LGBTQ+ Immigrant Seniors in California’s Central Valley: A Story of Inequality and Vulnerability

By Anny Patino

Artwork by Anny Patino

Central Valley resident Van Vanlandingham found himself sharing a room in a rehabilitation nursing home with two men who talked about the physical and sexual abuse gay men experienced and he became fearful. Vanlandingham is gay and, like many other LGBTQ+ people, he was hesitant and afraid to share his identity because of the homophobia in nursing homes, doctors’ offices, and assisting living facilities. The Central Valley, which encompasses all parts of 19 California counties: Butte, Colusa, Glenn, Fresno, Kern, Kings, Madera, Merced, Placer, San Joaquin, Sacramento, Shasta, Solano, Stanislaus, Sutter, Tehama, Tulare, Yolo, and Yuba, is known for residents’ conservatives views.

The lack of acceptance for the LGBTQ+ community in the Central Valley stands in contrast to California’s liberal image.

The Senior LGBTQ+ Community in the Central Valley

Seniors experience mistreatment in care facilities based on their sexual orientation and gender identity. As LGBTQ+ seniors are driven to move back to the Central Valley due to the unaffordability of living in more LGBTQ+-friendly cities like San Francisco or Los Angeles, they not only struggle to survive but also to get the care they need.

Elderly LGBTQ+ people of color are more vulnerable to the displacement caused by gentrification because they are more likely to be foreign-born with disadvantaged socioeconomic backgrounds. The pandemic has further exposed the pitfalls of our current healthcare system, dangers that are exponentially increased when people have complex, overlapping vulnerabilities.

There are programs that are dedicated to helping the elderly, but how accessible and friendly are these programs for the LGBTQ+ community and the undocumented community?

Senior LGBTQ+ Immigrants & the Healthcare System

Mapping Immigrants At-Risk — BIMI — illustrating the percentage of foreign-born people without healthcare insurance in California.

Imagine navigating this world as an elderly LGBTQ+ immigrant, as someone who doesn’t speak English well, or as someone without papers. LGBTQ+ immigrants often left their homelands because they were fleeing violence and discrimination. This means that they often do not have family or friends to turn to in the U.S. Isolation puts seniors at greater risk because they may be unable to get medical support in case of an emergency.

There exists another layer of complexity when we focus on the undocumented community. Imagine paying taxes most of your life and not even receiving Medicare because you lack a social security number. These vulnerabilities affect thousands of people; 267,000 undocumented LGBTQ+ adults live in the United States, forming 2.7% of the undocumented community. Elderly people receive Medicare once they reach the age of 65. The eligibility requirements include being a citizen or having established a minimum of 5 years of legal residency as a lawful permanent resident or as an individual with Temporary Protected Status (TPS), and having worked for a minimum of 10 years in Medicare-covered employment. However, if elderly immigrants cannot provide the eligibility working history they may need to pay a monthly premium of $471 for Medicare Part A and $148.50 for Medicare Part B. On the other hand, individuals who are undocumented are ineligible. Where or to whom do you turn to in case of a crisis when you are limited by your immigration status?

Graph from Gaps in Health Services for Immigrants in the Central Valley A publication from the Berkeley Interdisciplinary Migration Initiative

Where are the tax funds going?

Mathematically, the fractional cost of providing healthcare for all is minimal compared to the moral component of being able to provide the quality of life a human being deserves and the medical care needed to protect everyone during a pandemic. Unlike fellow LGBTQ+ seniors, LGBTQ+ senior undocumented immigrants cannot benefit from Medicare and Social Security even though they contribute $9 billion dollars to this programs. Unable to receive financial support to cover their living and medical expenses, LGBTQ+ immigrants live in extreme poverty, below 200% of the federal poverty level. Undocumented immigrants contribute $3.2 billion dollars to California’s state and local income tax and the approximate cost to expand Medi-Cal will be a fractional cost at only $250 million. No one should have to live in fear of immigration enforcement or being judged a ‘public charge’ for seeking health services.

Undocumented immigrants contribute so much to these programs from which they are excluded. More than that, everyone deserves to live with dignity and be treated humanely.

Will increased awareness catalyze meaningful transformation?

Elderly LGBTQ+ people of color report not having a usual place to go when sick or in need of health advice. One reason is their ineligibility to enroll in healthcare programs, and the other is the lack of sufficient health care facilities. The Central Valley has only 1.52 clinics per 1,000 foreign-born people without health insurance, which is not sufficient to provide care for its population. Even when they find a place to ask for health services, LGBTQ+ older adults receive inferior, neglectful healthcare or have been denied health care altogether. In other words, older LGBTQ+ immigrants are facing challenging circumstances that impact their eligibility to enroll in programs and access the facilities that support their basic needs.

I believe that LGBTQ+ people should not be afraid or ever feel the need to re-closet themselves when seeking care, or to have their immigration status or socioeconomic status be a factor in their decision to seek care. The purpose of this blogpost is to bring awareness to a population that is often overlooked. Awareness is the first step to create a more accepting and empathic society, safe enough for immigrant LGBTQ+ seniors to exist.

In a country where around 3 million LGBTQ+ adults are over the age of 50, what would you do today to protect and care for their well-being?

I call on public officials and Californians to do more. First, we need to advocate for Medicare and MediCal expansion to cover undocumented seniors so they can have access to medical advice and care. Second, we need to advocate for additional funding to current LGBTQ+ senior programs so that they can better reach the community to provide resources like meals, housing, anti-discrimination training in an elderly care facility, and healthcare clinics. Nobody wants to live in fear of being themselves, nor should they have to. It is important to continue advocating for the LGBTQ+ immigrant community to be treated with dignity.

About the Author

Anny Patino [they/their] is a Cognitive Science undergraduate student at the University of California, Berkeley. They are part of the Undocumented Research Program (URP) a collaborative program between UC-Berkeley’s Institute for Research on Labor and Employment (IRLE) and the Berkeley Interdisciplinary Migration Initiative (BIMI).

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The Berkeley Interdisciplinary Migration Initiative (BIMI) is a partnership of migration experts at UC Berkeley who investigate the social, political, legal and economic dynamics of migration globally as well as locally. We strive to advance thoughtful and substantive conversations on migration that leverage the university’s cutting-edge scholarship and its public mission to educate current and future generations. We embrace new data- gathering technologies as well as embedded, on-the-ground fieldwork, drawing from the interdisciplinary expertise of faculty, students and the communities with which we engage. Bringing together research, training and public engagement, BIMI aspires to inform, educate and transform knowledge to improve the well-being of immigrants and the communities they live in.

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