When Injustice Gets Old: A Systematic Review of Trans Aging

Abstract

A lack of knowledge regarding the needs and experiences of trans and gender-nonconforming older adults contributes to and perpetuates the experiences of marginalization associated with being trans. Mitigating the conditions of marginalization—including those that are compounded by age—requires the production of trans aging knowledge. It was with the intent to produce such knowledge that this systematic review was undertaken. In so doing, five medical databases, eight social science databases, and two gray literature databases were searched. These included the following: CINAHL (1942–), Medline (1942–), Health Services/Technology Assessment Texts, Web of Science, EMBASE (1947–), Sociological Abstracts (1952), Social Services Abstracts (1806–), Gender Studies Database (1972–), LGBT Life with Full Text, Ageline (1978–), PsycINFO (1806–), Scopus, ERIC, The New York Academy of Medicine Grey Literature Report, and Dissertations & Theses: Full Text. A total of 436 titles and abstracts were independently reviewed. Of these, 106 full-text articles were retrieved; 34 met the inclusion criteria and were reviewed. The following themes were identified:

1.	the methodological challenges associated with conducting research with trans and gender nonconforming older adults;
2.	violence and abuse among trans and gender nonconforming older adults;
3.	discriminatory policies and practices in health and mental health care;
4.	the lack of appropriate HIV/AIDS education, prevention, and treatment strategies for trans and gender nonconforming older adults;
5.	obstacles in education, employment, government systems, and housing; and
6.	the lack of adequate social support networks.

Gaps in the literature, recommendations for future research, and implications for policy and practice were also identified.

KEYWORDS:

• violence
• discrimination
• structural barriers
• HIV/ AIDS
• support networks

ACKNOWLEDGMENTS

The authors would like to gratefully acknowledge University of Toronto Librarians Jenaya Webb, MA, MLS, and Carla Hagstrom, MA, MLS, for their assistance in conducting the database searches. They also would like to thank Esme Fuller-Thomson, PhD, for her patient guidance and support. They are further indebted to the following authors for their timely response to requests for missing articles: L. Cook-Daniels, T. M. Witten, and M. Brown. Finally, the authors are grateful to Aging Today for extending their permission to cite copyrighted articles.

All authors contributed equally to this research and are listed in random order.