Because humans tend to experience an increasing number of disabilities and chronic conditions as they age, old people on average have far more contact with health care providers than do younger people. It is common for old people to live at least for a time in an institutional setting such as a hospital or nursing home. Even if we’re able to continue living at home, frail, impaired elders often need others’ assistance with such intimate personal tasks as bathing and toileting.

What these facts mean for transgender persons is that the option of being completely “stealth” shrinks as one ages. Although some post-operative MTFs look completely female even unclothed, that is not the case for FTMs, MTFs who could not afford or didn’t want genital surgery, crossdressers, and other transgender and intersex individuals whose secondary sex characteristics and/or genitals don’t “match” their dressed appearance.

The fact that, unlike their non-transgender lesbian and gay male peers, most trans elders can NOT be closeted in health care settings, makes it even more imperative that efforts to educate aging and health services personnel and institutions about sexual orientation and gender identity diversity include detailed information about trans elders. Unfortunately, that transgender inclusion is in name only far too often.

A good example of this “disappearing T” phenomena is a resource packet for aging services providers on LGBT issues created by Age Concern England, “Opening Doors: Working with Older Lesbians and Gay Men.” Despite its title, the Introduction states that the packet uses the term “lesbian and gay older people to encapsulate lesbian, gay, bisexual, and transgender older people.” (p. 2, emphasis added) Unfortunately, that is the only time transgender people are mentioned.

As “Good Practice Guidance” for including lesbians and gay men in aging services, “Opening Doors” is pretty good. It’s written by a mainstream aging organization for mainstream aging organizations. It addresses why lesbians and gay men are different from their heterosexual peers; talks about such diversity within the gay community as ethnic minorities, rural lesbians and gay men, disability issues, and economics; explores some common myths; and offers a very enlightening (although skewed toward gay male) history of what current elders in Great Britain have lived through. It gives advice on gaining input from older lesbians and gay men, conducting outreach to elder gays, and designing both gay-specific and mainstream-but-welcoming programming.

Much of what’s in the packet could pertain to trans elders, with the addition of language like “gender identity” and “transphobia.” Language adjustments alone would not help in the areas where trans elders’ needs are distinctly different from the needs of non-trans lesbians and gay men, such as the segments on couples and partnership rights (since many trans people have legal marriages), and health care. There is also, of course, nothing on the needs of transitioning elders or their families. The extensive list of resources includes no mention of the programs that do serve trans elders, there are no trans-related terms listed in the glossary, and there’s nothing about trans history and its impact on the transpeople who lived through it.

To address the “disappearing T” phenomena in services and programs that claim to serve LGBT elders, the Transgender Aging Network (TAN), an arm of FORGE, recently produced, “Is Your ‘T’ Written in Disappearing Ink? A Checklist for Transgender Inclusion.” It is available for downloading at http://www.forge-forward.org/handouts/InclusionChecklist.pdf. Feel free to print it out and pass it along to your local LGBT aging project; it’s one small step you can take to start making that disappearing “T” fully and permanently visible.