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For the vast majority of cisgendered people who experience alignment between the sex they were assigned at birth, the body they have and their gender identity they are comfortable with (Schilt and Westbrook, 2009), the experience of trans people is a distant one. More of us share an experience of aging and the associated concerns about reduced independence, deterioration of health and increased need for care and support. The paper aims to discuss these issues.

For trans elders, the experience of aging has specific features that have a major impact on their lives if not understood, planned for and responded to appropriately. This paper presents findings from a qualitative study exploring trans peoples experiences, concerns and suggestions for how agencies providing elder care can better meet their expectations (Jones, 2013).

The research revealed low confidence in the ability of current aged care services to meet the needs of trans elders due to a limited understanding of the relationship between health and social care specific to trans people; undervaluing the networks in trans people’s lives; the need to demonstrate culturally competent services and real concerns regarding tackling discrimination and abuse. Despite legislative advancements, there was a sense that activism is central to tackling these issues and trans people are articulating their demands for shaping future provision. The research identifies a number of recommendations for care providers and future areas of research.

In response to identifying an absence of trans voices being heard on the subject of trans elder care, this study sought to understand expectations of services, amplify the voices of the participants and share the priorities they articulated to influence future service design and practice.

In early 2017 I was watching YouTube, and being bounced around by its algorithmic recommendations. One suggestion appearing down the side bar column of jpegs was MARROW, from Anohni’s 2016 album Hopelessness. It figures a black background and foregrounds an ageing, smiling, bejewelled woman lip-syncing to the song. She is the American artist Lorraine O’Grady. Watching it felt odd, as if something was `out of place’.

Anohni speaks through her, using ventriloquist tactics to displace her own body and O’Grady’s voice. This interested me. It was the first time I had been presented with the body of an ageing woman without knowing what she looked like in youth (unlike Madonna or Aretha Franklin for example). And it was the first time I had seen lip syncing done in such an eerie fashion. The tactic is used on other music videos for tracks taken from the album where ageing women and women of colour are centre stage.

Using the idea of a place that it is ‘out of time’, in that the music videos are set in a blank space and the lip- syncing upsets the idea of a single sutured speaking author, the chapter explores the idea of `queer temporality’ by using Judith Halberstam’s 2005 work. It suggests that the music videos are potentially transgressive in their presentation of a non-normative and fractured bodies. It uses work from ageing studies (Baars, 2012) and trans-ageing (Moglen, 2008) to suggest the transgressive potential of Anonhi’s music videos in how they position transgendered voices and ageing bodies.

This chapter explores age-based variations in the healthcare experiences of transgender people. Specifically, we outline how transgender people narrate their experiences with coming out and transition in later life as well as possibilities for future research and clinical practice concerning older transgender populations. To this end, we begin with a review of the limited literature on older transgender populations including the ways such findings converge and diverge from studies of younger transgender populations. Then, we analyze data gathered from older transgender people throughout the United States concerning their experiences with health events, healthcare providers, and healthcare settings. For this empirical analysis, we draw on over 250 qualitative responses from transgender people over the age of 40. The findings of this chapter demonstrate the importance of adjusting existing healthcare protocols to provide adequate care for aging transgender populations. Specifically, our analyses highlight gaps in access and quality of healthcare delivery as well as issues related to medical education, trans-inclusive protocols, and sex-gender segregated medical traditions. The implications of our work here reveal important possibilities for expanding transgender healthcare access as well as existing barriers to such access. We specifically utilize the case of our respondents and the existing literature to illuminate gaps in needs assessment and healthcare delivery concerning older transgender populations. We will conclude the chapter with recommendations for bridging such gaps in research, education, and system operation.

We compare the deinstitutionalization of psychiatric patients and the developmentally disabled in the United States and demonstrate that there were two path-dependent processes with significant qualitative and quantitative differences, ultimately leading to better outcomes for developmentally disabled individuals.

Using secondary literature, we construct a sustained comparison of the two processes in terms of outcomes, timing, tempo, extent, funding, demographic composition, and investment in community services. We then reconstruct the strategies of de-stigmatization and framings of moral worth deployed in the two cases, analyzing their effects on deinstitutionalization in terms of conceptions of risk, rights, and care.

Deinstitutionalization began later for developmentally disabled individuals than for psychiatric patients, and was a more gradual, protracted process. It was not driven by fiscal conservatism, discharges, and the trans-institutionalization of the senile aged, as was deinstitutionalization for psychiatric patients, but primarily by the prevention of institutionalization of young children, and increased investment in infrastructure. Consequently, the deinstitutionalization of the developmentally disabled was far more thorough and successful. The process was shaped by the framing of the developmentally disabled as “forever children” by parents’ organizations that demanded a balance between autonomy, protection, and the provision of care. In contrast, the deinstitutionalization of psychiatric patients was shaped by their framing as autonomous citizens temporarily suffering from “mental health problems” that could be prevented, treated, and cured. This frame foregrounded the right to choose (and also refuse) treatment, while undervaluing the provision of care.

“Disparity” implies the existence of a “markedly distinct in quality or character,” difference between one group and another. Some groups, due to elevated stigma associated with group membership, are invisible as a disparate minority and therefore, while there may be a great inequity in healthcare between that group and the normative population, the invisible minority is ignored. This chapter addresses the issue of healthcare for the transgender-identified population. We address how the normative viewpoint of mental illness and unacceptable religious status, along with lifelong perceived and actual abuse and violence, creates a socially sanctioned inequality in healthcare for this population.

Globalisation is generally defined as the “denationalisation of clusters of political, economic, and social activities” that destabilize the ability of the sovereign State to control activities on its territory, due to the rising need to find solutions for universal problems, like the pollution of the environment, on an international level. Globalisation is a complex, forceful legal and social process that take place within an integrated whole with out regard to geographical boundaries. Globalisation thus differs from international activities, which arise between and among States, and it differs from multinational activities that occur in more than one nation‐State. This does not mean that countries are not involved in the sociolegal dynamics that those transboundary process trigger. In a sense, the movements triggered by global processes promote greater economic interdependence among countries. Globalisation can be traced back to the depression preceding World War II and globalisation at that time included spreading of the capitalist economic system as a means of getting access to extended markets. The first step was to create sufficient export surplus to maintain full employment in the capitalist world and secondly establishing a globalized economy where the planet would be united in peace and wealth. The idea of interdependence among quite separate and distinct countries is a very important part of talks on globalisation and a significant side of today’s global political economy.

Unwanted intrusive thoughts (UITs) are a major public health concern (Nock et al., 2008; Bentum et al., 2017), and they are key to the development of a variety of dysregulated behaviours (Jungmann et al., 2016; Bergen et al., 2012). Thus, this study aims to investigate reductive mechanisms for unwanted intrusive thoughts by analysing aspects of affectivity in clinical and non-clinical samples.

Quantitative means of data collection and analysis were used to explore UITs and affectivity. In total, 530 adults took part in this study (236 males, 253 females and 15 transgenders). Participants consisted of clinical (N = 168) and non-clinical samples (N = 336) who completed the Midlife in the United States sense of control scale (Lachman and Weaver, 1998), 20-item neuroticism scale (Goldberg, 1999), self-compassion scale (Neff, 2003a), flourishing scale (Diener et al., 2009), Positive and Negative Affect Schedule - Negative Scale (Watson et al., 1988), generalised anxiety disorder seven-item (Spitzer et al., 2006) and repetitive thinking questionnaire-10 (McEvoy et al., 2010).

Participants who experienced high levels of psychological flourishing, emotional stability, self-compassion, perceived control and affective well-being were prone to experience minimal UITs. Anxiety was positively related to UITs. These findings suggest that these aspects of affectivity may aid the reduction or management of clinical and non-clinical unwanted intrusive thoughts.

This study has addressed gaps in knowledge and the literature on UITs by demonstrating that psychological flourishing, emotional stability, self-compassion, perceived control and affective well-being as aspects of affectivity can be implemented as a reductive mechanism for UITs, and such implementation may have a high probability of effective reduction or management of clinical and non-clinical unwanted intrusive thoughts.