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Chapter 8: Older Transgender Women and Family Relationships

Martha B. Leighton
Plymouth State University
Elizabeth M. Dolan
University of New Hampshire

Transgender women face significant challenges throughout the life cycle in comparison to their cisgender sisters (individuals who are assigned female at birth and self-identify as women). Individuals who are trans have been found to face widespread, pervasive discrimination and hostility in multiple areas of their lives and across the lifespan (Langley, 2006; Lombardi, 2010; Yu, 2010). This qualitative study of transgender women aged 55 to 77 examined how: (a) participants experienced a specific challenge, that is, familial disapproval; (b) they developed strengths and resiliencies as a response to that challenge, and (c) they employed coping strategies to counteract the effects of reduced or absent family supports.

Throughout this paper the participants are referred to as trans women, or MTF (male to female) individuals. The choice of trans women versus transwomen is deliberate and akin to the move away from using the term autistic child in favor of child with autism. In this construction, trans becomes an adjective that describes a single aspect of these women’s experience–gender identity–rather than making gender identity their sole defining aspect.

Hobfoll’s Conservation of Resources Theory

This paper focuses on resiliency in the face of rejection. Therefore, Hobfoll’s Conservation of Resources (COR) theory (1989) is used to examine those individuals who are well-resourced and employ successful coping strategies allowing them to conserve those resources resulting in enhanced well-being. Conversely, individuals who lack resources may employ ineffective coping strategies and experience loss spirals that adversely affect their well-being.

The underlying premise of Hobfoll’s theory (1989) is the assumption that individuals are highly motivated to keep, protect, and amass resources. Because the potential, or actual, loss of resources is threatening, individuals may behave in ways that increase their chances of acquiring and maintaining objects, personal characteristics, or conditions that are seen as positive or valuable. To gain resources or to offset losses, individuals may employ resources they have on hand or use resources they can recruit from the environment. When individuals obtain and stockpile resources, they experience positive well-being. When resources are lost or threatened, or when an investment of resources fails to result in additional gain, psychological stress ensues, and the individuals become vulnerable.

Hobfoll (1989) identified four types of resources: objects, conditions, personal characteristics, and energies. Objects are considered resources because of their instrumental potential, or because they are difficult to acquire or have monetary value and are closely linked with socioeconomic status. Conditions are resources only if they are culturally valued. The condition of being female in a Western society that devalues women is not a resource but being a woman in a matriarchal society would be. Likewise, being a person of size in the United States, where thinness is the standard of beauty, is not a resource, but in other cultures where size is equated with power and wealth, being large would be a conditional resource. The third type of resource, personal characteristics, does not refer to attributes such as appearance or intelligence. Instead, Hobfoll used the term specifically to describe an individual’s state of mind. In the COR model, personal characteristic refers to an optimistic outlook. An optimistic outlook that conceives of the world as predictable, orderly, and benign is a key resource and aids in resisting stress. The fourth type of resource, energies, refers to a variety of intangibles such as time, money, and knowledge. The main utility of energies is in allowing individuals to obtain resources of other types. Social support, which can mitigate stress, is not relegated to the four resources, but may be viewed as a resource when it provides other resources and/or facilitates their preservation.

According to Hobfoll (1989), when individuals deploy resources to counteract loss, they often engage in replacement strategies, they replace the original resource with an equivalent or with a symbolic substitute, or indirectly replace the resource with something different that fills the same need. Conservation strategies, on the other hand, do not involve deploying or replacing resources. Instead, individuals conserve resources by reinterpreting the loss as a challenge or a benefit or reevaluating the resource that has been lost and lowering its value, so they no longer experience a feeling of loss.

Because resources are not distributed equally, Hobfoll theorized that individuals with fewer resources would be the most vulnerable to additional losses. Individuals who can stockpile resources are protected by those stockpiles, allowing them to evaluate situations where their resources are threatened and apply resources in an effective manner. Individuals who start with depleted resources, however, have fewer options and may apply strategies that have a lower chance of success and, potentially, a high cost. Over time, individuals who start with fewer resources may apply resources ineffectively and experience multiple net losses, entering what Hobfoll termed a “loss spiral.” As their resources become depleted, they lack the ability to offset additional loss, and depletion continues until their well-being is severely affected (Hobfoll, 1989).

Using Hobfoll’s COR theory (1989) has important implications for the trans community. Because many trans people face challenges throughout the lifespan that make it difficult to acquire and accumulate resources, COR theory appears to predict that at least some individuals who are trans will experience a loss spiral, meaning they may enter older age with depleted resources. Trans individuals, however, may develop and employ adaptive COR strategies such as replacement and reevaluation that make them more resilient as they grow older. The conservation strategies trans women employed were explored, as well as whether specific resource conservation strategies contributed to strength and resiliency in older age.

Review of Literature

According to Turner (2009), trans youth commonly experience disapproval and rejection from their parents. Parents may refuse to allow youth to transition, enforcing that refusal with harassment and punishment that penalizes them for dressing and acting in a way that is perceived as “inappropriate.” In one study of familial responses to trans youth, 40% of participants described family reactions to their gender identity that were aggressively hostile, including verbal abuse and physical violence (Koken, Bimbi, & Parsons, 2009).

Parental rejection is known to have long-lasting consequences for individuals who are trans, putting them at risk for substance abuse, homelessness, incarceration, suicide, and survival crime such as sex work. Grant et al. (2011) cited figures from the National Transgender Discrimination Survey (NTDS) showing trans individuals who experienced familial rejection were three times more likely to be homeless than individuals whose families were accepting, and nearly twice as likely to become incarcerated or engage in substance abuse as those with accepting families. They also found that rejection increased suicidality dramatically. Fifty-one percent of participants in the NTDS who had experienced familial rejection reported attempting suicide versus 38% of those whose families were affirming.

Later in the life course, rejection by families of origin and intimate partners may result in reduced social supports. Social support from partners, family, and social institutions (such as formal religion) are important to older people because these supports can impact many facets of life, including health, perceived quality of life, and cognitive abilities (Witten, 2009). Cook-Daniels and munson (2010) (sic) suggested that many older trans individuals do not have access to the usual family and friend supports relied on by cisgendered elders because of the alienating effects of transphobia. Spousal support may be particularly at risk and losing a long-term spouse can leave a trans individual without a partner’s support at particularly vulnerable times. Witten and Whittler (2004) noted that in some cases, transition may influence relationships with children as well. Children may feel abandoned and angry when a parent transitions, straining intergenerational relationships and further decreasing overall support from family.

Trans elders with diminished family and community supports may experience lower overall well-being and may be more likely to engage in what Witten and Whittler (2004) termed “self-care abuse” (p. 517). Preliminary studies appear to show support for this effect, such as Cook-Daniels and munson’s (2010) report that midlife and older trans respondents in their study showed very high levels of self-neglect.

Individuals who are trans may find ways to compensate for lack of family support. Persson (2009) suggested that individuals who are trans may exhibit unique strengths and resiliencies in older age related to their gender identity, including coping skills developed during the coming-out process and a life-time of dealing with discrimination and oppression, lessened sensitivity to ageism since gender-related oppression is perceived as the dominant “ism,” strong support from family-of-choice networks, and flexible gender role perceptions.

The purpose of this paper is to reflect on the experiences of a small sample of trans women relative to their families. Specifically, the three research questions concerned: (a) familial disapproval and rejection experienced by the older trans women; (b) strengths and resiliencies developed as a response to familial challenges; and (c) coping strategies employed to counteract lack of family of origin support.

Methodology

The research design for this study was exploratory and qualitative. The study consisted of a series of interviews that were analyzed using grounded theory techniques. The interview format was semi-structured and was flexible enough to allow for probing questions and elaboration of topics or specific points that arose as the structured questions were answered.

The population for this study was trans individuals who were over the age of 55, lived in the United States, identified as women, and were living as women full-time. Individuals who were female-identified but who had not transitioned were eliminated from the sample frame. The target sample size was 10 to 12 individuals. Older trans women constitute a hidden population that is very difficult, if not impossible, to identify using probability sampling techniques, therefore nonprobability sampling techniques were used. To identify trans women over 55, a combination of convenience sampling and respondent-driven sampling (Icard, 2008) was utilized.

Since trans status is a sensitive issue with the potential to cause harm to participants if confidentiality is breached, particular attention was directed to ethical issues in the areas of informed consent and privacy. To protect the interests of participants, strict confidentiality was observed during data collection and analysis. Each participant was required to complete a consent form meeting the requirements of the Institutional Review Board (IRB), and participants were identified using pseudonyms in all transcriptions, including this chapter.

Data were analyzed and reported in two ways: (a) descriptive demographic analysis of the sample; and (b) grounded analysis of themes identified from the interviews. The interviews were transcribed by the first author and coded using an open coding scheme that allowed themes to develop from the data. Once initial coding had been completed, a second stage of focused coding was performed to identify core concepts and categories to facilitate analysis. Analysis took into account four general categories of phenomena – conditions or causes, interactions among people, strategies and tactics, and consequences (Monette, Sullivan, & DeJong, 2008). Once open coding was completed, and focused coding was applied to identify data categories and key concepts, the data were further analyzed to determine how the concepts and categories that emerged related to the research questions.

The coding scheme was developed by the first author and reviewed and double-coded by the second author. Results of the double coding were analyzed, and interrater reliability was acceptable.

Findings

Sample

A total of 11 trans women completed interviews as part of this study, and one trans woman’s wife also offered comments. Demographic information gathered from the participants can be helpful in understanding the stories heard. Four participants were from the New England states, and one each from Virginia, Pennsylvania, Indiana, Colorado, Minnesota, Oregon, and Washington. The women who participated in the study ranged in age from 55 to 77 and were racially and ethnically homogenous, with 10 of the 11 participants identifying themselves as White and one participant identifying herself as Native American.

The study participants were generally well educated: All had graduated from high school and completed some form of post-secondary education or training, and nine of the 11 had received a college degree, either an associate’s degree or a bachelor’s degree. Four of the participants held post-graduate degrees.

Four of the women identified their sexual orientation as bisexual, four as lesbian, three as asexual/none, and one as “bisexual/queer/pansexual.” All of the participants had been partnered at some point in their lives – the majority of them with women. Six of the 11 study participants reported they were partnered at the time of the interview, five with women and one with a man. Of the five participants who were not currently partnered, two were widowed after being married to women and three were divorced from women. One of the participants who reported her status as divorced was living platonically with her ex-wife.

Familial Disapproval and Rejection

During focused coding, experiences with disapproval and rejection by family of origin emerged as a primary theme. Participants also revealed the consequences of the disapproval and rejection by their families. Two main concepts arose relating to disapproval and rejection within the participants’ families of origin – correction and rejection. The first concept, correction, was a childhood phenomenon. Parents’ actions, reactions, and words clearly alerted participants about the unacceptable nature of gender variant behavior. In some cases, the correction was overt. Mary, a 55-year-old scientist who transitioned in her 40s, related one such incident when her “stash” of female clothing was discovered and her parents made their expectations clear that she not engage in feminine behavior: “. . . At one point my stash got found and I kind of, you know, got sat down and, well, you know, ‘Boys do this and girls do that.’ You know, ‘We’d like you to do that.’” Later on, this correction was reinforced when Mary expressed an interest in figure skating and her father insisted that she play a more appropriately “masculine” sport, ice hockey.

Like Mary, Georgette, a 65-year-old former engineer who went on disability to facilitate transition in her late 50s, was caught with female clothing and received a verbal correction from a parent. Georgette interpreted a correction from her mother as a warning to hide her gender-variant behavior if she could not change it.

There was a coded message that you’ve just been busted, and you shouldn’t be doing this. And if you are going to do this, then here’s the protocol. I didn’t know what sense to make out of that other than to hide things more carefully.

In other cases, corrections were subtle and sometimes, unspoken, yet participants still got the message – gender variance was wrong and should not be expressed, or it should be hidden. As Wendy, a 77-year-old activist who transitioned in her late 50s, put it: “It wasn’t what the rest of my boy friends were doing . . . and I knew that my family probably didn’t want to have to deal with it.” Kelly, a 66-year-old retired electronics technician who transitioned at age 41, took the covert message to hide her difference to heart:

The invisible child, that’s what I tried be as much as possible. I stayed away from home as often as I could, I didn’t have many friends, basically I’d go away and hide or go to the mall or something like that.

The second concept, rejection, was tied to transition and/or coming out to the family and could occur at any time during a participant’s life. Participants spoke about rejection by parents, siblings, and children, as well as more distant relatives such as aunts and uncles. Rejection as described by participants could take the form of distancing or termination of a relationship, or it might entail refusing to affirm the participant’s gender identity. Most of the participants told of family members who did not affirm their trans identity, although a few spoke of outright relationship termination. Heather, a 58-year-old lawyer on disability who transitioned in her late 40s, noted, “I was banned from coming home” due to rejection on the part of her mother. Isabelle, a 74-year-old former engraver who started transitioning at age 25, spoke of being rejected by her son due to his concerns that her gender identity would confuse his children or jeopardize custody of his stepson:

I got on the phone and I was, I was asked not to come back any more. That uh, they thought that I was just going to be confusing the [grand]children. But then, ah, then there’s the ah, the [grandchild’s biological father] that’s in the mix as well, and ah they were afraid that if he found out, that he would find some way to use it. Yeah, that some way he’d find a way to cause trouble with it. So that part of it, OK, I understand your issue. One the other side, come on, can’t you stand up for me?

Julie, a 77-year-old retiree who transitioned at age 64, also experienced rejection by her son and was estranged from her grandchildren. She said, “My oldest son shut everything off. I am not allowed to come to his house. His children, for sixteen years, did not know their grandfather was a woman.”

Georgette told of a more distant relative who terminated their relationship:

I have an aunt who lives on the East Coast who is near the end of her life and she was my godmother . . . and we’ve corresponded at birthdays and Christmas for years and occasionally talked on the phone, and when I sent her a letter about my transition I’ve never heard from her since. And I sent her a couple more cards and no response and they didn’t come back as undeliverable. Just no response.

Family members who did not affirm a participant’s gender identity responded in a variety of ways. Some did not understand the difference between sexual orientation and gender identity, while others thought it would be easier if the participant were gay. Amanda, a 70-year-old retiree who transitioned at age 49, said of her parents: “They thought I was gay. They had no understanding. They just wanted it to go away. My mother was mostly concerned about what other people would think. And my father just wanted to be left alone.” Anna, a 56-year-old musician who was transitioning for a second time, noted, “I had already come out as [gay], so when there was more coming out I think there was stuff like, ‘Oh, it would have been easier if you were gay.’”

Others refused to accept the changes that occurred during transition. Isabelle’s father told her, “I will tolerate it, but I won’t accept it.” She said, “He made it known for the rest of his life that I wasn’t really his daughter. I was really his son.” Beth, a 74-year-old retired engineer who began to transition at age 40, described her children’s reaction: “They still love me, but they still want their dad. And I can understand that. They haven’t lost me. I’m still here. I still love them as much. But, you know, they want their dad.”

Participants reported that disapproval and rejection by families of origin had serious and long-lasting consequences, including mental anguish, depression, substance abuse, and suicidality; suppression of their authentic selves, and delayed transition. Although the negative reaction of loved ones took its toll, the participants also showed an amazing amount of strength and resiliency.

Strengths and Resiliencies

Participants self-identified numerous strengths and resiliencies developed as a result of their experiences, including honesty, authenticity, positivity, perseverance, self-confidence, resourcefulness, self-sufficiency, decisiveness, self-awareness, giving up gendered expectations in dealing with others, not caring what others thought, seeing both male and female perspectives, combining male and female skill sets, and letting go of male personality attributes such as aggression. An additional strength, self-advocacy, was identified through focused coding.

The participants often saw strengths such as self-sufficiency, positivity, self-reliance, perseverance, resourcefulness, and decision-making as related to one another. Dora linked self-reliance to decision-making:

I want to be incredibly self-reliant . . . I just don’t want to impose on people. I think in a way it’s a good quality. But it’s just a side of me. One character of strength I got out of this is to a certain level being very, very self-sufficient. Making decisions.

Mary correlated decision-making with resourcefulness and self-reliance: “I did have to figure out something for the first time on my own [during transition]. It was actually a good thing to learn self-reliance, resourcefulness . . .” Isabelle saw a relationship between positivity and resiliency: “Resiliency . . . I can get over it pretty quickly . . . I try to find a way around [problems] with a positive resolution rather than just [finding] ways to fight back.”

While all the strengths and abilities that were identified appeared to help participants navigate the challenges of daily living, the ability to engage in self-advocacy also appeared to increase participants’ optimism about older age. One participant, Isabelle, noted that she no longer feared aging as a trans person, “because of what we’re doing here at the [LGBT community center] . . . working to bring more awareness and knowledge to the caregivers and our society that [trans people] are here.” Another participant, Wendy, was hopeful that her work with senior-care providers to offer appropriate, respectful care for elder LGBTs would facilitate her own aging as a trans person, and she was also confident in her ability to advocate for herself in older age, if necessary, saying, “I think I’m vocal enough and compelling enough to make a case for myself.”

Coping Strategies/Replacing Supports

Participants were asked to identify support systems, and focused coding was also used to identify coping strategies used by participants to counteract the loss of social support due to disapproval or familial rejection. The trans women interviewed indicated that they found their current partners provided essential support. Similarly, the participants created “families of choice” and were working toward forging relations with their families of origin.

Relying on Intimate Partners. When asked to identify their strongest support(s), most participants named their current partners. Ten of the eleven participants were currently partnered with women or had been partnered with women in the past; only one was partnered with a man. Female partners helped provide economic stability by increasing overall income and assets, and they also provided significant social support.

Isabelle explained how she and her ex-wife decided to move in together to conserve financial resources:

We [decided we could] cast away half of all of our expenses, practically, all of the utilities that we were paying double, etc. etc. etc. . . . I had purchased a townhome and uh, I had room for two, where we would each have our own living spaces and share the common, you know, living room, dining room, uh kitchen, so forth. We’d each have our own suite, basically.

Isabelle acknowledged that entering into a shared living arrangement with her ex-wife made it possible for the two of them to live independently as they aged and avoid the cost of assisted living or nursing home care: “That was part of the original idea, so that we wouldn’t be living alone and, uh, getting older as we are, that accidents can happen, falls can happen, but having someone there was an assurance, it was necessary.”

Dora also described a shared living arrangement with an ex-partner that combined elements of economic and social support:

I’m moving in with an old friend. I’m moving out this weekend. Actually, a woman that I had a sexual relationship with years ago. It’s more of a friendship relationship, but it may change. We both gone through things. She was married twice, and I was married once - we go back years and years. She owns a house and her daughter and boyfriend live upstairs. The whole first floor is ours. I have my own bedroom and a big living room.

Participants who were doing well financially were clear about the ways in which their female partners contributed to their economic status. Citing her relative financial stability in retirement, Beth said, “I had a good job and my wife had a good job at Harvard . . . we had some savings, not a lot.” Judy and Mary, who have been partnered since high school and work as government scientists, said they have been “very lucky” to have two incomes, characterizing their financial situation as “very stable.”

Participants were also clear about the ways in which social support from their partners was important to their overall well-being in older age. Mary said bluntly, “I wouldn’t be here without her.” Beth said of her partner, “She was magnificent support. She had a wonderful heart and she died of lung cancer, but you know she was my true soul mate. We had twenty years together.” Kelly described how her partner protected her in a way that others had not:

I’ll give you an example. We were renting at the time, Jeannie’s been very protective of me, and the landlord where we were renting was very rude and abrupt to me one day and I mentioned it and she stormed off and gave him what for. Jeannie’s a big woman. And she’s very outgoing, I’m not. I tend to be on the reserved side. Definitely the reserved side. And she’s very outgoing. I think honestly if anyone tried to mess with me and she was around, she’d deck them . . . it wasn’t like that most of my life.

Anna’s partner specifically affirmed her gender identity:

All along in the household I am “A” and she is “D.” Regardless of how I was presenting outside the house. Actually, that is a huge thing. I know some people who won’t tell their spouse or something like that because . . . they are sure that that is the end of the relationship and . . . I am in a relationship where my partner knows and affirms who I am. And that is awesome. It’s just awesome.

Fostering Connection with Families of Origin/Families of Choice. In addition to relying on intimate partners, participants consciously worked to foster relationships with accepting members of their families of origin and/or form new families of choice. Amanda found: “My brother went and had fits and threatened to kill me and all kinds of stuff . . . but, his daughter turned out to be one of my best friends and she’s still one of my best friends.” Georgette also found a relationship with more distant family of origin members was affirming:

So I grew up in the Midwest and I had cousins who grew up in the Midwest and a whole branch of that cousin group moved here to the Seattle area so I told them about Georgette and a couple months later I got a call from one of them and they said “We’re having Thanksgiving at my place and I’m inviting you and you can come as George or Georgette, it’s your choice.” So I went as Georgette and it was wonderful. And the younger generation was the second cousins and they were in their late 30s and they got the pronouns like that (snaps fingers) . . . And then after the dinner, I drove his wife, who is five years older than I am, and one of the daughters back to their place and we had, in the 20 minutes on the road, a really good woman-to-woman conversation.

Georgette cited the continuing cultivation of this relationship as a strategy aimed at ensuring she will have adequate social support as she ages in place in the Seattle area.

Forging new connections with family of choice could be as important as, or more important than, connections with family of origin. Beth declined to return to her native England after the death of her wife because her family of choice was so important to her:

After my wife died, I was suspected of having bone cancer, which turned out to be a false alarm. And at the time I asked a woman if she would be my medical proxy that was a public health nurse. Just to know she is a director of public health. And her family . . . she and her family took me under their wing. And they become part of my surrogate family here. All the rest of my family is over in England. When my wife died, a number of people said “Well, now you’ll be going back to England to be with your family.” And I said, “No, my life is here, my home is here, my social structure is here. This is where I belong.”

Family of choice relationships were often formed with members of the lesbian and gay communities. Isabelle said:

Most of them have developed from the gay community. Some of my oldest friends that I still am close to, were people that I met early on in my search . . . looking for like minds and people who I could talk to and people who could understand what I am thinking and feeling. So, outside of the gay community I haven’t got too many because, well, most people have just moved on anyway.

Dora explained how important the social support was that she gained from her LGBT family of choice:

I played in the women’s softball league. If I hadn’t done that at that particular point in time to get away and just find myself . . . I would not have had as good of a turnout. I found a new family. I found a new circle. It allowed me to grow into the person I wanted.

Mary’s wife, Judy, identified their family of choice as a gay male couple:

We did have Bill and Donald when Donald was still alive. That was a definite second family of choice, a gay couple that we knew, that Donald was my best friend. He died of cancer a few years ago. I ended up moving in with Bill and Donald to help take care of Donald when he was sick . . . we were all very, very close.

Discussion

Results of the study indicated that participants experienced disapproval and rejection throughout the life course from members of their families of origin and from intimate partners, and that familial disapproval and rejection had negative consequences that often continued to affect them later in life, the most severe of which were mental anguish, delay of transition, and divorce. In response to these familial challenges and other challenges in their lives, participants appeared to develop a number of strengths and resiliencies in older age and employed coping strategies to replace social supports lost due to familial disapproval and rejection. Coping strategies fell into two main categories: (a) relying on intimate partners; and (b) fostering connections with accepting members of their families of origin and/or forming families of choice.

These findings suggest that although family disapproval and rejection are distressing for trans women and have negative consequences throughout the life course, the strengths and resiliencies trans women develop in response to familial challenges and their ability to successfully employ coping strategies to replace social supports lost due to family rejection may mitigate the effects of familial disapproval and rejection and contribute to well-being in older age.

Hobfoll’s Conservation of Resources (COR) theory states that individuals may behave in ways that increase their chances of acquiring and maintaining objects, personal characteristics, or conditions that are seen as positive or valuable, and replacing or reevaluating resources that are lost. It also predicts that individuals may conserve resources by reinterpreting loss as a challenge or a benefit or reevaluating a resource that has been lost and lowering its value, so they no longer experience a feeling of loss (Hobfoll, 1989).

Participants in this study demonstrated all types of behaviors predicted by Hobfoll’s COR theory. They suppressed their true gender identities to please their families when young. They allied with female partners and maintained family connections to increase their changes of acquiring and increasing conditions (social support) and personal resources (self-esteem). And they conserved resources by reevaluating (reframing) negative experiences.

Suggestions for Policy and Advocacy

Results of this study indicated that female partners were an important source of security and support for participants. The trans women in this study identified numerous examples of stress-related growth in the form of strengths and resiliencies resulting from the challenges of living as gender-variant individuals. Because social connection appears to foster stress-related growth (Cox, Dewaele, van Houtte, & Vincke, 2011; Tedeschi & McNally, 2011), and because some older trans women may lack social supports due to familial rejection, working to keep trans women connected with family (including family of choice), community, and friends may be effective in increasing their well-being. Mobility issues and lack of access to transportation can impede social connections in older age, so significant others, family members, allies, care providers, and social workers may need to problem-solve to keep older trans women from becoming isolated. Another approach may be to provide trans women with the opportunity to tell their stories and share the entirety of their experiences, including traumatic experiences. One-on-one interactions, family gatherings, support groups, qualitative research studies, classrooms, and oral history projects all provide settings in which trans women might be encouraged to share their experiences. It may also be beneficial to encourage older trans women to engage in activism by volunteering with trans rights organizations or groups with a broader civil rights focus, such as the National Center for Lesbian Rights or the American Civil Liberties Union. Finally, because an accepting social environment appears to encourage stress-related growth (Cox et al., 2011), friends, family members, allies, and providers can monitor their own responses to trans women to ensure they are providing an affirming environment.

Limitations

This study has limitations. The exploratory nature of the study precludes any possibility of generalized results. The participants in this study were quite homogeneous – primarily White, well-educated, and relatively well-off financially – a direct result of the combination of convenience and respondent-driven sampling. The sample also lacked women of advanced age (age 80 or over), individuals of color, individuals without post-secondary school education, individuals from an urban environment, individuals in assisted living or nursing homes, and individuals of lower socioeconomic status. The sample also lacked participants from the southern United States. In any sample population, diversity helps researchers and practitioners understand the circumstances and resources that might be different from a middle-income sample. Financial and educational resources, as well as where one lives, can, and will, impact an individual’s life experiences. A second limitation concerns how transition was addressed.

The study did not capture the experiences of an entire group of older individuals who identified as trans female but who could not transition due to the threat of discrimination. Nor did the study discriminate between individuals who transitioned socially, via the use of hormones, or by undergoing sexual reassignment surgery.

Finally, the study did not differentiate between the experiences of those who transitioned early in life and those who transitioned later. The majority of participants in this study were what could be considered “late transitioners.” The differing social contexts and varied intersectionality of these populations suggest that findings might be more divergent if the study had recruited individuals who did not transition, included questions relating to method of transition, or gathered data on how the participants’ experiences related to age at transition.

Future Research

Since research in the field of trans aging is limited, there are multiple opportunities for future research. One suggestion would be to expand this study. Working with a larger sample, focusing on other experiences (such as employment), and using different sampling techniques that produce more diversity, particularly in the areas of advanced age, race/ethnicity, socioeconomic status, educational level, living situation (assisted living/nursing home), and geographical location, would yield additional and potentially more diverse data on the experiences of older trans women. The inquiry could also be expanded to include trans men, whose experiences might be markedly different than those of trans women.

Because social and historical context plays an important role in the experiences of trans women, it will be important to continue gathering data on aging in the trans female community in light of ongoing social and legal changes such as the institution of state and national protections against discrimination related to gender identity and the legalization of same-sex marriage. Ongoing studies can provide important information about how social realities are changing and what the effects of those changes are for the next wave of aging trans women.

Conclusion

The body of research on trans aging remains limited. This study represents a first step in understanding the lived experiences of trans elders and suggests some directions for future research and legal/policy efforts. It is important to remember that although the results of this study showed the participants faced significant challenges in their family relationships, focusing on strengths as well as deficits revealed some important new information about the ways older trans women adapted to and coped with the challenges of living in a world which is not affirming of gender diversity.

By examining the participants’ strengths and resiliencies, as well as their strategies in replacing lost social supports, this study showed the lives of older trans people are defined by more than deficits. Their life stories are rich, varied, and include successes as well as challenges. The trans women in this study demonstrated success in maintaining loving relationships with long-time partners and drawing strength from connections with families of origin as well as families of choice. As researchers, allies, and advocates continue to explore the lives of trans elders, using this technique of focusing on successes as well as challenges can help create a body of work that reflects the diverse experiences of this population and informs efforts to improve their well-being in older age.

References

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