Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population

Purpose: This study is one of the first to examine the physical and mental health of transgender older adults and to identify modifiable factors that account for health risks in this underserved population. Design and Methods: Utilizing data from a cross-sectional survey of lesbian, gay, bisexual, a...

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Bibliographic Details
Published in:The Gerontologist 2014-06, Vol.54 (3), p.488-500
Main Authors: Fredriksen-Goldsen, Karen I., Cook-Daniels, Loree, Kim, Hyun-Jun, Erosheva, Elena A., Emlet, Charles A., Hoy-Ellis, Charles P., Goldsen, Jayn, Muraco, Anna
Format: Article
Language:English
Subjects:
Aging
Data Collection
Elderly
Gender identity
Health
Health Problems
Health risk assessment
Health Status
Humans
Mental Health
Middle Aged
Older people
Risk
Risk Factors
Sex Role Identity
Social support
Stigma
Stigmatization
Stress
Transgender Persons
Transsexuality
Victimization
Vulnerable Populations
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Summary:Purpose: This study is one of the first to examine the physical and mental health of transgender older adults and to identify modifiable factors that account for health risks in this underserved population. Design and Methods: Utilizing data from a cross-sectional survey of lesbian, gay, bisexual, and transgender older adults aged 50 and older (N = 2,560), we assessed direct and indirect effects of gender identity on 4 health outcomes (physical health, disability, depressive symptomatology, and perceived stress) based on a resilience conceptual framework. Results: Transgender older adults were at significantly higher risk of poor physical health, disability, depressive symptomatology, and perceived stress compared with nontransgender participants. We found significant indirect effects of gender identity on the health outcomes via fear of accessing health services, lack of physical activity, internalized stigma, victimization, and lack of social support; other mediators included obesity for physical health and disability, identity concealment for perceived stress, and community belonging for depressive symptomatology and perceived stress. Further analyses revealed that risk factors (victimization and stigma) explained the highest proportion of the total effect of gender identity on health outcomes. Implications: The study identifies important modifiable factors (stigma, victimization, health-related behaviors, and social support) associated with health among transgender older adults. Reducing stigma and victimization and including gender identity in nondiscrimination and hate crime statutes are important steps to reduce health risks. Attention to bolstering individual and community-level social support must be considered when developing tailored interventions to address transgender older adults’ distinct health and aging needs.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/gnt021