Accessing sexual health and pleasure at every age.
In 2013, photographer Jess Dugan set out to document an underrepresented population within an already underrepresented group. "I think, in general, a lot of the discussions around trans people are very youth-focused,” they said in a 2018 interview about their photo project, To Survive on This Shore. “I think that older (trans) adults are often left out of that conversation.”
In a world where transphobia is the norm, Dugan shined a light on an uncomfortable truth: Older trans people are additionally marginalized by age. The discrimination most trans and gender-nonconforming people face when they’re younger gets worse over the years, especially as they become more reliant on America’s dysfunctional health care system.
Centering the health of trans elders—including sexual health—is one way to address the many disparities facing trans people over the course of their lives.
Steps to Safer Sex
According to the CDC, trans people receive HIV diagnoses at three times the national average, making them more vulnerable to HIV/AIDs than the general population. Furthermore, research shows that few healthcare providers screen for HIV among older adults under the false assumption that sexual activity diminishes with age—putting older trans people at a greater risk for illness while also dealing with a health care system that’s already discriminatory towards gender nonconformity.
Medical Transition and Sexual Health
Some trans people pursue hormone replacement therapy (HRT) in order to more closely align their bodies with their gender identity. While HRT, like other transition-related medical treatments, is generally understood to be very safe and highly effective, many doctors are unaware that it can affect older trans people differently than younger trans people. The long-term effects of hormone treatments for trans people are not known—as HRT only became available in the 1930s.
The Pursuit of Pleasure
Some trans people have addressed the dearth of institutional sexual health resources for trans people by creating their own. Trans women journalists Serena Sonoma and Ana Valens wrote guides to educate cis people who have sex with trans women of all ages. Both guides recommend good communication and discourage the cis-centric “underlying assumptions,” as Valens puts it, about trans people’s bodies that affect them everywhere, from first dates to the doctor’s office.
The HRC’s Safer Sex for Trans Bodies and Brazen: Trans Women Safer Sex Guide are two trans-spearheaded resources for safer sex and dating for trans people that also offer education on how long-term medical transition affects trans peoples’ bodies and sex lives.
These resources are important for trans people of all ages because sexual health encompasses mental and emotional as well as physical wellbeing: Pleasure is a component of wellness. Ensuring free and accessible medical care for all, including transition-related medical care, is the first step toward adequate sexual health care for trans people of all ages.