Exploring the mental health care challenges of older transgender people in the Cape Metropole: A participatory photo voice research project
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This project was born after the researcher, a practicing social worker at a psychiatric facility, observed the presence of high rates of anxiety and depressive disorders among transgender patients. These patients were often also abandoned by their family or primary caregivers. This research was part of a larger National Research Foundation (NRF) project in the Western Cape and Gauteng, which explored LGBT older persons’ care needs. It differed from the main project in that it focused on the mental health care challenges experienced by older transgender people. The project was funded by the NRF and the researcher was allocated funding from that project to explore LGBT aging and care in the marginalised areas. LGBT discrimination has been indicated as a key factor in the onset of mental health issues later in adulthood. Older adults are generally at a higher risk of developing mental disorders. The older transgender community with mental health care needs thus often suffers multiple forms of oppression within a heteronormative society. The aim of the research was to determine the mental health care challenges experienced by older transgender people in the Cape Metropole, Western Cape. Objectives to reach this aim included exploring and describing the unique challenges faced by older transgender people, their experiences when accessing mental health care, and describing strategies of addressing their mental health care needs. The research methodology entailed a qualitative approach. Snowball sampling was applied for selecting five older transgender participants and five key informants. Photo voice, a Participatory Action Research (PAR) design, was used. Data collection consisted of in-depth interviewing, focus groups, and photo journaling. Themes were developed from the data utilising Thematic Analysis, aided by Atlas.ti software. Ethics and trustworthiness were certified through guidance by the research supervisor. This research was classified as high risk, since it involved marginalised individuals from the aged LGBT community. Anxiety in the group was anticipated and dealt with by providing further counselling where needed. The findings indicate that older transgender people experience minority stress across all racial and age cohorts. They suffer heightened anxiety when accessing healthcare services, as they anticipate transphobia and oppression. In addition, the intersectional socio-economic status of age and gender identity seems to contribute to building resilience within the participants. Lastly, substance use and social and professional support were identified as coping strategies in the face of on-going discrimination.