There has been a huge growth in research on trans aging in the last decade. And it’s about time, isn’t it?
For this article, we did a limited literature search to learn more about current hot topics in gender gerontology (gerontology is the scientific study of old age, the process of aging, and the particular problems of old people.) We won’t claim that we did an exhaustive search, or have the resources to do a full review of current research projects, but we thought we’d share some high-level themes and ideas for aging well.
Who Are Trans Elders?
Research and common use tend to classify anyone aged 50+ as an elder. Gerontology typically classifies elderly adults as those aged 65 and up.
By 2030, all living Baby Boomers will be aged 65 or older. By 2050, more than 130 million Americans are expected to be aged 50 and older. (1, 2) Many current elders grew up during times of far less social acceptance for LGBTQ+ individuals and enforced cisnormality. As we see increasing numbers of people identifying as LGBTQ+ in each generation, we can assume that there will be a lot more of us in the future.
What Challenges Do Trans Elders Face While Aging?
Several studies that we read identified aging challenges for trans elders compared to cis elders:
- higher rates of mental, cognitive, and physical health problems (3)
- depression, anxiety, and loneliness
- dementia and cognitive (thinking) problems
- chronic illness, disability, and poorer overall health
- lower access to affirming and age-aware care providers
- lower lifetime income
- lack of affirming end of life supports
Multiple studies focused on lifetime stress as the underlying reason for health disparities. We’ve talked about Minority Stress before – it is the additional stress burden put on individuals and populations because of oppression. Living through discrimination and marginalization is harmful to current and future stress. For many now-elders, there was more pressure to not come out and potentially more “blowback” for being out. The strong cultural messages to live a “normal” life contributed to internalized stigma and shame, decreased safety, and increased vigilance. (4) Marginalization leads to lower social supports and overall health. Many trans elders never came out, or are just now exploring coming out.
What Can We Do About Those Challenges?
Resilience.
Resilience is the ability to adapt and adjust to challenges. The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress.” It can be described as a personal trait, a process, or an outcome. It isn’t likely to be static: sometimes we are more resilient than others. (5)
What Helps Trans Elders Build Resilience?
- A strong sense of self and a “positive identity appraisal.” (6) For many people, exploring and embracing their trans identity is an act of resilience which lowers the stress burden of hiding aspects of themselves. Identity affirmation is associated with greater well-being, life satisfaction, and social connectedness. “Coming out” socially isn’t a requirement, but can add support benefits. A “negative identity appraisal” happens when a person internalizes societal prejudice. This has been linked to poorer overall physical and mental health.
- Social Support – having a strong social network is strongly associated with better mental and physical health for older adults. Studies indicate that older LGBTQ+ people tend to have larger social networks but perhaps fewer sources of immediate nuclear family support, and thus rely on extended networks more than cis peers.
- Activities that promote physical and mental health – physical activity, emotional ties to other people, and brain exercises improve the health of the body and the mind.
How Have Others Done This?
Queer theory talks about “embracing failure” as a uniquely queer approach to thriving. For elders transitioning later in life, this can mean rejecting previous ideas of what they should be and embracing their heart identity. Simply put: thriving as their authentic selves rather than existing as an unhappy version of themselves. (4)
Embracing Pride grows from being your authentic self.
Embracing Community – queer social networks have a strong history of chosen families. Growing a network of affirming friends and family keeps you healthy. Many individuals do this by joining social groups or volunteering their time to causes and organizations. Some do this by mentoring queer and trans youth.
Embracing Activity – physical activity, leisure activity, and wellness activities. This doesn’t necessarily mean training for a marathon at age 67, but it can mean a daily short walk or chair yoga. Bonus points for meeting a friend for exercise, hanging out, and companionship. Wellness activities can include maintaining nutrition and avoiding smoking and other harmful activities.
A study that interviewed 19 transgender elders identified the following concerns and experiences of trans elders regarding aging:
- fear of mistreatment
- isolation and loneliness increased due to transgender identity
- money worries
- less ability to control their care and lives
- unaffirming medical providers
- finding fulfillment in embracing their identities. (7)
These seniors found hope in increasing health care system and provider inclusivity, in engaging with their communities, in activism, and in using tools such as advance directives to be able to document their wishes should they be unable to communicate them due to illness or disability.
One participant said:
“The key to the whole thing is to have good relationships and good friends…having emotional support, physical support, and support to getting things done.”
Another mentioned:
“I didn’t know much at twenty…Over a period of time I became more comfortable with me, and especially after transitioning…The sooner you’re comfortable with who you are, you don’t worry so much about what other people think.”
Worry and Wisdom: A Qualitative Study of Transgender Elders’ Perspectives on Aging
Hope And Change For Aging
We see hope in arising in many forms:
- Technology and the internet – elders have more and more experience with an online life and building community and networks online. There are more opportunities to have community outside your home or physical location
- Organizations like SAGE and Pride Place for affirming senior housing and community centers
- Increasing awareness of appropriate gender care for older adults
- Increasing research
- More attention paid to end-of-life care and advance directives that affirm the individual
See our recent article Trans Aging Resources and Elder Support for links.
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Citations and Reading List (Pardon our lack of consistent formatting!)
1 Fredriksen-Goldsen KI, Cook-Daniels L, Kim HJ, Erosheva EA, Emlet CA, Hoy-Ellis CP, Goldsen J, Muraco A. Physical and mental health of transgender older adults: an at-risk and underserved population. Gerontologist. 2014 Jun;54(3):488-500. doi: 10.1093/geront/gnt021. Epub 2013 Mar 27. PMID: 23535500; PMCID: PMC4013724.
2 “Witten, T., & Eyler, A. E. (2012). Gay, lesbian, bisexual, and transgender aging: Challenges in research, practice, and policy. Baltimore: Johns Hopkins University Press.”
3 “Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach Nik M. Lampe, Harry Barbee, Nathaniel M. Tran, Skyler Bastow, and Tara McKay
The International Journal of Aging and Human Development 0 10.1177/00914150231171838″
4 Fabbre VD. Gender transitions in later life: a queer perspective on successful aging. Gerontologist. 2015 Feb;55(1):144-53. doi: 10.1093/geront/gnu079. Epub 2014 Aug 26. PMID: 25161264; PMCID: PMC4542896.
5 Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014 Oct 1;5. doi: 10.3402/ejpt.v5.25338. PMID: 25317257; PMCID: PMC4185134.
6 Fredriksen-Goldsen KI, Kim HJ, Bryan AE, Shiu C, Emlet CA. The Cascading Effects of Marginalization and Pathways of Resilience in Attaining Good Health Among LGBT Older Adults. Gerontologist. 2017 Feb;57(suppl 1):S72-S83. doi: 10.1093/geront/gnw170. PMID: 28087797; PMCID: PMC5241752.
7 Adan M, Scribani M, Tallman N, Wolf-Gould C, Campo-Engelstein L, Gadomski A. Worry and Wisdom: A Qualitative Study of Transgender Elders’ Perspectives on Aging. Transgend Health. 2021 Dec 2;6(6):332-342. doi: 10.1089/trgh.2020.0098. PMID: 34993305; PMCID: PMC8664103.
Also on our reading list:
