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Published online by Cambridge University Press: 26 August 2025
Gender identity issues in the elderly are often overlooked in psychiatric practice. Older transgender and gender-diverse adults face significant barriers, including social isolation, stigma, and limited access to gender-affirming care. These challenges, coupled with healthcare discrimination and gatekeeping, negatively impact mental health outcomes, often leaving this population underserved in healthcare systems.
The aim is to identify the challenges transgender and gender-diverse elderly individuals face in accessing appropriate medical care and to explore how these barriers impact their overall health and well-being. Additionally, the objective is to propose strategies to improve both the mental health and general healthcare outcomes for this vulnerable group, ensuring that their specific needs are addressed within healthcare systems.
A narrative review of the literature was conducted using PubMed, ResearchGate, and Medline databases. Search included combinations of the terms “gender identity,” “geriatic psychiaty “ and “gender dysphoria. Studies were selected based on their relevance to understanding the mental health and healthcare needs of elderly transgender and gender-diverse individuals.
The review revealed that elderly individuals with gender identity concerns experience higher levels of depression, anxiety, and social isolation. Historical discrimination and healthcare disparities significantly impact their well-being. Studies indicate that increased risks for dementia, linked to factors such as cardiovascular disease and sexually transmitted infections, further heighten their vulnerability.Moreover, there are significant gaps in gender-affirming care within geriatic services. Healthcare providers often lack the training necessary to address the specific needs of older transgender adults, leading to delays or denials in appropriate care.
This review highlights that transgender and gender-diverse older adults remain a population often overlooked in psychiatric and geriatric care. Recognizing the importance of tailored care for this population is essential, as well as training healthcare providers and implementing gender-affirming treatments to ensure inclusive, equitable care that meets their specific needs.
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