Late-Life Transition Like Bruce Jenner's Full of Challenges, Rewards, Experts Say
People with issues involving gender identity may struggle for years before taking action
FRIDAY, April 24, 2015 (HealthDay News) -- Patricia Harrington is many things: a woman in her 60s, a successful physicist and radiation oncology programmer, and currently the intake coordinator for the Transgender Legal Defense and Education Fund.
The New York City native is also someone with firsthand knowledge of what it means to undergo the complex journey from male to female, something former Olympic champion Bruce Jenner is expected to speak about in a "20/20" interview with ABC's Diane Sawyer on Friday evening.
"I was very cautious," Harrington said. "It's not a day and night kind of thing. When I was very young I was severely bullied, so after that I kind of closed down and spent decades denying who I was.
"When that finally became unbearable, I began to explore the options and test the water in slow motion," she added. "I began at 40, and very slowly tried to undo years of repression. I experimented with cross-dressing. I was lucky enough to connect with people and get support, and I built up my self-confidence, and eventually came out at work."
Some have questioned why Jenner, 65, has been so slow to speak publicly about his situation. But Harrington said that she took nearly a decade to sort through her "psychological process." Then, at the age of 48, she decided to begin hormone therapy.
Harrington's experience was an entirely private matter -- worlds apart from the media speculation surrounding Jenner, the Olympian and reality TV star ("Keeping Up with the Kardashians") who appears poised to become the world's most widely publicized figure for gender transition.
The issue of late-life transitioning from one gender to another has also gathered attention this year with the award-winning, Web-based television series "Transparent." In that series, set in contemporary Los Angeles, Jeffrey Tambour plays a divorced father in his senior years making the difficult journey from a male to a female identity.
It's a dynamic that can pose a unique set of circumstances and challenges, experts said.
"The decision to transition in mid- or late life is not uncommon," said Loree Cook-Daniels, policy and program director for FORGE, a Milwaukee-based transgender support organization.
"For many, it's preceded by a crisis or life change, in which someone realizes that life is short," she added. "Or you might wait until retirement, so coming out at work, and risking losing a job, is no longer an issue. Or maybe there's a family change, such as the kids moving out, or the spouse dying, or the parents dying. All of these events can free a person up to begin a transition.
"At the same time," she continued, "while trans discrimination is widespread at all ages, a late-life transition can be more complicated than it is for someone in their teens or twenties."
On the home front, there are spouses, children and grandchildren to consider, Cook-Daniels noted. On the work front, there's the threat of job and income loss, compounded by age discrimination while looking for new work.
"And, of course, older people are more likely to have other chronic issues that can make it more difficult to take hormones or undergo surgery," she said.
Michael Silverman, executive director of the Transgender Legal Defense and Education Fund, added that "while becoming your authentic self takes courage at any age, for someone in later life social acceptance can also be a particularly big deal. Simply because someone has transitioned doesn't mean that they don't still want to be a longstanding member of their church, or golf club, or community center."
That said, Silverman highlighted one silver lining for older adults contemplating medical options. A new U.S. Department of Health and Human Services ruling issued just this past year suggests that for the first time, "Medicare will now cover medical interventions in support of gender transition, including surgical procedures and hormone therapy."
Harrington pointed out that "everyone is different" and no two transitions are alike. Some people never undergo surgery or hormone therapy, "and being transgender has nothing to do with what medical procedures you have," she said.
However, in her case, hormones "made the biggest change in my life," she said. "Once I began, I knew it was right. It was like having a pair of shoes that don't fit, and finally getting a pair that fit. About a year later I changed my name, my documents, everything at work. And it all fell into place organically. The discomfort was just gone."
Harrington also acknowledged being fortunate to have had strong personal and professional support throughout her transition. And, in some ways, beginning the process at a more mature age made the journey easier.
"I can just roll with the punches," she said. "I can just brush things off. When I was younger, this was all just unthinkable. It was unobtainable and unreachable. Yes, times are changing, of course, and there's been a tremendous amount of progress over the years. But I suppose I've changed as well. I'm less sensitive. I'm more comfortable. And I'm very grateful and amazed that I got to where I now am. I'm finally able to be myself."
There's more on transgender issues at the Human Rights Campaign.