Hopefully We Are All Getting Older

The alternative is not good, getting planted six feet underground. As we LGBT people get older we once again become more vulnerable in long term care facilities, nursing homes, and even in our own home when health care workers come into our homes.

The Challenge of Being Transgender in a Nursing Home
Many elder-care facilities are ill-equipped to deal with the needs of transgender seniors, who fear that a move to assisted living may leave them vulnerable to discrimination and harassment.
The Atlantic
By Mo Perry
August 12, 2015

Brett, who is transgender, has a full beard, a low speaking voice, and has had his breasts removed. But he never had sex-reassignment surgery, meaning that his transgender status would quickly become obvious to a nursing-home aide charged with bathing or dressing him. Like many transgender seniors, he worries what this will mean for him once he enters a nursing home or assisted-living facility.
[…]
One thing, though, is clear: For transgender people, aging into the later years of life can present a unique set of challenges.

Most transgender people have not surgically transitioned—for reasons that include prohibitive cost and decreased sexual function—so when they disrobe in a medical setting, they’re automatically outed, explained Loree Cook-Daniels, the founder of the Milwaukee-based Transgender Aging Network. “That inability to closet even if they want to means we have a much bigger problem in getting trans people to health care,” she said.

Also consider crossdressers, will they be able to crossdress in a LTC facility?

“As I am only part-time in each gender, I am worried that I will be in some situation that will force me to be considered totally masculine,” one of Witten’s study participants wrote, like “being assigned to ‘the boy’s room,’ meaning exile from femininity.”

One of our fears is being “outed” to the staff or to the residents.

The roommate question, in particular, can be fraught with complications. Brett recently experienced what life might be like for him in a long-term care facility when he checked in for a temporary stay in a St. Paul nursing home to recover from a back injury. After a week in a single room, he said, he was assigned a male roommate—but he worried that a roommate of either gender would soon discover that he was transgender, a fact he didn’t want to be publicized.

“A female would have a problem with me, and I’d have a problem with a male,” he said. “I wouldn’t want him to know about me … And with the gossip in nursing homes, that secret would last about a week.”

The staff must be trained that any divulgence of patient’s gender dysphoria is a HIPAA violation! In addition segregating trans patients is a violation on non-discrimination laws here in Connecticut and may also be a violation of the Fair Housing Act.

Mitigating the effects of social isolation experienced by older LGBT adults is a goal of the advocacy group Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE). One of the organization’s current priorities is working to secure recognition for the LGBT community in the Older Americans Act (OAA), the source of federal funding for senior-care programs across the country, as a population of “greatest social need,” deserving of dedicated funds for training, outreach, and services. (The current interpretation of the term, as explained by the U.S. Administration on Aging, is vague: “In some communities, such isolation may be caused by minority religious affiliation. In others, isolation due to sexual orientation or gender identity may restrict a person’s ability to perform normal daily tasks or live independently. Each planning and service area must assess their particular environment to determine those populations best targeted based on ‘greatest social need.’”)

I have received a number of reports of trans people in nursing homes being shunned and isolated by the other residents. Nursing homes and LTC facilities must be made aware of the possibilities of LGBT patients being rejected by the residents.

There are many problem areas that have to be worked on to insure that the needs of the elderly LGBT population and caregivers are slowly beginning to realize our unique needs.