Angela Ruocco, Martina Manoli, Matteo Marconi, Marina Pierdominici
J Sex Gender Specif Med 2025, 11(1): online ahead of print

Summary. Transgender and gender diverse (TGD) people represent a broad spectrum of individuals whose gender identity differs from their recorded sex at birth. Despite recommendations from major international organizations, like the World Health Organization, TGD individuals still face harassment and discrimination in all areas of their lives. This includes difficulties in accessing healthcare services and essential resources such as education, employment, and housing, which adversely affect their physical and mental health. For this population, aging presents unique social, physical and mental health challenges. The absence of culturally competent healthcare and the effects of minority stress often result in delayed medical care, which can potentially exacerbate conditions associated with aging. Unfortunately, to date, there is a paucity of literature on older TGD people, which has resulted in a lack of understanding of the impact of their lifelong experiences of marginalization and social rejection, as well as the long-term health effects of gender affirming care. This narrative review seeks to contribute to the field, providing an overview of the condition of older TGD people, identifying critical health needs, and highlighting areas requiring urgent attention as the TGD population and global aging trends continue to rise. It underscores the importance of developing inclusive healthcare policies that promote access to culturally competent services, support ongoing education and training for healthcare providers, and integrate gender affirming care into standard aging protocols. Furthermore, future research should not only address the specific health concerns of older TGD individuals but also explore the intersectionality between aging, gender identity, and gender affirming care, examining the cumulative impact of these factors on overall health outcomes.
Keywords.Transgender and gender diverse people, aging, healthcare disparities, gender affirming care, caregiving.