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10 posts from May 2014

May 30, 2014

A Major Victory: Medicare Will Cover Transition-Related Care

Today, the Department of Health and Human Services (HHS) Department Appeals Board (DAB), an independent federal appeals board, ruled that Medicare must cover medically necessary care for individuals with gender dysphoria, just as it covers medically necessary care for those with other medical conditions.  In short, Medicare will now cover transition-related care for transgender older adults. 

SAGE applauds our advocacy partners, Gay & Lesbian Advocates & Defenders (GLAD) the American Civil Liberties Union (ACLU), Lambda Legal, and the National Center for Lesbian Rights (NCLR), for their tireless advocacy on this issue.  This is an important milestone for transgender older adults, who after a lifetime of being denied medically necessary care, are finally on a level playing field with other Medicare recipients. Older transgender individuals are now able to get the comprehensive medical coverage they need and deserve. 

The ability to access complete gender-transition related health care is essential to ensuring the health and well-being of transgender patients.  The Medicare policy denying this care ran counter to decades of extensive scientific and clinical research, which supports surgically altering an individual's primary and secondary sex characteristics as a safe, effective and medically necessary treatment for severe gender dysphoria. This decision is lifesaving for many transgender individuals suffering from severe gender dysphoria.  Both the medical and mental health professions have recognized that when denied proper medical care, individuals with gender dysphoria can develop severe psychological distress, dysfunction, and debilitating depression -- placing them at increased risk for suicide and self-harm. 

Recognizing the dangers of denying proper medical care, the American Medical Association and the American Psychological Association have issued policy statements recognizing the medical necessity for gender transition-related treatments including hormone therapy and/or sex reassignment surgeries, as well as mental health care. For more information on this important change, the National Center for Transgender Equality has put together a comprehensive fact sheet on Medicare coverage of transition-related care.

-- Posted by Aaron Tax, SAGE's Director of Federal Government Relations

May 29, 2014

Aging and HIV: New Insights, New Recommendations

In the early days of the HIV/AIDS epidemic, most people diagnosed faced death within a few years, if not sooner. Thirty years on, much has changed; HIV has become a more manageable chronic illness and many people are aging with the disease. 

The proof is in these startling statistics: it's predicted that 50 percent of people with HIV in the U.S. will be age 50+ by 2015—and by 2020, more than 70 percent of Americans with HIV are expected to 50+.

With that in mind, SAGE, the Diverse Elders Coalition (DEC) and ACRIA (AIDS Community Research Initiative of America)  have created a report outlining eight recommendations to address the needs of a growing demographic of older adults with HIV, many of whom are LGBT and people of color. The full report, Eight Policy Recommendations for Improving the Health & Wellness of Older Adults with HIV, can be found online here.  

In conjunction with this project, several leaders in the field joined forces for a recent national teleconference on HIV & Aging. Among the many issues discussed, Dan Tietz of ACRIA highlighted the power of images. Tietz reminded listeners that "It's important to target prevention messages to older adults. Don't use images of young adults and teenagers to reach at risk older adults." 

As the experience of living with HIV/AIDS has changed, our approach to care and messages about prevention must also evolve. This new report should serve as an important resource in accomplishing that goal. 

-- Posted by Kira Garcia


Exploring Housing Struggles and Solutions in a New Webinar

One of the biggest issues facing many LGBT older adults in cities and towns across the country is finding safe, affordable housing. With this in mind, SAGE and Enterprise Community Partners are co-presenting a webinar on June 4th from 2:30pm-4:00pm ET, on building housing services and supports that are inclusive and supporting of LGBT elders.

Due to higher levels of financial insecurity and a general lack of affordable housing, many LGBT elders find that they cannot afford homes in the communities in which they have lived for years. Others face harassment and intimidation in their homes and in long-term care settings from aging professionals, other residents, and even their own family members. [1] In fact, in a recent report, the San Francisco Aging Policy Task Force concluded, “that the number one problem LGBT older adults are dealing with…is ensuring they have stable housing.”[2] 

Join this outstanding panel as they discuss public policy solutions including: increasing access to affordable housing, connecting health care providers to housing providers, addressing housing discrimination, and increasing the number of LGBT culturally competent housing providers. 

Building Housing Services & Supports Webinar

Wednesday, June 4
2:30pm-4:00pm ET
Register online here

Michael Adams, Executive Director, SAGE


  • Cheryl Gladstone, Senior Housing Program Director, Enterprise Community Partners, Inc.
  • Kat Taylor, Disability Rights Program Manager, Equal Rights Center
  • Seth Kilbourn, Executive Director, Openhouse
  • Sherrill Wayland, Executive Director, SAGE Metro St. Louis

Serena Worthington, Director of National Field Initiatives, SAGE


[1] The Aging and Health Report: Disparities and Resilience Among Lesbian, Gay, Bisexual and Transgender Older Adults, Fredriksen-Goldsen, K. I., Kim, H.J., Emlet, C. A., Muraco, A., Erosheva, E. A.,Hoy Ellis, C. P., Goldsen, J., Petry, H., Institute for Multigenerational Health, 2011, http://caringandaging.org/wordpress/wp-content/uploads/2012/10/Full-report10-25-12.pdf

[2] LGBT Aging Panel Zeros in on Housing, Matthew J. Bajko, Bay Area Reporter, March 6, 2014,  http://www.ebar.com/news/article.php?sec=news&article=69531


May 21, 2014

After Marriage Equality, What’s Next?

Today's post is from Serena Worthington, Director of National Field Initiatives for SAGE. Follow Serena on Twitter at @SerenaWorthy

As marriage equality becomes law in state after state including my home, Illinois, many advocacy organizations are asking themselves and their communities, “What’s next?” With this in mind, I was excited to present at the LGBT Equality Institute hosted by Equality Illinois on May 17, the 10th anniversary of the legalization of same-sex marriage in Massachusetts (the first state to do so). 

The Institute focused on myriad issues still facing the LGBT community. I asked Roey Thorpe, Director of Advocacy Programs for the Equality Federation, if community conversations like this are the trend and the answer was a great, big, “Yes!”  Thorpe says that “What’s next?” is of the biggest questions facing the LGBT movement right now.

She also said that for “activists in states that have achieved their legislative agendas, the challenge is to reframe our work and continue to motivate and inspire people so that we maintain the political power we have worked so hard to build. We still have so much work ahead of us: making discrimination illegal in the remaining 29 states; reducing violence against transgender people; and achieving the policy solutions that have eluded us.”

Roey adds, “In the many states where people are grappling with this question have shifted their focus from legislation toward ‘lived equality,’ looking at the experience of LGBT people and our loved ones from cradle to grave, understanding where the disparities exist and creating approaches that will make a real difference in the quality of life for our communities."

For more on the 29 states without discrimination protections for LGBT people, check out this eye-opening map from the Center for American Progress.

Serena Worthington with Gautam Raghavan, White House Public Engagement Advisor on LGBT Issues


The Institute drew 150 attendees from across Illinois drawn by a slate of great topics. I attended two excellent sessions: a keynote panel on the Federal LGBT Policy Agenda with U.S. Rep. Jan Schakowsky, a senior member of the Illinois Congressional Delegation, Gautam Raghavan, White House Public Engagement Advisor on LGBT Issues, and Meg Gorecki, Midwest Director for the U.S. Department of Justice and a session on Access to Health Care as a Civil Rights Issue.

In the latter session, David Munar, the newly appointed Executive Director of Howard Brown Health Center, addressed the question of the day directly, saying that, "Achieving marriage equality is great but how do we harness that energy to improve health care access across every letter of the L, G, B and T and across the entire age span?”

Over the years, I have co-presented with Britta Larson, Director of Senior Services, at SAGE Center on Halsted many times and it was a great pleasure to do so again. During our session, LGBT Older Adults: Preparing for the Age Wave, we reviewed the culture, needs and concerns of LGBT older adults and offered best practices on how to better serve LGBT older adults who are currently seeking access to basic services. A number of people raised concerns about the readiness of mainstream aging providers to serve LGBT elders. I was glad to be part of the larger conversation about where the LGBT movement is headed and to have the opportunity to hear from LGBT elders about their priorities.


May 15, 2014

A Quick Chat With SAGE Participant Michelle Malloy

May is Older Americans Month! To celebrate, we're launching a series of conversations with SAGE participants on our blog.These 'quick chats' will reveal a bit more about the fabulous folks who enjoy the incredible array of programs offered by SAGE. Our first chat is with SAGE participant Michelle Malloy, who has been a SAGE participant since 2010. She is a 55-year-old bisexual New York City native who has been out since 1977. We caught up with Michelle at our Women's Group in Harlem. 
Michelle (left) and her partner Karen at SAGE Harlem


Thanks for talking with me Michelle! So when did you come out?

I came out at age 18 in 1977. My cousin Cynthia [a SAGE staffer] was already out; she paved the way for me. We had a lot of fun going to clubs together in the city, like the Loft and Paradise Garage.

And you’re here with your girlfriend, is that right?

Yes, my partner Karen Massey and I have been together since 1991. She’s my best friend. When I fell down in the train station in December she was the first person I called. We help each other. People don’t always think we’re a couple though. As we get older, people look at us differently. Sometimes people think she’s my aunt or my mom!

And what do you love most about her?

She’s honest—about everything!

What do you do professionally? Are you out at work?

I work part time as an Executive Assistant in a neurosurgery office. I came out at work in 1985. I didn’t really experience any difference in how I was treated after I came out. I’m looking forward to retirement at age 62!

Exciting! What are you planning to do with your retirement?

Travel--to Vegas, or any country with a casino! I love to gamble.

What was your biggest win?

I once won $6400—it was $4200 after taxes. I used it to pay off my credit card.

That’s so practical!

Yes, you’ve got to be!

Any advice for our readers?

Live your life to the fullest—it’s so short! Don’t let anyone tell you how to live it!

Great advice—thank you Michelle!

-- Posted by Kira Garcia 

May 14, 2014

The State of HIV and Aging: National Teleconference May 28

In recognition of Older Americans Month, SAGE (Services and Advocacy for GLBT Elders), ACRIA (AIDS Community Research Initiative of America) and the Diverse Elders Coalition are co-sponsoring a national teleconference on Wednesday, May 28th, 2014, 2-3PM ET, on the issues facing older adults with HIV -- a rapidly growing demographic with distinct needs and pronounced disparities. It’s estimated that by 2015, one in two people with HIV in the U.S. will be 50 and older, many of whom are LGBT and people of color. The teleconference will include an update on the state of the AIDS epidemic among older people, as well as a discussion on policy opportunities that would improve the health and overall wellness of older people with HIV. Leaders from the aging, LGBT and HIV/AIDS fields will also discuss how providers can best support people with HIV as they age.

When: Wednesday, May 28th, 2014
Time: 2:00-3:00 PM ET
Dial In: (559) 726-1300
Participant Passcode: 292757#

To RSVP, or for more information, please e-mail Bryan Pacheco to bpacheco@diverseelders.org


Dr. Jennifer Kates, Vice President and Director of Global Health & HIV Policy at the Kaiser Family Foundation

Dan Tietz, RN, JD, Executive Director, AIDS Community Research Initiative of America (ACRIA)

Hilary Meyer, Director, National Programs, Services and Advocacy for GLBT Elders (SAGE)

Aaron Tax, Director of Federal Government Relations, Services and Advocacy for GLBT Elders (SAGE)

Bryan Pacheco, National Coordinator, Diverse Elders Coalition (DEC)

Naomi Schegloff, Project Co-Director, of The Graying of AIDS


May 13, 2014

SAGE Supports Anti-Mandatory Mail Order Drug Legislation

A consultation with a pharmacist can be critical for any patient with questions about a new prescription--are there side effects to look out for? How and when should the drug be taken? What are the risks of taking multiple medications at once?

For older adults, particularly those living with HIV/AIDS, these questions are especially critical given the many medications they are often taking; this conversation with a pharmacist can be life-saving. With this in mind, SAGE has submitted the following memorandum in support of new legislation that will ensure that consumers cannot be required to receive their prescriptions by mail under certain health plans. The legislation has been put forward by Senator George Maziarz (R-Newfane), and New York State Assembly Member Carl E. Heastie. 

By ensuring that consumers can access the guidance of a pharmacist, this new legislation will help older adults live longer, healthier lives.



A5723B (Heastie) / S3995B (Maziarz)


SAGE strongly supports passage of A.5723A (Heastie)/S.3995A (Maziarz). This legislation is necessary to clarify and strengthen provisions in current law to ensure that consumers can have the choice of accessing their covered medications from a local pharmacy or by mail order.  Legislation—which went into effect in 2012—was was supposed to guarantee this choice, but it has not worked as intended because consumers continue be directed to out-of-state specialty pharmacies and are unable to fill their prescriptions at local pharmacies.  This legislation would better define terms and remove provisions in current law that have served to impose extra requirements on network community pharmacies as a precondition for providing covered medications otherwise available by mail order.  

Services and Advocacy for GLBT Elders (SAGE) is the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults. The mission of SAGE is to lead in addressing issues related to LGBT aging. In partnership with constituents and allies, SAGE works to achieve a high quality of life for LGBT older adults, supports and advocates for their rights, fosters a greater understanding of aging in all communities and promotes positive images of LGBT life in later years. 

SAGE has seen the ways in which mail order requirements can complicate the health choices and health outcomes of LGBT older people, in particular those living with HIV and those managing multiple chronic conditions with life-saving medications. For example, People with HIV/AIDS are increasingly age 50 and older and many are disproportionately LGBT. Additionally, older adults in particular face challenges managing increased chronic conditions and multiple medications, many of which can rely on discussions with local pharmacists for proper medication management. And delivery delays are far too common—and could be disastrous. If a client is not at home to receive the medication, the mail carrier needs to make multiple attempts. In some instances, expensive medications that need to be refrigerated have spoiled or been stolen when left outside in front of the door by a mail carrier. This means that individuals who run out of medications may need to skip doses, which can lead to drug resistance, compromised overall health and more expensive and intensive treatment. 

SAGE believes that consumers are the ones who decide whether to receive medications by mail or from a local pharmacy. This decision should not be left up to an insurance company. A. 5723A/ S. 3995A provides an important protection for the people we serve and we strongly support its enactment.  For further information, please contact Robert Espinoza, Senior Director for Public Policy and Communications at SAGE at 212-741-2247.  


Michael Adams
Executive Director

May 9, 2014

Pride and Parenthood: A Conversation with Jane Fleishman About Her Intentional LGBT Family

Today's post is written by Kira Garcia, SAGE's Director of Media Relations and Integrated Marketing.

With Mother’s Day approaching, it’s a great time to honor the courage, creativity and hard work—not to mention abundant love--that goes into creating LGBT families. It would be tough to find a better example of this than the family of Jane Fleishman and Joan Tabachnick. Jane and Joan co-parent their son Ezra, 21 and daughter Rose, 17, with their dads, Irwin and John.

All six of us at India House 2014
Jane Fleishman (second from left) and her family


At 60, Jane is pursuing a PhD in Human Sexuality after a career in staff development at a large psychiatric facility. Joan, 58, is a consultant specializing in sexual violence prevention. Irwin is a therapist specializing in transgender teens & families, and John is a retired school principal and puppeteer. I sat down to talk with Jane about her family’s remarkable story.

When did you decide to become parents, and how did parenthood come about for you? I know you have a unique story.

We have an intentional gay and lesbian family, but we all came to it in different ways.

In the late ‘80’s I wanted to be a mom but wasn’t sure how to do it-- I didn’t have a partner. I was searching around and thought I’d find a friend to be a donor. I asked my friend Irwin f he’d be a donor and he said he’d actually like to be a dad. His partner, John, was supportive.

So we embarked upon this project! It took me a long time but I finally became pregnant, and Ezra was born in 1992.

I love being a lesbian mom, and I love my community. Around the time Ezra was born, a lot of my friends were becoming sick with HIV and AIDS and I lost a number of close friends. So when we had a ceremony to celebrate the birth of this baby, everyone was happy to have a reason to get together that wasn’t a memorial. People were coming together for birth instead of death.

I met Joan when I was five months pregnant with Ezra. I had no idea what would happen but I knew she was amazing!

Wow, so Joan and Ezra were new to your life at the same time!

Yes! It was a magical time; I fell in love with both of them at the same time.

Joan’s commitment to become a mom with me was instrumental in helping me have another baby which I wasn’t sure I could do alone. So three and a half years later we had Rose. Rosie has the same bio dad as Ezra, but to recognize Joan’s role as a parent, we gave her Joan’s last name.

So you and Irwin were the legal parents, and then Joan became a third legal parent more recently.

Yes; we always wanted Joan to become a third parent but it wasn’t really an option. Initially, we understood that for Joan to become a legal parent, one parent would’ve had to give up parental rights—we didn’t want that to happen! We were about expansion, not contraction. We wanted the law to acknowledge Joan. Then we heard of friends in Boston who filed for three legal parents under the MA law which recognizes the “best interests of the child.”  When they went through with their legal adoption we knew it was now possible. She became a legal parent in 2012. It was great—we had our friends there and it was beautiful. Joan’s mother came up and we celebrated with bagels and lox.

When we began 20 years ago, it felt like we were ahead of the law but we knew the law would catch up with us—and it did!

What has surprised you most about parenthood?

I came out in the 70’s when I had to be really secretive at work. I couldn’t come out everywhere I wanted to. I felt like my lesbian and gay community was my neighborhood, my people. And I’m so close to my neighbors now! But when I was a young person I never knew my neighbors because I thought they’d shun me.  

When I became pregnant I became part of this huge new community. Hetero women saw me in this new way—I had a shared lived experience with hetero women that I’d never had before! It was wonderful but it was also kind of weird.

How do you think the world has changed for gay parents since your kids were born?

Well, my kids grew up in what is sometimes called, “Lesbianville, USA”. In Northampton a lot of the hetero families are like ‘we wish we had two moms!’ people joke about it, but the water is different here.

 When Rosie was in kindergarten she’d say [of her classmates] ‘he’s got 2 moms … and she’s got 2 moms, but no one’s family is exactly like ours.’ She knew a whole cohort of people that allowed her to be acknowledged, visible, seen, and not so different.

Yet when my son went to college he was struggling with how out he could be about his moms. He was in Boston, and it was a big school and it wasn’t as safe. But now both of my kids are totally out and proud about their parents. But they didn’t get the opportunity to decide whether they wanted to be out. They had to struggle like parents of gay children have to struggle—‘who do I tell?’

I’ve seen a lot of changes in 20 years. I was one of the first to have a baby in my community. There were people in my office who were like ‘why are you bringing a baby into this world, with so much hate?’ and I had to answer those questions.

From the moment Ezra and Rosie were born, we all took a stand that we’d be honest with them at every level, that they would know who their parents were, so that they could be proud.

There’s still hate and intolerance in the world. I’m fighting now the backlash in Uganda. So the issues are not gone. But my children have learned to be proud of our family and we are so happy to have held on to our own dreams of what is possible. 


May 8, 2014

SAGE Applauds New Guidance by ACL that Extends Benefits to Same-Sex Married Couples

Today's post is written by Aaron Tax, SAGE's SAGE’s Director of Federal Government Relations.

[Washington, DC] This week, the Administration for Community Living (ACL) announced how it will implement last year’s historic SCOTUS decision, United States v. Windsor, which struck down the Defense of Marriage Act (DOMA) on June 26, 2013. Specifically, the ACL issued guidance to its grantees that they must now follow a “place of celebration rule” and consider the terms “spouse”, “family”, and “relative” as being inclusive of same-sex married couples. 

This means that a couple who marries in Massachusetts and moves to Mississippi (where their marriage is not recognized) would still be considered married in the eyes of the federal government with respect to ACL programs. And in particular, any reference to the terms “spouse”, “family”, and “relative”, in the Older Americans Act, would apply to their relationship.  

The ACL grantees affected by this guidance include State Units on Aging, Area Agencies on Aging, senior centers, adult day care centers, home health agencies, organizations that deliver Meals on Wheels, and other entities that make up the aging network.  

Here are a few examples of how the ACL guidance will impact families: 

  • Historically, individuals in opposite-sex marriages who have become eligible for meal services at age 60, have been allowed to share those meal benefits with spouses younger than 60. Now, that benefit has also been extended to younger same-sex spouses. 
  • If older individuals do not have the capacity to direct case management services themselves, a family member can direct those services. That definition of “family member” now includes spouses from same-sex married couples.  
  • The Older Americans Act generally defines exploitation as someone with responsibility for an older adult (including a fiduciary or caregiver) acting in his or her self-interest, and against the best interest of the person being cared for.  The term “caregiver”, in this context, defines a number of types of individuals, including family members. That definition of “family member” is now inclusive of spouses from same-sex married couples.  
  • No individual shall be appointed Director of the Office of Long-Term Care Ombudsman Programs if the individual, or any member of the immediate family of the individual, is subject to a conflict of interest.  That definition of “immediate family” is now inclusive of spouses from same-sex married couples.  
  • The ACL’s National Family Caregiver Support Program funds a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.  The program provides information about available services, assistance in gaining access to the services, counseling and support groups,  training, respite care and supplemental services.  The definition of “family caregiver” is now inclusive of spouses from same-sex married couples.  

Read the full ACL guidance: http://www.acl.gov/Funding_Opportunities/Grantee_Info/docs/Community_Living_Guidance.pdf 

Read more about the SCOTUS decision, United States v. Windsor: http://sageusa.org/newsevents/release.cfm?ID=79 

Learn more about the ACL: http://acl.gov/About_ACL/Organization/Index.aspx

To learn more about this development, please contact Aaron Tax, SAGE’s Director of Federal Government Relations at atax@sageusa.org

May 7, 2014

SAGE Wins Two 2014 Communicator Awards from the Academy of Interactive and Visual Arts

Today's post is written by Robert Espinoza, SAGE's Senior Director for Public Policy and Communications. Follow him on Twitter.

SAGE is proud to announce that it has received two 2014 Communicator Awards from the Academy of Interactive and Visual Arts (AIVA)! The Communicator Awards is the leading international creative awards program honoring creative excellence for communication professionals.

The Communicator Awards is an annual competition honoring the best in advertising, corporate communications, public relations and identity work for print, video, interactive and audio. This past year, it received more than 6,000 entries from ad agencies, interactive agencies, production firms, in-house creative professionals, graphic designers, design firms, and public relations firms.

  • SAGE received an “Award of Excellence” (AIVA’s highest honor) for our SAGE Story Contest Memes. As part of LGBT History Month in October 2013, SAGE elicited stories from LGBT older people around the country on the importance of community in their lives, especially in reducing isolation. The month-long social media contest was part of SAGE Story, our premiere national digital storytelling program. The memes were retro, flirty and whimsical in style, modernizing the imagery of a distant era with campy slogans and LGBT themes. 
A SAGE Story Meme
  • SAGE also received an “Award of Distinction” for our print design of SAGE’S Strategic Plan, “The Road Ahead. Released in September 2013, SAGE’s strategic plan set the organization’s direction for the next three years. The design for this public plan used art deco illustration (with SAGE characters) and a “road map” theme to connote SAGE’s future in seeking to achieve even more national impact for millions of LGBT older people.


An illustration from the SAGE Strategic Plan


Both items were designed by RD Design, based in Milan, New York.

SAGE's marketing and communications has won widespread acclaim and numerous awards.  In 2012, it received two awards of distinction in 2012 from the International Academy of the Visual Arts, as well as a GLAAD Amplifier Award for excellence in advertising and social marketing. In 2010, it received a GLAAD Media Award in Advertising for Outstanding Social Marketing for its New York City campaign on caregiving support for LGBT older people.