Long-Term Care Expectations and Plans of Transgender and Nonbinary Older Adults.

Abstract

Transgender and nonbinary (TNB) older adults endure discrimination from medical providers and expect it in institutional long-term care. Gender identity-based discrimination is connected to negative health outcomes and reluctance to access needed care. The aim of this study is to explore how gender identity affects TNB older adults' fears, hopes, and plans for use of institutional long-term care. Co-investigators conducted semi-structured interviews with 24 TNB older adults in Minnesota, collaboratively analyzed the results using reflexive thematic analysis, and member-checked emergent themes. Oppression is central to participants' consideration of future long-term care. They fear mistreatment and loss of authentic gender expression and recognition in long-term care facilities. Fears of oppression factor into consideration of suicide and physical transition, although some participants hope societal shifts will lead to unbiased long-term care. Creation of anti-oppressive institutional and community-based long-term care options is critical to effectively serve TNB people as they age into dependence.