Out On The Couch
Caring for LGBTQ+ Caregivers of Older Adults
LGBTQ+ caregivers of older adults (generally people age 60+) are a special population in need of support and affirmative care. These family members and friends provide unpaid physical and/or emotional assistance to spouses and partners, parents, friends–some of whom were former partners–siblings, and neighbors. While temporary caregiving for others, when one is recovering from surgery, injury, or illness, can take place at any stage of life and is challenging in many ways, caregiving for older adults can last for many years. This article will explore the issues that some LGBTQ+ caregivers experience in the course of caring for elders.
I have had the privilege, during my years of practice in the field of aging, of facilitating support groups for caregivers seeking out assistance. The members of my groups have openly shared their innermost thoughts and feelings about giving care with me and with each other. They have expressed feeling that there is no end in sight as more and more of their time and energy becomes consumed with caring for a loved one who will never get better–only worse. Some members have participated in these groups for years on end as they witness the gradual decline of their care recipients due to dementia, medical frailty, cancer, or Parkinson’s disease.
All of these caregivers find that their friends and acquaintances just don’t understand what they are going through and the toll that giving care takes on them. They have relied on each other, and on a trained social worker who holds space in the group setting, to help them navigate the increasingly challenging situations they encounter. When providers become more well-versed in understanding experiences of unpaid caregiving in LGBTQ+ communities, people like these can get better care and more support outside of a group setting. So here are a few things to bear in mind about these generous, caring, and often severely stressed-out individuals.
First, it is common for queer and trans people who are not related by blood or marriage to care for each other. In fact, former romantic partners will sometimes become caregivers. Mainstream service providers may not be accustomed to this, and community members have reported encountering a lack of understanding about why an ex-partner would remain closely connected. But the formation of familial relationships among our loving LGBTQ+ communities is commonplace; a number of my LGBT older adult clients have considered their exes to be family members. It is important that providers include anyone an older adult has designated as a caregiver in health care decision making processes–and also that providers recognize the significant strain such caregivers may experience.
That strain can manifest in a number of different ways and lead to negative social and health outcomes. Providing physical, emotional, and financial support for a loved one while putting one’s own needs on the back burner time and again leads to exhaustion and isolation. And LGBTQ+ caregivers face risk factors beyond those commonly experienced by non-LGBTQ+ caregivers. For instance, LGBTQ+ adults who are childless are often expected to take on all of the responsibility of caring for aging cisgender and heterosexual parents. But they may also have faced a historic lack of acceptance, potentially entailing verbal and/or physical abuse, from those parents. And same-sex partners and spouses may still face significant discrimination in the medical, senior services, and institutional settings in which their loved ones receive care.
Without adequate support and without anyone to help share the care, caregivers risk burning out. While LGBTQ+-specific groups can be difficult to find outside of SAGE: Advocacy and Services for LGBT Elders’ NYC headquarters, caregiver support programs are available in every state. The National Family Caregiver Support Program (NFCSP), a federal initiative, provides grants to fund not only support groups but case management and some respite and supplemental services. This means that local resources–from assistance with information, benefits and entitlements, and referrals to limited financial help paying for home care and medical supplies–are available to all unpaid caregivers.
Further, an important piece of legislation affecting caregivers has been enacted in roughly 40 states so far. The CARE (Caregiver Advice, Record, and Enable) Act, known by a different name in some states, requires hospitals to ask patients, at the time of their admission, if they would like to designate someone as their caregiver. Whatever the relationship of the caregiver to the patient, the hospital must then record the caregiver’s name in the medical record, notify the caregiver of patient discharge, and provide training for performing medical tasks once the patient is home. This is an important legal consideration for LGBTQ+ caregivers without a formal or documented relationship to their care recipients.
For further reading on this topic, check out the selection of caregivers’ resources at the National Resource Center on LGBT Aging.
Stewart, D. B., & Kent, A. (2017). Caregiving in the LGBT Community: A Guide to Engaging and Supporting LGBT Caregivers through Programming. Retrieved September 29, 2019, from https://www.lgbtagingcenter.org/resources/resource.cfm?r=883.
By Briana Shewan, MFT
In order to prioritize femme voices, all quotes in this article are from femmes.
Positionality makes a big difference in femme identity: Please note I am a cisgender, white, thin, millenial femme from an upper-middle class background formally trained as a psychotherapist.
Have you ever wondered if you’re femme? Have you been circling around femme identity for a while without knowing if it fits? Are you unsure if you get to call yourself femme? Maybe you’ve heard “femme” more and more and you’re curious about it?
Femme is a beautiful, complex identity. What it looks like, means, and encompasses is different for each of us. I’m sure for many femmes there’s a sense of resistance at my attempt to categorize the identity here. I don’t mean to imply that being femme fits into one specific box! In fact, quite the opposite is true. Femme is all about stepping outside of traditional femininity. Spoiler! I’m getting ahead of myself.
Rather, this article is intended to broadly clarify femme identity by exploring its common themes. As the term “femme” becomes more widely known than ever before, it’s helpful to distinguish what it isn’t, and what it is (I’m a therapist; I’m choosing not to end on a negative note). Whether you share it as a resource for starting more nuanced conversation in your community or you wait until no one’s around to see you secretly explore the magic of femme essence, this article is for anyone who isn’t sure how they relate to it. May you be a baby femme in the making!
What Femme Isn’t…
A Straight Identity
Not all queer-identified femmes agree on this, but many, including myself, strongly feel that femme is a queer identity. Therefore, to be straight and call yourself femme is appropriative. . This is because to do so erases the history of femmes in queer liberation movements and its political identity as it relates to heteronormativity, and perpetuates femme invisibility for those who are queer identified (Barrett-Ibarria, 2017). In reference to femme invisibility, Alaina Monts states “…I do think that a lot of it has to do less so with any sort of purposeful femme erasure in queer communities (although that is extremely prevalent), and much more to do with the fact that it’s an identity being co-opted by folks who aren’t queer… Part of me wonders if femme invisibility has less to do with us being mistaken as straight and more to do with the fact that straight people are trying to be us” (Monts, as cited in Chung, 2016).
“It’s possible that femme’s resonance may be partly due to our current political climate, and the resistance it represents to the toxicity of masculinity” (Barrett-Ibarria, 2017). It’s important to note that, despite its wider current-day political relevancy, femme isn’t a trend. It’s history dates back to the 1930s within queer of color ball culture (Buchanan, 2018). To identify as femme while straight dismisses its historical, political, and cultural significance.
Synonymous with Femininity
Although femme and femininity are closely related, they aren’t interchangeable. Femininity refers to the socially constructed idea of what is feminine and isn’t necessarily queer, whereas femme is, in a sense, the queering of femininity – not just identifying as queer, as I’ve already discussed, but the embodiment and embracing of queerness in the full meaning of the word. This key differentiation is why it’s so important for femme to stand on its own (Tonic, 2016).
As Cassie Donish clarifies, “The term ‘femme’ does not simply mean ‘feminine’; it is used in queer circles to designate queer femininity, in a way that’s often self-aware and subversive. It’s both a celebration and a refiguring of femininity” (Donish, 2017).
“I see femme as the rebellious teenage daughter of femininity,” distinguishes Chung. “Femme is the process of taking the feminine words that were placed in my body, words like ‘soft, weak, quiet’ and transforming them into: ‘wild, loud, confident’… When I broke up with femininity and embraced femme, I felt strong and confident and powerful…” (Chung, 2016).
Every Feminine-Presenting Queer Woman
Self-identified femmes and feminine-presenting queer women are all feminized people and, as such, experience being devalued in our patriarchal society (Buchanan, 2018). That being said, not every feminine-presenting queer woman identifies as femme. Madeleine said, “Anyone who is girly/feminine is not necessarily femme. Femme is an identity; feminine and girly are descriptors” (Urquhart, 2015).
The term femme can be used loosely without understanding how someone self-identifies. There is value in both someone claiming femme identity, and not claiming it. You can’t assume that a queer woman is femme because they are assumed feminine-presenting.
…And What Femme Is!
Yes it is!
“…Among the LGBTQ+ community, femme is a descriptor that can feel as inherent to someone’s identity as lesbian, bisexual, or genderqueer,” writes Kasandra Brabaw (Brabaw, 2018). Femmes may have any gender identity; some consider femme their gender identity, whileother femmes may have a different gender identity (such as transwoman, nonbinary, cis-woman, genderfluid, agender, etc.) and consider femme their gender expression (“femininity” aligns with gender expression in that it encompassess behaviors, mannerisms, appearance, etc. within a certain cultural context).
Additionally, there are femmebois, tomboy femmes, femme daddys, femme dykes, etc. who use language to describe their femme identity even more accurately. Other femmes reject these categorizations altogether. “Ultimately, ‘femme’ is about breaking binaries. It’s about subverting cultural expectations. It’s about being more than one thing. It’s about queerness,” sums up Tonic.
An Intentional Relationship to Your Femininity
Many femmes consider their identity to be an intentional expression of their femininity as opposed to one that adheres to typical constraints of feminine performance. Rather, femmes creatively and uniquely celebrate the parts of themselves that would otherwise be suppressed, denied, or defined for them. “As long as normative gender roles exist there will be an urgent need for people, femmes included, to push at their boundaries,” writes Heather Berg, Gender Studies professor at USC (Barrett-Ibarria, 2017).
Femme’s relationship with femininity is one of reclamation and transcendence. It’s about agency. “The whole point of [being femme], for me,” states Cassie, “is to break people away from their assumptions. I don’t like the strict rules of traditional femininity, but I don’t want that to mean that I can’t be feminine at all” (Urquhart, 2015).
Femme’s expression of femininity can be both fierce and hard as well as tender and soft and everything in between. It often challenges larger notions that equate femininity to vulnerability and vulnerability to weakness. “Our culture hates femininity, calls it weak. Our culture is inept at nurture and care, terrified of vulnerability and softness—all things that are squarely in the femme’s handbag. To indulge in femme culture is actually to be brave, and to have strength,” states Maurice Tracy (Donish, 2017).
Its Own Identity
Today femme is proudly an identity that is not defined in relation to anything else. “I didn’t self-identify as femme until I met other queer folks who helped me see that femme is its own identity,” states Artemisia FemmeCock. “Femme is intentional; it’s a way of simultaneously challenging and celebrating femininity. It recognizes that I identify with aspects of femininity but don’t identify with the heteronormative system that trivializes and demonizes them” (Donish, 2017).
Femininity is often defined in relation to masculinity and positioned as its opposite, whereas femmes don’t see themselves within this binary. Femme pushes back on misogynistic ideas that feminized people are defined through a patriarchal lens or male gaze. Femme is glorious all on its own.
Unique to Each Person
“From the invisibility queer femmes can feel in some lesbian circles to the sharp vulnerability inherent in being a trans woman, no two femme-identified individuals share the same experience of what it means to be femme,” says Joss Barton (Donish, 2017).
For many femmes, their identity encompasses more than their sexuality and gender. It is the entirety of their queerness existing in a capitalist, white supremacist society. Femme identity is often strongly linked to class due to its significant historical context as a working class lesbian identity in the 1950s and ‘60s. Leah Lakshmi Piepzna-Samarasinha said:
Ableism lifts up a white, able-bodied, traditionally feminine, middle-class body as the ‘right’ way to be femme. Because of ableism in the movements I’m part of, it took me years to find a disability justice community where I didn’t have to closet my disability in order to still be femme. My cane, sexy non-stiletto boots and bed life are femme now because of the labor of disability justice comrades. Many of them, like Patty Berne of Sins Invalid, are deeply femme (Pérez, 2014).
As Macarena Gomez-Barris, chair of the Social Sciences and Cultural Studies department at Pratt Institute explains, “In some communities, femme identity also symbolizes a rejection of whiteness, a term used to represent decolonized womanhood” (Barrett-Ibarria, 2017).
In fact, black femme scholar Kimberlé Crenshaw coined the term “intersectionality” in 1989. “Intersectionality is a tool for the experiences of black women which are “greater than the sum of racism and sexism” (Crenshaw, 1989, p. 140).
Of course, there’s also femme relationships, sex, and aesthetics. One femme may be a kinky monogamous top who only dates other femmes; another may be pansexual and polyamorous. One femme may feel strongly about shaving, while another may feel strongly against it. One femme may refuse to leave the house without makeup and hair in perfect order, another may be ambivalent about glitter (gasp!).
As Laura Lune P. says, “I’d like for the myth that femme only looks one way to be smashed. Femme doesn’t only mean red lips, sky high heels and perfectly manicured nails (although it can most certainly mean that). Femme means whatever you want it to mean for yourself and however you want it to look like if that gender feels like home to you” (Pérez, 2014).
Barrett-Ibarria, S. (2017, December 20). Who Gets to Identify as ‘Femme’? from https://www.vice.com/en_us/article/xw4dyq/who-gets-to-identify-as-femme
Brabaw, K. (2018, June 20). A Brief History Of The Word “Femme”. Retrieved from https://www.refinery29.com/en-us/femme-lesbian-lgbtq-history
Buchanan, B. (2018, March 19). Women and Femmes Unite! – Blu Buchanan – Medium. Retrieved from https://medium.com/@BlaQSociologist/women-and-femmes-unite-30ec59e6a658
Chung, C. (2016, July 18). What We Mean When We Say “Femme”: A Roundtable. Retrieved from https://www.autostraddle.com/what-we-mean-when-we-say-femme-a-roundtable-341842/
Crenshaw, Kimberle. “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics,” University of Chicago Legal Forum: Vol. 1989: Iss. 1, Article 8. Available at: http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8
Donish, C. (2017, December 04). Five Queer People on What ‘Femme’ Means to Them. Retrieved from https://www.vice.com/en_us/article/d3x8m7/five-queer-people-on-what-femme-means-to-them
Pérez, M. (2014, December 3). Femmes of Color Sound Off. Retrieved from https://www.colorlines.com/articles/femmes-color-sound
Tonic, G. (2016, August 24). The Difference Between Femme & Being Feminine. Retrieved from https://www.bustle.com/articles/166081-what-does-femme-mean-the-difference-between-being-femme-being-feminine
Urquhart, E. (2015, March 12). Not Your Great-Aunt’s Girly Lesbian. What Does Femme Mean Today? Retrieved from https://slate.com/human-interest/2015/03/femme-lesbians-shouldnt-be-defined-by-their-butches.html