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Geriatric Transgender Care

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Transgender Medicine

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

There is a growing need to put older transgender and gender non-conforming individuals (TGNC) to the forefront of healthcare services, policies, and research. The TGNC population continues to be underserved. The knowledge on this topic will grow over time as better data collection tools emerge. The aging process for cisgender and transgender individuals occurs in parallel. While nuances in the approach to health care exist, the first step is to acknowledge the presence of TGNC individuals as patients in various transitions. It is essential to offer a culturally competent, inclusive, and affirmative health care to everyone. Furthermore, it is also important to facilitate care across clinical settings. As chronic illnesses turn into life-limiting diseases, it is essential to guide and support the patients through the process of advance care planning including end-of-life care. Palliative and hospice care are specialized programs that could be offered toward patients experiencing serious illness across its trajectory.

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References

  1. Bradford J, Reisner SL, Honnold JA, Xavier J. Experiences of transgender-related discrimination and implications for health: results from the Virginia transgender health initiative study. Am J Public Health. 2013;103:1820–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. James SE, Herman JL, Rankin S, et al. The report of the 2015 US transgender survey. Washington, DC: National Center for Transgender Equality; 2016.

    Google Scholar 

  3. Poteat T, German D, Kerrigan D. Managing uncertainty: a grounded theory of stigma in transgender health care encounters. Soc Sci Med. 2013;84:22–9.

    Article  PubMed  Google Scholar 

  4. Walker RV, Powers SM, Witten TM. Impact of anticipated bias from health care professionals on perceived successful aging among transgender and gender non-conforming adults. LGBT Health. 2017;4(6):427–33.

    Article  PubMed  Google Scholar 

  5. Fredriksen-Goldsen KI, Cook-Daniels L, Kim HJ, et al. Physical and mental health of transgender older adults: an at-risk and underserved population. Gerontologist. 2013;54(3):488–500.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Witten TM. It’s not all darkness: robustness, resilience, and successful transgender aging. LGBT Health. 2014;1(1):24–33.

    Article  PubMed  Google Scholar 

  7. United States Census Bureau. Population estimates. https://www.census.gov/newsroom/facts-for-features/2016/cb16-ff08.html (2014). Last accessed Apr 2018.

  8. Porer KE, Brennan-Ing M, Chang S, et al. Providing competent and affirming services for transgender and gender non-conforming older adults. Clin Gerontol. 2016;39(5):366–88.

    Article  Google Scholar 

  9. Flores AR, Herman JL, Gates GJ, Brown TNT. How any adults identify as transgender in the United States? Los Angeles. The Williams Institute: CA; 2016.

    Google Scholar 

  10. Espinoza R. Out and visible: the experiences and attitudes of lesbian, gay, bisexual, and transgender older adults, ages 45–75. Services and Advocacy for Gay Lesbian Bisexual Transgender (SAGE) 2014.

    Google Scholar 

  11. Parent MC, DeBlaere C, Moradi B. Approaches to research on intersectionality: perspectives on gender, LGBT, and racial/ethnic identities. Sex Roles. 2013;68:639–45.

    Article  Google Scholar 

  12. Nadal KL, Davidoff KC, Davis LS. A qualitative approach to intersectional microaggressions: understanding influences of race, ethnicity, gender, sexuality, and religion. Qual Psychol. 2015;2(2):147–63.

    Article  Google Scholar 

  13. Carroll L. Therapeutic issues with transgender elders. Psychiatr Clin N Am. 2017;40:127–40.

    Article  Google Scholar 

  14. Aldwin CM, Igarashi H, Gilmer DF, Levenson MR (2013) Health, illness, and optimal aging: biological and psychological perspectives, 2nd ed. New York: Springer Publishing Company; 2013.

    Google Scholar 

  15. Van Wagenen A, Driskell J, Bradford J. I’m still raring to go: successful aging among lesbian, gay, bisexual, and transgender older adults. J Aging Stud. 2013;27:1–14.

    Article  PubMed  Google Scholar 

  16. Diewald M, Mayer KU. The sociology of the life course and life span psychology: integrated paradigm or complementing pathways? Adv Life Course Res. 2009;14:5–14.

    Article  Google Scholar 

  17. Bonanno GA, Westphal M, Mancini AD. Resilience to loss and potential trauma. Annu Rev Clin Psychol. 2011;7:511–35.

    Article  PubMed  Google Scholar 

  18. Smith BW, Tooley EM, Christopher PJ, Kay VS. Resilience as the ability to bounce back from stress: a neglected personal resource? J Posit Psychol. 2010;5(3):166–76.

    Article  Google Scholar 

  19. Porter KE, Oala CR, Witten TM. Transgender spirituality, religion, and successful aging: findings from the Trans Metlife Survey. J Relig Spirit Aging. 2012;25:112–38.

    Article  Google Scholar 

  20. Witten TM. End of life, chronic illness, and trans-identities. J Soc Work End Life Palliat Care. 2014;10:34–58.

    Article  PubMed  Google Scholar 

  21. Grant JM, Mottet LA, Tanis J, et al. Injustice at every turn: a report of the national transgender discrimination survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2011.

    Google Scholar 

  22. When health care isn’t caring? Lambda legal survey on LGBT people and people living with HIV; 2010.

    Google Scholar 

  23. Adams M, Tax AD. Assessing and meeting the needs of LGBT older adults via the Older Americans Act. LGBT Health. 2017;4(6):389–93.

    Article  PubMed  Google Scholar 

  24. Johnson L, Shipperd JC, Walton H. The psychologist’s role in transgender specific care with US veterans. Psychol Serv. 2016;13(1):69–76.

    Article  PubMed  Google Scholar 

  25. Puckett JA, Cleary P, Kinton R, Mustanski B, Newcomb ME. Barriers to gender affirming care for transgender and gender non-conforming individuals. Sex Res Soc Policy. 2018;15:48–59.

    Article  Google Scholar 

  26. Haider AH, Schneider EB, Kodalek LM, Adler RR, Ranjit A, et al. Emergency departmental query for patient-centered approaches to sexual orientation and gender identity: the EQUALITY study. JAMA Intern Med. 2017;177(6):819–28.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Maragh-Bass AC, Torain M, Adler R, Ranjit A, Schneider E, et al. Is it okay to ask: transgender patient perspectives on sexual orientation and gender identity collection in healthcare. Acad Emerg Med. 2017;24:1–13.

    Article  Google Scholar 

  28. Chochinov HM, McClement S, Hack T, Thompson G, Dufault B, Harlos M. Eliciting personhood within clinical practice: effects on patients, families, and health care providers. J Pain Symptom Manag. 2015;49(6):974–80.

    Article  Google Scholar 

  29. Mahan RJ, Bailey TA, Bibb TJ, Fenney M, Williams T. Drug therapy for gender transitions and health screenings in transgender older adults. JAGS. 2016;64:2554–9.

    Article  Google Scholar 

  30. Ettner R. Care of the elderly transgender patient. Curr Opin Endocrinol Diabetes Obes. 2013;20:580–4.

    Article  PubMed  Google Scholar 

  31. Tazaiux M, Swaab DF, Bakker J. Sex differences in the neurokinin B system in the human infundibular nucleus. J Clin Endocrinol Metab. 2012;97:2210–20.

    Article  Google Scholar 

  32. Sherbourne Health Centre. Guidelines and protocols for comprehensive primary health care for trans clients. http://sherbourne.on.ca/guidelines-protocols-for-trans-care/. Last accessed 3 May 2018.

  33. The World Professional Association for Transgender Health (WPATH). https://www.wpath.org/publications/soc. Last accessed 3 May 2018.

  34. The University of California San Francisco (UCSF) Center of Excellence for Transgender Health. http://www.transhealth.ucsf.edu/trans?page=guidelines-home. Last accessed 3 May 2018.

  35. Shell JA. Sexual issues in the palliative care population. Semin Oncol Nurs. 2008;24:131–4.

    Article  PubMed  Google Scholar 

  36. Bober SL, Recklitis CJ, Bakan J, et al. Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention. J Sex Med. 2015;12:189–97.

    Article  PubMed  Google Scholar 

  37. Chung E, Brock G. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. J Sex Med. 2013;10(Suppl1):102–11.

    Article  PubMed  Google Scholar 

  38. Griebling TL. Sexuality and aging: a focus on lesbian, gay, bisexual, and transgender (LGBT) needs in palliative and end of life care. Curr Opin Support Palliat Care. 2016;10:95–101.

    Article  PubMed  Google Scholar 

  39. Lawton A, White J, Fromme EK. End of life and advance care planning considerations for lesbian, gay, bisexual, and transgender patients. J Palliat Med. 2014;17:106–8.

    Article  PubMed  Google Scholar 

  40. Stausmire JM. Sexuality at the end of life. Am J Hospice Palliat Care. 2004;21:33–9.

    Article  Google Scholar 

  41. LGBT older adults in long term care facilities: stories from the field. SAGE, Lambda Legal, and National Senior Citizens Law Center collaboration. https://www.diverseelders.org/resource/lgbt-older-adults-in-long-term-care-facilities-stories-from-the-field/ (2011). Last accessed 3 May 2018.

  42. Arthur DP. Social work practice with LGBT elders at the end of life: developing practice evaluation and clinical skills through a cultural perspective. J Soc Work End Life Palliat Care. 2015;11(2):178–201.

    Article  PubMed  Google Scholar 

  43. Rawlings D. End-of-life care considerations for gay, lesbian, bisexual, and transgender individuals: case study. Int J Palliat Nurs. 2012;1(18):29–34.

    Article  Google Scholar 

  44. Metlife Mature Market Institute. Still out, still aging: the Metlife study of lesbian and gay baby boomers. https://www.tandfonline.com/doi/full/10.1080/15504280903472949?scroll=top&needAccess=true (2010). Last accessed 3 May 2018.

  45. Cartwright C, Hughes M, Lienert T. End-of-life care for gay, lesbian, bisexual, and transgender people. Cult Health Sex. 2012;14(5):537–48.

    Article  PubMed  Google Scholar 

  46. Hughes M, Cartwright C. LGBT people’s knowledge of and preparedness to discuss end-of-life care planning options. Health Soc Care Community. 2014;22:545–52.

    Article  PubMed  Google Scholar 

  47. Aging with dignity: five wishes. https://agingwithdignity.org/docs/default-source/default-document-library/product-samples/fwsample.pdf?sfvrsn=2. Last accessed 3 May 2018.

  48. POLST: advance care planning for the seriously ill. http://polst.org/wp-content/uploads/2018/01/2013.09.26_Final-POLST-Article.pdf. Last accessed 3 May 2018.

  49. MOLST: medical orders for life sustaining treatment. https://www.health.ny.gov/forms/doh-5003.pdf. Last accessed 3 May 2018.

  50. Stein GL, Bonuck KA. Attitudes on end-of-life care and advance care planning in the lesbian and gay community. J Palliat Med. 2001;4(2):173–91.

    Article  CAS  PubMed  Google Scholar 

  51. Harding R, Epiphaniou E, Chidgey-Clark J. Needs, experiences, and preferences of sexual minorities for end-of-life care and palliative care: a systematic review. J Palliat Med. 2012;15(5):602–11.

    Article  PubMed  Google Scholar 

  52. National Resource Center on LGBT aging. https://lgbtagingcenter.org/resources/resource.cfm?r=569. Last accessed 3 May 2018.

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Correspondence to Noelle Marie Javier .

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Javier, N.M. (2019). Geriatric Transgender Care. In: Poretsky, L., Hembree, W. (eds) Transgender Medicine. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-030-05683-4_6

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  • DOI: https://doi.org/10.1007/978-3-030-05683-4_6

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-030-05682-7

  • Online ISBN: 978-3-030-05683-4

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