Gaining Respectful Health Care, a Struggle for Transgender Elders

Pamela Howland, 76, moved back to San Francisco in part because of the discrimination she faced in Arizona hospitals because she is transgender. (Ryder Diaz/KQED)

Editor's Note: In the coming years, California's senior population is expected to grow more than twice as fast as the total population. As part of our occasional series on health called Vital Signs, we're spending the month focusing on older adults. Today we meet 76-year-old Pamela Howland. When she retired, Howland decided she could finally live as a woman after spending her entire life as a man. But being a transgender senior has come with many challenges, including discrimination, even in health care settings.. 

By Pamela Howland

I had decided that the years I had left, I wanted to live the way I wanted to live. It was a shame that I had to make the change because it would have been so much easier to continue living as a male rather than encounter the difficulties of living as a transgender female that doesn't pass as female.

I had been in Arizona about two years, when I had a [abdominal] surgery and the surgery damaged a very key nerve in controlling my gastrointestinal system.

I spent on and off three months in the hospital, and I had some very, very terrible treatment both by nurses and doctors.


They didn't approve of me taking estrogen, so they weren't going to go out of their way or do anything to help me take that estrogen. I said, I have to take it and not only that, if I don't take it I'm going to go through withdrawal. They just assume say, 'Let him suffer.'

That's another thing that comes up continually. 'Sir.' I'm called "sir" rather than "ma'am."

You're trapped. And not only that, you're very vulnerable because you're in the hospital for a reason: you're sick.

As I get older, there are going to be other reasons why I'm hospitalized. It happens to everyone.

The only way I could be confident about the medical system was to come back to San Francisco. So, I left a home that I had planned on living in the rest of my life -- and an area I planned on living the rest of my life -- purely for medical support.

I think the absolutely most important thing for anyone is to have an advocate, someone who can help you through whatever medical crisis or medical difficultly you're having. If you're not being heard, if they're not paying attention to you, your advocate can do something for you because you're not in a condition where you can do anything about it.

That story was reported by Ryder Diaz.

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