Long-Term Care Expectations and Plans of Transgender and Nonbinary Older Adults

K. Abel Knochel, Dylan Flunker

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Problem: Transgender and nonbinary (TNB) older adults endure discrimination from medical providers and expect it in institutional long-term care. Gender identity–based discrimination is connected to negative health outcomes and reluctance to access needed care. Objective: The aim of this study is to explore how gender identity affects TNB older adults’ fears, hopes, and plans for use of institutional long-term care. Method: Co-investigators conducted semi-structured interviews with 24 TNB older adults in Minnesota, collaboratively analyzed the results using reflexive thematic analysis, and member-checked emergent themes. Findings: Oppression is central to participants’ consideration of future long-term care. They fear mistreatment and loss of authentic gender expression and recognition in long-term care facilities. Fears of oppression factor into consideration of suicide and physical transition, although some participants hope societal shifts will lead to unbiased long-term care. Conclusion: Creation of anti-oppressive institutional and community-based long-term care options is critical to effectively serve TNB people as they age into dependence.

Original languageEnglish (US)
Pages (from-to)1542-1550
Number of pages9
JournalJournal of Applied Gerontology
Issue number11
Early online dateFeb 12 2021
StatePublished - Nov 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the University of Minnesota Clinical and Translational Science Institute?Community Health Collaborative Grant and the University of Minnesota Office of the Vice President for Research?Serendipity Grant on Aging. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award Number UL1TR000114).

Publisher Copyright:
© The Author(s) 2021.


  • discrimination
  • health-related quality of life
  • institutional care
  • long-term care
  • transgender


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