What Is Successful Aging in Lesbian and Bisexual Women? Application of the Aging-Well Model

Abstract Objectives Most evidence concerning aging ignores women’s sexual orientation, yet sexual orientation-related discrimination across the life course may influence older lesbian and bisexual women’s risk for poorer health. Understanding aging-well in this group is vital to development, testing, and implementation of evidence-based health promotion programming and services for aging sexual minority women. Method Data were from the Women’s Health Initiative (N = 15,691; heterosexual n = 15,002, lesbian n = 440, bisexual n = 249) extension study. Multivariable linear and logistic regression tested associations between sexual orientation and indicators of successful, effective, and optimal aging-well in age-stratified groups of women (60–74 and 75+). Results Lesbians aged 60–74 were more likely (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.16, 2.18) to report good self-mastery, more social support (b = 2.92, 95% CI, 1.99, 3.85), and greater likelihood of enjoying life (OR 1.46, 95% CI 1.06, 2.01) compared with heterosexual women. Bisexual women aged 75+ reported increased personal growth (b = 1.09, 95% CI 0.23, 1.95) compared to heterosexuals. While lesbians aged 75+ had greater likelihood of living in a nursing home (OR 1.96; 95% CI 1.01, 3.82) and were less likely to be happy at least most of the time (OR 0.68, 95% CI 0.49, 0.99), they reported greater self-mastery (OR 1.55; 95% CI 1.06, 2.26) than their heterosexual peers. Discussion Aging-well is not the same for all women. Health promotion programs may consider maximizing sexual minority women’s internal and external resources—including social supports, self-mastery, and personal growth—to promote wellness in older age.