Dan Stewart: Advocate for LGBTQ+ Aging Adults
As a transgender man and gerontologist, Stewart understands challenges and works to promote inclusive care and equitable policies for older population
Two principles in Dan Stewart's Indigenous heritage help guide his advocacy work: The first is known as the Two-Spirit tradition, which holds that diversity in sexual orientation and gender identity is sacred; the second is called the Seventh Generation Principle, a concept that decisions made today must consider their impact on the next seven generations to come.
It is that heritage and philosophies that helps guide Stewart, who is transgender and Two-Spirit, in his role as deputy director of the Aging Equality Project at the Human Rights Campaign Foundation where he works to promote inclusive care and equitable policies for lesbian, gay, bisexual, transgender and queer aging adults. Stewart is one of Next Avenue's eight 2025 Advocates for Aging.
"My identity as Two-Spirit is centuries old," he explains. "In a lot of my teachings with health and social service providers, I make note that, while we see a lot of disparaging remarks and distrust and discomfort with trans people, in many Native societies and cultures, transgender people and gender diverse people have been elevated and seen [as] spiritual. It's kind of a connection because of their recognition of both masculine and feminine energies. From an Indigenous perspective, my identity is honorable and a gift in order to see things in a different perspective and to be able to reach different people of different identities."
"I'm dedicated to creating a future that our children deserve and creating a reality that our elders deserve."
Beyond Indigenous and transgender, the multi-hyphenate Stewart self-describes as a Chicano, gerontologist, multimedia artist and, most recently, father. Stewart and his spouse welcomed their first child, a son named River, earlier this year.
As Stewart focuses on enjoying his newborn, he also reflects on his work with LGBTQ+ aging adults, saying his child is "a reminder of the importance of why I do the work I do and why I'm dedicated to creating a future that our children deserve and creating a reality that our elders deserve."
A major project for Stewart is the creation of the Long-Term Care Equality Index (LEI), a joint project with SAGE and HRC Foundation. Launched in 2019, the LEI is a national benchmarking tool and roadmap for United States senior housing communities to support their efforts of LGBTQ+ inclusion of residents, visitors and staff. Modeled after the successful Healthcare Equality Index, the LEI evaluates senior housing communities based on four core pillars: non-discrimination and staff training, resident services and supports, employee benefits and engagement, and a public commitment to the LGBTQ+ community.
Stewart co-authored the first report in 2021 and the updated 2023 report , which includes data from 200 communities in 34 states and the District of Columbia. Key findings show that 90% of the surveyed communities now include the terms "sexual orientation" and "gender identity" in their resident non-discrimination policies, up from just 18% in the 2021 report.
"One of the biggest concerns facing older LGBTQ+ people is their future – especially when finding welcoming and inclusive places to live and receive care in their later years," says Michael Adams, chief executive officer of SAGE, in the report. "The LEI is a powerful tool that helps ensure that LGBTQ+ elders get the respectful care they deserve as they age."
Early Years
Stewart didn't start out studying gerontology or LGBTQ+ rights issues while studying at Saint Louis University in St. Louis, Missouri. "I initially started out in my undergrad career with an idea of pursuing a Ph.D. doing academia and I had an opportunity to work at the local children's hospital doing work with children with autism and early signs of autism," Stewart explains. "It was really fascinating, but ultimately, I found that my heart and passion wasn't really in it. And one thing I knew about a Ph.D. is that you really should care about and love the topic."
During his senior year, he completed a 150-hour practicum at a long-term care community, Little Sisters of the Poor Nursing Home. "I really didn't have much experience with this population, but what I came to find was a love of connection and speaking to folks, hearing their stories, learning about their experiences and finding folks that were hungry for a connection." At that point, he says he had come out as gay, but "I had not yet come out as trans and transitioned, although I had a sense and an idea."
It was a few years later when he had transitioned to a male and was using male pronouns when he says he was pushed out of a job at a religiously-affiliated long-term care because "they didn't know how to manage having someone transition on the job, despite having great evaluations and relationships with the older adults."
It was also during this time as a master's student when a professor asked all the students to imagine what their life would be like at age 80. "I had just come out as trans, my family of origin was not a part of my life at that time, I wasn't legally married, I was partnered, didn't have any children, and quickly realized, 'Oh, no, I will probably have to rely on formalized care to meet my needs. What does that mean?'"
Stewart realized it could mean being misgendered by staff in a housing facility, having to rely on staff to administer weekly doses of testosterone, and facing other challenges specific to the LGBTQ+ community. He started to look into the research available at the time.
"We saw that elders were less likely to have support as they aged," he says, "were more likely to avoid preventative care and in turn [were] experiencing chronic illness and chronic disease sooner — almost an accelerated aging process." LGBTQ+ elders are also more likely to go back into the closet to receive care, Stewart says. "Everyone deserves dignity and respect regardless of who they are, who they love, or where they live."
Advocacy Work
He explains that academic work around aging, including a course in sexuality and aging, "really started a pathway of wanting to learn more about this and want to try to make it better."
"I did aging-related work, but I also did a lot of education, for health care access," he says. "While working for PROMO, Missouri's LGBTQ+ advocacy organization, we had a grant through the Missouri Foundation of Health to travel all across the state and teach health care providers, social service providers, aging service providers, how to provide inclusive and competent care. I did a lot of self-disclosure of my identity to help people, too. … [Society is] getting to a place where people know someone who is gay or lesbian, but, as a whole, not many folks personally know someone who's transgender, and so we're trying to challenge the misinformation as well as continuing to humanize why we were talking about things such as inclusive policies and practices and protocols that help staff have respectful interactions. Those are important, not just for the LGBTQ person, but also for the staff to feel confident and secure and how they're approaching their clients or patients."
"The reality is that ageism is strong in our culture. We also have a tendency to desexualize older adults."
Stewart's work energized him but there came a turning point in 2018 when he had to decide if he would continue his studies and pursue a Ph.D. or continue his advocacy work full time through social services. "It was a very hard decision. I was the first of my mother's family to graduate with the undergrad, let alone a master's degree. I had a lot of personal worth tied up into this, but in reality recognizing the impact that I wanted to make really necessitated a different path."
That led to his current role at HRC Foundation overseeing aging-related work: "I had opportunities as a grad student over the years, and now, being able to function on an institutional level to build relationships and address a lot of these systemic ills and concerns that I saw firsthand 10 years earlier has been kind of a really full-circle moment."
"The reality is that ageism is strong in our culture," Stewart says. "We also have a tendency to desexualize older adults. [But] there's been such a growth in acknowledgment this population exists. I would say partially because we are seeing more LGBTQ elders come out, especially those of the baby boomer generation who were loud and proud for decades. We also have different expectations of what aging services are going to provide and we're seeing more staff members be out or have family members that are LGBTQ. … We're seeing positive movement in one area where there is continued conversation — even with residents who are straight — acknowledging that many of these folks' grandchildren identify as LGBTQ and there's a desire to show up for them to support them and continue to be present for them."
As Stewart continues to live — and age — in many worlds, including Indigenous, transgender, scholar, spouse and parent, he's committed to helping make the world one he thinks we all deserve for generations to come.
