Search results

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.

Recent evidence shows that any form of physical activity, not just aerobic activity to improve cardiovascular fitness, can have significant health benefits. However, physical inactivity is increasingly widespread. Recent health promotion has emphasised the value of integrating activity into daily life, yet popular attention continues to focus on sporting excellence and team sports. Data from people in early and late middle age in the West of Scotland demonstrate that sporting and team activities are rarely undertaken throughout adult life, especially amongst women and people from more disadvantaged circumstances. The activities that are most commonly taken up and sustained throughout later adult life are walking, swimming, social dancing, keep fit/aerobics and golf. There is a need for greater emphasis, by all those in physical activity promotion, on activities which are the most likely to be sustained into adulthood.

The experimental parliamentary subsidy on knights' fees and freehold incomes from lands and rents of 1431 was the only English direct lay tax of the Middle Ages which broke down. As such, this subsidy has a clear historiographical significance, yet previous scholars have tended to overlook it on the grounds that parliament's annulment act of 1432 mandated the destruction of all fiscal administrative evidence. Many county assessments from 1431–1432 do, however, survive and are examined for the first time in this article as part of a detailed assessment of the fiscal and administrative context of the knights' fees and incomes tax. This impost constituted a royal response to excess expenditures associated with Henry VI's “Coronation Expedition” of 1429–1431, the scale of which marked a decisive break from the fiscal-military strategy of the 1420s. Widespread confusion regarding whether taxpayers ought to pay the feudal or the non-feudal component of the 1431 subsidy characterized its botched administration. Industrial scale under-assessment, moreover, emerged as a serious problem. Officials' attempts to provide a measure of fiscal compensation by unlawfully double-assessing many taxpayers served to increase administrative confusion and resulted in parliament's annulment act of 1432. This had serious consequences for the crown's finances, since the regime was saddled with budgetary and debt problems which would ultimately undermine the solvency of the Lancastrian state.

In the past 50 years, numerous reference books have been written on the subjects of medieval history, art, literature, and philosophy. Steven F. Vincent provides a guide to selecting modern, as well as standard, sources of information on the Middle Ages.

Using a life course perspective, we identified perceived events, transitions and trajectories in older adults' lives that contributed to and inhibited continuous participation in physical activities and exercise at three stages of their lives (ie, young adulthood, middle adulthood, late adulthood). In‐depth interviews with nine men and six women provided an understanding of how societal processes and opportunities, life course roles and transitions and individual meanings of physical exercise influenced the older adults' perceptions of and current participation in physical activity and exercise.

Sexual education in adolescence may represent the only formal sexual information individuals ever receive. It is unclear whether this early educational experience is sufficient to promote lifelong sexual health literacy. The purpose of this paper is to examine the influence of the timing and source of sexual knowledge on current safe sex knowledge and risky sexual behaviours among middle-aged and older adults in the USA.

Participants (n=410, mean age=53.9, 50.7 per cent female) reported whether and when they received sexual knowledge from various sources. They were asked about their current safe sex knowledge and their lifetime sexual risk behaviours.

Most of the participants (61.5 per cent) received formal sexual education in adolescence and 20.2 per cent reported formal sexual education post-adolescence. Across the life span, friends were the most common source of sexual information. The sample scored in the upper mid-range on the scale indexing safe sex knowledge (M=6.69, SD=1.64, range=0-8). Participants reported engaging in an average of approximately four (out of 16) risky sexual behaviours across their lifetime. Those with formal sex education in adolescence scored significantly higher on safe sex knowledge. However, they also engaged in more risky sex behaviours.

This study is among the first to situate the normative, formal sexual education experience of adolescence within a life span context that not only accounts for time, but also multiple sources of influence. It would appear that there are more things to learn about the long-term influence of sexual education programmes during the formative years by studying adult sexual health and knowledge.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.