Coming Out as Transgender Later in Life

This blog focuses on a segment of the transgender population that isn’t frequently the topic of media articles: older trans people. They don’t typically embrace their trans identities until their 50s, 60s, or beyond and their experiences with coming out are different from their younger counterparts, because they are steeped in the historical context of a transphobic society.

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Transgender adults (all ages) typically report that their first experience with gender dysphoria was between the ages of 3 & 7. But there’s a large generational difference in terms of how long younger vs. older trans adults take to embrace their identity and start their transitions. Trans teens and young adults typically wait between 9 to 14 years to begin their transitions, where trans people ages 60+ wait on average 50 or more years to begin transitioning. A few factors help account for why older trans people wait:

• Starting in childhood, they were severely corrected or ignored when they expressed thoughts / exhibited behavior deemed gender dysphoric
• The science on gender identity was transphobic, and being LGBTQ+ was considered a mental disorder or even criminalized
• The AIDS crisis worsened the discrimination, stigma & disinformation against the LGBTQ+ community
• They saw (and perhaps experienced) how society ridiculed and penalized those who dressed or behaved in ways not associated with their birth gender
• They legitimately felt they could lose everything (career, home, family, respect of community etc.) if they came out as transgender
• There were few in-person support resources, and no internet to help them know they were not alone

THE IMPACT OF SOCIETAL TRANSPHOBIA & DISCRIMINATION
Decades ago, society’s restrictive attitudes about transgender individuals were bolstered by transphobic influences from within the medical community:

• “Passing” was the only acceptable goal. As recently as the mid-1970s, doctors wouldn’t provide hormone or surgical treatment to transitioning patients past a certain age, out of the belief that after their early 20s, they (particularly trans women) would lose their ability to “blend in”. That myth’s been debunked – but more importantly, blending in shouldn’t be the goal, and looking trans (whatever that means) shouldn’t carry any risk or stigma!
• Medical gatekeeping was the norm. Historically, the vast majority of trans women were prohibited from being public about their transition. So much trans history has been erased by the ironic contradiction that in order to transition, you couldn’t make being trans part of your new identity – you had to go stealth.
• Trans activism was highly suppressed. Cis straight society knew that it’s hard to organize or garner support around your oppression when you aren’t even allowed to bring it up. Restricting activism & freedom of speech perpetuated ugly stereotypes and ensured that coming out would continue to be dangerous.

While attitudes about gender identity are much more evolved today, disinformation continues. Representations of trans people in the media continue to be limited & stereotypical, with characters portrayed as tragic, comical or dangerous. And in politics, organized transphobes now fearmonger and portray trans existence as a dangerous youth fad or edgy “lifestyle choice” to be corrected. Decades of effectively erasing trans elders from visibility helps perpetuate this lie too, because when people only see trans youth or trans young adults, the common assumption is that trans elders either “outgrew the phase” or even worse – don’t live long enough to become an older transgender.

SO WHAT PROMPTS OLDER TRANGENDERS TO FINALLY COME OUT?
After sometimes decades in the closet, it’s usually a significant life event that prompts an older person to finally come out as trans (e.g. death of a spouse, divorce, retirement, serious medical diagnosis, etc.). It either makes them feel free or triggers thoughts of mortality (making them want to experience being their true selves, if only for a brief period of time). Either way, powering through to become visible can be a liberating experience.

Benefits / advantages of transitioning later in life

• It can mean having more economic resources available, making physical transition costs more manageable
• Transgender adults median age 60 report larger social networks than non-transgender adults of the same age
• Older transgender adults are excited for the future & the freedom to finally be themselves
• Older transgender adults’ life experience & acquired interpersonal skills can give them more confidence and resilience than their younger counterparts

Challenges of transitioning later in life

• Pre-existing medical conditions are more prevalent in older people, increasing the odds that surgery may result in complications. Older patients are typically encouraged to use non-surgical ways to enhance their transition.
• Some hormone therapies aren’t prescribed to trans patients over a certain age because of health risks. And the safer alternative hormones or hormone blockers may not be as robust in their effects
• A social network of close friends is important, for ongoing social support and help with recovery after surgery. While older transgender adults do report a large social network, their contacts tend to be at more of an acquaintance-level (vs. close friends) as compared to their younger trans adults
• Factors including lack of tech-skills, hardware, transportation and mobility can make it more challenging to connect older transgenders to online and in-person support services
• Ageism exists in queer communities just like everywhere else – even younger progressive members of the LGTBQ+ community can have limiting and subjective ideas about whose body is worth looking at or worth having.

Tips for coming out & transitioning as an older trans person
There is no one right way to transition, regardless of age! Here’s a few suggestions to consider:

• Start by finding a gender-affirming mental health therapist. They can help you process your feelings; prepare to come out to family, friends and loved ones; and offer guidance and support with social and physical transitioning. A mental health therapist can also provide a letter of support for gender affirming medical care which will fulfill healthcare insurance provider and surgery center requirements.
• Find gender-affirming medical professionals – quality practitioners who you feel comfortable with to answer questions and guide you through options on hormone therapy, surgery etc. Your therapist can provide resources, too.
• Experiment with your gender expression. Start social transitioning (pronouns, hair / makeup, clothing, appearance etc.) as soon as you’re comfortable. Have fun with it!
• Research & explore. Discover online groups & social media pages, community organizations, etc.m visit new places and make new like-minded friends. And if you haven’t already, take time to educate yourself on being transgender and transitioning.
• Prepare for conversations with others. Consider who you want to talk with (and who you don’t), what you need to have happen during these discussions, what you hope will happen, what you’re afraid might happen, and how you’ll handle it if things don’t go well, etc.) If you are nervous about the discussion, speak with your therapist about it and write it down / practice in advance.
• Relationships with children, whether young or fully grown, are a factor in an older person’s transition. Discuss with your therapist how to have an age-appropriate conversation with your child(ren), sooner rather than later. Hold it in a private space where the conversation can’t be overheard and will be completely confidential. Speak respectfully, honestly & candidly, and understand that their reaction may not be what you expect. Give them time to respond, and the space they need afterwards to process the information emotionally.
• Be honest with yourself about what you want from your newly-embraced identity
• Be clear about what you need from friends, family, colleagues and your medical professionals
• Focus on the future! Don’t belabor what could have been, focus on what can & WILL be!

Every trans elder is living proof that being transgender includes a future; that trans existence is a viable way of being that accrues age and dignity and deserves respect. Because the body and the life that is most worth having is the one that you’re most happy with. And you deserve nothing less.

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IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community. Every day, we strive to provide the highest quality mental health care for clients of all ages and across the spectrum of identities. For anyone needing affirming and validating support or healing with any issue, please click here or email us at help@intraspectrum-chicago.com.