ArticleThe Gerontologist2026
Gender affirmation among transgender and gender-diverse people in middle age and late life: a scoping review.
Article in The Gerontologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
BACKGROUND AND
objectivesAlthough gender affirmation is a social determinant of health for transgender and gender-diverse people, reviews have predominantly focused on the medical domain and on younger populations. We conducted a scoping review by mapping peer-reviewed studies on 4 domains of gender affirmation among transgender and gender-diverse people in middle age and late life. RESEARCH DESIGN AND
methodsUsing the Joanna Briggs Institute's scoping review methodology and PRISMA-ScR reporting guidelines, we conducted a literature search of the following databases: MEDLINE, Social Work Abstracts, CINAHL PLUS from EBSCOhost, APA PsycINFO, ASSIA, Sociological Abstracts from ProQuest, and SCOPUS. Of the 1,339 studies identified, 58 were included in this review. We used a hybrid thematic content analysis to synthesize the key findings.
resultsThe participants reported both gender-affirming and non-affirming experiences in (a) the psychological domain, which includes identity confusion, dysphoria, internalized stigma, and self-acceptance and identity realization in later life; (b) the social domain, which encapsulates decisions to conceal or disclose their gender identity, experiences of rejection or support, and community engagement and advocacy actions; (c) the medical domain, which concerns access to and experiences with gender-affirming care and non-affirming services in healthcare; and (d) the legal domain, which involves pursuing gender recognition, navigating legal documentation, and facing systemic barriers in end-of-life planning. DISCUSSION AND IMPLICATIONS: This review highlights the multi-dimensional needs associated with gender affirmation and the systemic barriers faced by transgender and gender-diverse adults in middle age and late life. It provides insight into gender-affirming experiences that can inform more age-friendly and gender-affirming care.
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