Abstract
Trans and gender diverse ageing in care contexts: Research into practice presents essential research and practice knowledge from multidisciplinary scholarly experts. This book aims to “support practitioners by exploring the context of gender diversity in ageing and providing practical guidance for practitioners who work with older people in a range of settings” (p. 1).
The introduction explains the structure of the book: key terms; demographics of trans, non-binary and gender diverse ageing; gender diversity and the life course; and practical issues in gender diverse ageing. Part I explores what we know about older trans and gender diverse people from existing research. Part II explores perspectives from practice in a range of health, wellbeing, and care settings. Part III considers how services can be made more inclusive, with a focus on identifying barriers and considering alternative perspectives on inclusivity. Each section of the book incorporates activities and reflections to help readers apply the information to their own professional or academic context.
Readers are introduced to Witten’s (2009) model of three potential life trajectories for older trans persons that considers “interactions between life course, gendered experiences and social reactions” (p.6). Witten identifies “(i) those who have always lived within a society that accepts gender diversity and who have aged within that context, (ii) those who have ‘come out’ as trans in later life and (iii) those who came out as trans in early life and have since aged (2009, p. 6)”. Witten adds that it is unlikely that the delineation between these trajectories is absolute.
Diversity is an essential theme throughout this book. In chapter three, Toze writes that a “population being at risk of challenges does not mean that everyone experiences those challenges, and vulnerability is not a monolithic state” (p. 63). Although older participants in Toze’s research demonstrated agency and skill in navigating life, loneliness may be a significant concern.
In the introduction, Toze, Willis, and Hafford-Letchfield explain that adults “who first explore and/or express gender diversity in later life often report this to be a joyful experience and indicate an intention to live life to the full” (p. 8). However, they add that older trans persons may also regret that they were not able to experience this liberation earlier and may be strongly impacted by socioeconomic exclusion, discrimination, lack of legal recognition, and poor access to healthcare. As discussed in chapter three, participants in Toze's research expressed agency, skill, resilience, and robustness despite their challenges.
Available resources include an ecosystem of trans peer support networks, including support groups, magazines, and the internet, that provide opportunities for information sharing, emotional support, advocacy, crowdfunding opportunities, as well as links to self-medication. In chapter four, Hafford-Letchfield, Cocker, McCormack, and Manning highlight the importance of family acceptance and support as a protective factor at any time of life. They emphasize that support from social workers for relationships with children and grandchildren is especially needed. Relationships with siblings can also be an important source of support. Despite family support available to some individuals, “there are minoritised communities within trans populations who have a long trajectory of family abandonment and rejection complicated by other identities such as disability, ethnicity and sexual identity” (p.86).
In the introduction, the editors note that “terminology, categories and underlying concepts around trans and non-binary identity and gender diversity are contextual, historically situated and frequently changing” (p. 4), and “trans people may locate their age both in terms of their total lifespan and the time they have been interacting with the world as a trans person” (p. 7). Practitioners are encouraged to listen to their clients and clients’ significant others and communities and consider the intersectionality of race, age, and class. In chapter three, Toze encourages practitioners to understand the effects of past negative experiences with service providers that have resulted in older trans persons’ cynicism toward mainstream services. Toze also recommends that practitioners participate in community-building collaborations to build effective partnerships and share expertise toward the development of resiliency.
Addressing terminology in the introduction, Toze, Willis, and Hafford-Letchfield advise practitioners to listen and respect personal choices, reflecting the terminology preferred by trans persons and their communities. They note that there are differences in perspectives on terminology within communities and variations with race, age, and class. In chapter five, Baril recommends critical trans gerontology as useful in understanding experiences of trans masculine ageing in a cisgenderist and ageist society.
In the conclusion, the editors offer the following as big messages, while acknowledging that there is currently a culture war that appears to harm mental health of gender diverse persons. First, “developing and delivering a person-centred, person-led approach to care that is collaborative and centred on the wishes and preferences of older trans people as the experts on their lives” (p. 221). Second, “Promoting the autonomy of older trans people is an underpinning principle for delivering trans-inclusive and affirming practice” (p. 221). Third, “adopting an intersectional lens for better understanding older trans people’s lives and the heterogeneity among this population” (p. 221). This third recommendation includes a focus on “diversity between different generations of older trans people” (p. 221, emphasis in original). Fourth, “recognising and assessing the social support networks of older trans people.” Lastly, a resounding message is “the ethical responsibility of helping professionals, such as social workers, community workers and healthcare professionals, to advocate for older trans individuals and to ensure that services for and accessed by older people are trans inclusive, cisnormative-critical and safe to access” (p. 221).
