Older Transgender People’s Discrimination in Healthcare: A Scoping Review

Background: Given the healthcare challenges older people and people who identify as LGBTQ+ are faced with, it becomes critical to explore how older transgender individuals experience discrimination in healthcare settings. Objectives: We followed the PRISMA guidelines for scoping reviews to map existing literature, and identify key themes, specific to transgender adults aged 65 and older and how they experience discrimination in healthcare. Eligibility criteria: This scoping review explored studies that focused on discrimination against transgender people older than 65 in any healthcare settings, which were published in English in the last twenty years. Sources of evidence: Evidence was extracted from Scopus, ProQuest Central, Health & Medical Collection, PubMed, CINAHL, Medline, and Psychology and Social Sciences databases. Charting methods: We used streams of search with specific keywords. Two researchers were involved in the screening of articles, coding and analysis. Results: The search showed that research focusing on transgender people older than 65 and discrimination in healthcare was rather limited. The findings revealed that older transgender individuals frequently anticipated or experienced discrimination in healthcare settings, resulting in service avoidance and adverse health outcomes. Despite sometimes reporting lower overt discrimination than younger cohorts, older trans people faced comparable levels of victimization, compounded by age-related vulnerabilities and socioeconomic marginalization. Structural barriers, such as misaligned documentation, lack of provider competence, and financial constraints, further hindered access to healthcare. However, the presence of empathetic, culturally competent providers and access to LGBTQ+-specialized services might improve care engagement and outcomes. Conclusions: This review concluded that targeted policy reforms, inclusive clinical practices, and community-based support systems were essential to address these disparities. It called for greater institutional accountability and interdisciplinary research to ensure safe, affirming, and equitable healthcare for aging transgender populations.