Ageing is a universal experience, but various factors, including gender, profoundly influence the journey. For cisgender and transgender women, ageing brings a distinct set of challenges and opportunities that shape their experiences in unique ways. Understanding these nuances is essential in creating supportive environments that address the specific needs and concerns of older adults of diverse genders.
My Personal Story: Bridging the Gap
I am Cynthia Fortlage, a 58-year-old transgender woman who transitioned in my early 50s. My story encapsulates the complex interplay between gender and ageing. After living most of my life as a man, I finally embraced my true identity and began my transition journey. This significant change in my later years brought liberation and new challenges.
Navigating healthcare became a nuanced task. As I aged, I faced typical health concerns like managing cholesterol and monitoring bone density. Additionally, due to a medically induced reduction in hormone therapy, I experienced menopausal-like symptoms. The added layer of gender-affirming hormone therapy required finding a healthcare provider knowledgeable about both geriatric care and transgender health. My experience underscores the importance of inclusive and competent healthcare systems that understand the unique needs of older transgender individuals.
The Intersection of Gender and Ageing
As individuals age, their experiences of gender can be reshaped by numerous factors, including societal attitudes, healthcare systems, and personal relationships. For both cisgender and transgender women, ageing often involves navigating societal roles and expectations. Traditionally seen as caregivers, older women might struggle with identity as their caregiving roles diminish or change. Additionally, they face gendered ageism, which combines the prejudices of sexism and ageism, leading to a devaluation of their contributions and a disregard for their needs​ (Oxford Academic).
Transgender women encounter these issues compounded by transphobia. Ageing can bring heightened visibility in a world that may still hold prejudices against gender diversity. For those who transition later in life, the ageing process can coincide with the early stages of their gender affirmation journey, presenting unique challenges related to healthcare, legal recognition, and social acceptance​ (Oxford Academic)​​ (Women's Brain Health Initiative).
Healthcare Needs and Access
Older adults, in general, have increasing healthcare needs as they age, but gender plays a crucial role in shaping these needs and access to appropriate care. Both cisgender and transgender women require specialised care related to menopause, osteoporosis, and other gender-specific health issues. However, the medical community sometimes overlooks the unique needs of ageing women, leading to inadequate support​ (Oxford Academic)​​ (Brain Canada Foundation).
Studies show that long-term gender-affirming hormone therapy in transgender women can have significant impacts on cognitive and brain health, necessitating careful management by informed healthcare providers​ (Women's Brain Health Initiative)​​ (SpringerLink)​.
For transgender women, accessing healthcare can be fraught with additional barriers. They may face discrimination or a lack of knowledgeable providers, particularly regarding gender-affirming care. Hormone replacement therapy (HRT), for example, requires careful management as individuals age, necessitating medical professionals who understand the intersection of ageing and transgender health. The fear of discrimination can also lead to avoidance of medical care, exacerbating health issues that could have been managed or prevented with regular treatment​ (Brain Canada Foundation)​​ (Women's Brain Health Initiative)​.
Social and Emotional Well-Being
The social dynamics of ageing can significantly impact emotional well-being, and these dynamics are often influenced by gender. Older women might experience social isolation due to the loss of spouses or partners, children moving away, or retirement from work. Community engagement and social support networks are vital in mitigating these effects, but ageism can hinder these opportunities​ (Oxford Academic)​​ (Brain Canada Foundation)​.
Transgender and gender-diverse older adults often face compounded isolation. Many may have experienced rejection from families or communities earlier in life, which can persist or worsen with age. Creating inclusive social spaces and ensuring access to affirming care and community support are crucial in addressing these issues. Peer support groups and organisations that cater specifically to older trans+ individuals can provide much-needed connections and reduce feelings of isolation​ (Oxford Academic)​​ (Brain Canada Foundation)​.
Financial Stability and Employment
Economic security is another critical concern for ageing adults, with significant gender disparities. Older women are more likely to face financial instability due to a lifetime of gender pay gaps, interrupted careers for caregiving, and longer life expectancies. Ensuring access to pension benefits, affordable housing, and employment opportunities for older adults can help alleviate some of these financial pressures​ (Oxford Academic)​​ (Brain Canada Foundation)​.
For me, the challenges extended to the job market. After transitioning, I spent 18 months submitting applications for roles I felt qualified for based on my extensive experience. Despite my efforts, I received only three interviews, none of which resulted in a job offer. Two interviews revealed a mismatch between the job descriptions and what the employers were looking for. This left me pondering whether my lack of job offers was due to my gender, age, being trans+, or a combination of these factors. As no one was willing to provide feedback, I could only assume that multiple intersecting forms of discrimination were at play.
Transgender individuals often face even more significant financial challenges. Discrimination in employment, lower earning potential, and the high costs of gender-affirming treatments can leave trans+ individuals particularly vulnerable as they age. Policies that promote employment non-discrimination, support for transitioning in the workplace, and access to financial assistance programmes are essential in addressing these disparities​ (Oxford Academic)​​ (Brain Canada Foundation)​.
Moving Forward: Creating Inclusive Support Systems
It is imperative to foster inclusive support systems at all levels of society to address the unique needs and concerns of older adults of diverse genders. Healthcare providers must be trained to understand and respect the specific health needs of cisgender and transgender women. Social services and community programmes should prioritise creating safe and welcoming spaces for older adults, regardless of gender identity​ (Oxford Academic)​​ (Brain Canada Foundation)​.
Policymakers must also play a role by enacting and enforcing laws that protect against discrimination and promote equal access to resources. Public awareness campaigns can help combat ageism and transphobia, shifting societal attitudes towards greater acceptance and inclusion​ (Oxford Academic)​​ (Brain Canada Foundation)​.
In conclusion, the experiences of ageing are deeply intertwined with gender, shaping the unique needs and concerns of older adults. By recognising and addressing these nuances, we can create a society that supports and values individuals of all genders throughout their lives.
Cited Studies
"Gendered Ageism and Health: Examining the Link Between Ageism, Gender and Health Outcomes in Older Adults" - Journal of Aging Studies.
"Brain and Cognitive Effects of Long-Term Gender Affirming Hormone Therapy in Aging Trans Women" - Brain Canada Foundation​ (Women's Brain Health Initiative)​​ (SpringerLink)​.
"Experiences of Ageing in Transgender Individuals: Addressing the Intersection of Gender and Age" - Journal of Gerontological Social Work.
"Healthcare Barriers and Disparities for Transgender Individuals: A Comprehensive Review" - American Journal of Public Health.
"Economic Insecurity in Older Women: The Impact of Lifelong Gender Disparities" - The Gerontologist.