Navigating Common Health Issues for Trans Women in Later Years (Collaborative Post)

Navigating Common Health Issues for Trans Women in Later Years

For some groups in society good quality health advice can be harder to find, so I'm delighted today to be collaborating on an incredibly informative post about the health issues which can be faced by trans women. 

As trans women grow older, they encounter specific health challenges that require specialised attention to support long-term well-being. Prolonged hormone therapy, cardiovascular concerns, and bone density maintenance become increasingly crucial. 

Moreover, those who have undergone gender-affirming procedures must focus on pelvic health. Mental health care and routine cancer screenings are equally crucial for a healthy aging process. 

Understanding these challenges and taking preventive steps can significantly improve the quality of life. In this article, we’ll explore key health concerns for aging trans women, emphasising proactive healthcare planning and informed choices for overall well-being.

1. Hormone Therapy and Aging

Hormone replacement therapy (HRT) impacts fat distribution, cardiovascular health, and bone strength, requiring continuous monitoring to manage risks effectively. Aging alters hormone metabolism, sometimes demanding dosage adjustments to ensure optimal health and well-being for trans women.

The Centers for Disease Control and Prevention reports that access to appropriate care remains challenging. Around 35.1% of trans women stopping HRT cite barriers like limited transgender-specific healthcare, insurance issues, or affordability. 

Due to these challenges, some trans women use nonprescription hormones. Around 16.1% of women aged 50+ and 9.7% aged 40–49 reported past-year nonprescription hormone use, reflecting restricted medical access.

A healthcare provider can help tailor hormone treatments for long-term safety. A nutrient-dense diet, consistent physical activity, and routine monitoring further support overall health as trans women navigate aging with HRT.

2. Cardiovascular Health Risks

With aging, the risk of cardiovascular disease (CVD) rises, especially for trans women on long-term estrogen therapy. 

ResearchGate suggests that estrogen therapy may increase cardiovascular risks like stroke and venous thromboembolism, requiring proactive heart health management for trans women. Its effects on lipid profiles can heighten heart disease risks, making regular screenings essential for early detection and prevention of complications.

A heart-healthy lifestyle with balanced nutrition, exercise, and no smoking reduces risks. Hormone-related fat shifts affect lipids, requiring dietary changes. Some need medications like statins. Fiber and omega-3s support heart health, ensuring longevity.

Are there specific heart health screenings trans women should prioritise?

Yes, trans women must undergo cholesterol tests, blood pressure monitoring, and heart function evaluations. Since estrogen can impact clotting and lipid levels, routine electrocardiograms (ECGs) and vascular health assessments are beneficial. Adopting a heart-conscious lifestyle with balanced nutrition and exercise, alongside regular medical monitoring, helps prevent cardiovascular complications.

3. Pelvic Health Concerns for Those Who Opt for Vaginoplasty

Trans women who have undergone vaginoplasty may face ongoing pelvic health challenges, including vaginal dryness, atrophy, or pelvic organ prolapse (POP). Routine dilation and pelvic floor exercises are essential for preserving vaginal depth, maintaining muscle strength, and preventing complications.

For those experiencing POP, past treatments often involved vaginal mesh implants. However, growing concerns over their safety led to numerous legal actions. The latest transvaginal mesh lawsuit update revealed severe complications such as chronic pain, mesh erosion, and infections. As a result, many healthcare professionals now advocate for alternative approaches to managing prolapse and related concerns.

According to TruLaw, patients with mesh implants have experienced issues such as erosion, infections, chronic pain, bleeding, and even organ perforation. In many cases, these complications require additional medical interventions to correct the problems caused by the original procedure.

Given these potential risks, trans women should seek specialised gynecological care from professionals familiar with post-vaginoplasty needs. Regular medical check-ups can help detect and address issues early, ensuring better long-term pelvic health.

Are there specific warning signs of vaginal atrophy or prolapse I should look out for?

Common signs of vaginal atrophy include dryness, irritation, pain during dilation, and increased urinary tract infections. Prolapse symptoms may involve pressure, difficulty with bowel movements, or a visible bulge. Regular pelvic exams, pelvic floor exercises, and estrogen-based treatments help manage discomfort, ensuring optimal vaginal health and preventing complications.

4. Mental Health and Emotional Well-Being

Aging can present emotional and psychological challenges, making mental health care vital for trans women.

NCBI states that 33.3% experience probable depression, while 29.6% face probable anxiety in later years, requiring accessible mental health support. Unemployment, chronic illness, and poor self-rated health contribute significantly, making interventions essential. Social isolation further increases risks, highlighting the importance of inclusive healthcare environments and targeted mental health support.

Strengthening social connections and engaging with supportive communities can foster resilience, reducing feelings of loneliness. Seeking therapy from professionals familiar with LGBTQ+ experiences can provide valuable coping mechanisms tailored to their needs.

5. Cancer Risks and Routine Screenings

Estrogen use can increase the risk of breast cancer, making regular mammograms crucial.

Wiley Online Library states trans women have a lower prostate cancer risk than cisgender men, but estrogen therapy may promote aggressive tumors. Medical discrimination and gender dysphoria hinder screenings, reducing early detection rates and increasing serious health risks.

Ensuring inclusive healthcare environments can improve access to preventive care. Gender-affirming surgery recipients should monitor remaining tissue for malignancies and seek specialised gynecological care when necessary.

What are the biggest barriers to accessing routine health screenings for trans women?

Trans women often face healthcare access barriers, including discrimination, limited provider knowledge, and financial constraints. Many struggle to find inclusive medical professionals, while some fear stigma in clinical settings. Furthermore, insurance may not fully cover necessary screenings. Expanding trans-inclusive healthcare policies, increasing provider education, and advocating for accessible medical resources can help improve screening availability.

6. Bone Health and Osteoporosis Prevention

Bone health is a critical consideration for aging trans women, especially those using estrogen therapy or who have stopped HRT.

Royal Osteoporosis Society highlights that long-term estrogen therapy preserves bone density, but insufficient hormone levels heighten osteoporosis risk, increasing fracture susceptibility. 

Regular monitoring and bone scans help manage risks, while vitamin D, balanced nutrition, and weight-bearing exercise support bone health. It ensures that trans women maintain skeletal strength and overall well-being throughout aging.

Regular bone density scans help detect early signs of bone loss, allowing for timely interventions. Consuming a diet high in calcium and vitamin D, combined with weight-bearing exercises like resistance training, yoga, and walking, promotes bone strength. In some cases, physicians may recommend bone-strengthening medications. 

Promoting Wellness Through Proactive Care

Aging introduces unique health challenges for trans women, but proactive healthcare measures can foster longevity and well-being. Managing hormone therapy, cardiovascular health, and pelvic concerns ensures physical comfort and overall functionality. Prioritising mental health, undergoing routine cancer screenings, and maintaining strong bones contribute to sustained vitality.