Issues Related to the Care of Transgender and Gender Diverse Individuals with Dementia

Objective(s): The objective of this review is to explore the health and social care needs of transgender and gender diverse (TGD) individuals with dementia. This growing population has historically been understudied, resulting in a gap in knowledge of their unique needs.

Data Sources: Literature search encompassed 8 databases:
EBSCOhost CINAHL Plus with Full Text, Wiley Journals, ProQuest Central, Taylor & Francis Ejournals, SAGE Journals, JSTOR, Wiley-Blackwell, EBSCOhost eBook Community College Collection, PubMed Central
Search terms: "transgender dementia", “gender dysphoria dementia”
Additional information was sourced directly from the US census, Population Reference Bureau, Alzheimer’s Disease International, and The World Professional Association for Transgender Health (WPATH) Standards of Care Version 8,
Reviewed references cited within relevant articles to identify additional studies.

Study Selection: Studies selected were limited to those published in English between 2013 and 2024 which focused on older TGD individuals old with dementia. A total of 18 studies were selected based on these criteria.

Data Extraction: Data quality was assessed by considering the specific age range of included population, how individuals were identified as TGD, stage of dementia, the country in which the study took place, and the year of publication.

Data Synthesis: The populations of older individuals, individuals with dementia, and individuals who identify as TGD are growing. TGD individuals are at an increased risk for developing dementia due to higher rates of risk factors associated with dementia including depression, social isolation, tobacco use, and hypertension. Additionally, TGD individuals commonly experience transphobia within the health care system and their families which limits their ability to access necessary services including gender affirmative care. Individuals with dementia may experience “living in the past” and for those who are TGD this can result in confusion, dysphoria, and a decreased sense of safety. There is limited research available about the unique needs of the intersection of older TGD individuals with dementia.

Conclusions: The lack of education and understanding for care needs specific to older TGD individuals with dementia leaves an already vulnerable population without needed protections, support systems, access to care, or security of a dignified existence. Focused academic research is needed to build a robust understanding of the needs of this population and develop an encompassing set of standards of care. Additionally, consistent disseminated information to care professionals through ethical education, training, and broad improvements throughout systems of care is critical.

Author(s) Disclosures: The author(s) declare no conflicts of interest.