Gender Affirmation Among Transgender and Gender-diverse People in Middle Age and Late Life: A Scoping Review.

Authors

Chenxi Yang, Yu-Te Huang, Yue Xu, Peter A Newman

Published in

The Gerontologist. Aug 12, 2026. Epub Aug 12, 2026.

Abstract

Although gender affirmation is a social determinant of health for transgender and gender-diverse people, reviews have predominantly focused on the medical domain and on younger populations. We conducted a scoping review by mapping peer-reviewed studies on four domains of gender affirmation among transgender and gender-diverse people in middle age and late life.
Using the Joanna Briggs Institute's scoping review methodology and PRISMA-ScR reporting guidelines, we conducted a literature search of the following databases: MEDLINE, Social Work Abstracts, CINAHL PLUS from EBSCOhost, APA PsycINFO, ASSIA, Sociological Abstracts from ProQuest, and SCOPUS. Of the 1,339 studies identified, 58 were included in this review. We used a hybrid thematic content analysis to synthesize the key findings.
The participants reported both gender-affirming and non-affirming experiences in (1) the psychological domain, which includes identity confusion, dysphoria, internalized stigma, and self-acceptance and identity realization in later life; (2) the social domain, which encapsulates decisions to conceal or disclose their gender identity, experiences of rejection or support, and community engagement and advocacy actions; (3) the medical domain, which concerns access to and experiences with gender-affirming care and non-affirming services in healthcare; and (4) the legal domain, which involves pursuing gender recognition, navigating legal documentation, and facing systemic barriers in end-of-life planning.
This review highlights the multi-dimensional needs associated with gender affirmation and the systemic barriers faced by transgender and gender-diverse adults in middle age and late life. It provides insight into gender-affirming experiences that can inform more age-friendly and gender-affirming care.

PMID:
42587425
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.

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