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Lesbian, gay, bisexual, and transgender (LGBT) older adults have largely been an invisible population, although they are now emerging from the shadows. Along with shifting demographics and profound graying of the global population, the older adult population is becoming increasingly diverse. Estimates indicate that more than 100 million Americans are aged 50 and older (US Census Bureau 2013b). By 2030, it is estimated that nearly 133 million Americans will be aged 50 and older with the 50-64 age group shrinking slightly, and those 65 and older nearly doubling (US Census Bureau 2013a).

LGBTQ older adults have higher levels of psychological distress as compared to older adults in general. They also experience multiple barriers to accessing equitable, culturally competent mental health and aging services because of their distinct histories and particular social contexts. This article discusses this lack of access to services, and highlights an innovative way mental health services are being delivered in LGBTQ communities.