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  • The Radical Art of Staying Present: How San Francisco’s LGBTQ+ Elders are Redefining Survival
  • Integrative Oncology and Holistic Care

The Radical Art of Staying Present: How San Francisco’s LGBTQ+ Elders are Redefining Survival

Asep Darmawan July 24, 2026 7 minutes read
the-radical-art-of-staying-present-how-san-franciscos-lgbtq-elders-are-redefining-survival

Introduction: A Life Etched in the Fabric of the City

In the heart of San Francisco, a city defined by its radical history and shifting landscapes, lives a man whose personal timeline serves as a living archive of the queer experience. Mark, now 74, has been a fixture of the city since 1994, a man who has navigated the neon-lit euphoria of the nightlife scene, the grit of the leather community, and the profound trauma of the HIV/AIDS epidemic.

Mark’s story is not merely one of survival; it is an exploration of what it means to exist fully in the present when the future was once promised to be nonexistent. Through his enduring connection with the organization Shanti, Mark has found more than just support—he has found a bridge between his past as a cultural builder and his present as an elder. His bond with volunteer Crown serves as a testament to the power of human connection, proving that even in a rapidly changing world, the simple act of showing up for one another remains the most revolutionary service of all.

Chronology: A Journey Through Decades of Change

The Early Years: Identity as an Anchor

Born into a generation where the closet was the default, Mark defied the norm early. Out since he was 17, he describes his identity not as a burden, but as a clarity. "It was never a problem for me," he reflects. This unwavering sense of self provided the bedrock upon which he built a life as an electrician, a bathhouse worker, and a vibrant member of the city’s leather community.

The Crisis: Navigating the Epidemic

The mid-1980s and early 90s brought a shadow that would define a generation. When Mark was diagnosed with HIV, the medical community was scrambling to understand a virus that was, at the time, a death sentence. He watched friends disappear—lost to a disease that claimed a generation of artists, lovers, and thinkers. While others succumbed to the crushing weight of hopelessness, Mark pivoted. He rejected the rigid timelines of terminal illness. "I should have been dead years ago," he says with a shrug. "But I had more things to do."

The Turning Point: Radical Acceptance

After suffering a stroke, Mark was faced with a pivotal choice: become bitter or become light. Influenced by his sister’s sage advice, he chose the latter. This embrace of "silliness" became a survival mechanism, a way to dismantle the gravity of his circumstances. By letting go of the need to plan for a future he was told he wouldn’t have, Mark mastered the art of living in the present.

Supporting Data: The Vital Role of Peer Support

The work performed by organizations like Shanti is not merely "social work"—it is a critical infrastructure for the survival of LGBTQ+ elders.

According to various advocacy reports, LGBTQ+ seniors are significantly more likely to live alone and lack the familial support networks that buffer the aging process. For survivors of the HIV epidemic, this isolation is compounded by a history of trauma and systemic marginalization.

The Shanti Model

Shanti, where Katy currently serves as the HIV Programs Director, operates on a model of "radical presence." Unlike traditional clinical care, which often focuses on metrics, medication adherence, and billable hours, Shanti focuses on the relational health of the individual.

  • Peer Support: Matching volunteers with clients based on compatibility rather than just need.
  • Community Integration: Ensuring that elders remain tethered to the cultural life of the city.
  • Oral History Preservation: Recognizing that the lived experiences of survivors are vital cultural assets.

Official Perspectives: The Value of Mutual Connection

Katy, HIV Programs Director at Shanti

Katy first encountered Mark years ago through housing support services, but their relationship evolved into something far more profound. "Mark has lived in San Francisco for so long and been an important figure in nightlife and the leather community," Katy explains. "He has amazing oral history to share. He’s also a natural mentor figure with a sort of radical acceptance approach to life born out of his unique experiences."

Katy is quick to debunk the myth that support services are a one-way street. "The relationship is mutual," she asserts. "Mark is giving us just as much as we hope to give him." She highlights the systemic danger of allowing individuals like Mark to fade into the background. "Without Shanti, we might have passed by each other a hundred times," she notes. "Shanti is the link that brings us together."

Mark and Crown, HIV Client and Peer Support Volunteer

Crown, Peer Support Volunteer

The introduction of Crown, a peer support volunteer, marked a new chapter in Mark’s life. Their connection is refreshingly free of the "helper-helped" dynamic that often plagues social services. Crown describes their initial meeting as an immediate spark of recognition. "He was warm, generous, and very welcoming," Crown says. "And incredibly patient with me."

Crown emphasizes that their time together is not about problem-solving. "There’s value in the relationship," Crown notes. "We talk about life, death, and everything in between." This space, free from the pressure of "fixing" a life, allows for genuine, human connection.

Implications: The Cultural Necessity of Connection

The Invisible Generation

Mark’s story sheds light on a broader sociological concern: the invisibility of long-term survivors. As the city of San Francisco continues to gentrify and shift, the cultural builders of the 70s, 80s, and 90s are often pushed to the margins. These individuals hold the keys to the city’s identity, yet they are often the most vulnerable to the erosion of community support.

The implication for urban policy and social service agencies is clear: we must prioritize the social health of our elders. If we fail to foster connections across generations, we lose more than just individuals; we lose the collective memory of the struggles and triumphs that built the city’s inclusive culture.

Redefining "Success" in Aging

Mark’s approach to life offers a counter-narrative to the standard American obsession with future-planning and accumulation. In a culture that demands constant goal-setting, Mark’s refusal to worry about what comes next is a radical act of defiance.

When asked what he looks forward to most, he offers a response that is both humorous and profoundly philosophical: "Nothing," he says, followed by a beat. "Or everything." This paradox is the essence of his wisdom. By choosing to find "everything" in the present moment, he is able to experience a quality of life that transcends the limitations placed upon him by his diagnosis.

Conclusion: A Legacy of Laughter and Presence

The story of Mark and Crown is a quiet one, devoid of grand gestures or headline-grabbing interventions. Yet, it is perhaps one of the most important stories being written in San Francisco today. It reminds us that behind the clinical labels of "long-term survivor" or "elder" are human beings with humor, history, and a desperate need for authentic connection.

Shanti’s ability to facilitate these pairings—to bridge the gap between people who would otherwise be strangers—is the connective tissue that keeps the community alive. As we look to the future, we would do well to follow Mark’s lead: to stop counting the days and start making the days count. One connection at a time. One laugh at a time. One day at a time.

In the end, it is not the long-term plans or the distant horizons that define our existence; it is the warmth of a companion’s hand, the sharing of a story, and the courage to be fully present in the here and now. Mark, at 74, has mastered this art. He stands as a beacon for all of us, proving that even after the storm has passed, the capacity for joy remains the most enduring human trait.

About the Author

Asep Darmawan

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