatsApp_Image_2021-04-27_at_16.42.04.jpeg","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1619513284374_WhatsApp_Image_2021-04-27_at_16.42.04.jpeg","height":626,"width":1280},"url":"https:\/\/thehomeground.asia\/destinations\/singapore\/how-ageing-hits-harder-for-the-queer-community\/","about":["Community","Health & Wellness","Local","Sex & Gender","Singapore"],"wordCount":2128,"articleBody":"In recent years, more programmes and resources have been established to meet the needs of Singapore\u2019s ageing population. These include the Senior Priority Scheme, which improves an individual\u2019s chance of getting a flat, as well as the Silver Support Scheme, which offers quarterly cash payouts to seniors with low lifetime wages and little or no family support.\u00a0However, ageing can be a trickier process for the queer community, as they face elder care options that may not be accepting of their gender identity and sexual orientation. What are some unique challenges that LGBTQ+ individuals encounter in the process of ageing? TheHomeGround Asia finds out. With Singapore\u2019s total fertility rate declining over the past decades, and falling to a historic low of 1.1 in 2020, decreasing birth rates coupled with a high life expectancy have led to Singapore facing an ageing population.\u00a0But, despite a host of initiatives designed to cater to the needs of the elderly in Singapore, one group has fallen through the cracks \u2013 the queer community. In their later years, many who identify as LGBTQ+ face multiple hurdles, be it through housing policies or medical ones, to the more personal, such as being unable to find acceptance and facing discrimination.The use of language in self-identificationLeow Yangfa, Executive Director of Oogachaga, a non-profit that aids the LGBTQ+ community through the provision of counselling and support services, says older LGBTQ+ individuals may identify themselves using different characteristics, unlike younger individuals who are \u201ccomfortable\u201d using the terminology of LGBTQ+ to describe themselves. He asserts that this may lead to implications of how people \u201caddress, define, work with and support LGBTQ+ elders.\u201d\u00a0For instance, an older male who is \u201ceffeminate in their gender expression, and attracted to other men,\u201d says Mr Leow, may \u201cinterchangeably see himself as a gay man or trans woman.\u201d The person may use both male or female pronouns (he or she) when referring to themselves, and may not mind being called by ‘uncle’ or ‘aunty’.He adds, \u201cLikewise, an older woman who is somewhat masculine-presenting, not in a relationship with anyone but maybe previously attracted to women, may or may not see herself as a butch, lesbian or tomboy.\u201d\u00a0In contrast, he states that more contemporary terms used for self-reference within the LGBTQ+ community include ‘lesbian’, ‘gay’, ‘bisexual’, ‘transgender’, ‘queer’ and ‘nonbinary’.\u00a0Mr Leow also explains that some of the terms used by elderly LGBTQ+ individuals, such as \u2018homosexual\u2019, \u2018transsexual\u2019, or even \u2018ah kua\u2019, refers to a transgender person in Hokkien, may be considered outdated or potentially offensive to those who are more modern.\u00a0According to the GLAAD institute, the term ‘homosexual’ is perceived to be offensive due to its clinical history, as it suggests that people who are attracted to the same sex are ‘somehow diseased or psychologically\/emotionally disordered’. While the term ‘transsexual’ is not considered an umbrella term, as many transgender people, whose gender identity differs from what they were assigned at birth, do not identify as transsexual.\u00a0Social isolation among the elderlySocial isolation is also common within the queer elderly community.\u00a0According to June Chua, co-founder of The T Project, isolating themselves is sometimes a coping mechanism for senior members of the transgender population to avoid challenges. Founded in 2014, The T Project runs Singapore\u2019s only shelter for transgender people and supports the community through outreach, counselling and advocacy.\u00a0\u201cThey never go out. [The] T Project sends food donations to the elderly transgender community,\u00a0 from what I see, they all stay at home, don’t have [handphones]. They watch TV, listen to radio,\u201d she says.This happens to many queer elderly individuals as well.\u00a0Retired general practitioner and LGBTQ+ activist Dr Roy Tan, who has been instrumental in documenting Singapore\u2019s LGBT culture and history, says that many older LGBTQ+ individuals remain closeted, even to other queer people.\u00a0Dr Roy Tan started Singapore\u2019s first LGBT pride parade in 2008, which later developed into Pink Dot SG. He is currently challenging the constitutionality of Section 377A of the Penal Code, which criminalises sex between men. (Photo courtesy of Dr Roy Tan)Dr Tan started a group, Volunteer Befriending and Helping Service, to help meet the needs of queer elderly people, from physical to monetary assistance. But, his enquiries regarding elderly queer people in need of help met with little success, as many have not come out gay or lesbian.\u00a0\u201cSo you see, the amount of shame that’s associated with being gay is also very hindering [when it comes] to reaching out to people.\u201d\u00a0\u00a0Other factors, such as a lack of contact with or rejection by family members, the deaths of parents, siblings and friends over time, can further push LGBTQ+ elderly into living in solitude, says Mr Leow.\u00a0\u201cSome may [be] unable or not ready to connect socially with younger generations for various reasons, and have difficulty seeking LGBT+ [or] non-LGBT+ peers their own age,\u201d he shares, adding that being alone might prevent them from meeting their social and sexual needs.Elderly individuals in the queer community face social isolation, with some feeling compelled to go back into the closet. (Source: Canva)\u00a0Going back into the closet\u00a0Gender identity aside, ageing in a nursing home can be difficult to adjust to. A person might not be able to enjoy the same lifestyle choices and freedom in their daily routine.\u00a0Ms Chua shares her earlier experiences as a volunteer in an old folks\u2019 home: \u201cI hadn’t started The T Project yet. It’s so horrible… [when they] give haircuts, it’s like [a] factory; one by one, they [are] rolled out. No options, all short hair.\u201dQueer individuals living in nursing homes face an additional challenge: Having to go back into the closet, if they cannot be open about their gender identity. Uncongenial social environments, such as homophobic attitudes and behaviour from fellow residents in the nursing home or even staff members, are further reasons for making this decision.Says Mr Leow, \u201cIt is not unusual that some LGBTQ+ elders, for their own social and emotional safety, decide to go back into the closet as they become older.”Dr Tan shares that there is a real fear of dealing with abusive and homophobic behaviour, especially if they cannot afford to hire elder care alternatives such as private nurses, and are sent to public nursing homes that tend to cater to heterosexual individuals\u2019 needs.\u00a0Living in a nursing or aged home could also mean not being able to receive visitors.\u201c[Some] have no friends, and [others are] afraid that friends will come and give the game away. After all, friends come and talk about [LGBT-related issues], everyone’s gonna know that [they] are gay,\u201d he says.\u00a0For those in the transgender community, however, stepping back into the closet is not an option, says Ms Chua. \u201cFor gay, lesbian, bisexual [people], the last resort is to go back to the closet, so they can enjoy the benefits of what cisgender [a person whose gender identity is aligned with the sex they were assigned at birth] elderly enjoy. Just go back to the closet, be a cisgender, heteronormative man or woman. But… for transgender persons, [that\u2019s not possible],\u201d she explains, citing the example of transgender females who already present feminine traits physically.\u00a0\u201cA lot of people just cut their hair, start dressing as a man again and try to act [in a more masculine manner]. They just forgo their identity completely,\u201d says Dr Roy Tan. (Source: Canva)The struggles of the transgender community\u00a0When it comes to legally changing one\u2019s sex, Singapore is among a handful of Asian countries that recognises transgender people. Since 1973, sex reassignment surgery has been legal, and those who have undergone the procedure can change their gender marker on their identification cards. But the birth certificate cannot be altered, as according to some sources, it is considered a historical document.\u00a0Hence, Ms Chua says that if a nursing home requires a potential client\u2019s birth certificate when applying for a place, this might present an issue of whether a post-operative transgender person will be assigned to a male or female room, if this is determined by the gender identity indicated on the birth certificate.\u00a0\u00a0She says, \u201c[Transgender individuals] may be already presenting as females [with physical traits such as] long hair and [larger] breasts. But their gender marker [on their birth certificates] is male, so they’re sent to a male nursing home.\u201d\u00a0Ms June Chua (second row, fifth from right) at Pink Dot 2017. (Source: The T Project \/ Facebook)\u00a0Access to insurance coverage is another issue.\u00a0Many transgender individuals are current or former sex workers, explains Ms Chua, and do not have savings under the Central Provident Fund programme. Some hold low-wage jobs, and many are now receiving financial assistance, leading to many not having the means to afford insurance.\u00a0\u201cSo if you are lower-income, the group that needs insurance the most, [if you] cannot pay, [you] cannot get it,\u201d she says, adding that those who can afford it have to fork out for higher premiums.Aside from affordability, many transgender individuals also encounter limitations in terms of insurance coverage, whether they are pre-operative or post-operative.\u00a0Dave* (not his real name), a transgender male person, says that purchasing insurance plans can be difficult, sharing his experience when he tried to purchase a new insurance plan.\u00a0\u201cI got caught up in the underwriting phase because I had to declare that I have a medical condition, and that I will be undergoing surgery in [perhaps] the next few years. And anything related to the surgery, to my former [and] new genital tract, will not be covered under insurance,\u201d he notes.\u00a0\u00a0He questions where he fits in when it comes to coverage, and whether he would still receive coverage as a woman even if the gender marker on his IC indicates that he is a man.\u00a0\u201cRationally speaking, the [plan] for a cisgender woman would not cover prostate cancer, [and] that for a [cisgender] male, would not cover breast cancer. But I am at risk of breast cancer, [and] I will not have prostate cancer.\u201dDave also claims that undergoing hormone therapy is recognised as a pre-existing medical condition, hence any possible side effects of the treatment \u2013 \u00a0including cancer, heart attack, and stroke \u2013 are not covered under an insurance plan, as well.\u00a0Financial advisor Wayne (not his real name) clarifies that a hospitalisation and surgical insurance plan covers one\u2019s hospitalisation and surgical fees, and although it excludes an initial sex change operation, it does not explicitly exclude complications at a later stage.\u00a0He adds that the approval of an insurance policy depends on an underwriter evaluating and assessing the risk of insuring an individual.\u00a0\u201cIf the underwriter deems the applicant to be too high risk, he or she will reject the application, or use ‘exclusions’ to manage the risk. This is a case-by-case situation and is not set in stone,\u201d he explains.\u00a0\u201cUnderwriters use this exclusion method so ‘higher risk’ individuals can still be covered for everything else, as opposed to not being covered at all.\u201dFinancial limitations\u00a0Private nursing can be expensive, limiting it to those who are more financially secure and can afford to pay for it.\u00a0A quick search reveals that private nursing care in Singapore can cost between S$1,200 and S$3,500 (US$905 – US$2,640) per month, prior to a subsidy provided by the Ministry of Health. Two types of nursing homes are available: Private nursing and those run by voluntary welfare organisations. Subsidies are also available, subject to applicants meeting the criteria, which takes a few factors into account, such as the number of family members within the same household, the annual value of their current place of residence, and the gross income of the person who requires care, as well as that of their direct family.\u00a0While financial limitations affect anyone looking for nursing care, regardless of their gender identity, Ms Chua explains that transgender people who have low to no income have no option save for public nursing homes, since they receive little to no support from their families, and rely on financial aid from the Government.\u00a0She shares, \u201cThey don’t have money to pay for insurance; they live day-by-day. They must [hope] that they don’t get a stroke, they don’t get [into] an accident. If their mobility is affected, it’s straight to a nursing home. That’s the only option for them: State-funded nursing homes.\u201d\u00a0This is the first in a two-part series on ageing within the LGBTQ+ community in Singapore. Look out for the second instalment, when we explore further the social implications and challenges of aging for queer people.\u00a0Join the conversations on THG’s Facebook and Instagram, and get the latest updates via Telegram."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Destinations","item":"https:\/\/thehomeground.asia\/destinations\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Singapore","item":"https:\/\/thehomeground.asia\/destinations\/\/singapore\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"How ageing hits harder for the queer community","item":"https:\/\/thehomeground.asia\/destinations\/singapore\/how-ageing-hits-harder-for-the-queer-community\/#breadcrumbitem"}]}]