2: “I need to get on with it”: experiences of older trans people navigating healthcare

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This chapter will discuss the healthcare needs and experiences of older trans and gender diverse (including non-binary) people in the UK, drawing upon empirical qualitative data collected through the Integrating Care for Trans Adults project, conducted at the Open University from 2019 to 2021. This project included an exploration of the unique health challenges faced by older trans people with transition-related and non-transition-related healthcare. These data comprise 33 semi-structured interviews with participants ranging in age from 51 to 82 years old. A major theme we unpacked was the concept of waiting – especially waiting for gender-affirming care and managing a sense of ‘time running out’. A wide range of overlapping and specific considerations for the healthcare of trans elders were explored, including hormone replacement therapy, healthcare screening programmes, hair removal limitations, surgery later in life and plans and concerns about social care. Consideration of trans elders requires a nuanced consideration of time, as an individual trans elder may have transitioned historically, or recently, such that one is young in ‘trans time’. Most of the participants in this study transitioned relatively recently and so reflected on the mental, physical and social challenges transition as an elder specifically created. The participants in this study discussed the factors posing barriers to transition earlier in life and lack of access to information. All participants reported transition as a positive life step, and although many wished they had transitioned sooner, this was not a universal sentiment.

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