When LeZlie Lee Kam came out, she wasn’t sure where to turn.

“I had to go to the library to find out anything about what it meant to be lesbian,” the 64-year-old says, whispering the word lesbian to underscore how covert she had to be at the time.

While a student at York University in the ’70s, Kam started a relationship with another woman, keeping it a secret for three years. But eventually, her girlfriend’s family found out and sent her back to Trinidad, which is where Kam is also originally from.

This spurred her to seek out like-minded people, which led her to an LGBTQ organization at York and to the Lesbian Organization of Toronto. There, she became a peer counsellor on the phone helpline.

Society has made advances in the decades since, but as a longtime community organizer, Kam continues to campaign for change: she now advocates for fellow LGBTQ seniors and their right to health care, social services, and housing.

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Seniors are the fastest-growing age group in Ontario. The number of those 65 and older is expected to double by 2041, reaching 4.6 million. But the number of LGBTQ seniors in long-term care facilities and retirement homes is not as easy to establish, because many residents fear the potential social consequences of coming out in these environments.

George Hartsgrove of the Ottawa Senior Pride Network says the lack of data stems in part from the fact that intake forms used by long-term care facilities don’t allow patients to identify whether they’re part of the LGBTQ community.

“How in hell can they serve a community if they can’t even identify it?” he asks.

At an event on October 1 — the International Day of Older Persons — Egale Canada Human Rights Trust and the LGBTQ-focused 519 Community Centre asked governments and organizations to pledge to implement policies, programs, and services that protect the rights of older LGBTQ people.

A survey of LGBTQ seniors undertaken by Egale in 2016 and 2017 shows that the primary issue for respondents was fear of being forced back into the closet in residential care.

“Often people go back into the closet when they enter long-term care facilities,” says Martin Krajcik, a consultant with Egale who works with seniors and hears about their struggles first hand.

At the 519 event, he says, he was approached by a senior who told him about experiencing homophobia at the facility they lived in — one staff member told them that they were “going to hell.” Krajcik was familiar with the facility in question: Egale had previously provided its staff with LGBTQ-focused inclusivity training.

He says that, because of high staff turnover rates, the benefits of such training programs can be hard to sustain — but he also acknowledges that a divide exists between the creation of laws and their enforcement on the front lines.

Prejudice based on sexual orientation and gender identity is prohibited under the Ontario Human Rights Code, but staff who work with seniors are not required to take cultural-competency training — whether to provide it is a decision left up to management in individual facilities. South of the border, Massachusetts recently became the first state to require that anyone working with LGBTQ seniors undergo specialized training in how to provide care.

A spokesperson for Raymond Cho, Ontario’s minister for seniors and accessibility, told TVO.org via email that the province will “work with all levels of government as well as stakeholders to provide adequate housing and address housing challenges for all Ontarians.” However, it’s unclear what concrete initiatives the government has in the works that would actively address issues affecting LGBTQ seniors.

“There is evidence suggesting that fears of homophobia and transphobia within formal care prevent health-care utilization, timely diagnosis, and treatment of major health conditions and treatment adherence among older LGBTQ2+ people,” says Arne Stinchcombe, a psychology instructor at the University of Ottawa who researches health and aging.

Providing inclusive and safe environments for LGBTQ seniors is “essential,” Stinchcombe says. He sees positive work being done in larger, better-resourced urban centres such as Toronto, but worries about individuals in smaller communities.

Long-term care facilities are regulated by the province and receive some government funding — a basic room costs roughly $1,850 per month. Retirement homes, though, aren’t supported through public funding, so residents bear the financial burden. A recent study by the Canada Mortgage and Housing Corporation showed that the 2018 average rent for a standard space in a retirement home is $3,618, up 2.6 per cent from 2017.

Barbara Michalik oversees programs at the Rekai Centres, two non-profit long-term care facilities in Toronto — one of which is located just outside Church-Wellesley village. She estimates that 15 per cent of residents at each facility identify as part of the LGBTQ community.

She says that non-profit and private care facilities can exercise more independence than their city-run counterparts — they can bypass a lot of red tape, allowing them to adapt more quickly. Rekai, for example, has added gender-neutral pronouns to its forms; “staff champions” pin rainbow flags to their uniforms. In June, the Wellesley location became the first long-term care facility in the province to host a drag show.

“We had pretty much the whole home come down,” she says of this summer’s event.

Currently, there are no long-term care homes in Ontario that specifically serve the LGBTQ community. But next year, Rekai will begin work on a new 25-bed “rainbow unit” at the Wellesley location. Scheduled for completion by 2022, it will provide a supportive space for LGBTQ seniors to live but be open to all Rekai residents. What’s needed, Michalik says, is safe spaces — not segregated spaces.

Creating such spaces is important for LeZlie Lee Kam, who jokingly says that her advocacy is inspired by self-interest: “I want to make sure that if I have to end up in one of those places, it’s going to be queer-friendly.”

Miles Kenyon writes about human rights, free speech, LGBTQ issues, and animal protection.