8: Gender-affirming surgery in later life: centring older adults’ perspectives to promote equitable access and person-centred surgical care

Publication Date:
19 Jul 2024
Pages:
134–151
DOI:
https://doi.org/10.51952/9781447370048.ch008
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Pre- and postoperative considerations for older transgender and gender diverse (TGD) people seeking gender-affirming surgery are often overlooked. In this chapter, we examine how older age impacts pathways to gender-affirming surgery, the experience of surgery and postoperative surgical and psychosocial outcomes. We address perceptions of older adults’ appropriateness for surgical candidacy based on assumptions about sexuality in older adults, patient preferences and postoperative outcomes, resulting in both inequitable access to surgical procedures and minimal outcomes data for this population. Financial resources, adequate health education and information specific to healthcare and sexuality for older TGD individuals present additional factors influencing equitable access. We also explore how insufficient trans competency in various care-based settings can impede access to surgery and compromise postoperative care. Finally, we examine the role of social support for older TGD individuals and identify best practices for supporting older gender-affirming surgical candidates before, during and after gender-affirming surgery.

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