Reflection and Refraction

Health Equity Fellow Andy presenting survey findings to the LGBTQ advisory committee.

Health Equity Fellow Andy presenting survey findings to the LGBTQ advisory committee.


Andy Post is a Health Equity Fellow placed with Capitol Hill Housing for the summer through Humanity in Action. The fellowship, in partnership with Virginia Mason, focuses on the intersection of health and housing in LGBTQ care in Seattle. This is his reflection. 


I entered Capitol Hill Housing (CHH) at the beginning of the summer, dropped off by the number 49 bus a block away from the turf at Cal Anderson Park. My task, as I knew it then, was to help with pre-development research to support a new apartment building for low-income seniors that affirms the needs of LGBTQ elders in the community. But what exactly is pre-development? I gradually learned the outlines of the process: CHH was working to establish an advisory committee of leaders from LGBTQ community organizers, health care providers, and nonprofits. On my fifth day, we had an initial meeting with some of these leaders. The main topic of conversation: who in the LGBTQ community was not there that should be? Which community groups encompassed by the rainbow of letters L-G-B-T and Q in the King County area, would influence the design, planning, and character of the project?


This question only provokes further questions: why affordable housing for LGBTQ elders? Who needs access to affordable housing the most? What are their needs in the housing process? How can this process be a celebration of care for this community, rather than a divisive struggle for limited resources?


LGBTQ elders face many challenges compared to their heterosexual peers. Thanks to research from Dr. Karen Fredriksen-Goldsen with University of Washington and Generations Aging with Pride, the needs of LGBTQ elders are beginning to be documented. Results show disparities in health, income, and social status that make aging difficult for LGBTQ seniors. 54% of LGBTQ elders in King County suffer from social isolation (linked to higher risk of poor health and premature mortality), nearly half of elderly transgender adults had household incomes at or below 200 percent of the federal poverty level, and in 200 nationwide trials testing for differential treatment in seniors seeking senior housing, the tester with a same-sex partner experienced adverse treatment. Based on these national and local surveys, LGBTQ seniors are more likely to be in poverty, are at higher risk for illness, face discrimination when seeking a home, and are less likely to have support of biological children or family.


Data collection in the world of community development and healthcare is political. Data influences our ability to advocate for, legislate, build, and care for different demographics. While the current administration is taking steps to eliminate LGBTQ identity from national surveys, the research from leaders on LGBTQ gerontology is clear: LGBTQ elders need affordable housing solutions and culturally competent care. But the question arrives again: which cohort within the community?


For over 40 years, Capitol Hill Housing has worked to build vibrant and engaged communities by responding to community needs. But who we engage and the extent to which we can incorporate their input will greatly shape the final project. As part of my fellowship, I visited Virginia Mason’s Bailey Boushay House, a care center for people living with HIV/AIDS. Over half of their clientele currently experiences homelessness. That same day, I participated in a focus group with Living Positively, a social and support group organized by Lifelong for HIV positive men, many of whom are living on a fixed income. The differing needs of these two cohorts only begins to illustrate how who we listen to and how we synthesize their input will greatly change the result of the project. For example, if we prioritize the needs of the portion of the LGBTQ community experiencing homelessness, the services and design of the building will look different than if we prioritize fixed or low-income renters. Even these examples are weighed heavily towards older white gay men living with HIV. Our process of community outreach has just begun, but we are committed to employing a race and social justice analysis to our efforts. Our project—and our community—will be best served by a project that acknowledges and confronts structural racism.


The key word in community development work truly is process. Over the summer, I worked to interview seniors who are reflective of the broader LGBTQ community. These interviews provide insight not only into health and aging needs, but the individual stories that inform the tradition of care we hope to participate in. We hope to feature 7-8 of these interviews in a short film that speaks to why LGBTQ senior affordable housing is needed here in Capitol Hill. Yet again, because 7-8 people cannot represent the full breadth of this project, we will continue to work with and expand our Advisory Committee to hear from as many relevant voices as possible.


In addition to the short film, we are planning a queer gathering; an event to invoke our muses in LGBTQ care and include the larger public in this community development process. On September 21st, we will convene stakeholders and community members to illuminate the tradition of caring for LGBTQ elders in Capitol Hill. Queer art, delicious food, and music, featuring artists such as Storme Webber and Michael Woodward, will bring generations together to create a strong foundation for CHH’s project. You can register for the event here, or on Facebook.

refraction diagram


Process, process, process. I stalled over whether to use this clichéd symbol, but I looked up the physics of forming a rainbow this morning. A layer of water droplets forms a medium of different opacity that disperses white light in a particular way. What results is a refraction of the visible light spectrum, each color appearing as distinct in an arc of light. The task of pre-development and community development is to be the water droplets: those who absorb incoming light and help align internal and external reflection.


This summer I have had the opportunity to meet with over thirty members of the LGBTQ senior community in King County, and over twenty organizations that fight for LGBTQ rights throughout the state. Their stories and openness to share are a testament to the strength of this community—and the necessity of creating a central home and gathering place on Capitol Hill.


My experience began with a solitary morning walk through Cal Anderson. And so it continues. A few weeks back, I visited the Cal Anderson House, and interviewed two wonderful men who shared their history as residents of the building named after Washington state’s first openly gay legislator. Hearing about the resilience, struggles, and continued advocacy of these community members reminds me what is at stake in this work.


Andy Post is a Health Equity Fellow placed with Capitol Hill Housing for the summer through Humanity in Action. The fellowship, in partnership with Virginia Mason, focuses on the intersection of health and housing in LGBTQ care in Seattle.