1
LGBTI fact sheet 4b - Discrimination,
exclusion & trauma
The influence of historical
discrimination, exclusion
and trauma
Older LGBTI peoples may have
experienced stigma, discrimination,
criminalisation, family rejection
and/or social isolation throughout
their lifetime (1-6).
• Many have been left with residual fears
from the times in which they grew up (7).
Australia’s history of discrimination toward
LGBTI peoples dates back more than a
century.
Timeline
1901
Australia becomes a federation. State and territory governments adopt variations of the UK's
anti-homosexual laws. Sexual activity between men was considered a capital crime leading
to execution.
1949
Sexual activity between men was gradually reduced from a crime punishable by death to a
crime punishable by life imprisonment, with Victoria the last State to downgrade the penalty
in 1949.
1950
With the advent of new diagnostic and surgical techniques, doctors began performing
‘normalising’ surgeries on intersex infants without their consent despite the surgeries being
irreversible and not medically required. This practice continues throughout the world today.
1952
The American Psychiatric Association classified homosexuality as a Sociopathic Personality
Disorder. Until the 1980s a person could be sent for medical treatment to be ‘cured’ of their
homosexuality.
1968
The American Psychiatric Association defined homosexuality as a Sexual Deviation.
1968
Homosexual Law Reform Society formed in Canberra.
1969
The Stonewall riots occur in Greenwich Village, New York. Transgender people were key
catalysts to this uprising which is often considered the starting point for Gay Liberation
worldwide. The ripple effect was soon apparent in Australia.
1970
Campaign Against Moral Persecution (CAMP) formed in Sydney. Branches in other states
formed later.
1972
SA Police throw an openly gay academic man into the Torrens River resulting in his death,
focusing attention on gay rights and police violence.
SA legislates that if anal sex is committed in private between consenting adults older than
21, this will be a defence to the crime.
1973
The American Psychiatric Association removed homosexuality from the mental illness
classification.
1975
SA is the first state in Australia to decriminalise male acts of homosexuality and equalise the
age of consent for same sex activity and heterosexual activity.
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4b - Discrimination, exclusion & trauma
1978
First Gay Mardi Gras parade held 24th June in Sydney to mark 'International Gay Solidarity
Day'. The violent police response and the arrest of 53 people brought national attention.
1980
‘Transsexualism’ introduced into the revised edition of the mental health manual used by
psychiatrists, the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) to describe
the transgender experience.
1982
Australia’s first reported case of HIV/AIDS.
1984
The Australian Medical Association removed homosexuality from its list of illnesses and
diseases.
1992
The World Health Organisation removed homosexuality from its list of illnesses and diseases.
Ban on same-sex attracted men and women serving in the military removed.
1994
The revised Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) renamed the
transgender experience ‘gender identity disorder’.
1997
Tasmania is the last state in Australia to decriminalise homosexuality.
The ‘homosexual advance defence’, also known as the gay panic defence is upheld by the
High Court of Australia. This is a legal defence used when a defendant claims they acted in
a state of violent temporary insanity due to an alleged psychiatric condition called
‘homosexual or trans panic’.
2003
The United Nations Human Rights Committee found Australia in breach of the International
Covenant on Civil and Political Rights for denying a veteran's pension to same-sex spouse.
Tasmania was the first State in Australia to abolish the homosexual advance defence.
2004
The Australian Government amended the Marriage Act to explicitly exclude same-sex
couples from marriage. Marriage is defined as the ‘union of a man and a woman to the
exclusion of all others.’
2008-
2009
Commonwealth legislation (relating to areas such as health, ageing, employment, defence,
education, immigration, citizenship, families, tax and community services) was reformed to
improve equality for LGBTI peoples and recognise same sex de facto couples.
2011
The Australian Government passes passport legislation allowing for an 'x' gender option, and
the ability for transgender people to select their gender without medical intervention.
2012
Australian Government developed a National Strategy for LGBTI Ageing and Aged Care.
Amendment to the Aged Care Act 1997 to afford older LGBTI peoples ‘special needs group’
status.
Until 2012 the Australian government refused to issue a 'Certificate of No Impediment to
Marriage' to same-sex couples effectively preventing them from getting married in many
overseas countries.
2013
The revised Diagnostic and Statistical Manual of Mental Disorders (DSM-V) renamed the
transgender experience ‘gender dysphoria’.
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4b - Discrimination, exclusion & trauma
2013
ACT passed same-sex marriage legislation but it was quashed by the High Court. Federal
legislation prevented Australian States from passing their own laws.
Sex Discrimination Act 1984 amended to prohibit discrimination on the grounds of sexual
orientation, gender identity or intersex status. This was the first time intersex status was
protected under Australian discrimination legislation.
2014
The Australian high court ruled that NSW Registrar of Births, Deaths and Marriages must
recognise a third gender allowing for a person’s sex to be registered as ‘non-specific’.
2016
The standard diagnostic tool for epidemiology, health management and clinical purposes,
the International Statistical Classification of Diseases 10th Revision (ICD-10) released.
Transsexualism classified under ‘Mental and Behavioural Disorders’.
Queensland was the second last state in Australia to abolish the homosexual advance
defence. This defence remains available in SA.
Queensland was the last state in Australia to equalise the age of consent.
2017
Australian Marriage Law Postal Survey votes to approve legalising same sex marriage and
the Marriage Amendment Bill 2017 introduced into the Australian Senate. The bill amended
the definition of ‘marriage’ in the Marriage Act to recognise a ‘union of 2 people’ enabling
same-sex marriage. The first legal same-sex weddings under Australian law were held on 15
and 16 December.
The Australian Government released the Aged Care Diversity Framework as a step towards
more inclusive aged care. Together with the LGBTI Aged Care Action Plan, these documents
replaced the LGBTI Ageing and Aged Care Strategy.
2018
The new ICD-11 which reclassifies ‘gender incongruence’ under ‘conditions related to sexual
health’ released. ICD-11 will be presented at the World Health Assembly in 2019 to come
into effect in 2022.
2019
The Australian Government released the document ‘Actions to support Lesbian, Gay,
Bisexual, Trans and Gender Diverse and Intersex elders: A guide for aged care providers’.
• The threat and actuality of heterosexist
harassment, sexual assault and/or violence
are frequently a part of LGBTI people’s
history and/or day-to-day lives (8-13).
• Rates of physical and non-physical abuse
are reportedly highest for transgender men
and women (4, 14-22). Incidents are
frequently not reported to the police (13).
• Older LGBTI peoples may have
experienced human rights and citizenship
violations throughout their lives, including
being denied the right to marry and form a
family as well as the right to hold
documents that reflect their gender
identity.
• Amending public documentation to
reflect the affirmed gender of transgender
and intersex peoples can be essential to
their sense of personal and identity
recognition (23, 24).
Human rights violations
4
4b - Discrimination, exclusion & trauma
• Attitudes toward LGBTI peoples vary
greatly across spiritual and religious
traditions. Religious institutions have
historically played a significant role in how
LGBTI peoples are viewed.
• LGBTI peoples may be part of a religion
whose traditions prohibit LGBTI expression.
As such the person may struggle with
shame and guilt when torn between their
identity and the teachings of their faith.
• Even those who are non-practising may be
affected by the religion of their upbringing
or the religious norms reflected in society
(4, 18, 25).
• Transgender people may have been
humiliated when attending a funeral or
other service in a place of worship, which
practices gender separation, when they
are forbidden to enter either the women’s
or men’s areas.
• Some same-sex attracted and
transgender people have previously been
subjected to ‘conversion, reorientation or
reparative therapies’ in an attempt to
suppress their sexual orientation or change
their gender identity.
• Such unregulated therapies were often
delivered by practitioners who were
operating outside the medical system and
rarely accredited. These harmful
conversion therapies were ineffective and
often left the person with increased mental
health issues (16, 26-29).
• Ongoing isolation in dementia or a mistrust
of authority arising from past experiences
of discrimination and institutional abuse by
medical, health and welfare services (5,
30-33) can trigger BPSD.
• The impact of criminal convictions
continues for some older gay, lesbian and
transgender people where the convictions
remain on criminal record, even when they
have previously been convicted of
engaging in consensual sexual activity,
despite changes to the law (16, 34).
• This can impact on their ability to travel,
find a job and/or participate in voluntary
work or other activities that require a
criminal background check (35).
• Recent changes to legislation in some
states of Australia mean that those
previously convicted of homosexual sex
between consenting adults can now apply
to have their criminal record expunged
(33).
• These cases were often not fully
investigated (9, 36-39). Many have been
reopened or are still under investigation.
• Older gay men and transgender people
may have memories of the fear associated
with this shameful period in Australia’s
history; dementia will potentially
exacerbate the related trauma.
• Many older gay men and lesbians have
traumatic memories of their peers dying of
AIDS-related conditions in the 1980s and
Note: From the 1970s until the early 90s,
instances of gay men being hunted,
entrapped, assaulted and killed
because of their sexual orientation
occurred in Sydney and other parts of
Australia.
Some were chased to their deaths off
cliffs; others disappeared and have
never been found.
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4b - Discrimination, exclusion & trauma
90s (40). Those who survived the death of a
partner or close friends from AIDS often
had a limited support system and access
to traditional mourning rituals to assist them
through the bereavement process.
• The advent of the HIV/AIDS virus was used
by some to rationalise discrimination and
violence, giving perpetrators an excuse to
express their prejudices against gay men
(9, 12, 41). While violence was illegal it was
often socially sanctioned (12).
• Transgender and intersex older peoples
may have suffered discrimination or
harassment in many day to day areas of
life when they do not fit within social
norms, e.g. when shopping for medicines,
clothes, shoes or cosmetics (2) and/or
when accessing fitness activities, sports,
accommodation or overseas travel (42).
• Older LGBTI peoples who did not conform
to expected gender norms as children, in
terms of dress, the toys they played with or
other behaviours, were frequently
diagnosed with Gender Identity Disorder
(see glossary). As children they may have
been traumatised by being subjected to
psychotherapy and/or behaviour
modification as well as bullying and social
isolation.
• Older people who are part of the LGBTI
community may have developed
resilience in the face of lifelong systemic
and social discrimination (16, 43-45).
• Broader informal support systems which
may include members of their family and
community can provide increased
resources to draw on to deal with life
challenges and help build resilience (44,
46). This resilience can mediate the
impact of discrimination as they age (47).
• Older LGBTI peoples may have developed
resilience through the strategies they have
used to manage their physical, emotional
and social well-being with the strength of
their community around them (43, 48-50).
• Equally, they may have found meaning in
providing support and guidance to
younger members of the community.
• The onset of dementia can potentially
bring traumatic memories to the fore and
erode the resilience that has given the
person who is L, G, B, T or I strength in the
past, increasing their vulnerability to BPSD.
References
1. Barrett C, Harrison J, Kent J. Permission To Speak:
Determining strategies towards the development of
gay, lesbian, bisexual, transgender and intersex
friendly aged care agencies in Victoria. Victoria,
Australia: Matrix Guild Victoria; 2009.
2. Australian Human Rights Commission. Addressing
sexual orientation and sex and/or gender identity
discrimination: Consultation report. Sydney,
Australia: Australian Human Rights Commission; 2011.
3. Guasp A. Lesbian, gay and bisexual people in
later life. London, UK: Stonewall UK; 2011.
4. Bockting WO, Knudson G, Goldberg JM.
Counseling and Mental Health Care for Transgender
Adults and Loved Ones. International Journal of
Transgenderism. 2006;9(3-4):35-82.50. Bockting WO,
Knudson G, Goldberg JM. Counseling and Mental
Health Care for Transgender Adults and Loved
Ones. International Journal of Transgenderism.
2006;9(3-4):35-82.
5. Reynolds R, Edmonds S, Ansara YG. Silver
Rainbows: Advances in Australian ageing and aged
care. Australasian Journal on Ageing. 2015;34:5-7.
6. Aged Care Sector Committee Diversity Sub-
group. Actions to support Lesbian, Gay, Bisexual,
Trans and Gender Diverse and Intersex elders: A
guide for aged care providers Canberra, Australia:
Commonwealth of Australia as represented by the
Department of Health; 2019.
Transgender & intersex experiences
Resilience
6
4b - Discrimination, exclusion & trauma
7. Kirby M. Foreword. In: Birch H, editor. Dementia, Lesbians and Gay Men: Alzheimer’s Australia Paper 15. Vic,
Australia Alzheimer’s Australia; 2009.
8. United Nations entities. Joint UN statement on ending violence and discrimination against lesbian, gay,
bisexual, transgender and intersex people.: United Nations entities: ILO, OHCHR, UNAIDS Secretariat, UNDP,
UNESCO, UNFPA, UNHCR, UNICEF, UNODC, UN Women, WFP and WHO; 2015.
9. Mason G. Violence Against Lesbians and Gay Men. 1993.
10. Waite H. Old lesbians: Gendered histories and persistent challenges. Australasian Journal on Ageing.
2015;34:8-13.
11. Rothman EF, Exner D, Baughman AL. The prevalence of sexual assault against people who identify as gay,
lesbian, or bisexual in the United States: a systematic review. Trauma, violence & abuse. 2011;12(2):55-66.
12. Comstock G. Violence Against Lesbians and Gay Men. New York, US: Columbia University Press; 1992.
13. Mooney-Somers J, Deacon R, Klinner C, Richters J, Parkhill N. Women in contact with the gay and lesbian
community in Sydney: Report of the Sydney Women and Sexual
Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014, 2016. . Sydney, Australia: ACON & Sydney Health Ethics,
University of Sydney; 2017.
14. Leonard W, Mitchell A, Patel S, Fox C. Coming forward: The underreporting of heterosexist violence and
same sex partner abuse in Victoria. Melbourne, Australia: Australian Research Centre in Sex, Health and Society,
La Trobe University; 2008.
15. National Coalition of Anti-Violence Programs (NCAVP). Lesbian, gay, bisexual, transgender, queer (LGBTQ)
and HIV-affected hate violence 2014. New York USA: New York City Anti-Violence Project; 2015.
16. Australian Human Rights Commission. Resilient individuals: Sexual orientation, gender identity and intersex
rights national consultation report. Australia: Australian Human Rights Commission; 2015.
17. Lombardi EL, Wilchins RA, Priesing D, Malouf D. Gender violence: transgender experiences with violence and
discrimination. Journal of homosexuality. 2001;42(1):89-101.
18. American Psychological Association (APA). Guidelines for Psychological Practice with Transgender and
Gender Nonconforming People. American Psychologist. 2015;70(9):832-64.
19. Kenagy GP. Transgender health: findings from two needs assessment studies in Philadelphia. Health & social
work. 2005;30(1):19-26.
20. Fileborn B. Sexual violence and gay, lesbian, bisexual, trans, intersex, and queer communities. Melbourne,
Australia: Australian Institute of Family Studies; 2012 March 2012.
21. Leonard W. Private Lives 2: The second national survey of the health and wellbeing of GLBT Australians.
Melbourne, Australia: Gay and lesbian health Victoria (GLHV); 2012.
22. Finkenauer S, Sherratt J, Marlow J, Brodey A. When Injustice Gets Old: A Systematic Review of Trans Aging.
Journal of Gay & Lesbian Social Services. 2012;24(4):311-30.
23. Couch M, Pitts M, Mulcare H, Croy S, Mitchell A, Patel S. TranZnation: A report on the health and wellbeing of
transgender people in Australia and New Zealand. Melbourne, Australia: The Australian Research Centre in Sex,
Health and Society, La Trobe University; 2007.
24. Australia and Aotearoa/New Zealand intersex community organisations and independent advocates.
Darlington Statement: Joint consensus statement from the intersex community retreat in Darlington. Darlington,
NSW; 2017.
25. Val’s Café. Aged Care Assessment Service (ACAS) LGBTI inclusive assessment guide sheets. Melbourne
Australia: Val’s Café Australian Research Centre in Sex, Health and Society at La Trobe University; 2015.
26. Freedom2b. SOGII Rights Consultation- Submission to the Australian Human Rights Commission. NSW
Australia: Freedom2b,; 2015.
27. Parliament of NSW. Business of the House: Reparative therapy. In: NSW Po, editor. Sydney, Australia2013. p.
24722.
28. Dickinson T, Cook M, Playle J, Hallett C. 'Queer' treatments: giving a voice to former patients who received
treatments for their 'sexual deviations'. Journal of clinical nursing. 2012;21(9-10):1345-54.
29. Winter S, Diamond M, Green J, Karasic D, Reed T, Whittle S, et al. Transgender people: Health at the margins
of society. The Lancet. 2016;388(10042):390-400.
30. The Gender Centre Inc. Inquiry into elder abuse in New South Wales. Sydney: The Gender Centre Inc; 2015.
31. Ghattas D. Standing up for the human rights of intersex people – how can you help? Brussels, Belgium:
European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA); Organisation
Intersex International Europe (OII); 2015.
32. Latham JR, Barrett C. As we age: An evidence-based guide to intersex inclusive aged care. Melbourne,
Australia: Australian Research Centre in Sex, Health and Society, La Trobe University.; 2015.
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4b - Discrimination, exclusion & trauma
33. COTA Victoria, Transgender Victoria, Dr Sue Malta National Ageing Research Institute (NARI). Safeguarding
the End of the Rainbow: A guide to help LGBTI people to plan an end of life of their choice. . In: Victoria C, editor.
Melbourne, Victoria Australia: COTA Victoria; 2018.
34. Human Rights Law Centre. Righting historical wrongs: Background paper for a legislative scheme to
expunge convictions for historical consensual gay sex offences in Victoria. Melbourne Australia: Human Rights
Law Centre; 2014.
35. United Nations Human Rights Council. Living free and equal: What States are doing to tackle violence and
discrimination against lesbian, gay, bisexual, transgender and intersex people. Geneva, Switzerland: United
Nations; 2016.
36. Innis M. When Gangs Killed Gay Men for Sport: Australia Reviews 88 Deaths. New York Times. 2017 January
30, 2017.
37. Ozturk S. Sydney's killer: The gay-hate epidemic that claimed 80 men. Sydney Star Observer. 2013 August 8,
2013.
38. McNab D. Getting away with murder: Police culture, gay hate, and Sydney's shame, . The Guardian. 2017 11
March, 2017.
39. Benny-Morrison A. Police to review 88 possible gay-hate deaths. The Sydney Morning Herald. 2016 May 22,
2016.
40. Birch H. Dementia, Lesbians and Gay Men: Alzheimer’s Australia Paper 15. Vic, Australia: Alzheimer’s
Australia; 2009 October 2009.
41. New South Wales Anti-Discrimination Board. Discrimination - the other epidemic: Report of the inquiry into
HIV and AIDS related discrimination. Sydney, Australia: New South Wales Anti-Discrimination Board; 1992.
42. Grant J, Mottet L, Tanis J, Harrison J, Herman J, Keisling M. Injustice at every turn: A report of the National
Transgender Discrimination Survey. Washington DC, US: National Centre for Transgender Equality and National
Gay and Lesbian Task Force; 2011.
43. Leonard W, Lyons A, Bariola E. A closer look at Private Lives 2: Addressing the mental health and well-being
of lesbian, gay, bisexual and transgender (LGBT) Australians. . Melbourne, Australia: The Australian Research
Centre in Sex, Health & Society, La Trobe University; 2015.
44. Jones RL, Almack K, Scicluna R. Older bisexual people: Implications for social work from the 'Looking Both
Ways' study. Journal of gerontological social work. 2018;61(3):334-47.
45. Fredriksen-Goldsen KI, Shiu C, Bryan AE, Goldsen J, Kim HJ. Health Equity and Aging of Bisexual Older Adults:
Pathways of Risk and Resilience. The journals of gerontology Series B, Psychological sciences and social sciences.
2017;72(3):468-78.
46. McNutt BR. Disenfranchised grief and resilience among gay widowers: A phenomenological exploration.
Dissertation Abstracts International: Section B: The Sciences and Engineering. 2015;76(2-B(E)): No Pagination
Specified.
47. McParland J, Camic P. Psychosocial factors and ageing in older lesbian, gay and bisexual people: a
systematic review of the literature. Journal of clinical nursing. 2016;25(23-24):3415-37.
48. Kushner B, Neville S, Adams J. Perceptions of ageing as an older gay man: a qualitative study. Journal of
clinical nursing. 2013;22(23-24):3388-95.
49. Hash K, Rogers A. Clinical Practice with Older LGBT Clients: Overcoming Lifelong Stigma Through Strength
and Resilience. Clinical Social Work Journal. 2013; 41(3):249-57.
50. Averett P, Yoon I, Jenkins CL. Older lesbians: experiences of aging, discrimination and resilience. Journal of
women & aging. 2011;23(3):216-32.
Consultation for all aspects of this project was undertaken with consumers, Government
representatives, LGBTI peak bodies, researchers, experts and those experienced in providing
services to LGBTI peoples with dementia. An advisory group was established to provide expert
guidance throughout the project.
This project was funded by a grant from the DCRC Knowledge Translation Program. Additional
benefactors from the LGBTI community are gratefully acknowledged.
See Fact sheet 1 – Overview for details.