Homophobia directed at the elderly has many faces.

Home health aides must be reminded not to wear gloves at inappropriate times, for example while opening the front door or making the bed, when there is no evidence of H.I.V. infection, said Joe Collura, a nurse at the largest home care agency in Greenwich Village.

Image Jalna Perry of Boston said her guard was always up in nursing homes. Credit... James Estrin/The New York Times

A lesbian checking into a double room at a Chicago rehabilitation center was greeted by a roommate yelling, “Get the man out of here!” The lesbian patient, Renae Ogletree, summoned a friend to take her elsewhere.

Sometimes tragedy results. In one nursing home, an openly gay man, without family or friends, was recently moved off his floor to quiet the protests of other residents and their families. He was given a room among patients with severe disabilities or dementia. The home called upon Amber Hollibaugh, now a senior strategist at the National Gay and Lesbian Task Force and the author of the first training curriculum for nursing homes. Ms. Hollibaugh assured the 79-year-old man that a more humane solution would be found, but he hanged himself, Ms. Hollibaugh said. She was unwilling to identify the nursing home or even its East Coast city, because she still consults there, among other places.

While this outcome is exceedingly rare, moving gay residents to placate others is common, said Dr. Melinda Lantz, chief of geriatric psychiatry at Beth Israel Medical Center in New York, who spent 13 years in a similar post at the Jewish Home and Hospital Lifecare System. “When you’re stuck and have to move someone because they’re being ganged up on, you put them with people who are very confused,” Dr. Lantz said. “That’s a terrible nuts-and-bolts reality.”

The most common reaction, in a generation accustomed to being in the closet, is a retreat back to the invisibility that was necessary for most of their lives, when homosexuality was considered both a crime and a mental illness. A partner is identified as a brother. No pictures or gay-themed books are left around.

Elderly heterosexuals also suffer the indignities of old age, but not to the same extent, Dr. Lantz said. “There is something special about having to hide this part of your identity at a time when your entire identity is threatened,” she said. “That’s a faster pathway to depression, failure to thrive and even premature death.”