Abstract
AbstractWe carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.
Highlights
The literature on the challenges faced by trans1 people when requiring health and social care has increased over the last 10 years
Seventeen papers originated from the United States of America (USA), four from Australia, four from Canada and four from Europe
We located relatively few papers focused on older trans adults and fewer papers still originated from the United Kingdom (UK)
Summary
The literature on the challenges faced by trans people when requiring health and social care has increased over the last 10 years. A review and synthesis of peer-reviewed recent literature (2008–2014) about transgender health identified 116 studies in 30 countries (Reisner et al, 2016). The topics considered in the review include: access to health care and marginalisation (Ming et al, 2016; Winter et al, 2016a), clinical care considerations (Wylie et al, 2016), issues of global health burden and equity (Lo and Horton, 2016; Reisner et al, 2016), the connection between trans This paper focuses on what is known about older trans adults and their experiences of health and social care
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