Let’s Ensure Culturally Competent Support for LGBTQ+ and People Aging with HIV Nationwide

From SAGE’s 40+ years of experience in serving LGBTQ+ older people and engaging in advocacy on LGBTQ+ aging issues, we know first-hand that social isolation, poverty, and a lack of access to affordable and welcoming housing are major challenges as we age. Most older people experience at least some of these issues, but they are compounded for LGBTQ+ elders due to lifetimes of facing stigma and discrimination, harassment, a lack of access to culturally competent service providers, and thin support networks.

Did you know?
  • LGBTQ+ elders are 2x more likely to live alone and 4x less likely to have children than their heterosexual, cisgender peers. This makes it more difficult to age successfully in their homes and communities
  • A national survey in 2015 reported that 65% of older transgender respondents felt that they would have limited access to care as they age, and 55% feared that they would be denied medical treatment
  • 70% of LGBTQ+ older people fear having to “re-closet” themselves when seeking elder housing
  • 53% of LGBTQ+ elders report feeling isolated from others
  • 41% of LGBTQ+ older people report having a disability, compared to 35% of heterosexual older people
  • 50% of all Americans living with HIV are over 50 years old


Many states hold public listening sessions or offer comment periods as they develop their State Plans on Aging. We will make sure you have the tools and resources you need to speak out!


We’re collecting stories of LGBTQ+ and HIV-positive elders nationwide. Do you have a story of facing challenges in seeking elder services? Or maybe you have one about the life-saving impacts of LGBTQ+-friendly services? We want to hear from YOU!


We know that local aging services and supports are critical for the LGBTQ+ community to succeed as they age. However, fear due to a lifetime of discrimination and current lived experiences prevents many LGBTQ+ elders from accessing the care and support they need to thrive.


Old and Bold: Services for All ensures that LGBTQ+ elders and older people living with HIV nationwide can access welcoming aging services and supports regardless of where they live. Our mission is to build a world where LGBTQ+ people can age with dignity and respect. A world where without fear, they can access services like meal assistance, senior center programs, health and wellness promotions, caregiver support, benefits enrollment, transportation, or any other aging service. But this world cannot and will not exist without the hard work of our community taking action.


The cornerstone of Old and Bold: Services for All is the Older Americans Act (OAA).

The OAA is the federal law that ensures older people receive the services and supports they need to age well in their communities. Since 1965, the OAA has supported programs like home-delivered meals (e.g., Meals-on-Wheels), congregate meals, programs through senior centers, chore and transportation assistance, and an entire range of services and supports. These programs allow people to age successfully at home and in their communities.

In 2020, SAGE successfully advocated for LGBTQ+ inclusion when Congress updated the OAA. Now, the OAA requires state and local aging agencies to conduct outreach and engage with the LGBTQ+ community, and to determine what services are needed and if their needs are being met. This updated law will impact LGBTQ+ elders in every single state and every single community across the nation.

In 2021, the Biden administration issued guidance to states that details how to implement the updated OAA. As states develop their State Plans on Aging, they are encouraged to equitably include LGBTQ+ elders and older people living with HIV/AIDS in those plans. The Administration also released updated guidance in March 2023. However, to ensure that LGBTQ+ elders receive the services and supports they deserve, LGBTQ+ elders and allies must speak out.

That’s why Old and Bold: Services for All exists. We will make sure that LGBTQ+ and HIV-positive older people get the tools and resources needed to make their voices heard. Together, we will work with states to ensure that their State Plans on Aging include LGBTQ+ and HIV communities and that service providers serve our communities with care.


SAGE stands ready to serve as a resource to ensure that your State Plan complies with federal requirements and is inclusive of LGBTQ+ & HIV+ elders. We can redline a draft plan, provide sample language, and/or set up a call to talk through your options.

  • Chris Almvig, SAGE co-founder

    We always said that “community means taking care of our most vulnerable.” I see SAGE taking that to a larger level with their federal advocacy efforts.

    — Chris Almvig, SAGE co-founder