Building markets for alternative facilities.

Several years ago, developer Joy Silver was walking to her home in the Greenwich Village section of New York City when she saw flashing lights a few blocks away. She feared that police activity might involve her residence.

As she got closer, however, she realized that the flashing lights were coming from The Village Nursing Home, a long term care facility with a large alternative lifestyle population.

And the lights weren't from the police--they were from a large disco ball inside the nursing home. "I looked through one of the windows and saw a room full of elderly people and go-go boys up of a table dancing under the flashing lights," Silver said. "And I thought, 'That's the kind of place (where) I want to be when I'm ready for long term care.'"

Almost seven years later Silver is about to see the first shovel go into the ground at Rainbow Vision Properties, an LGBT-marketed retirement community in Santa Fe, N.M. Scheduled for groundbreaking as this issue was going to press, the $32 million, 146-unit development already has 130 people on its waiting list.

"We're not inventing something new," Silver said. "We are addressing a major need within the LGBT community."

Not all LGBT seniors successfully fit in at mainstream Long term care facilities, so many have chosen to live in places that cater specifically to their needs. Facilities such as The Palms of Manasota, in Palmetto, Fla., Carefree Cove in Zionville, N.C., and GayCare in Daly City, Calif., have functioned for several years with an almost exclusively homosexual clientele.

In recent years, Silver and other developers have launched other specialty housing projects in anticipation of a booming elder LGBT housing market. According to John DeLeo, president and chief executive officer of the Shaman Development Group in Fort Lauderdale, Fla., there's a need for 6,000 additional units of gay and lesbian housing each year for the next 20 years to meet expected demand. "That's the reality," DeLeo said. 'And if we sit here with our heads in the sand, we'll one day come to realize that there's no place for us--unless we act now."

Part of this need, experts contend, stems from LGBTs' inability to find acceptance in traditional long term care facilities. While anti-discrimination laws apply to "mainstream" citizens, it is legal to discriminate against lesbians, gays and bisexuals in 36 states, according to Andrew Shippy, an associate researcher for Pride Senior Network in New York City. Transgender persons are worse off, with anti-discrimination laws only applicable in four states, he said.

Despite the perceived housing need, the road's been rockier than expected for developers. It has taken Bonnie McGowan nine years to get Birds of a Feather Resort Communities, a 165-acre LGBT retirement complex in Pecos, N.M., past myriad subdivision approvals and legal appeals. This past summer, construction began on the project's first phase. "The one thing I've learned from all of this is how hard it is to be a pioneer in something," McGowan said.

For DeLeo, finding funding was more difficult than public acceptance. "I would have liked to have thought it would happen overnight, but it just doesn't happen," said DeLeo, who started the process in 1998. "There were few 'white shoe' financial groups who wanted to take a chance on this, simply because it was an untested market."

As major financiers recognized the gay and lesbian market's buying power--about $800 billion, according to Interactive Week--the attitude has changed. Still, "one of these facilities has to go up and sell out immediately and be outrageously successful in the bottom line before there's any large-scale development," DeLeo said.

The usual rigid approval process and general construction period has extended the wait. "If I were to get one started by the summer of next year--2005--it wouldn't be ready for another 24 months," he said. "That's if I can start one in the next 12 months."

Though DeLeo and other developers consider the LGBT demographic perfect for newer upscale residences, advocacy groups such as Senior Action in a Gay Environment (SAGE) in New York City stress there's also a need for affordable, lower-end LGBT facilities.

"It's terrific that those (higher-end) places are beginning to get built, but it's a tiny number of us that can go into them," said Amber Hollibaugh, SAGE's director of education and advocacy. "The majority of LGBT people are in working-class communities. That's the bulk of this country. ... We're just not the visible ones."

That's one reason developer Tony Salazar, president of McCormack Baron Salazar, a residential developer based in St. Louis, had little trouble getting financial assistance from the Los Angeles Community Redevelopment Agency and the Gay & Lesbian Elder Housing Corp. for his project.

Encore Hall, a 103-unit low-income LGBT development in Hollywood, Calif., is set for groundbreaking in November. "From a political point of view, this hasn't been hard at all--there's no gay-lesbian homophobic issue," Salazar said. "The hardest part is the strict development side. There's no land here. Land prices are skyrocketing. There's high competition for a limited amount of ground."

By Any Other Name

Whereas "gay" and "lesbian" carry standard meanings in the everyday world, the meaning of the "T" in LGBT can be dizzying, experts note. "Transgender" could refer to a cross-dresser or it could mean someone who has had a full sex change.

"Unfortunately, it's a broad umbrella term," said Tarynn Witten, executive director of the TransScience Research Institute in Richmond, Va. "For example, a female-to-male transsexual might identify by that title, or he might consider himself merely 'male,' or even call himself a 'transman.'"

Health care workers should address each individual TG by their preferred self-description to avoid offending anyone, Witten added, "You can't just call them 'transsexuals' any more than you can call an intersex person a hermaphrodite," she said. "You need to understand--and ask--how each of these people want to be called."

Identity exposed? Physicians, administrators and TGI residents must carefully weigh how much disclosure should be made on a transgender or intersex resident's lifestyle, Witten noted. Not informing enough people of a TG's past lifestyle could cause problems, Too many people knowing definitely will.

In the end, timed discretion is best, Witten advised. "Typically, the general rule is that you reveal what you reveal when you need to reveal it," she said, "It's nobody's business otherwise."