Aims: To describe the demographic, socioeconomic and mental health characteristics of transgender and gender diverse (trans) Australians aged 50 years and older, and examine associations between socioeconomic adversity, protective factors, and mental health outcomes.
Methods: Cross-sectional analysis of 140 trans adults aged ≥50 years from the TRANSform study (May 2024). Participants completed validated mental health measures (GAD-7, PHQ-9, SWLS) and reported socioeconomic adversity and protective factors. Multivariable logistic regression examined associations with mental health outcomes, adjusting for food insecurity, financial strain, housing insecurity, homelessness, and healthcare discrimination.
Results: Compared with younger trans adults, older participants had lower rates of probable anxiety (32.3%) and depression (46.1%), yet levels remained substantially elevated. Positive indicators included 43.6% reporting life satisfaction and 81.4% having supportive healthcare professionals. However, socioeconomic challenges persisted: 36.4% experienced food insecurity, 37.9% housing insecurity, and 11.4% homelessness. Mental healthcare discrimination emerged as the strongest predictor of adverse outcomes (depression OR 7.75, 95% CI 2.20-34.28; self-harm ideation OR 6.87, 95% CI 1.83-28.77). Food insecurity was independently associated with anxiety (OR 2.66, 95% CI 1.10-6.54), depression (OR 2.54, 95% CI 1.06-6.24), and self-harm ideation (OR 3.31, 95% CI 1.02-11.54). Community support was protective against suicidal thoughts (OR 0.33, 95% CI 0.15-0.76) and planning (OR 0.35, 95% CI 0.15-0.82).
Conclusions: Older trans Australians demonstrate considerable adaptive capacity alongside persistent structural vulnerabilities. Findings highlight critical needs for trans-affirming mental health services, policies addressing material security, and community-connection interventions to support healthy ageing in this population.