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Transgender Aging Research Agenda
The Raw Questions

• To give researchers, policymakers, funders and other interested parties
  guidance on what topics they could usefully focus their work.

• To articulate what the trans+/SOFFA (significant others, friends, family, and allies) communities feel WE need and want to know about growing older transgendered/SOFFA.

• To give TAN itself a basis upon which to design its research, activities, services, and priorities.

• Do older trans persons of different ethnicities lose their place in ethnic
  and trans communities focused on the young?

• Will ANY community honor my elder status?

• How do all of the other question categories specifically affect us due to ethnicity or race?

• Will I be "seen"?  (Trans people are expected to be both young and white.)

• My SO is 20 years my senior.  What if she can no longer take care of herself?  What happens if I have to work?  Because we do not have a legal marriage, would my visitation rights to her be affected?

• Whether to be "out" to everyone in extended family -- to in-laws, etc.
  How and when (and why) to tell?  How to describe "pre-trans" history?

• Legal inheritance issues.

• As my parents become senile, will they know who I am?  How will my status with my siblings be affected?

• How will my family deal with my "other gender" status?

• What group will I belong to?  Hetero, lesbian, queer...?

• What happens if my transness suddenly gets revealed?

• How do I honor my past as a female, but a male later in life?

• What social networks will be in place as we age?

• I fear that younger generations will not respect/honor how difficult it was to come out when I did (assuming it gets easier, that things change).

• How do you meet people as an adult when you no longer have access to broad groups of people such as in college, at work, etc.?

• How do youth issues interface on a social/political level with elder issues?

• What do non-transitioning/genderqueer folks who get older do to stay visible?

• What happens when "youth" culture gets old?

• Will I have a community later?  Will I be accepted?

• Will there be a third box on all those forms I fill out to include my gender identity?

• How do I deal with assumptions made about my gender based on my looks?

• Will it get more difficult over the years?

• How can elder genderqueer people find one another?

• How can genderqueers, low/no hormone folks get proper and respectful health care?

• How do non-transitioning and/or genderqueeer folks stay visible/viable in our later years?

• All of the above, what if I am poor and have to live in subsidized elderly housing, nursing homes, with family?

• Feeling like always being around youth.  [Editor's note: I do not understand what this person meant well enough to reframe this as a question.]

• Does menopause affect surgery, hormones, etc.?

• Do hormones affect cancer risk, the growth of cancer, or its treatment?

• Can one have breast cancer after chest surgery?

• Do hormones affect liver problems?

• Does binding before chest surgery cause problems for surgery?

• How can transmen be screened for breast cancer without having to necessarily "come out" to a doctor?

• What are the long-term effects of hormone use on osteoporosis, liver function, and cholesterol levels?

• When/how often should an MTF have breast cancer screenings?

• What are the long-term risks/complications for FTMs who decide not to have a hysterectomy?

• Will I have access to care if I'm low-income?

• How can genderqueers, low/no hormone folks get proper and respectful health care?

• How can we get respectful and knowledgeable health care staff?  (Specific
  concern: nurses assisting with going to the bathroom/bathing.)

• Are treatment decisions affected by someone being TG or TS, given the disrespect already accorded the elderly?

• What will happen to pre-/non-op transsexuals in hospitals, nursing homes, and other situations that would entail shared rooms, bathrooms, etc.?

• Will long term health insurance coverage provide adequate insurance, especially for trans people?

• Can I refuse treatment from a non-trans-friendly nurse/doctor/aide?

• How will medical hospitals with a religious affiliation treat a trans patient?

• How do I get medical insurance without lying?

• How do we train medical professionals to be knowledgeable and respectful?

• How do we deal with emergency medical personnel?

• Do hormones affect cancer risk, the growth of cancer, or its treatment?

• Do hormones affect liver problems?

• What are the long-term effects of hormones?  Are there differences based on whether you have a usual dose or a low dose?  What happens if you stop hormones after years of use?

• What is the affect of starting and stopping testosterone?

• What happens to the body when there are NO hormones (either "male" or
  "female") naturally occurring?

• What are the long-term effects of hormone use on osteoporosis, liver function, and cholesterol levels?

• Does use of testosterone increase the risk of heart and other problems to the non-trans male level?

• Should those taking testosterone also take calcium?

• What's the health/aging *prevention* value of testosterone versus estrogen?

• Concerning osteoporosis: What are the long-term effects of testosterone on osteoporosis?  What if you take a smaller than usual dose?  What if you have to stop taking testosterone for any reason?

• If I don't have a hysterectomy, how will my female organs be affected by use of testosterone?

• What are the health problems that might necessitate stopping hormone
  treatments?

• What are the effects of hormone use in combination with medications for mental health issues?

• Should I adjust my testosterone dosage downward as I age?

• Should I adjust my estrogen dosage upward or downward as I age?

• Does coming off estrogen increase a trans person's risk of Alzheimer's Disease?

• Are marriages involving trans people legal?

• Are wills involving trans people legal?

• How is custody of children affected by one or more parents being trans?

• How should Durable Powers of Attorney (DPOA) involving one or more trans people be drafted?  Do trans people have any difficulty getting DPOAs honored?

• What happens when legal documents (wills, DPOAs, etc.) use a trans person's previous name/gender designation?

• What happens in situations where a state doesn't allow a DPOA to cover mental health care, including treatment of dementia?

• When trans people have children, is the child's access to Social Security benefits in case of one parent's death ever compromised?

• Is there a bias against trans people in arrests and/or sentencing?

• What happens to trans people who are arrested and jailed, given such institutions' sex segregation practices?

• I am executor of my parent's estate.  Will my trans status affect that?

• Can one get Social Security if one hasn't had a job per se (been self-employed or had spotty work or lived in a communal arrangement), paid taxes, etc. in years?

• Can one's access to Social Security be compromised if one's legal gender is different from that on a government file?  How does the application process work in such cases?

• Will retirement benefits be affected by transitioning?

• How do I find accepting communities in such venues as church groups and activity clubs?

• How do we actively create our own such activities?

• Will I *have* a club when I'm older?

• Will I *have* a sports team when I'm older?

• Will I have comfortable access to a bar when I'm older?

• Will I be accepted in heavily gendered spaces?

• Will there be other transpeople, and could I start a trans group?  (Editor's
  note: originally listed under "mental health" issues)

• What kind of living arrangements will I have access to if I'm low-income?

• Will assisted living facilities take me as a trans person?

• Who will take care of me?  I have no children.

• How will long term care insurance help or make more difficult living arrangements that are comfortable for a trans person?

• Can/have trans people invested in long term care insurance to try to stay in their homes?

• Are there caregivers who know about trans people/issues?

• Would it be possible for a group of trans elders to buy, cooperatively, a house that they can live in for the rest of their lives?  Could one apply long term care insurance to its purchase?  What about a similar situation with a group of trans/queer elders going in together to a larger nursing home or retirement home, etc.?

• Can I find a trans-friendly place to live?

• What happens in situations where a state doesn't allow a Durable Power of Attorney (DPOA) to cover mental health care, including treatment of dementia?

• What psychiatric services are available to older trans people?

• What are the effects of hormone use in combination with medicine for mental health issues?

• Will there be other transpeople, and could I start a trans group?

• What about the increase in depression among elders?

• What about a possible increase in mental health problems related to dementia, Parkinson's, and other illnesses such as cardiac problems, cancer, etc.?

• Are there benefits gained through the experience of being trans that help in adjusting to changes in lifespan development?

• What do we do about elders with regard to medical payments when we have elders who are trans and have HIV/AIDS?

• How have no-hormone, no-op trans guys dealt with perceptions, be they not passing or passing for really young, as they get older?

• What will happen to me if I get dementia and regress in my memory to my pre-transition name and/or gender? How will others react?

• How does the average age of death of trans people compare with that of non-trans people?

• Is the mortality rate of trans people affected by trans issues such as hormonal use?

• Is there an increased mortality rate for trans people due to health care workers' attitudes, limited access to health care for trans folks, lack of insurance coverage, etc.?

• Are elder trans people more lonely than non-trans elders and hence attempt or complete suicide more?

• Do trans people fear what will happen to them after death due to internalized transphobia?

• Is the mortality rate increased due to hate crimes?

• Alternative spirituality formation  [Editor's note: I don't understand well enough what the questioner intended to reframe this as a question.]

• How does not being able to or choosing not to legally marry affect benefits
  (such as pensions)?

• Do Social Security benefits ever get lost in the name/gender change?

• If I move to a new place, should I come out?  How?

• Can I find a trans-friendly place to live?

• Where/how do I find sex partners as I get older?  What personals cater to us?  What bars?

• How do I handle sexuality given issues of self-image, body-image?

• How can I better connect my mind and my body?

• How do I use body parts that are both dysphoric and aging?

• How do I find older, trans-aware potential partners?

• Will I still love my body when I get old?

• When I age, will I be more drawn to being "straight" out of convenience?

• Where do I find access to relevant safer sex information?

• What are sexologists doing to prepare for us?

• How is recovery time affected when folks have trans-related surgery later in life?

• Will people be shocked to find I don't have a phallus, but appear male?

• How is long-term recuperation affected by physical health?

• How do you handle intake questions?

• Does the elasticity of the skin make for different results when older people have surgery?

• Should I have surgery if I'm close to death (i.e., how to weigh five years of enjoying my body versus money for the kids)?

• Has anyone done this before me?

• How can we bring all this information together in an easy-to-access resource?

• How do non-transitioning and/or genderqueer folks stay visible/viable in our communal history?

• Who will write our history?

• How can you find people who are now living as trans elders and talk to them about their lives and/or our potential future?

• Where can we find/how can we create a more comprehensive history of transsexualism in the last 60 years?

• How is psychological adjustment for both the family and self when transitioning later in life?

• Will I be able to pass?

• Will my voice change?

• Will I grow/shrink?

• For a late-transitioning FTM, does coming off estrogen increase the risk I'll get Alzheimer's Disease?

• Will I be able to get a job?

• Will I get fired mid-job if I transition later in life?

• Will I get harassed on the job?

• Will my company's health insurance cover my needs?  Hormones?   Surgery?

• Will retirement benefits be affected by transitioning?

• How do I get a new job being both older and trans (i.e., two strikes against me)?

• Will I lose everything if I work in a place 20 years and transition?

• How do older cross-dressers do that on the job?