By: Jo Ann Halberstadter, Esq.
It is difficult to determine the number of transgender people in this country who are 65 or older. However, recent estimates suggest that there are at least 1.5 million Lesbian, Gay, Bisexual, Transgender (LGBT) people in the U.S. today who are 65 and older, and this population will double by the year 2030. (See https://www.sageusa.org/issues/general.cfm#sthash.8OKpIIdT.dpuf) Yet, many long term care providers still do not address the unique realities and needs of transgender older adults, leaving them at risk for isolation, neglect and discrimination.
Consider the following excerpt from an article written by Daniel Redman for Aging Today, the bimonthly newspaper of the American Society on Aging at http://www.asaging.org/blog/fear-discrimination-and-abuse-transgender-elders-and-perils-long-term-care:
Phyllis Frye is a long-time lawyer and a judge in Houston. She is also a prominent transgender activist. To transition from male to female-her true gender identity-she underwent several medical procedures and takes estrogen. In Phyllis's life, she chooses where and how she lives without fear. Looking to her future, she is adamant she would not feel safe living in a nursing home.
Transgender elders are afraid of long-term-care facilities. As Frye puts it, "A secret fear of all transgender people, surgical or not, is to grow old and be psychologically abused, day after day, by the staff of a nursing home." Transgender elders are afraid staff members will refuse to let them live consistent with their gender identity, deny them appropriate medical care (such as hormone therapy), violate their privacy and leave them vulnerable to harassment and mistreatment.
Most elderly people are reluctant and fearful about moving to a nursing home and losing their independence and dignity. For a transgender elderly person, that fear is compounded by the fear that they will be denied their hormone therapy and forced to live in their original sex. They are also afraid that they will be ridiculed or harassed by both staff and residents, receive less than adequate care, including physician administered medical care, or that they will be forced to "hide" their true sexual identity.
A long term care provider should put in place the following measures to help insure that transgender residents feel welcome and respected:
1. Develop a nondiscrimination policy that specifically guards against discrimination based on gender identity and sexual orientation;
2. Provide LGBT (Lesbian, Gay, Bi & Transgender) training to all CNA's and other personnel such as is mandated by law in California and twelve other states;
3. Make sure that common areas contain literature and other items of interest dealing with issues affecting LGBT persons such as a rainbow flag and pamphlets addressing issues facing the aging LGBT community.
4. Create or designate unisex or single-stall restrooms;
5. Provide self-help/support groups for LGBT residents. Provide opportunity for the group to express concerns regarding LGBT issues or stigma within the facility.
6. Ensure that visitation policies are implemented in a fair, nondiscriminatory manner;
7. Use neutral and inclusive language in interviews and when talking with all residents. Ask the resident what pronoun they prefer;
8. Listen to and reflect residents' choice of language when describing their own sexual orientation and how the resident refers to his/her relationship or partner;
9. Provide information and guidance on specific health concerns affecting LGBT persons;
10. Stay current and knowledgeable on issues affecting LGBT persons and available resources.
If you have any questions regarding this article, please contact Jo Ann Halberstadter, Esq. at jhalberstadter@barmak.com or call (609)-454-5351.
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