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Social support and unmet needs among older trans and gender non-conforming people during the COVID-19 ‘lockdown’ in the UK

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    ARTICLE

    Social support and unmet needs among older trans and gender non-conforming people during the COVID-19 ‘lockdown’ in the UK

    Michael Toze, Sue Westwood and Trish Hafford-Letchfield
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    © 2021 Taylor & Francis Group, LLC
    https://doi.org/10.1080/26895269.2021.1977210
    Published inInternational Journal of Transgender Health
    PublisherTaylor & Francis
    Published online:15 Oct 2021
    Volumeahead-of-print
    Issueahead-of-print
    Pages1 - 15
    Abstract
    Background

    Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions.

    Aims

    This study aimed to explore older TGNC people’s social support networks, key concerns and unmet needs during the COVID-19 ‘lockdown’.

    Methods

    A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants.

    Results

    The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance.

    Conclusions

    Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks.

  • Outline

    Sections

    1. Abstract
      1. Background
      2. Aims
      3. Methods
      4. Results
      5. Conclusions
    2. Introduction
    3. Background
      1. TGNC aging
      2. COVID-19 and the UK ‘lockdown’
    4. Methodology
      1. Design
      2. Measure
      3. Recruitment
      4. Data analysis
    5. Results
      1. Participant demographics
      2. Personal, practical and social support
      3. Impact of COVID-19 lockdown
    6. Discussion
    7. Strengths and limitations
    8. Conclusion
    9. Disclosure statement
    10. References
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    Figure 1.
    TGNC responses to ‘Top 3 concerns’ question in the COVID -19 and Older LGBT + People survey (Westwood et al., 2020).

    subtitles Table 1.

    1. How old are you? [Select box]

    2. How would you describe your

     Sex/gender [Free text answer]
     Sexuality [Free text answer]
     Ethnicity [Free text answer]
     Is your sex/gender the same you were assigned at birth? [Y/N]
    1. Do you consider that you have a disability? [Yes/No]


     If Yes, please describe [Free text answer]
    1. Do you have any significant health conditions? Yes/No.


     If Yes, please describe [Free text answer]
     Do you come under the ‘Shielded’ category according to Covid-19 regulations, due to your health condition? [Yes, No, Don’t know]
    1. Are you living alone or with others? [Alone/with others]


     If living with others, what best describes their relationship to you? [Free text answer]
    1. What are your top 3 concerns about how you are currently affected by Covid19? [Free text answer]

    2. Do you have someone you can call upon in an emergency? [Y/N]


     If yes what is that person’s relationship to you (e.g. friend, neighbor, brother, sister, etc.)
    [Free text answer]
    1. How are you getting essential food, household supplies and medication? [Free text answer]

    2. What are your usual support networks? [Free text answer]

    3. How are your support networks affected by mandatory isolation? [Free text answer]

    4. How are you maintaining connections with your support networks? [Free text answer]

    5. What challenges if any, are you experiencing in maintaining connections with your support networks? [Free text answer]

    6. Have your support networks changed due to Covid-19 regulations? Yes/No.


     If Yes, in what way? [Free text answer]
    1. What do you think about your PHYSICAL health and wellbeing during mandatory social isolation? [5-point Likert scale – lot better; slightly better; no difference; slightly worse; lot worse].

    2. What do you think about your MENTAL health and wellbeing during mandatory social isolation? [5-point Likert scale – lot better; slightly better; no difference; slightly worse; lot worse].

    3. Do you provide support to others? [Y/N]


     If yes, what is your relationship(s) to them? [Free text answer]
     If yes, how is mandatory isolation affecting how you now provide that support? [Free text answer]
    1. What strategies are you using to cope with social isolation due to COVID-19? [Free text answer]

    2. Do you think you have any unmet needs due to COVID-19? [Y/N]


     If yes, what are those unmet needs? [Free text answer]
     If yes, how would you like those unmet needs to be met? [Free text answer]
     If yes, who would you like to meet those unmet needs? [Free text answer]
    1. Is there anything else you would like us to know and/or think we should address in relation to older LGBT + people and Covid-19? [Free text answer]

    Questions in the COVID-19 and Older LGBT + People survey (Westwood et al., 2020).

    Table 1.

    subtitles Table 2.

     Someone to call in an emergency?
     YesNo
    TGNC participants in current study79%21%
    All participants in current study90%10%

    TGNC responses to emergency contact question in the COVID -19 and Older LGBT + People survey (Westwood et. al., 2020).

    Table 2.

    subtitles Table 3.

    Doing own shopping (either wholly or supplemented with online shopping and pharmacy deliveries)23 (61%)
    Online shopping and pharmacy deliveries only10 (26%)
    Shopping done by others5 (13%)

    TGNC responses to practical support question in the COVID -19 and Older LGBT + People survey (Westwood et. al., 2020).

    Table 3.

    subtitles Table 4.

    FriendsFamilyLGBT &/or trans specific support groupLocal charitiesColleaguesFaith groupNHSNeighborsEx-partnerHousematesSpouseNone
    2197433221115

    TGNC participants’ social support networks according to responses in the COVID -19 and Older LGBT + People survey (Westwood et al., 2020).

    Table 4.

    subtitles Table 5.

     A lot betterSlightly betterNeither better nor worseSlightly worseA lot worse
    TGNC sample1 (3%)6 (16%)20 (53%)8 (21%)3 (8%)
    Full sample18 (5%)69 (18%)174 (46%)92 (25%)22 (6%)

    TGNC and full sample responses to question about the impact of COVID-19 on their physical health, in the COVID -19 and Older LGBT + People survey (Westwood et al., 2020).

    Table 5.

    subtitles Table 6.

     A lot betterSlightly betterNeither better nor worseSlightly worseA lot worse
    TGNC sample1 (3%)2 (5%)15 (40%)12 (32%)8 (21%)
    Full sample6 (2%)26 (7%)161 (43%)145 (38%)37 (10%)

    TGNC and full sample responses to question about the impact of COVID-19 on their mental health, in the COVID -19 and Older LGBT + People survey (Westwood et al., 2020).

    Table 6.

    subtitles Table 7.

     A lot betterSlightly betterNeither better nor worseSlightly worseA lot worse
    Physical health1 (3%)6 (16%)20 (53%)8 (21%)3 (8%)
    Mental health1 (3%)2 (5%)15 (40%)12 (32%)8 (21%)

    Comparison of TGNC responses to questions about the impact of COVID-19 on their physical and mental health, in the COVID -19 and Older LGBT + People survey (Westwood et al., 2020).

    Table 7.
    image
    Supplementary materials are not available for display.
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