SACRAMENTO – Senator John Laird, Chair of the Senate Select Committee on Older LGBTQ+ Californians, convened a hearing this week that highlighted the growing challenges facing LGBTQ+ older adults – many of whom survived decades of stigma, loss, and activism but now face barriers accessing the care and support they need to age with dignity.

The hearing, titled “Supporting the Generation That Built the Movement,” brought together state leaders, advocates, and those with firsthand experience to examine how California’s systems are serving LGBTQ+ seniors and where they are falling short, particularly for those aging with HIV, and transgender older adults navigating long-term care.

“What we heard was pretty straightforward,” said Laird. “California has developed a lot of programs, but too many people still can’t access them when they need them. If you’re choosing between rent, food, and your medication, the system isn’t working. We’ve got to fix that.”

Speakers underscored that LGBTQ+ older adults, especially long-term HIV survivors and transgender seniors, carry unique and often overlooked needs shaped by decades of discrimination, social isolation, and survival.

Across the hearing, several themes emerged:

• Access gaps persist despite existing programs, with many seniors struggling to navigate fragmented systems;
• Housing and affordability are central challenges, with some individuals spending the majority of their income on rent;
• Federal threats are increasing risk, including proposed cuts to Medicaid and the Ryan White HIV/AIDS Program; and
• Stigma and past trauma continue to shape care decisions, leading some to delay or avoid seeking services.

Advocates pointed to systemic patterns underlying these challenges.

“We are not seeing isolated problems; we are seeing patterns,” said Jax Kelly, Founder and CEO of the Aging and HIV Institute. “If systems are fragmented, people will experience gaps. If populations are not visible, they will not be served.”

“Long-term HIV survivors and others aging with HIV face unique challenges shaped by decades of loss, stigma, and resilience,” said Dr. Tyler TerMeer, CEO of the San Francisco AIDS Foundation. “This is the generation that has led the way with activism and courage, transforming the course of HIV in this country. And now, we must meet that same level of urgency and commitment.”

“People aging with HIV face complex health and social challenges that demand targeted, sustained investment,” said Dr. Toni Newman, Chair of Transcanwork. “Honoring their legacy means ensuring they have the care, support, and dignity they deserve.”

Panelists highlighted both progress and persistent gaps in supporting the growing population of older adults living with HIV. Programs like the AIDS Drug Assistance Program (ADAP) and Ryan White provide critical care, but providers described a reality where many seniors still struggle with:

• Rising healthcare and insurance costs
• Housing instability and food insecurity
• Mental health challenges and social isolation
• Navigating multiple, disconnected systems

Testimony from frontline providers and those with direct experience underscored how these pressures compound with age, particularly for those who lived through the height of the HIV/AIDS epidemic.

“Every LGBTQ+ person deserves to age with dignity, not with the anxiety of losing their housing or the fear that their life-sustaining medical care will be defunded,” said Dannie Cesena, Director of the California LGBTQ Health and Human Services Network.

The hearing also focused on transgender and gender nonconforming seniors, particularly those entering long-term care systems. While state agencies outlined protections under SB 219 requiring nondiscrimination and affirming care, advocates noted that policy does not always translate into real-world outcomes. Barriers include:

• Fear of discrimination in care settings
• Lack of awareness about rights and complaint processes
• Gaps in culturally competent care
• Isolation among older transgender adults, particularly those disconnected from traditional aging systems

“Passing protections is not enough,” said Bamby Salcedo of the TransLatin@ Coalition. “These rights must be understood, enforced, and lived in practice.”

Advocates warned that proposed federal actions, including cuts to Medicaid, attacks on transgender healthcare, and reductions to HIV programs, could significantly worsen existing gaps.

“We’re grateful to Senator Laird for convening this hearing and elevating the urgent health needs of LGBTQ+ older adults,” said Tony Hoang, Executive Director of Equality California. “Right now, the Trump administration is turning its back on them. California must meet this moment and ensure LGBTQ+ seniors can access the care and support they need to age with dignity.”

“Now is the time for California to double down on its commitment to LGBTQ+ older people and ensure through policy and action that they can continue to access the health and long-term care services that allow them to age with dignity and justice,” added Denny Chan, Managing Director of Equity Advocacy at Justice in Aging.

Laird said the hearing will inform ongoing budget and policy discussions, with a focus on improving coordination across systems and ensuring programs are reaching those most in need.

“This isn’t a one-off conversation,” he said. “We’re going to keep pushing until these systems actually work for the people who depend on them.”