The Needs of Older Trans People
Thanks to Dick Moore for providing the report and permission to reproduce many of its findings here. For more information on The 519, see their website at www.the519.org.
In July and August of 2002 the Older GLBT Programme of The 519 Church Street Community Centre collaborated with the Gay Men’s Community Development Program at ACT to host four community meetings (soundings) among people 50 years and older in various GLBT communities. The sessions aimed at providing people with an opportunity to talk about their lives as aging queers. Each sounding was for a discrete segment of the older GLBT community. This article reports the issues emerging from the soundings for MTF and FTM trans people over age 50.
Community Soundings for Trans People
The community soundings for trans men and women over fifty years of age provided an opportunity for members of the community to talk about their lives and health and to hear from others about the joys and struggles of growing older as trans men and women.
Rupert Raj, a trans man over 50 who is a well known trans activist and an experienced facilitator, led the session for trans men. Two men attended, indicating the small population of trans men over 50. Because of the size of the group, the meeting was conducted in a casual manner. Participants shared issues and concerns related to their aging and shared their own stories with one another.
Ruth Bramham, a trans woman over 50, who has experience facilitating support groups for trans people, facilitated the session for trans women. It attracted five people: two TS women, a TG woman and two gender dysphoric individuals who live as males.
FTM Community Sounding
Participants expressed a fear of insensitive, inappropriate care in their own homes or in care facilities. “The nurses and personal support workers are professional and want to provide quality care. I don’t want their first experience with a trans person to be when they give me a bath,” one participant said.
One man spoke of a phenomenon common to many aging people. He has an image of himself as young and fit. As he ages and experiences some debilitating conditions he is aware of physical changes (loss of acute eyesight, problems with balance, diminished mobility and energy) that demand adjustment of this self image.
Participants were sensitive to the differences between the experiences of trans men who transition earlier in their lives than those who transition later in life, as well as the profound differences between their experiences and needs and those of trans women.
The men also noted that gender transition is becoming a less unusual and more accepted phenomenon; the 519’s report of the sounding included the tantalizing note “There is a gap in consciousness and experience between those who transitioned in the 1970s and ’80s and those who transitioned in the ’90s and since,” further underscoring the need to go directly to trans elders to discover their needs, rather than extrapolating them from the experiences of younger trans people.
Participants noted the phenomenon of “going woodwork”: not identifying themselves as trans, and not having contact with the trans community, making them more difficult to reach. Some, however, seek out and remain within the GLBT community.
Several of the recommendations coming out of this sounding were around the need for trans-positive health care, such as the need for research into the long-term effects of hormone use, and the interaction of hormones with HIV medications.
In hospitals, nursing homes, home support agencies, and other health care facilities, they recommended training and advocacy to engender trans positive attitudes. Specifically:
Health care services and facilities need to develop and monitor the implementation of policies and protocols on informed choice, linguistic sensitivity and varied levels of literacy to ensure trans people receive sensitive and appropriate care.
Health care professionals and personal support staff require training that includes awareness of and sensitivity to the situation of transsexual people (body image, self esteem issues, hormone use, surgical and hormonal intervention, anormative appearance of genitals, etc.) and the special demands of providing personal care to them.
The sounding also had recommendations for The 519 that could be used by other community centers. The participants believe that The 519 has a responsibility to be a resource for trans people, to welcome trans people who have lost touch with the GLBT community. The trans men’s sounding also suggested that programming aimed at older trans men should be inclusive of those age 40 and older.
Regarding activities for trans communities, the trans men’s group suggested that separate trans men and women’s groups, as well as mixed trans and SOFFA, and mixed GLBT activities be organized at The 519. They suggested augmenting an existing drop-in dinner program with social activities, and inviting medical professionals to speak on transsexual issues.
MTF Community Sounding
Negative attitudes toward trans people among health care professionals was first in the list of concerns among older trans women, along with other health care issues related to their medication and complications from long-term hormone treatment.
After that, the list of concerns from the MTF community differs dramatically from those of the FTM community sounding. The participants expressed needs for support from community, family, and friends; a need for sensitive and appropriate social services; and a feeling of being an invisible minority. Additionally, the participants need protection from harassment and access to public accomodations, and encountered problems in procuring gender-appropriate identification.
To address their needs, participants recommended workshops with guest experts who would address topics of concern to trans women, and providing contacts through The 519 web site through whom trans women could inquire discreetly about resources and information. Like the trans men’s sounding, participants in the MTF community sounding recommended advocacy for research on the effects of long term hormone use and the interaction of hormones with drugs used to treat AIDS.
Issues Emerging from All of the Community Soundings
Themes common to the groups included:
- Concerns re the lack of access to sensitive, appropriate home and institutional care.
- Social isolation among different groups and the need for a range of regular opportunities to get together with groups of men and/or women of similar age range/orientation for meeting new people, discussion, education and socializing.
- Mental health issues related to non acceptance, homophobia, family disruption, self image, stress and confusion related to coming out, relationships, aging.
- Lack of acceptance and sensitivity to the needs of older members among existing GLBT organizations.
Recommendations Emerging from Community Soundings
- Advocacy with home care organizations, acute and long term care facilities related to developing, implementing and monitoring policies and protocols, staff and volunteer training. These policies, protocols training relate to anti homophobia and personal care issues.
- Development of support and counselling services for older GLBT people
- Advocacy and dialogue within existing GLBT organizations re access by older people to their programmes and services
- Advocacy for research on effects of long term use of hormones and interactions between prescribed hormones and drugs used in the treatment of AIDS.