“The Graying Minority”: Lived Experiences and Psychosocial Challenges of Older Transgender Adults During the COVID-19 Pandemic in India, A Qualitative Exploration

Abstract

Background: The Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. Certain factors like age, an immunocompromised state, and social impoverishment, etc. can add to health vulnerabilities during this pandemic. One such group is older transgender adults, who often bear a combination of these risks. As the world is aging fast, their numbers have also been increasing. With this in mind, this study explores the lived experiences and psychosocial challenges of older transgender adults during the COVID-19 pandemic in India.Methods: A qualitative approach was used. Ten individuals with “transgender” identity above the age of 60 were recruited with consent through purposive sampling. In-depth interviews were conducted on the telephone using a pre-designed interview schedule. They were recorded, translated, and transcribed verbatim. Hasse's adaptation of Colaizzi's phenomenological method was used for analysis. Independent coding and respondent validation were used to ensure the rigor of data.Results: The super-arching categories (with themes) were marginalization (“second” priority, stigma, social disconnection), the dual burden of “age” and “gender” (ageism, othering, and psychosexual difficulties), and multi-faceted survival threats (physical, emotional, financial) during the pandemic. Social rituals, spirituality, hope, and acceptance of “gender dissonance” emerged as the main coping factors, whereas their unmet needs were social inclusion, awareness related to COVID-19, mental health care, and audience to their distress.Conclusion: The elderly gender minorities are at increased emotional and social risks during the ongoing pandemic, and their voices are mostly unheard. The need for policy implementation and community awareness about their social welfare is vital to improving their health and well-being.

Sexual and Gender Minorities Facing the Coronavirus Pandemic: A Systematic Review of the Distinctive Psychosocial and Health-related Impact

“…These findings suggest that the intersection of age with further person characteristics (e.g., gender identity, sexual orientation) increases older LGBTQ individuals' risk for experiencing minority stress (Jen et al, 2020). The notion is further supported by a qualitative study from India based on interviews with transgender individuals 60 years and older (Banerjee & Rao, 2021). Participants reported marginalization and stigmatization due to their age and gender in health care settings and in public life.…”

“…LGBTQ individuals face discrimination in health care settings on a regular basis (Banerjee & Rao, 2021; LGBT Foundation, 2020). These results are particularly critical considering that many SGM are at increased risk for various diseases, including chronic conditions, respiratory diseases, overweight (Cahill, 2020;Potter et al, 2020;Whittington et al, 2020).…”

Psychosocial Impacts of COVID-19 Pandemic on Lesbian, Gay, and Bisexual People Living in Portugal and Brazil—A Qualitative Study

“…Hence, there is a need for policy implementation and community awareness about their social welfare and this is vital to improving their health and well-being. 80,81 Despite this, several participants proved to be positive, resilient, and determined to their personal growth, which is an essential factor in strengthening the LGBTQI community.…”

Uncertainty, Sex and Sexuality during the Pandemic: Impact on Psychosocial Resilience

“…The authors called upon for comprehensive HIV prevention plan for this group utilizing tele-health services. In another qualitative exploration of the lived experiences of older transgender adults from India, social disconnection, stigma, ageism, sexual difficulties and "survival threats" emerged as the main themes [54]. Social rituals, spirituality and acceptance of "gender dissonance" were the predominant coping factors during the pandemic whereas mental healthcare and social inclusion were the perceived unmet needs.…”