title: The aging population: imperative to uncouple sex and gender to establish "gender equal" health care.
abstract: OBJECTIVE
  The transgender community has long been marginalized in society. As the world's population ages, gender-unbiased health services for this growing population, with age-related chronic illnesses, will be essential. To optimally eliminate hurdles that trans individuals often confront when requesting services, it appears judicious to eliminate the strict and antiquated definition of what constitutes "normal" female and "normal" male.
  
  
  METHODS
  A review of literature on transgender medicine on PubMed over the last five years was conducted.
  
  
  RESULTS
  Existing statistics indicate that unacceptable bias and discrimination are occurring, making trans patients less likely to seek care. There are emerging initiatives that address the transgender and gender non-conforming population. Ongoing needs include defining what constitutes "gender equal," understanding the continuum of gender identity, and establishing and implementing guidelines for gender equal counseling and care.
  
  
  CONCLUSIONS
  With the routine practice of defining sex at birth and equating sex with gender in the health care setting, the transgender patient encounters multiple barriers to accessing and acquiring health care services. These strict gender labels appear to preclude the institution of gender equal care. Care templates on gender equal patient encounters should be implemented to better address transgender health needs in a non-biased manner.
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, CAB 2104, New Brunswick, NJ 08901, USA. Electronic address: bachmaga@rwjms.rutgers.edu.
authors.forename: Gloria A
authors.initials: GA
authors.lastname: Bachmann
authors.affiliation: Robert Wood Johnson University Hospital, One Robert Wood Johnson Place, New Brunswick, NJ 08901, USA.
authors.forename: Brianna
authors.initials: B
authors.lastname: Mussman
mesh_terms: D000375:Aging; D003695:Delivery of Health Care; D005260:Female; D005783:Gender Identity; D006297:Health Services Accessibility; D062985:Health Services for Transgender Persons; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011287:Prejudice; D063106:Transgender Persons
keywords: Gender nonconforming community; Transgender; Transgender discrimination; Transgender healthcare