Healthcare needs and assets of gender diverse older adults: A systematic integrative review

Abstract

Introduction: Gender diverse older adults often endure health disparities, encounter discrimination in healthcare settings, and experience lack of access to healthcare. However, members of this population also have assets that help to mitigate these healthcare challenges. A systematic integrative review was performed to synthesize recent studies of the healthcare needs and assets of gender diverse older adults living in the United States.

Methods: A search of PubMed, CINAHL, Web of Science, PsycINFO, and Google Scholar was conducted. Findings from selected studies were organized by theme and subtheme.

Results: Thirty-five articles met inclusion criteria. Seven themes were identified: (1) Inclusivity and acceptance, (2) Antidiscrimination protections, (3) Community, (4) Care of mind, body, and spirit, (5) End of life preparations, (6) Financial security, and (7) Intersectionality. These themes were further divided into 20 healthcare needs and 9 healthcare assets.

Conclusion: The findings call for increased training for healthcare providers to provide safe, gender-inclusive care environments; policy to combat discrimination across all healthcare settings; supportive community resources and healthcare advocacy; empowerment of gender diverse older adults through acknowledgment of their healthcare assets; and more research to discern the role of intersectionality in the applicability of the identified themes to gender diverse older adults of various sociodemographic backgrounds.

Clinical relevance: This review benefits clinicians by suggesting practice changes to address healthcare needs of gender diverse older adults while describing healthcare assets of this population for integration into health promotion initiatives.

Keywords: end-of-life care; gender diverse; gender minorities; healthcare access; older adults; palliative; transgender.