Equitable aging in health framework: a multi-systems and multilevel approach to health challenges and supports for...

While research on transgender older adults and health is growing, gaps remain about transgender older adults of color, immigrants, and other groups experiencing multiple forms of marginalization who are shaped by concurring experiences of oppression across the life course. This article aims to address these gaps by examining health challenges and supports among transgender older adults-many of whom are racially minoritized and immigrants-through an Equitable Aging in Health framework.

This community-driven study incorporates qualitative data from 37 transgender older adults from a larger study of 23 focus groups with 208 lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) older adults in California to examine challenges, thriving and surviving strategies, and recommendations regarding health, housing, social services, and caregiving. Data foreground experiences of transgender older adults who are racially underrepresented, immigrants, and have low incomes.

Transgender older adults identified challenges related to healthcare access, housing, employment, economics, and violence that often intersected with disability and aging. Transgender older Latina immigrants experienced elevated challenges related to language barriers, immigration status, and discrimination. Supports included community connections, financial and legal assistance, educational workshops, and homesharing programs. Healthcare access, health experiences, and overall well-being were intricately tied to challenges and supports in housing, social services, healthcare systems, and employment that existed at micro, mezzo, and macro levels.

The Equitable Aging in Health framework helps illuminate how challenges and supports described by transgender older adults, including immigrants and older adults who are racially minoritized, can shape health-related experiences for transgender older adults. Policies, services, and programs targeting transgender older adults, thus, would benefit from a multi-level, multi-systems approach.