Fear, Discrimination and Abuse: Transgender Elders and the Perils of Long-Term Care

By Redman, Daniel | Aging Today, March/April 2011 | Go to article overview
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Fear, Discrimination and Abuse: Transgender Elders and the Perils of Long-Term Care

Redman, Daniel, Aging Today

Phyllis Frye is a long-time lawyer and a judge in Houston. She is also a prominent transgender activist. To transition from male to female - her true gender identity - she underwent several medical procedures and takes estrogen. In Phyllis's life, she chooses where and how she lives without fear. Looking to her future, she is adamant she would not feel safe living in a nursing home.

Transgender elders are afraid of long-term-care facilities. As Frye puts it, "A secret fear of all transgender people, surgical or not, is to grow old and be psychologically abused, day after day, by the staff of a nursing home." Transgender elders are afraid staff members will refuse to let them live consistent with their gender identity, deny them appropriate medical care (such as hormone therapy), violate their privacy and leave them vulnerable to harassment and mistreatment.

These fears are widely prevalent in the community. In a study .published in 2010 in the Journal of GLBT Family Studies, and conducted by FORGE/ Transgender Aging Network, executive director Loree Cook-Daniels says, "People reported that they would rather kill themselves than enter a nursing home and be at the mercy of staff. That's how afraid some people are at the thought of being unable to defend themselves from transphobic healthcare providers."


Nursing home staff members have enormous power to ignore - and thus erase - a transgender elder's identity. For transgender elders, one of their worst fears is being placed in a facility that tries to force them to live in their original sex. By using the wrong pronouns or names, a staff member essentially negates a lifetime of struggle.

Transgender elders also fear staff will refuse to provide them with hormone therapy, force them to wear the other gender's clothing or prevent them from using appropriate restrooms or showers. Facility staff may view these issues as trivial. But for transgender elders they are fundamental to their sense of identity and dignity. Many transgender elders report that they would rather forego care altogether than live in such a facility.

To avoid dealing with bullying by other residents, and because transgender elders are different, some facilities will segregate them. An ombudsman official reports that in one California nursing home, a transgender resident was "prevented from eating with other residents, talking with them or being involved in social and recreational activities with other residents." Nursing home officials also employ this tactic against lesbian, gay and bisexual elders. Jane Gross of The New York Times reported in 2007 that it was a "common" practice to "move gay residents to placate otfiers" if other residents were homophobic.

In addition,, transgender elders fear rejection and loss of privacy. Many worry they will be ostracized, ridiculed or harassed if residents learn they are transgender. Some would prefer to keep their transgender identity private, and may be devastated if staff or residents disclose mat information. Others want to live openly, but may be prevented from doing so.


Sometimes, because of discriminatory attitudes, nursing home officials will bar a transgender elder from their facility. In late 2007, an older transgender woman who was homeless contacted Chicago's Center on Halsted - a community center serving me lesbian, gay, bisexual and transgender community. She needed emergency brain surgery, but doctors refused to operate on her unless she had somewhere to go afterward.

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Fear, Discrimination and Abuse: Transgender Elders and the Perils of Long-Term Care


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