Even in Massachusetts, which is considered a beacon of tolerance and diversity for many gay, lesbian, bisexual, and transgender Americans, the older members of this group remain in the shadows, as in the rest of the country.

Many fear going into assisted-living or skilled nursing facilities, or getting home health care, say those who work in agencies serving gay and lesbian elders. They retreat into the closet rather than face scornful remarks of fellow residents or possible discrimination from caregivers.

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