Uni que Issues of Transgender Elders

1. Unique Issues of Transgender Elders Loree Cook-Daniels Founding Executive Director Transgender Aging Network October 16, 2010

2. Transgender Aging 101: “Transgender Elders and SOFFAs: A Primer for Service Providers and Advocates” http://www.forge-forward.org/handouts/TransEldersSOFFAs-web.pdf

3. Topics Significant differences from LGBs Who social workers will work with The ones to worry about

4. Gender assumptions are more primary than sexual orientation assumptions Gender first identity assigned at birth Presumed tied to biology Presumed unchangeable

5. Whole social system built on gender dichotomy/assumptions Clothing Names Titles/honorifics Bathrooms Sports Advertisements Men are from Mars, Women are from Venus

6. Consequences of challenging the binary assumptions Anger Suspension of civility Violence Confusion Curiosity Jokes Bathroom fights

7. The “T” Includes the Rest of the Letters

8. There May Be Bias • LGB people can be transphobic • Transgender people can be homophobic

9. Legal Status Differs Marriages involving a trans person are in legal limbo: law and policy are unsettled about legalities, eligibility for benefits like Social Security Result: More income insecurity There are fewer employment, housing, and public accommodations non-discrimination laws (and organizational policies) covering gender identity compared to sexual orientation Result: 97% of transgender people have been discriminated against or experienced harassment on the job Lower income, particularly in retirement

10. Legal Status Differs (2) Health care insurance has routinely excluded transgender-related benefits (This may change under health care reform’s outlawing pre-existing condition exclusions) Result: more “non-congruent” bodies Document changes governed by many different laws with different requirements Result: more document discrepancies

11. High Risk of Involuntary Outing A “non-congruent” body automatically outs a trans elder in health care and intimate care settings Documentation discrepancies may involuntarily out a trans elder

12. Trauma histories are pervasive ...transgender individuals experience sexual abuse or assault at some point in their life.

13. Abuse by professionals common Assaults by police officers: 5 - 9% (5% FORGE, SA only; 9% NCAVP, all anti-LGBT hate crimes) Assaults by health care providers: 6%

14. Practical Consequences “…[A]s a trans 35 year old – who is a service provider who has borne witness to incidents of violence and abuse for elders, I’m scared to death about my own future. There is Alzheimer’s in my family, and I know there’s a good chance it’s going to claim me as well. What will happen to me once I can no longer advocate for myself? Will they call me “she”? Will they make fun of my body right in front of me, knowing I won’t really understand? Without a significant other, and without children, I fear I’ll be left in a nursing home somewhere where no one actually cares about me as a human being.…”

15. (continued) “…At 35 I’ve already written a “living will.” In Ontario it’s called a Power of Attorney for Personal Care. And honestly? I have more or less decided that I just won’t let myself get to that point where I can’t take care of myself. I’d rather take matters into my own hands and self-euthanize (that’s a nice way to say it, don’t you think?) while I am mentally cognizant and physically capable of it. Should the time come when I need to take my own life in order to avoid these horrific experiences, I will.”

16. Another example “I have decided not to have any life-extending surgery because of past mistreatment by nurses at [the Veterans Administration hospital].”

17. Mid-Life Transitioners Turning points: Retirement Death of parent/s Launch of child/ren Divorce Health scare WorldWideWeb

18. Gatekeeper Problems If an elder transitions later in life, will probably need to get “the letter” from a therapist; may therefore not disclose mental health issues, trauma histories, etc. Financing psychotherapy on top of hormones/surgery, aging health issues, and fixed income may force unhealthy choices.

19. Transition is Public Everyone can see the changes. People feel free to comment, ask questions. Questions that are “too personal” to ask the transperson are often asked of the SOFFA.

20. Partners Complicate All the Boxes Example #1: A man’s wife of 30 years transitions female-to-male (FTM) and they remain married partners. What is the original husband’s sexual orientation?

21. Partners Complicate All the Boxes Example #2: A longtime lesbian meets and falls in love with an FTM. What is the woman’s sexual orientation?

22. Partners Complicate All the Boxes Partner Sexual Orientation Heterosexual? Gay? Lesbian? Bisexual? Queer? Confused? Flexible? Transsensual? Trannyfag? Trannychaser?

23. If a non-trans partner doesn’t identify as LGB, will he feel comfortable in “LGBT” space? If a non-trans partner does identify as LGBQ but the couple looks heterosexual, will she be comfortable in “LGBT” space? Many trans/n0n-trans couples are “mixed orientation” – one identifies as LGB, the other as heterosexual

24. Health Care Problems Local physicians may not want to oversee a trans elder’s hormone regime. Only a few surgeons worldwide specialize in transgender surgeries (chest reconstruction, genital revision), so most transgender people travel a long way for their surgeries. Post-surgery problems? Local physicians don’t know how to handle.

25. What happened to all the early birds? Requirements of early transitioners: Divorce Must be heterosexual post-transition Abandon children and have no further contact Move Create a fictional history Never tell  Stay away from other transgender people!

26. Texas Case

27. Questions? Loree Cook-Daniels Founding Executive Director Transgender Aging Network 414-559-2123 www.forge-forward.org/TAN LoreeCD@aol.com