When Catherine Robertson was admitted to the hospital after a medical emergency in her seventies, she braced herself—not just for treatment, but for the real possibility of being misgendered by the people responsible for her care.
“I needed a catheter, and the nurse brought me the wrong one. The kind for men,” she said. “I lost it. How can you make a mistake like that? I’m lying right in front of you.”
Facing misgendering in healthcare
Aging is complicated enough without worrying about whether your identity will be respected in a doctor’s office, a hospital, or a long-term care facility. But for many older transgender adults in Alberta, that’s the reality.
Barriers to care, long wait times for gender-affirming services and a lack of education among providers leave many feeling unsafe or unwilling to seek care at all.
For Marni Panas, Venessa Robinson, and Catherine Robertson, navigating the health-care system as trans women in their fifties, sixties, and seventies has come with challenges—and a sense of community and resilience.
In Alberta, trans people seeking gender-affirming surgery say they must clear unnecessary hurdles, including getting physician and psychiatric approval to get on a waitlist. And even then, most publicly funded surgeries—such as vaginoplasty surgery—are only available through a single clinic in Montreal with years-long wait times.
“I shouldn’t have to wait three years just to be assessed to decide whether I’m suitable for surgery,” said Robinson, who remains stuck in Alberta’s gender clinic backlog. “I’m an adult. I should be able to make my own medical decisions.”
Panas, a longtime advocate for trans-inclusive healthcare in Alberta, has seen how these barriers push people out of the system entirely and the pain this can inflict on each person.
“People say, ‘I don’t know how to treat people like you,’ so they pass you off,” she said. “And eventually, there’s no place left to go.”
When emergency services fail trans people
The consequences of this lack of access extend beyond hospitals. One day, Panas called 911 for a missing trans woman, and the dispatcher’s response stunned her.
“I said she’s a trans woman, and their response was, ‘Well, she shouldn’t be in that profession then,’” she recalled. The dispatcher had immediately assumed she was a sex worker. “If I can’t even call 911 because I’ll be blamed for being in danger, how can I trust the health-care system?”
For trans older adults, concerns don’t end with emergency services and hospital visits. Many long-term care homes, some run by religious organizations, lack training or policies to support trans residents properly.
“When someone who’s trans comes into the system, there’s no planning for them,” says Celeste Pang, a professor at Mount Royal University who researches LGBTQ+ aging and healthcare. “There’s this whole issue made out of them when the issue is really that everything is gender segregated, and it hasn’t been thought through.”
This becomes more alarming if older trans people lose the ability to advocate for themselves.
“Sometimes you don’t have a choice in where you end up,” Panas said. “What happens if you end up in a long-term care home that doesn’t respect your gender identity?”
For many, long-term care isn’t just about medical support. It’s about avoiding complete isolation. A facility that doesn’t affirm a resident’s gender can leave them feeling even more alone, surrounded by people who don’t understand or support them.
The need for LGBTQ-inclusive senior homes
“We need dedicated LGBTQ+ care homes. One person here, one person there—it’s lonely. And isolation is deadly,” said Panas.
Beyond isolation, trans older adults also have specific medical needs that many care homes may be ill-equipped to handle.
“Who’s going to do my dilation for me? Who’s going to help me with basic care that impacts my gender dysphoria and mental health?” Panas asked.
Fighting for change in Alberta’s health-care system
Despite these very real barriers, trans older adults in Alberta aren’t waiting for the system to change. They’re actively working to improve it. Robinson, a member of Rainbow Elders Calgary, advocates for more education and protections in care homes. The organization visits senior facilities to educate staff and residents on LGBTQ+ inclusivity, ensuring trans seniors receive respectful care.
“If I end up in a care home, I want to be treated like any other woman,” she said. “I shouldn’t have to fear being misgendered in my final years.”
Robertson, vice president of Rainbow Elders Calgary, found immediate relief after joining the group.
“From the second I walked in, I went—” she took a deep breath of relief. “When you’re surrounded by people who get it, stress disappears. You’re allowed to smile just for being you.”
Panas has spent years working to implement systemic change in Alberta Health Services, helping introduce gender-inclusive patient records to ensure that chosen names and pronouns are correctly recorded.
“This is systemic change that can’t be undone,” she said. “Now, when a doctor sees a patient’s file, they don’t have to ask invasive questions. They already know what care that patient needs.”
While all three women praise some healthcare providers for their respect and willingness to learn, they say trans-specific training remains essential.
“Doctors don’t get taught how to treat trans seniors,” Robinson said. “It’s not that hard—if you’re not sure, ask. Respect should be the default.”
Despite increasing hostility toward trans rights in Alberta, all three women remain hopeful.
“I don’t see Alberta becoming more inclusive for trans folks right now. I see it going in the opposite direction,” Robinson admitted. “But I also know that communities like mine are resilient.”
For her part, Robertson believes in the power of an open mind.
“Allow your mind to stay open because things of incredible magnitude not only can happen, but I believe will happen,” she said.
For younger trans people worried about aging, their message is clear: find community, advocate for your rights, and don’t let fear stop you from living authentically.
