"We are One"

Transgender Health and Life Expectancy

The question of transgender life expectancy was raised on PinkEssence. (The blog post was on page 6 of my google search.) Several sources quoted a number of 23 years. I also saw 28 years mentioned. I didn't find any definitive reference for that number. I think it is unlikely that there are good data available at this time on the life expectancy of people self-identified as transgender or transsexual, because those categories have not been separated out in government data collection until recently. Also, the reluctance of many transgender people to publicly identify themselves makes it difficult to identify and study a representative sample of the overall population. I did a quick search on PUBMED and the CDC. A lot of the useful studies involve people with HIV/AIDS, which is a high-risk, low life expectancy group to start with. Transgender people seem to have below average outcomes even for this group due to fear of exposure and obstacles to health care. Suicide is another major risk. Here is a sample of some reasonably useful resources I found. I don't have access to most medical publications, but I'll try to review these some more in the next couple weeks and report if I find something informative. Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons: A Three-Year Prospective Study. Nuttbrock et al. 2012 Gender abuse is a fundamental distal risk factor for HIV/STI among younger MTFs. Interventions for younger MTFs are needed to reduce the psychological impact of gender abuse and limit the effects of this abuse on high-risk sexual behavior. Age differences in the impact of gender abuse on HIV/STI suggest the efficacy of peer-based interventions in which older MTFs teach their younger counterparts how to cope with this abuse. Transgender identity development as represented by a group of transgendered adults. Morgan SW et al. How do transgendered individuals describe their experiences of recognizing, acknowledging, and developing their identity as transgendered? Participants' stories about how they came to recognize and experience their identity as transgendered, analyzed from a lifespan perspective, displayed a similar pattern of life experience, reflected in three prominent themes: an early sense of body-mind dissonance, negotiating and managing identities, and the process of transition. The process that participants describe, beginning with childhood and ending with transition and the resolution of bodily discomfort, appears to be staged and developmental in nature. Further exploration into this process and comparison with other developmental theories may yield a model of normal, non-pathological development as transgendered.

End-of-life care for gay, lesbian, bisexual and transgender people.

Cartwright C et al Consultations were carried out with 19 service providers and 6 gay, lesbian, bisexual and transgender community members in the Northern Rivers and metropolitan Sydney areas of New South Wales, Australia. Participants reported barriers to health care service access due to discrimination, inappropriate care and lack of knowledge among both consumers and health care workers of legal rights at the end of life. While advance care planning can assist with improving end-of-life care, respondents reported a number of obstacles. These included a lack of knowledge and absence of perceived need and the additional obstacle of social isolation, leading to difficulties identifying alternative decision-makers. The study highlighted the need for education for gay, lesbian, bisexual and transgender people and health and aged care providers on existing legal provisions to prevent discrimination in end-of-life care. CDC Office on National HIV/AIDS Policy Fact   Sheet: HIV/AIDS and Transgender Persons (2005)

The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.
Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities.
Washington (DC): National Academies Press (US); 2011.
In a national study comparing more than 1,200 LGBT people aged 45–64 with a group of just over 1,200 individuals aged 45–64 from the general population, the MetLife (2010) survey found that the percentage reporting recent receipt of (and need for) care was greatest (19 percent) among the 5 percent of the sample identifying as transgender—comparable to the percentage of lesbians, somewhat greater than the percentage of bisexual women and men (17 percent), and much higher than the percentage of gay men as well as women and men from the general population (9 percent).

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Tags: CDC, HIV/AIDS, Pubmed, discrimination, expectancy, health, life, suicide, transgender

Comment by Rachel King on August 7, 2012 at 7:23am

On reading this blog, it is totally understandable why the majority of post-op women, fade into the night.

Who could blame them.

You would need rocks in your head to be open around stats like that.

Again it is another reason why stats are not going to be accurate, yet in spite of my pessimism about the accuracy, for the many who struggle day by day to find some acceptance, these studies are an important tool in changing the way people react and treat us.

Comment by Molly Vaughan on August 7, 2012 at 8:18am

Great research Joni, thanks for sharing it.  Let me add this report that I found from The National Center for Transgender Equality and the National Gay and Lesbian Task Force. They sent out 7,000 survey's and received just over 6,400 back.  I haven't gone through all of the report yet but much of the findings are interesting.  Their age range is from between 18-89 years.  I have an email out to their director and hope to hear back if they would be able to give a reliable number based on their research.  These numbers I am seeing though are way higher than I had previously seen reported, which makes me really happy.


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