Aging and the Experiences of Transgender and Gender Nonbinary Older Adults: An Exploratory Study

Background and Purpose:

Individuals who identify as transgender (T) and/or gender nonbinary (NB) face various struggles such as stigma and discrimination, and have a higher risk for mental health, physical health, and economic challenges as compared with those who identify within the binary of male/female and are cisgender. Older adults who identify as transgender and gender nonbinary nonbinary tend to be at higher risk for mental health challenges, substance use problems, victimization, transphobia, poor physical health, and physical disabilities as compared with older adults who do not identify as transgender and gender nonconforming. However, as with any group there is tremendous diversity in the lived experiences and aspirations of individuals who identify as transgender or gender nonbinary older adults. This study seeks to increase our understanding of the needs of these diverse individuals.

Methods:

Twenty individuals consented to be interviewed and audio-recorded. Seven participants (35%) identified as trans men; ten participants (50%) identified as trans women; and three participants (15%) identified as NB, not trans. Interviews were semi-structured using an interview guide with predetermined questions. Nine questions were asked- six pertaining to the study’s inquiry and three pertaining to the participants’ demographics. The researchers strove to ensure rigor throughout this inductive and iterative process. Maintaining an open and sensitive stance, questioning their own preconceptions, and examining how they might influence the data analysis, was imperative.

Findings

Six themes were identified: personal history; inner strength; acceptance; transitions; gendered spaces; and aging concerns. Most participants dealt with internal struggles such as maintaining secrets and contending with gender dysphoria (individual level of trans stigma), external challenges such as receiving negative messages from others (interpersonal level of trans stigma) and encountering barriers such as obtaining medical care (structural level of trans stigma). Despite dealing with these challenges, most spoke about having inner strength (individual level of self-worth). This individual-level factor seemed noteworthy and significant to the participants. Having community-level and/or group-level resiliency factors varied among the participants. Those who had a sense of belonging in a community or participated in group-level activities reported that these connections and activities were important sources of support.

Conclusion and Implications

As seen in this study, T/NB people have unique journeys and are a diverse community. Differences in gender identities and varying viewpoints of those identities (e.g., binary/nonbinary; static/fluid) should be considered along with persons’ other identities such as race in research. T/NB aging should also receive more attention. Practice implications include the need for healthcare and mental healthcare staff to be adequately trained in T/NB- specific needs and have a nuanced understanding of gender identities. Schools offering allied health and mental health education should be incorporating current research about T/NB older adults into the curriculum. Finally, resources and support groups should be specific to T/NB sub-populations’ needs. Given the backlash against T/NB persons and the vulnerabilities associated with aging and dependency on others, further research is needed, and more work must be done to educate existing and future service providers.