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照顾老年跨性别成年人:社会、护理和医学挑战。

Caring for the Older Transgender Adults: Social, Nursing, and Medical Challenges.

机构信息

"Elena Venizelou" General Hospital, Athens, Greece.

Ministry of Justice, Athens, Greece.

出版信息

Clin Nurs Res. 2024 Jun;33(5):277-284. doi: 10.1177/10547738241231054. Epub 2024 Feb 10.

DOI:10.1177/10547738241231054
PMID:38339880
Abstract

Aging is a challenging process for people with gender nonconformity. Indeed, the older transgender population faces several disparities in accessing and using health care and social support services. Furthermore, the clinical management of gender transition in later life is empirical since clear research evidence is lacking. This paper aimed to present the problems encountered by older transgender adults in their access to social support and health care and to propose insightful solutions to address them both from a social and medical/nursing perspective. Trans elders face profound disparities in health and social care due to factors associated with limited accessibility to health services, social restrictions, administrative failures, and physical vulnerabilities. The medical treatment of older transgender adults also needs a careful approach to achieve satisfying gender affirmation without clinically significant risks. The potential induction of hormone-sensitive malignancies and the provocation of major adverse vascular events are the main concerns. Gender transition in older adults without a prior history of following gender-affirming therapy is challenging due to biological factors related to advanced age. Caring for elderly trans people unfolds at multiple levels. International organizations and governmental bodies should address the underprivileged status of elderly transgender people by creating and implementing inclusive policies. Safe and respectful clinical and residential environments and the formation of clearer medical guidelines could meet the unique needs of older trans adults. Care providers must advocate for their patients and be equipped to provide safe and effective services.

摘要

老龄化是跨性别者面临的一个挑战。事实上,年长的跨性别群体在获得和使用医疗保健和社会支持服务方面面临着多种差异。此外,由于缺乏明确的研究证据,晚年性别过渡的临床管理是经验性的。本文旨在介绍年长的跨性别成年人在获得社会支持和医疗保健方面遇到的问题,并从社会和医疗/护理的角度提出有见地的解决方案。

由于与获得医疗服务有限、社会限制、行政失败和身体脆弱性相关的因素,老年跨性别者在健康和社会关怀方面存在严重差异。老年跨性别者的医疗治疗也需要谨慎的方法,以达到令人满意的性别确认,而没有临床显著的风险。激素敏感的恶性肿瘤的潜在诱导和主要不良血管事件的诱发是主要关注点。没有遵循性别肯定治疗的既往史的老年跨性别者的性别过渡是具有挑战性的,因为与年龄相关的生物学因素。

照顾老年跨性别者需要在多个层面展开。国际组织和政府机构应通过制定和实施包容性政策来解决老年跨性别者的弱势地位。安全和尊重的临床和居住环境以及更明确的医疗指导方针的形成,可以满足年长跨性别者的独特需求。护理提供者必须为他们的患者辩护,并具备提供安全有效的服务的能力。

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