My research is focused on the well-being of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, particularly mid-life and older adults. Understanding and addressing the social determinants of population health disparities (i.e., the causes of the cause)and downstream bio-psycho-social-spiritual-behavioral issues is critical to working toward health equity among marginalized groups.
Health, health disparities, and the pursuit of health equity among marginalized populations form the core of my research agenda, theoretically grounded in health equity and minority stress perspectives. I am particularly interested in the health and well-being of midlife and older lesbian, gay, bisexual, transgender, and queer (LGBTQ) midlife and older adults. Researchers have only recently begun to examine LGBTQ older adults as a population distinct from heterosexual older adults, and from their younger LGBTQ peers. Compared to their heterosexual age peers, midlife and older lesbian, gay, and bisexual older adults have significantly higher rates of many chronic health conditions, as well as higher rates of psychological distress. Midlife and older transgender adults appear to have even poorer physical and mental health than non-transgender midlife and older lesbian, gay, and bisexual adults. I have recently focused on understanding the causes, correlates, and consequences of the disparately highly rates of psychological distress and depression documented among LGBTQ older adults. Even low levels of psychological distress have been associated with elevated risks of premature chronic disease and mortality. The Institute of Medicine pointed out in its recent report on the health of LGBTQ Americans that documentation of population health disparities is a preliminary step in addressing health disparities, but illuminating the underlying relationships among risk and protective factors is essential to the development and implementation of culturally appropriate, effective interventions.
My particular interest in LGBTQ older adults began to coalesce during my master’s program. As a clinical intern (and subsequently clinical staff) at Seattle Counseling Service for Sexual Minorities (SCS), one specific experience was the catalyst that ignited my passion in serving LGBTQ older adults. One of my first clients, a 57-year-old gay man took his own life as a result of extreme psychological distress in the face of near-certain destitution because of discriminatory laws and policies that at that time did not recognize his 20-year relationship with another man. This tragedy became the impetus for my decision to pursue a doctorate and gain the skills to generate scholarship to inform practice and policy change that will benefit LGBTQ older adults. My research has provided me with unparalleled opportunities to identify how historical and current social contexts (including laws and policies) have and continue to marginalize LGBTQ older adults and negatively impact their health and well-being. Attending to these historical and current social contexts also benefits younger LGBTQ people, as they are tomorrow’s LGBTQ older adults; it also profits non-LGBTQ individuals by fostering understanding of how such marginalization can negatively impact the health and well-being of minority groups.
I have had the privilege to be part of the National Health, Aging, & Sexuality Study: Caring & Aging with Pride Over Time (NHAS), the first federally funded, national project of its kind to examine the health and aging needs of LGBTQ older adults. Findings from the NHAS, now a longitudinal study have been used to support an amendment to the Older Americans Act, which would (among other provisions) designate "LGBTQ older adults as a vulnerable population with greatest economic and social need as a result of a lifetime of discrimination," and prioritize research to address LGBTQ health disparities and equity. NHAS research was also presented at the first White House conference on LGBTQ aging, an Invited Congressional Briefing, and is being used to influence social policies that impact the lives of LGBTQ older adults in a multitude of other ways.
I am currently researching the relative roles of internal minority stressors (e.g., concealment of minority identity, internalized heterosexism), perceived general stress, and the mental health of older LGBTQ adults. I am also exploring whether and how gender identity may differentially influence the pathways of risk that lead to depression among transgender older adults and their non-transgender lesbian, gay, and bisexual counterparts. The overarching goal of my research agenda is to better understand how barriers to health equity, such as discrimination and victimization, 'get under the skin' to manifest as disease in order to design and implement interventions that promote LGBTQ health equity.
I engage the next generation of social work practitioners and scholars, bringing my research and practice experience into the classroom, highlighting interconnections between research, policy, practice, education, and service delivery. I use research findings to show how policies directly and indirectly affect the well-being of individuals, families, groups, and communities. In conjunction with ‘real life’ practice examples, students’ understanding of abstract theoretical concepts and the practical selection and application of evidence-based interventions is facilitated.
 Funded in part by the National Institutes of Health (NIH) and the National Institute on Aging (NIA), R01 AG026526, Fredriksen-Goldsen, PI.