“My support groups… have saved my life.”: facilitators of positive or satisfactory experiences in behavioral healthcare for transgender and gender nonconforming older adults

Abstract

Objectives

Transgender and gender nonconforming (TGNC) older adults experience significant behavioral health and healthcare disparities. Facilitators that contribute to positive behavioral healthcare experiences among this population, however, remain uncertain. In this study, we investigate facilitators contributing to positive or satisfactory behavioral healthcare experiences among a sample of TGNC older adults in the United States (US).

Method

Between September 2021 and January 2022, the first author conducted 47 semi-structured, individual interviews with TGNC adults aged 65 years or over in the US. Using an inductive grounded theory approach, we examined respondents’ positive or satisfactory experiences with accessing and utilizing behavioral health services, support, and resources. Analyses were conducted using NVivo (Release 1.6) software.

Results

Findings underscore the importance of addressing the specific or unique needs of TGNC older patients to promote positive or satisfactory experiences in behavioral healthcare. Three themes emerged: (1) engaging with behavioral healthcare practitioners who offer compassionate, patient-centered care; (2) accessing and utilizing culturally tailored peer-support groups; and (3) receiving equitable access to gender-affirming care and social services.

Conclusion

These findings highlight opportunities for expanding and incorporating these identified facilitators into behavioral healthcare research and practice, especially when promoting gender affirmation in care for TGNC older patients.

Keywords:

• Behavioral healthcare
• gender-affirming care
• peer-support services
• transgender
• LGBTQ+

Acknowledgments

The authors thank all of the interview respondents who have participated in this research study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

This study received ethical approval from the University of South Carolina Institutional Review Board.

Consent to participate

Informed consent was obtained from all participants for this research study.

Data availability statement

Research data are not shared.

Notes

1 The U.S. Substance Abuse and Mental Health Services Administration (2024:1) defines behavioral health as “the promotion of mental health, resilience and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities.”

Additional information

Funding

This research benefited from the financial support of the University of South Carolina Office of the Vice President for Research. The first author was also supported by the National Institute on Aging (R01AG063771-01; PI McKay) and the Alzheimer’s Association (AARFD-23-1145127; PI Lampe; Mentor McKay) during the preparation and submission process for this manuscript.