Dementia among trans older adults

Ageing and gender shifts

I recently came across an interesting study, led by Canada-based scholars Dr Alexandre Baril and Dr Marjorie Silverman, talking about the gender experiences of trans older adults who are living with dementia. Baril is a social work researcher and assistant professor at University of Ottawa. Silverman is an associate professor in the social work department at the University of Ottawa who uses a critical social gerontology lens in her qualitative research.

Their research looks at the experiences of an under-studied and hidden population — older trans adults who are living with dementia. Rates of dementia are higher among trans adults than among the general population, though the reason for this is unknown. They also share that tracking down trans adults with dementia presents unique challenges for researchers. Many of these individuals transitioned during a time when the goal was to blend in as best they could, their transition best kept secret for fear of negative social repercussions. This social taboo makes them particularly challenging to recruit for study as they are not likely to respond to research surveys.

Some of the trans older adults that they managed to track down and interview had previously undergone gender affirming medical procedures. As their dementia grew more severe, the researchers observed that they sometimes ‘forgot’ they had transitioned medically and became distressed by the changes to their body. This created a unique set of challenges for caregivers on how best to treat them in an affirming, respectful, and non-distressing manner.

In their presentation of the research for the Dementia Society of Ottawa and Renfrew County, Baril and Silverman cited existing interventions that have been developed to respond to this new cohort of ageing adults, from a gender neutral approach that avoids gendering these older adults entirely, to so-called gender affirming approaches that tend to minimize their shifting gender identities due to dementia. Baril and Silverman put forth their own proposed model of care — which they describe as gender-affirming, fluid and non-ageist.

As the numbers of trans people grow, and the numbers of people accessing gender affirming medical procedures increase, I anticipate we will see more ageing trans adults and their families facing difficult care decisions such as these.

You can watch the presentation and Q&A on Youtube: