Older trans individuals’ experiences of health and social care and the views of healthcare and social care practitioners: ‘they hadn’t a clue’

Abstract

This study investigated older trans people’s experiences of health and social care, and the experiences and views of practitioners in order to inform service development. Sixteen trans adults aged over 50 from Cheshire and nearby were recruited via community organizations and interviewed individually or in focus groups. Interviews were audiotaped and transcribed with consent. Health and social care service practitioners were interviewed remotely or face-to-face. Data were analyzed thematically supported by qualitative data analysis software. Three main themes were identified. ‘Levers’ indicated forces that influenced an individual’s contact with health and or social care positively or negatively, and encompassed five sub-themes: age; experiences good or bad; family/close relationships; LGBT identity/communities; and money/finances. ‘Contextual forces’ encompassed societal forces that shape individuals’ encounters in care, lack the potential for positive influence, and are more closely allied to stereotypes/myths: this theme included three sub-themes: discrimination/hate; ignorance; and risk from others. ‘Positive practices’ encompassed five sub-themes, including learning/training. In conclusion older age increases the importance of access to treatment for gender variance whilst simultaneously complicating it; older trans service users may be sensitive to potentially discriminatory experiences because of historical experiences; services should endeavor to understand individuals in the context of life history and psycho-social context; practitioners benefit from training in positive inclusive approaches to care; local community services are advantageous. Further research is needed with particular attention to social care, the experiences of trans men, and how to translate findings into person-centered practice, education and training.