Transgender Aging: What’s Different?

 In: Articles
In recognition of Transgender Awareness Week, SAGE and the National Resource Center on LGBTQ+ Aging will be highlighting one resource a day until Friday, November 20th which is the Transgender Day of Remembrance (TDOR).
Despite Caitlyn Jenner (66) coming forward this year with a gorgeous Vanity Fair cover and the Amazon Prime show Transparent receiving numerous accolades, including an Emmy for its cisgender lead Jeffrey Tambor, aging poses unique challenges for transgender older adults. They came of age during decades when transgender people were heavily stigmatized and pathologized. Some came out and made gender transitions during these years, while many others kept their identities hidden for decades and are now coming out and transitioning later in life. Many challenges facing transgender elders are common to the broader older lesbian, gay and bisexual population, but some are different. With a growing older transgender population, there is an urgent need to understand the challenges that can threaten financial security, health and overall well-being.

Transgender older adults face barriers in areas such as violence, employment and housing discrimination, privacy and documentation issues, a limited knowledge base, community support and engagement, and more. To learn more about these topics, check out our highlighted resource for the day: Improving the Lives of Transgender Older Adults, authored by SAGE and the National Center for Transgender Equality (NCTE).
For a quick rundown of the report, SAGE and NCTE discovered that a lack of cultural and clinical competence regarding transgender people and their health needs, as well as bias and outright discrimination by providers, created serious barriers to quality care for transgender older adults. These barriers, together with financial barriers, mean that many transgender older adults often avoid or delay seeking care. In addition, medically necessary care related to gender transition is often arbitrarily excluded from public and private insurance, despite the Affordable Care Act (ACA) suggesting otherwise. Inability to access this care can contribute to declining health, and these exclusions are often also used to deny coverage for preventive and other medical care transgender older adults need.

The confluence of widespread discrimination across the lifespan, weaker support networks, and barriers to quality care contribute to poor health outcomes for many transgender older people. Transgender people report higher rates of disability, general poor health, depression, anxiety, loneliness and suicidal ideation. Thus, many transgender elders enter their later years with severe health concerns yet without the social and community supports necessary to address them.

In addition, even though today’s aging services network provides a wide range of critical services for older adults, this network is currently ill-equipped to provide competent and nondiscriminatory services to transgender older adults, or to address their unique needs. Few aging providers offer cultural competence training or outreach specific to transgender communities. Many transgender older adults are not getting the support they need, and many are reluctant to seek services at all.

SAGE and other organizations are working on creating policies as well as some key solutions for addressing these barriers. To help inform and create this advocacy roadmap, SAGE brought together a diverse committee of leading experts from around the country, which identified several immediate policy and practice priorities to improve the lives of transgender older adults. In the meantime, you can learn more about transgender aging and supports via the National Resource Center on LGBTQ+ Aging.