A new book edited by professionals from Howard Brown Health aims to make information on transgender and gender nonconforming people as they age more accessible to healthcare providers.
Transgender and Gender Nonconforming Health and Aging, which Springer published in November, addresses the lack of educational resources for healthcare and research professionals about transgender and gender nonconforming ( TGNC ) people as they age.
"This book is the first of its kind, [gikving] providers who serve folks from the TGNC community a resource with holistic information on TGNC people who are getting older that is all in one place," said Cecilia Hardacker, director of education at Howard Brown Health. Hardacker co-edited the book with her colleagues Kelly Ducheny, director of behavioral health services, and Magda Houlberg, chief clinical officer.
The publication contains five chapters written by various interdisciplinary healthcare experts. Each chapter explores one of five critical topics relating to trans and gender nonconforming peoples' health, including foundational information needed to understand the experience of TGNC people, mental and behavioral health issues, social service considerations, concerns for nurses and long-term concerns for care providers.
Hardacker said most medical resources about transgender and gender nonconforming people are focused on younger populations, so this book aims to provide a resource for people who are looking to support TGNC people as they get older.
"The general belief is that for TGNC folks, especially trans women of color, the life expectancy is around 35 years old, but we're interested in being defiant of that notion and being able to support people as they grow older," Hardacker said. "We put this book together because we envision a world where people can live their healthiest and happiest lives well into their old age."
According to Hardacker, 10,000 people turn 65 in the United States every day, and that's expected to continue until 2030, but the country's healthcare and social service systems are not prepared to serve that many elderly people.
"All those issues—housing, social support, basic caregiving—need to be solved with LGBTQ and specifically trans communities in mind," Hardacker said. "This book is is just a tiny piece of that very big puzzle."
According to Hardacker, the book's primary audience is healthcare providers, including geriatricians, primary care physicians, psychologists, public health officials and social workers, but it was written in a tone that makes it accessible to TGNC community members who may also find the resource valuable.
"We wanted to make sure people who aren't well-acquainted with the community could pick up the essential information, but we also wanted to make sure people from the community could participate in writing it," Hardacker said. "My favorite part is the last chapter, where we invited trans and gender nonconforming people to write directly to healthcare providers about what's important to them. Those stories are powerful."
Stefanie Clark, a trans woman who describes herself as a "renaissance woman and activist," contributed a passage about her experiences in healthcare since coming out as transgender at 68 years old. In it, she details her journey from finding a new primary care physician to receiving transition-related services at Howard Brown Health and searching for a trans-friendly hospital when she needed knee-replacement surgery.
"Just putting the rainbow flag on your front door doesn't show that you're welcoming to transgender people," Clark said. "It just shows you've checked something off on your box that human resources sent."
Clark said when she was looking for hospitals to have her knee-replacement surgery, her main fears were potential discrimination from a roommate or staff member. The hospital was able to accommodate her with a semi-private room with no roommate, but she said she was still fearful of the staff potentially discriminating against her.
"Fortunately, the staff was very responsive," Clark said. "My records were marked with my preferred pronouns, and in the combined 12 days I was there, I was only misgendered once, which I think it was a heat-of-the-moment mistake or a new employee. That's a sign the hospital really cares."
Hardacker said she hopes readers will approach the book with an "open heart and open mind" to consider how they can incorporate its guidelines into their work.
"It's clear how much thought and care went into writing this book, and I hope readers see that and use this as a resource for their day-to-day practices," Hardacker said.
Transgender and Gender Nonconforming Health and Aging can be purchased online at www.springer.com/us/book/9783319950303 .
