Lesbian, gay, bisexual and trans+ a (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: a) social inequalities, including 'minority stress'; b) associated health-risk behaviours (e.g. smoking, excessive drug/alcohol use, obesity); c) loneliness and isolation, affecting physical/mental health and mortality; d) anticipated/experienced discrimination and e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: 1) Production of large datasets; 2) Comparative data collection; 3) Addressing diversity and intersectionality among LGBT+ older people; 4) Investigation of healthcare services' capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; 5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and sub-groups within this umbrella category; 6) Development an (older) LGBT+ health equity model; 7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association has changed the diagnosis of gender identity disorder to gender dysphoria (GD). In this critical narrative review we ask: What is gender dysphoria? We report on some of the inconsistencies in the articles that foreground distress while obfuscating the fact that not all trans and intersex people suffer stress or impaired functioning, and the inappropriate referencing to intersex people in the diagnostic criterion, claims about the GD diagnosis contributing to the depathologization of and reducing stigma surrounding trans people, the conceptualizations of “gender dysphoric” research subjects, and finally we question the etiological approaches using GD as a conceptual framework. We further suggest that there are a number of methodological issues that need to be resolved to be able to claim that the GD diagnosis can be validated. To shed light on these paradoxes and methodological issues in the DSM-5, we report on the content validity of GD by reviewing research articles postdiagnostic inception. These findings will contribute to the debate about the validity of GD as a diagnosis for the 21st century for those people who need to live a different gender to that assigned at birth.
In April 2017, the European Court of Human Rights ruled that requiring trans people to undergo sterilisation in order to grant legal gender recognition was a breach of human rights. In the UK, sterilisation has never been a legal requirement for trans people. However, hysterectomy and salpingo-oopherectomy have been strongly encouraged for trans masculine people on medical grounds, although the clinical evidence for current recommendations is weak. Within this article I analyse the issue from a feminist perspective and argue that current presumptions in favour of surgical intervention are influenced by the history of medical interventions to "fix" bodies perceived as female, coupled with a strong social taboo against the pregnant man. As a consequence, medical and legal frameworks are not necessarily facilitating optimal outcomes for the individual. I suggest that practices in this regard should be critically examined, with a view to developing more tailored, person-centred practices and facilitating informed choice.
In March 2020, the UK government introduced restrictions in public and private life to reduce the risk of contracting and spreading COVID-19 during the pandemic. People aged 70+ or categorised as 'clinically vulnerable' were advised to shield themselves from contact outside of their household (Gov UK, 2021). Multiple studies have examined the impact of government restrictions on different groups of older people in the UK (Age UK, 2020; Brown et al., 2020;Fraser et al., 2020;Webb, 2020) impacting their physical and mental health and well-being. Those in complete isolation experienced exacerbation of cognitive decline by lack of mental stimulation, loss of social contact and vital relationships to provide sustaining support (Palattiyil et al., 2021). These studies documented the profound effect of increased levels of fear, anxiety and loss on older people's lives. People from Black, Asian and other minority ethnic backgrounds experienced higher risks of morbidity and mortality associated with demographic and socioeconomic factors (Moorthy
Within existing academic literature, ageing within trans populations has primarily been addressed from the perspective of offering advice to service providers and clinicians, with relatively limited application of critical sociological perspectives. This article seeks to integrate the critical perspectives on gerontology with transfeminism, identifying areas of commonality regarding accounts of an integrated lifecourse, scepticism of biomedicalization, and an emphasis on local context. The article suggests that this integration provides a fruitful basis for developing future research into the study of trans ageing, and also provides theoretical development across many debates around age, gender and the lifecourse.
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