Index

Publication Date:
19 Jul 2024
Pages:
226–232
DOI:
https://doi.org/10.51952/9781447370048.bm001
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Gender diversity is becoming increasingly visible within society, with more trans, non-binary and gender diverse people coming forward throughout the life course. In settings such as social care, welfare services, housing and associated health disciplines, practitioners and service providers will see an increasing number of trans and non-binary service users as more trans people ‘come out’ and existing trans populations age.

Drawing upon theoretical perspectives from social gerontology, as well as contemporary research and the direct lived experience of older trans and gender diverse people, the book focuses on practical support for ageing trans, non-binary and gender diverse people, with an emphasis on person-centred care. Expertise is contributed by scholars from a range of disciplines, with particular attention to the scholarship of trans, non-binary and gender diverse people.

The book is aimed at professionals and practitioners working internationally in a range of public and social welfare services for older people, as well as students training for such roles, and educators involved in delivering professional training. Each section concludes with practical learning activities, designed to support professional practice.

A

abuse, intimate and domestic 152–153
barriers to accessing services 160–162
barriers to help seeking 159–160
domestic abuse recognition and identification 157–159
epistemological, political and social context 155–157
influencing and shaping practice 162–164
structural barriers 162
violence against trans people 153–155
acceptance 81
accessibility 108, 141, 142, 158
see also surgery
acrimony 84
activism (activists) 63, 100, 183
activities 85, 97
advocacy 19, 162
ageing, after surgery 139
ageing and care, trans, current situation 1
demographics 5–6
gender diversity and life course 6–7
practical issues 8–9
terminology 2–5
ageing, research studies evidence 15–18, 33–34
ageing and preparedness 32–33
health services and barriers 31–32
lives and trajectories 23–24
mental health, social support and inequalities 30–31
observation from datasets 20–23
physical health and inequalities 29–30
publication trends and study designs 24–29
stigma and violence 32
theoretically driven guidance 18–20
ageing, trans masculine 91–93, 100–103
autoethnographic account 96–99
COVID-19, wellbeing and body image 99–100
introspective approach to current literature 95–96
literature limitations 94–95
trans gerontological literature 93–94
Ageing with Pride Study 28
ageism 135–137
agency 19, 69, 161
Ahmend, A. 191
Almack, Kathryn 8, 222
anatomical reconstruction 139–140
animals, companion 160
Ansara, Y.G. 2
anxieties 100, 109
assumptions 125, 126
austerity 34, 72
Australia 85, 108, 206
Authentic Equity Alliance (AEA) 156
authentic self 195, 199
autoethnography 102
autonomy 140–141
avoidance, healthcare 47

B

Baril, A. 195
Barker, M. 197
barriers 6, 31–32, 52, 135, 209
to accessing services in DA 160–162
ageing bodies 93
to help seeking in DA 159–160
professionals 107–108
structural 162
Bartholomaeus, C. 111
Behavioural Risk Factor Surveillance System (BRFSS) 21, 28
Benjamin, Harry 182
Bentham, Jeremy 193
bias 34, 137
body image 99–100
Bornstein, D.R. 160
Bouman, W.P. 31, 68, 78
Brazil 154
British Journal of Psychiatry 186
Brown, N.T. 156
bullying 158

C

Caceres, B.A. 191
Callahan, Evelyn 8, 15, 67, 77
campaigning 69–72
Canada 206
care 69–72, 137
see also health services
care building and refusing  see non-agreement
care environments 158
care facilities 143–144
care, informal 81
care services 161, 198
care settings, dementia 193–196
Castle, Elijah R. 7, 221
Cauldwell, David O. 182
Census, UK 2021 22–23
Charlson comorbidity index 138
children 8, 50–51, 79–80, 84
cis (cisgender), definition 2
cisgenderism, definition 2
cisnormative, definition 2
class, social 101
coercive queering 6
collaborations 138, 188
colonisation 6
coming out 83
communications 84, 199
communities 22, 184, 223
practice perspectives 63, 69–72, 86, 141–142
Comprehensive personalised Care Model 205
compromise 84
confidence 130
trans clients 111–112
conflicts 200
consent, informed 44, 109
consequences 84
conversion therapy 22, 49, 109
Cook-Daniels, L. 163
cost-of-living crisis 34
costs 69
counselling 83, 163
COVID-19 pandemic 16–17, 30, 34, 72, 85, 99–100
Cox, Laverne 65
Crenshaw, K. 192
criminalisation 4
culture 3
curriculum, trans-inclusive 116–117

D

dam bursting 51
DASH checklist 163–164
data 115, 134, 137, 139–140, 143, 153
data collection 5–6
datasets 20–23, 62, 81, 109
death 84, 114, 209–210
death, premature 62
dementia 41, 94–95, 114, 186, 200, 223–224
see also neutrality, gender
demographics 5–6
depression 79
deprivation 206
determination, personal 69
diagnostic criteria 186–187
dialogues 93
digital literacy 141, 223
dignity 141
disability 97, 101, 154, 159, 163
discrimination 8
abuse 159, 160–162
ageing bodies 93
families 79–80, 86
inclusivity 192, 197, 206, 208
professionals 108, 117
refusing care 62
research 19, 32, 46
surgery 136
Sweden 120
diseases, noncommunicable 32
disenfranchisement, societal 136
disparity 34
diversity 91, 208, 221
gender 3
divorce 8
domestic abuse (DA)
definition 153
see also abuse, intimate and domestic
dysphoria 47, 101, 158

E

education 101, 142
Ellis, Carolyn 96, 102
embodiment 99
embodiment, gendered 135–137
encouragement 46
end-of-life care 204–205
conclusion and future research 210–211
research 205–210
energy levels 97
English Longitudinal Study of Ageing (ELSA) 16, 20
enhanced recovery after surgery (ERAS) protocol 138
Equalities Office LGBT survey 78
equality 127–128, 179
Equality Act (2010) 62, 114, 156
Equality and Human Rights Commission 156–157
equitable access  see surgery
equity 91
estrangement, family 85
ethnic groups 30, 211
European Commission 120
exclusion 64, 161, 162, 206
exclusion, socioeconomic 8
expectations 43
experiences 61, 85
conceptualising trans 183–184
medical and social transition 184–185
naming trans 182–183

F

Fabbre, Vanessa D. 42, 51, 63, 188
familiarity, trans people and issues 111–112
families 50, 77–78, 85–87, 198
abuse 157, 162
insights 81–84
parenting 78–81
surgery 142
fat deposits 97, 98
fears 94, 120, 159, 162, 195, 198
finances 206
financial privilege 101
FORGE project 162–163
Foucault, M. 193, 195, 199
fragmentation 71
frailty 138
Fredriksen-Goldsen, K.I. 19, 31
friends 85
funding 71, 72

G

gaps 34, 94, 108
Trans Ageing and Care (TrAC) study 110–116
gaps, knowledge 33
gaslighting 158
gatekeeping 64, 96, 101
gender 52, 184
Gender Affirmation framework 20
gender diversity 62, 192
life course 6–7
gender expression 194, 199
gender identities 5, 99, 108, 158, 197, 208
families 78–79, 81, 85–86
Sweden 121, 128, 131
see also neutrality, gender
gender identity clinics (GICs) 43, 186
gender inversion 184
Gender Minority Stress Framework (GMSF) 18
gender-non-conformity 182
see also neutrality, gender
Gender Recognition Act (2004) 113, 116, 210
Gender Recognition Certificate 113–114, 156, 210
generativity 86
Global North 3, 62
Global Social Work Statement of Ethical Principles 123
Global South 5
globalisation 6
Golub, S.A. 137
Government Equalities Office 21
grandchildren 83, 84
grandparents 78
groups 141, 159
Guadalupe-Diaz, X.L. 160
guidance 18–20
guidelines 116, 122, 127
gynecomastia 92

H

Hafford-Letchfield, Trish 9, 198, 223
hair removal 47–48
Harding, R. 206
Harper, Phil 8, 191, 196, 198
Harris, J.K. 29
hate crimes 162
health 6, 7, 20, 96, 120
Health and Retirement Survey 20
Health Equity Promotion Model 19
health outcomes 85
health services 31–32, 198
experiences 66–69
healthcare 8, 87, 93, 96, 107–108, 134
healthcare navigation 41–42
hair removal 47–48
HRT 44–45
screenings 45–47
surgery 48
transitioning later in life 48–52
waiting times 42–44
healthcare providers 31
Henry, R.S. 33
Herman, J.L. 156
heteronormativity 193
Heyam, Kit 7
Hillman, J. 32, 154–155
Hirschfeld, Magnus 182
history, trans 179–180, 187–188
changing terminology, concepts and experiences 180–185
production of realness 185–187
homelessness 80, 159
homes 153
homicides 153
homogenisation 181
honesty 84
honour-based abuse 157
Hospice UK 210
hospitalisations 155
housing 143, 159
Howerton, I. 29
HRT 44–45
Human Dignity Trust 4

I

identities 19, 28, 49, 158–159, 186–188, 206
ageing bodies 93, 95, 97
gender neutrality 191–192, 196, 201
see also gender identities
implants 140
inclusion 91
incomes 80, 160
independence 32, 140
inequalities 162, 205
financial 141
inequities 159
information 49–50, 110–111, 163, 207–208
surgery 134, 137, 142
information sharing 64
informed consent 44, 109
insecurities, professional 126–127, 130
insecurity 206
institutions 125, 136, 139, 140
Integrating care for Trans Adults (ICTA) project 41–42
internet 64, 223
intersectionality 163, 206, 211
ageing bodies 93–95, 100, 102
gender neutrality 191–192, 196
intersex 183–184, 186
interventions 163
interviews 41, 121–122, 124
intimate partner violence (IPV) 152
definition 153
see also abuse, intimate and domestic
intracommunity support 141–142
inversion 184
invisibility 116, 130, 152
Iridescent Life Course framework 19
isolation
abuse 159
ageing bodies 94
end-of-life care 206, 208
families 85
refusing care 65
surgery 140

J

Jordan, S.P. 161, 162

K

Kimberly, Laura L. 7, 221
Kitwood, T. 197
Klein, A. 137
Kneale, Dylan 222
knowledge 33
families 86
inclusivity 179, 193
professionals 108–109, 117
refusing care 69, 73
surgery 137, 142
Sweden 124–128, 130–131
trans issues in later life 112–115
Koob, R.M. 196

L

language
abuse 161
ageing bodies 99
gender neutrality 193, 196–197
professionals 110
Sweden 124, 126, 129
Lawler, S. 194
legal interventions 161
legal issues 117
legislation 87, 122, 127, 128
lesbian, gay, bisexual, transgender, queer and others (LGBTQ+) 15, 16–17, 19, 34, 61, 121
Lickert scale 111
life course theory 19
limitations 100
literacy, digital 141
literature 80, 155, 198, 205
introspective approach 95–96
limitations 94–95
trans gerontological 93–94
lives and trajectories 23–24
loneliness 84, 85, 159, 160
long-term care 140–141
longevity 15

M

magazines 64
malignant social psychology (MSP) 197
marginalisation 5, 16, 208
practices 63, 94, 102, 136
marriage 51
masculinity 92–93
mask wearing 100
McCormack, Keira 223
measures, validated 109
media 111, 116, 157, 186
medical treatments 95
menopause 44
mental health (illness) 62, 84, 94, 120, 155, 158
Messinger, A.M. 154
micro-aggressions 94, 96, 99, 163, 196–197
military service 30
minorities 17, 30
misgendering 91–92
Mollitt, P.C. 109
Morgan, Deborah 8
Morgan, L.M. 3
mortality 85

N

Nadal, K.L. 197
names 62
Nash, Adrienne 185
National Health Service (NHS) 45, 66–67, 68, 205
National Institute for Health research 41
National LGBT Survey 33
National Palliative and End of Life Care Partnership 204
National Surgical Quality Improvement Program (NSQIP) 138
navigation  see non-agreement
negotiations 84
networks 64, 71, 72, 161, 208–209, 221
neutrality 187
neutrality, gender 190–191
dementia care settings and power 193–196
impact of incorrect terminology and language 197
micro-aggressions and language 196–197
professionals working 198–199
recommendations 199–201
translocational positionality, intersectionality and identity 191–192
Nokoff, N.J. 31
non-agreement 72–73
experiences of community, campaigning and care 69–72
experiences of formal health services 66–69
transition pathways and possibilities 64–66
vulnerability, robustness and resilience 62–64
writing about trans ageing 61–62
non-binary, definition 2
nursing homes 140, 144, 155

O

offence, causing 129
Office for National Statistics 22
online groups 223
online platforms 142
online spaces 64, 134, 141
oppression 16, 19, 136, 181
ageing bodies 93, 95, 100
organisations 123, 130, 131
non-profit 121
othering 141, 208

P

palliative care
definition 204–205
see also end-of-life care
Pang, C. 141, 208
parenting 78–81
see also families
participants 22
partners 157, 198
partnerships 72
passing 154
Pearce, R. 7, 43, 64
peers 141, 159
pensions 114
persecution, state 62
police encounters 161
polycythaemia 69
poverty 80, 120, 206
power 193–196, 199, 201, 224
Power of Attorney 114
practical issues 8–9
practices, professional 179
precarity 71
prejudice 64, 79, 194
preparedness 32–33
professional 124, 130
see also Sweden
prisons 193
privacy 124, 156
professionalism 123, 130
professionals 4
ageing bodies 93–94, 99–102
families 80–81, 86
gender neutrality 191, 198–200
refusing care 72
Sweden 122–123
see also views and attitudes, professional
pronouns 4, 99, 158, 186, 200–201, 219
Sweden 125, 129–130
protection 130
protection, legal 62
protocols 67
public records 156
public spaces 160
publication trends and study designs 24–29

Q

queer joy 222
questionnaires 109, 110, 127

R

realness, production of 185–187
recognition, legal 8
record keeping 52, 207
recovery 138
reflection 123
critical 224
rejection 9, 86, 160
relationships 9, 63, 97, 180, 209
abuse 152, 155, 159–160
see also families
reporting 143
research 6, 8, 86
abuse 155, 157, 163
end-of-life care 205–210
future, end-of -life care 210–211
surgery 137, 143
see also ageing, research studies evidence
resilience 19, 62–64, 69, 72, 86, 222
resistance 63, 129, 162
resources 122, 131, 160
financial 86, 134
respect 158
retirement 8
Richards, C. 197
Riggs, D.W. 111
robustness 62–64
Rogers, M.M. 157, 161, 191
Royal College of General Practitioners 107, 115

S

safe spaces 131, 161, 200
safety 157
sample sizes 28
SaveLives 163
scholarship 188
Schultz, J.W. 159
screenings (screening services) 32, 45–47, 163
self-definition 181, 187
self-determination 99, 187
self-disclosure 187
self-esteem 160
self-medication 64, 68
self-realisation 66
self-reflexivity 131
self-regulation 193–194
self-reliance 160
self, sense of 158
separation 8
Serano, Julia 91
services 161
settings 196, 200, 207
social work 124–125
sexual wellbeing 222
sexuality 136, 184, 186, 197
shame 103, 157, 159
shelters 160
Silverman, M. 195
Smolle, Sofia 8
social care 87, 107–108
social inclusion 69
social media 116
social networks 84, 142
social policies 85
social services 93
Social Services Act (2001) 121
social stressors 18
social support 20, 31–32
see also families
social work (workers) 87, 109
Sweden 123–129
societies 81
spaces 156
stakeholder 81
standards 116
stealth imperative 183–184
stereotypes 64, 125, 135–136, 142, 161
stigmatisation 32
abuse 152
families 79–80
gender neutrality 198
professionals 117
surgery 136–137
Sweden 120
Stonewall 15
strategies, social work 127–129
stress 163
minority 86
stress, minority 96
stressors 160
structures, societal 128
studies 78, 79, 130, 137, 161
study designs 24–29
substance abuse 155
suicide 80, 155
support 125, 127, 131, 183
support groups (networks) 64, 69–72, 73, 141, 144, 208–209
support systems 50
surgery 48, 67, 134–135, 142–144
ageing bodies 92–93, 99–102
community support 141–142
gender-affirming surgery and long-term care 140–141
gender-affirming surgery in older age 137–140
gendered embodiment and ageism 135–137
surveillance 193
surveys 41, 78, 107, 110, 154, 156
see also Trans Ageing and Care (TrAC) study
Sweden 109, 120
context 121
profession and professionalism 122–123
social work 123–129
the study 121–122
what can we learn? 129–131

T

Tan, K.K.H. 18
Transgender Resilience Intervention Model 19
technologies 100, 223
assistive 138–139
terminology 2–5, 182, 197
testimonies, personal 187
therapists 109
threats 158
Towle, E.B. 3
Toze, Michael 30, 77, 94, 97
training 137, 163, 181
training, professional 115–116, 117, 121
Trans Ageing and Care (TrAC) study  see views and attitudes, professional
trans and gender non-binary (TGNB) 85
trans and gender non-conforming (TGNC) 85
trans, definition 2
trans men, definition 2
Trans MetLife Survey 28
Trans Murder Monitoring (TMM) project 153
Trans Safety Network 210
trans time 181
trans women, definition 2
transgender 182
Transgender Emergence Model 20
transitioning 43
families 81, 83
inclusivity 135, 186, 206, 208–209
later in life 48–52
refusing care 64–66
social 4
translocational positionality, intersectionality and identity 191–192, 196
transsexual 182–183
transvestite 182–183
traumas 102, 155, 156, 163, 222
trust 121, 137, 161

U

UK Household Longitudinal Study (UKHLS) 21
uncertainty 68
underfunding 20
understanding 128, 130
Understanding Society 21
see also UK Household Longitudinal Study (UKHLS)
unemployment 80, 160
United Kingdom (UK) 34
abuse.  see abuse, intimate and domestic
end-of-life care 204, 206
families 78, 85
professionals 107
refusing care 62, 66, 72
United States of America (US) 34, 62, 134
abuse 154, 162–163
inclusivity 184, 206

V

Vaccaro, A. 196
variables 17
demographic 109
Velocci, Beans 185
Vicente, Marta V. 181
victimisation 32, 160
videoconferencing 100
views and attitudes, professional 107–108
ascertaining gaps 110–116
background to study 108–109
survey design and respondents 109–110
trans-inclusive curriculum 116–117
Vincent, B. 196
violence 32, 83, 94, 152
in DA 153–155
violence, social 93
visibility 125, 160
volunteers (voluntary sector) 72, 81
vulnerability 80, 120, 138
abuse 154–155, 159
end-of-life care 206, 208
refusing care 61, 62–64

W

waiting times 42–44
Walker, R.V. 31
wellbeing 6, 108, 121, 160
ageing bodies 99–100
families 80, 85
Welsh Gender Services 116
Westwood, S. 155, 209
White, Francis Ray 97, 98, 99
Willis, Paul 206, 208
Witten, T.M. 6, 32–33, 63–64, 198, 204, 206
work methods, social work 127–129
work pressures 51
workforce 200
World Health Organization (WHO) 136, 204
World Professional Association for Transgender Health 116
wound healing 138

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