Spirituality & Religiosity in the Aging Transgender Community
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Published: THE JOURNAL OF RELIGION, SPIRITUALITY & AGING –
REVISION
Kidd, J. and Witten, T.M. (2007). Assessing spirituality, religiosity and faith in the transgender
community: A case study in violence and abuse - implications for the aging transgender community
and for Gerontological research. J. Religious Gerontology, 20 (1-2): 29-62.
UNDERSTANDING SPIRITUALITY AND RELIGIOSITY IN THE
TRANSGENDER COMMUNITY: IMPLICATIONS FOR AGING
1
2, 3
Jeremy D. Kidd
Tarynn M. Witten
RUNNING HEAD: Spirituality in the Aging Transgender Community
VCU IRB APPROVAL NUMBER: HM10279
KEYWORDS: Abuse, Aging, Faith, Religiosity, Spirituality, Transgender, Transsexual, Violence
1Jeremy
D. Kidd, AB, Department of Gerontology, Virginia Commonwealth University Randolph Minor
Access, 301 College Street PO Box 980228 Virginia Commonwealth University Richmond, VA 23298-0228
[email protected]
2 Tarynn M. Witten, PhD, MSW, FGSA, Department of Gerontology, Virginia Commonwealth University
Randolph Minor Access, 301 College Street PO Box 980228 Virginia Commonwealth University
Richmond, VA 23298-0228, School of Social Work, Virginia Commonwealth University, and Executive
Director, TranScience Research Institute. [email protected]
3
All correspondence and requests to this author at this address: Dr. Tarynn M. Witten, Center for the
Study of Biological Complexity, Suite 111, PO Box 842030, Trani Life Sciences Bldg, 1000 West Cary
Street, Richmond, VA 23284-2030
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ABSTRACT
We focus on issues arising in the assessment of the religious, spiritual, and faith beliefs and
practices of female-to-male (FTM) transgender people, individuals whose natal (genital) sex is
female but who now claim a culturally more masculine gender identity. Results are compared to
those found in the larger mixed transgender population Transcience Longitudinal Aging Research
Study (TLARS). Religiosity/spirituality/faith were measured by the Fetzer Multidimensional
Measurement of Religiousness/Spirituality instrument and by the TLARS survey instrument,
violence and abuse sub-component. The researchers found that the religious beliefs of the
respondents differed so dramatically from the normative Judeo-Christian-Islamic belief systems on
which conventional psychometric instruments were based that many of the survey respondents
expressed difficulty in completing the religiosity/spirituality/faith component of the survey. The
researchers conclude that traditional religiosity/spirituality instruments are not effective for the
study of religion/spirituality/faith in both the FTM and more general transgender-identified
populations.
These findings indicate the need for both a comprehensive ethnographic
investigation of FTM religious/spiritual/faith structures and also a re-construction of conventional
religiosity/spirituality/faith psychometric instruments more reflective of the life experiences of
FTM-declared individuals and more generally the transgender-identified population as a whole.
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INTRODUCTION AND BACKGROUND
The importance of religiosity/spirituality/faith in normative lifecourse aging has been
documented by a numerous researchers (Ai, 2000; Birren & Schaie, 2006; Brennan & Heiser, 2004;
Daaleman, Perera & Studenski, 2004; Idler, Kasl & Hays, 2001; Kennedy et al., 1996; Krause,
2006ab; Krause & Ellison, 2003; Langer, 2000; MacKinlay & McFadden, 2004; Moberg, 2001;
Peacock & Poloma, 1998; Wink, 1999). Levin (1994) points out that religion impacts the wellbeing of older adults in a number of ways it “reduces the risk of chronic and acute stressors which
adversely impact morale, offers cognitive or institutional frameworks, such as coherence or order
or meaning that buffer stress and facilitate coping, provides concrete social resources, such as
religious fellowship and congregational networks and enhances internal psychological resources
such as self-esteem and feelings of worthiness.”
The gerontological and geriatric literature supports the argument that social conditions (Kraaj
et al., 2002; Kubzamsky, Berkman, & Seeman, 2000), social network support (Lyyra & Heikkenen,
2006; Pinquart & Sorenson, 2000; Grossman, D’Augelli, & Hershberger, 2000), racial
identity(Anderson et al., 2004; Smedley et al., 2003), socio-economic status (Rautio, Heikkinen &
Heikkinen, 2001), and even social role (Krause & Shaw, 2000) can all have significant impact,
positively or negatively, on mortality, morbidity, health status, depression prevalence, overall
psychological well-being (Zhang & Hayward, 2001), successful aging (Rowe & Kahn, 1997), and
numerous other life course outcomes that are of current importance in the Healthy People 2010
Project (Healthy People 2010, 2000). The results of these studies can be briefly summarized as
follows: the lower the income, the less social support (e.g., friends, spiritual activity, supporting
organizations, neighbors upon whom one can depend), the less habitable the social conditions
(isolation, poor environment), the less education, the higher the risk for psychological dysfunction,
long-term poor quality of life, poor health status, increased morbidity and mortality, and reduced
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likelihood of being “a successful ager” in the sense of the MacArthur Foundation’s Successful
Aging Project (Crowther et al., 2002; Tornstam, 2005; Kaye, 2005; Parker et al., 2002; Reuters,
2006; Rowe & Kahn, 1997). Also, important to successful aging are the effects of both perceived
and actual violence and abuse across the lifespan (Witten, 2004).
Religiosity/spirituality/faith have also been demonstrated to have significant impact in
near end of life and end of life struggles (Belongia & Witten, 2006; Krause, 2003; Krause &
Ellison, 2003; Witten, 2002b; Idler et al., 2001; Daaleman & VandeCreek, 2000). Literature dealing
with fear of death (Cicirelli, 2002); palliative care (Keay, 1999), family and significant others (Haley et al.,
2002), terminal illness (McGrath, 2003) and Alzheimer’s Disease (Stuckey, 2001) demonstrates the
diverse
impact
and
importance
of
both
an
individual’s
as
well
as
a
family’s
religiosity/spirituality/faith during the later and last stages of life. However, little work has been
done on the effects of religiosity/spirituality/faith as mitigators of the long-term, age-related
effects of perceived/actual violence and abuse in and against highly stigmatized minority
populations (Creighton, 2001; Sisk, 2006; Witten, 2004); in particular, we speak of the world-wide,
transgender and intersex-identified populations.
With the worldwide number of transgender-identified individuals on the rise (Witten,
2003) and the highly stigmatized nature of the transgender-identity in many countries (Witten &
Eyler, 1999, 2007ab; Witten & Whittle, 2004), coupled with the elevated degree of violence and
abuse suffered by many members of these populations (Gender Education & Advocacy, 2005;
Herek et al., 2002; Lombardi et al., 2001; Sisk, 2006; Witten & Eyler, 1999), the importance of
understanding religion/spirituality/faith effects in mitigating the effects of perceived and actual
violence and abuse across the lifespan in these populations is particularly important for healthcare
practitioners, spirituality-based counselors and therapists, and Social Workers (Greene, 1986;
Kaye, 2005, Reese, 2001; Tirrito, 2000), as well as elder care facilities staff (Witten, 2002b, 2005b;
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Witten, Eyler, & Weigel, 2000; Witten & Whittle, 2004). We begin with a brief overview of
transgender identities.
Brief Overview of Transgender Identities
Transgender is a term used broadly “to describe people who transcend the conventional
boundaries of gender, irrespective of physical status or sexual orientation” (Feldman & Bockting,
2003). The term is used to refer to groups such as transsexuals, cross-dressers, drag queens, drag
kings, and gender queers, as well as myriad other members of the “gender community (Sims, 2007;
Witten & Eyler, 1999; Witten et al., 2003).” While the exact number of transgender-identified
individuals is difficult to estimate, an international survey administered by Witten and Eyler (1999)
found that 8% of the TLAR survey respondents identified their gender identity as something other
than completely feminine or masculine. Based upon these estimates, Witten (2003) projected a
range of 4.1-12.3 million elder transgender-identified persons (65 years and older) worldwide. Her
work did not include the various cultural variations of transgender discussed in Witten and Eyler
(2007ab) and is therefore likely to underestimate the actual size of the global elder transgenderidentified population.
Within the diverse collection of gendered identities, one of the most invisible is the femaleto-male (FTM)-identified population. FTMs are individuals whose natal (genital) sex is female but
who now self-profess a more culturally masculine gender identity. FTMs sometimes, but not
always, adopt a more culturally normative masculine gender expression through aesthetic,
cosmetic, hormonal, and/or surgical means. Several other identity labels falling within the FTM
category are transman, man-born-woman (MBW), as well as numerous others.
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SPIRITUALITY, RELIGIOSITY AND FAITH IN MINORITY POPULATIONS
Application of Religiosity/Spirituality/Faith Measures to Minority Populations
Many researchers (Nagayama Hall, 2001; Campesino & Swartz, 2006) have expressed doubts
about the applicability and efficacy of conventional psychometric instruments for studying
minority populations; particularly those groups with histories of stigmatization and discrimination.
This is clearly appropriate to the transgender and intersex-identified populations. Nagayama Hall
(2001) describes these conventional research methods as having given rise to “empirically supported
therapies” (ESTs). Despite their effectiveness in treating certain disorders in the general population,
they are only empirically applicable to “ethnic minority persons. . . who are acculturate, speak
English, are educated, are not socio-economically disadvantaged, are not strongly identified with
ethnic minority cultures, and have not experiences much discrimination and disenfranchisement”
(Nagayama Hall, 2001, p. 502).
Often researchers opt to simply replace the conventional Euro-Caucasian vocabulary of an
EST with more culturally appropriate vernacular; taking an “etic approach” that emphasizes the
universality of psychological conditions. However, Nagayama Hall advocates for the creation of
“culturally-sensitive therapies” (CSTs) which factor into both the language and methodology a minority
population’s unique life experiences, historic discrimination, historic/systemic disenfranchisement,
and cultural influences, thereby avoiding reductionist findings.
The ineffectiveness of conventional psychometric instruments also appears to apply to the
religious beliefs of ethnic minority populations which are not necessarily identical to those of
European, middle class people, on which many of these instruments were normed (Nagayama
Hall, 2001).
Even when researchers attempt to create instruments that are reflective of
contemporary religious plurality (King et al., 2001), they often rely heavily on majority religious
traditions (e.g., Christianity and Judaism) and/or conventional concepts within Euro-Caucasian
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religious discourse (e.g., monotheism, after life, near death experience, divine anthropomorphism).
We shall momentarily demonstrate that this type of approach portents significant problems, when
dealing with the transgender-identified community. By means of example, consider the following.
Conventional research instruments, normed on Euro-Caucasian Judeo Christian followers,
are not applicable in Latina/o populations who do identify themselves as Catholic because of the
incorporation of cultural principles such as personalismo and familismo (respectively, intimate
connections with other people and with one’s immediate family), and the use of pre-colonial
symbolism (e.g., Nuestra Senora de Guadelupe) that is not present in the same manner or degree in
European Catholicism (Campesino & Schwartz, 2006). An instrument that measured religiosity
only as it is configured in European civilizations would not adequately assess or examine this
branch of Latina/o spirituality/religiosity/faith. “Simply translating items in questionnaires from
English to Spanish is not sufficient if the underlying concepts of the questionnaire are reflective of
dominant Anglo-European, individualist perspectives (Campesino & Schwartz, 2006).”
In response to some of these issues, some researchers have attempted to create various
culturally sensitive/alternative instruments (i.e., Adel-Khalek, 2004; Daaleman et al., 2002; Hatch et
al., 1998; Hays et al., 2001; Horn et al., 2003; Krause, 2002b; MacKinley & McFadden, 2004;
Reker, 2001b). However, none of these instruments has been normed on the transgender or the
intersex-identified populations worldwide. And even if they were, it is highly likely that they would
not accurately reflect the religious/spiritual/faith experiences of these populations, given their
diversity and frequently non-traditional nature.
Application to Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI) Populations
A similar phenomenon of unique religious orientation has been observed in populations of
lesbian, gay and bisexual (LGB) Christians. “In response to heterosexist and unwelcoming
[religious] communities, LGB-affirming faiths have evolved, either by altering traditional faith
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doctrine to be inclusive (e.g., Dignity for LGB Catholics) or creating entirely new faiths specifically
serving the LGB community (e.g., the Metropolitan Community Church” (Lease et al., 2005, p.
379)
A recent study by Sullivan-Blum (2004) further illustrates this evolution and
conglomeration of religious identity as well as the diversity of religious expression in LGB
populations. Sullivan-Blum ethnographically examines the religious practices and spiritual beliefs
of four drag queens, all of whom identify as gay men. Given the FTM survey’s operational
umbrella definition of “transgender,” it is also possible to use of this label to describe the gender
components of these four individuals’ identities who have collectively experienced a variety of
Protestant upbringings and anti-gay congregational attitudes.
The four respond to this
homophobia in different ways. One stopped attending church altogether, still calls himself a
Christian, but legitimizes his gay drag queen identity by drawing on the Native American thirdgender concept of “Two Spirit People” (Jacobs, Thomas & Lang, 1997; Sullivan-Blum, 2004;
Witten & Eyler, 2007b). Borrowing from Hindu and Taoist perspective of gender (Witten, 2002a),
he also claims to reproduce the divine om of creation through the unity of his conventional belief
in Jesus’ teachings (ying) and his sexual and gender subversion of Christian doctrine (yang).
Another interviewee adheres literally to Protestant teachings and ritual, even condemning his gay
male identity.
The experience of religious isolation places many LGB (and T) people outside the realm of
those for whom Nagayama Hall (2001) says psychotherapeutic research will be “most useful”. These
biographies also illustrate the ways in which non-normative, non-binary gender identities can
affect religious identity formation and transformation. The participants in the Sullivan-Blum
(2004) study “. . . mine the inconsistencies and contradictions in Christian discourses of sin, sexual
morality and theology to carve out a space for their spirituality that is reconciled to their gender
Spirituality & Religiosity in the Aging Transgender Community
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and sexual identity even if this requires going beyond traditional Christianity” (Sullivan-Blum,
2004).
The inapplicability of conventional religiosity/spirituality/faith psychometric instruments
can be further explored using “standpoint theory” as articulated in Hartsock (1995). While
Hartsock's core claim in “The Feminist Standpoint” speaks only of genetic women, many elements
of her analysis can be extrapolated to the sociological and historic experiences of transgender
people. Drawing on historic materialism, Hartsock states that “material life (class position in
Marxist theory) not only structures but sets limits on the understanding of social relations” and
that the material lives of two groups are constructed in opposition then their worldviews similarly
diverge, leaving the “rulers” with a “vision. . . [that] will be both partial and perverse (Hartsock,
1995).” Transgender people possess an identity which directly opposes the dominant notion of
binary gender (Doyal, 2001; Eyler & Wright, 1997; Greenberg, 1998). This gendered opposition
results in many, if not all, transgender people leading lives from fundamentally different
perspectives than non-transgender people.
A psychometric instrument based solely on the
perspective of the dominant gender binary worldview will most often result in “partial and
perverse” conclusions, reflecting the limited vision derived from a ruling “standpoint.”
Spirituality/Religiosity/Faith in the Transgender-Identified Communities:
What Do We Know? Prelude to Late Life: Mid-to-Late Life Issues
Witten (2004) and Hunter (2005) address many issues related to mid-to-late life struggles in
the LGBT populations in general (Hunter, 2005) and the transgender-identified population in
particular (Witten, 2004). Midlife for the transgender-identified person can be a time of
importance at a number of levels (Witten, 2004). For many MTF identified individuals, they will be
“coming out” and addressing their gender struggles (Witten & Eyler, 2007ab). For many FTM
individuals, who typically come out at a younger age than MTF, they will be examining their life
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path and addressing traditional midlife issues as seen through the lens of a gendered lifestyle that
might have been in existence since their late teens or early twenties. Thus, the spiritual life path for
many of these individuals will be a very personal experience that is potentially profoundly affected
by their gender journeys (Witten, 2002a).
It is particularly important to take note that there is an increase in spirituality and religiosity
(Jones, 1996) of the mid-life transgender-identified parent. Moreover, it is frequently within the
context of spiritual, religious, and/or faith isolation and disenfranchisement that the transgender
and/or intersex-identified individuals experience the need to maintain a religious/spiritual/faith
component within their lives. Many of these transgender and intersex individuals now, because
they are now newly “out,” no longer have access to the traditional spiritual dwellings of their past
lives as most traditional religions and spiritualities see non-normative sex, gender, and sexualities
as not only unacceptable, but a sin. Others, who have been out for long periods of time, may wish
to return to the fold and find that they are no longer welcome. Thus, the transgender/intersex
person is frequently isolated from family, friends, job, and the spiritual support network. Consider
the following quotations from both the TLARS and from this survey (spelling and grammar
retained as written):
• Clergy: when my sister was married in my hometown church, I was only
permitted to view the ceremony from the loft. not allowed into the
church with the others.
• Insulted by Catholic priests Re: my chosen dress being incongruent with
my gender.
• My church said that they didn’t mind my being a transsexual woman and
that I could attend services as long as I promised to remain celibate for
the rest of my life.
• Religion let me down. The Bible, which meant so much to me, is being
used against me.
Sadly, the only mention of anything in the Bible that could be interpreted as possibly related to
transgender identities is Leviticus 20:13 which states that, “If a man has intercourse with a man
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as with a woman, both commit an abomination. They must be put to death.” However, it is also
clear that use of this as an anti-transgender mandate conflates the binary body (birth
body/genital body) and the constructions of emergent sexuality and gender identity based upon
that body without an understanding of such genetic differences as intersex or the fact that it is
possible that there is a conflation between the “right mind and the wrong body (Cassell,
1998).”
Intergenerational issues surrounding religion, spirituality and faith are also an important
priority (Witten, 2003; 2004). Many TLAR respondents had one or more elder parents, relatives or
family members about whom they were worried. For some, showing up as the “new” self could
create problems for the other family members as well as for themselves around issues of religion,
spirituality and/or faith. For example, one respondent asked,
• What happens at a funeral? Everyone knows they had a son. How do I
show up and explain myself? How do we handle the life crisis issues?
Another respondent's brother has a brain tumor.
• My parents have forbidden me to come home. They will not let me talk
to him. I can’t go to see him. I can’t go to the funeral. How am I
supposed to handle this?
This study seeks to demonstrate to Social Science and Gerontology/Geriatrics researchers
the need for a new frame of analysis that incorporates the viewpoints and vision of transgenderidentified people, who also experience the world differently. Research that moves beyond the
viewpoint of a “simple dualism . . . posits a duality of levels of reality, of which the deeper level or
essence both includes and explains the ‘surface’ or appearance... (Hartsock, 1995; Witten & Eyler,
1999, 2007b).” This type of research would not only enhance our understanding of the life
experiences of transgender-identified individuals, but would also increase our knowledge of society
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in general. And, in the process, provide potentially useful constructs that could be translated to a
more general population.
METHODS
Participants
The TLAR study design and implementation are reported elsewhere (Witten & Eyler,
1999; Witten, 2007b). In this current FTM survey research project, surveys were administered to
33
self-identified,
natal
females
who
also
self-identified
as
female-to-male
(FTM)
transsexual/transgender persons. In this study, the FTM label was not defined. This research
project was approved by the Virginia Commonwealth University’s Institutional Review Board. Of
the 33 surveys distributed, 13 surveys were returned by postal mail (39% response rate). This
response rate is in line with other studies that focused on LGBT populations (42%, Comstock,
1989; 42%, Bradford et al, 1994; 68%, Witten & Eyler, 1997). The FTM survey respondent age
range was 18-42 years old representing a much narrower and younger range than the larger TLAR
survey. Eleven of the FTM respondents were Caucasian (85%), one respondent was Latino (8%),
and one was African-American (8%). This is a much narrower racial distribution than that found
in the larger TLAR survey (n = 206) in which the respondents were 72.3% Caucasian, 5.8%
Hispanic/Puerto
Rican/Cuban/Spanish,
Islander/Filipino/Asian
Indian,
0.5%
9.7%
Native
African-American,
8.3%
American/Aleut/Eskimo
Asian
and
Pacific
3.4%
Biracial/Multiracial/Other descriptors. Note that, while the TLAR survey contained a broader
base of racial respondents, the percentages of response are quite similar (not statistically testable).
Five of the FTM respondents (38%) had post-secondary education, with four of those
having undergraduate or graduate degrees (31%). These results are consistent with the TLAR
respondents who reported 43.3% having a college degree and 24.9% having a graduate degree.
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With respect to employment status and personal gross income, 1 FTM respondent was
unemployed, 9 employed full-time, 2 full-time students and 1 part-time student. The income range
was $1,500 - $45,000.
Materials
The FTM survey instrument consisted of four clearly identified sections: Demographics,
Religiosity/Spirituality/Faith, Experiences of Violence and Open Concluding Comments. All four
sections contained a mixture of qualitative and quantitative items. Surveys were collected over a
six month period from June 2006 through the end of December 2006.
The demographic section of the survey instrument asked for such items as respondent’s
race, employment status, gross annual income, level of financial strain, relationship status, highest
level of education, biological sex, and chromosomal sex (if known). Where relevant, respondents
were also asked about the gross annual income of their partner(s). Qualitative questions were used
to determine the respondent’s gender identity and sexual orientation so as to allow for a more
nuanced answer.
In the religiosity/spirituality/faith section of the survey instrument, respondents were first
asked to identify their own religious orientation and that of their partner(s), if applicable, from a
number of choices provided.
This list was compiled using responses from the TLAR survey
Wave 1 (Witten & Eyler, 1999; Witten, 2006; Witten & Eyler, 2007ab) demographics sub-survey
component. The researchers provided respondents with 19 options as well as “None” and
“Other” options. Table [1] illustrates the full range of options of available to respondents. The
Fetzer Multidimensional Measurement of Religiousness/Spirituality (Fetzer, 1999) was also used
to quantitatively assess religiosity/spirituality. Long forms of the Fetzer instrument were used in
order to assess daily spiritual experiences, private religious practices, and meaning making. Short
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forms of the instrument were used to assess organizational religiousness and religious/spiritual
coping.
(Table 1 Approximately Here)
Experiences of violence were the focus of the third portion of the survey.
Both
quantitative and qualitative items were used to acquire information about the types, frequency, and
specific nature of violent incidents experienced by the respondents. Questions were drawn from
the TLAR (Witten & Eyler, 1999) violence sub-survey component in order to allow comparison
with TLAR results. Respondents were also asked whether the incidents they experienced were hate
crimes given the following operational definition of a hate crime: “Intimidation, abuse, harassment
based on bigotry or bias with respect to one’s actual or perceived race, religion, ethnicity, disability,
sexual orientation or gender identity or expression. This can take a physical, verbal, emotion, or
sexual form.” Unlike the TLAR survey, the researchers did not provide the survey participants
with definitions of the different forms of abuse/violence. The Fetzer (1999) subscale entitled
“Religious/Spiritual Methods of Coping to Find Meaning” was used to assess the degree to which
religion enabled the respondents to cope with their experiences of violence. Respondents were
also given qualitative items related to coping and meaning making.
The final section of the survey offered the respondents a space to provide any last
thoughts that were either survey or non-survey related.
Design and Procedure
Surveys were distributed via two regional Virginia support and social groups for female-tomale transgender-identified persons. One of these groups was primarily a discussion group for
FTMs; the other was more loosely organized and was a predominantly social group. Surveys were
distributed to respondents either in person or by postal mail. Respondents then returned the
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survey to the researchers in a pre-stamped, pre-addressed envelope. Potential survey contacts
were also made via snowball/word-of-mouth sampling.
ANALYSIS
SPSS v13/14 (SPSS, Chicago, IL) was used for all of the statistical analyses. Differences in
means between groups were tested with t-tests, differences in modes using Mann-WhitneyWilcoxon tests, frequency differences between groups using χ2-tests, correlations using Pearson
correlations and standard descriptive measures when needed. Where relevant, all distributions
were tested for normality. When normality testing failed, we used distribution-free methods to test
for differences. Significance was set at p < 0.05.
RESULTS
Body, Sex, Gender & Sexuality
All FTM survey respondents reported a female genital (natal) sex. Sexual orientation and
gender identity of the respondents were determined qualitatively. Self-identifications with regard
to sexual orientation included such labels as bisexual, queer, straight, and “heterolesbian,”
indicating the plasticity of the sexual identification process. A number of questions were asked of
the TLAR participants in order to sort out respondent’s sex, gender identity and sexuality. For
example, when asked for their biological self-identification (genital sex), most replied female, male,
or intersex. However, 3.5% responded with such items as “gay boy, sex change, transgender, and
FTM/transman,” indicating the conflation and fluidity of sex, gender identity and sexuality within
the transgender identified population (Witten, 2004, 2005a).
FTM gender self-identifications varied similarly and included male, boy, mostly male,
transgender, “genderqueer,” FTM, transsexual, queer, “straight male living in a female body,” and
trans-man. It is very interesting to note that male, rather than masculine, was used as the gender
identifier. This is consistent with the results of Pryzgoda & Chisler (2000) who found that there
were numerous terminology conflations, misunderstandings, and misuses around words used to
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describe sex, gender and sexuality. These results were further supported by the work of Witten
(2004).
Current and Past Upbringing Religiosity, Spirituality and Faith of the FTM and TLAR Respondents
With regard to current religious orientations of the respondents, only five (38%) of the
FTM respondents were able to match their religious orientation with one of 19 possible choices
provided in the FTM survey (Table [1]). This is significantly different from the larger TLAR
survey results which demonstrated that 76% of the survey respondents were able to match their
current religious preference with the available list choices. 24% (n = 200) of the TLAR
respondents chose “Other” as their current religious preference and wrote in alternatives despite
the fact that thirteen options were provided, including such choices as Taoist, Buddhist, Quaker,
and Alternative Healing Circles, along with the traditional Judeo-Christian-Islamic choices. It
should be noted that this choice offering is considerably more comprehensive than that of
conventional reports such as those given by the American Religious Data Archive (ARDA), a
leading source of information about religious beliefs and practices in the United States. This
organization, which is cited by the U.S. Census Bureau (2006) as a source of religious data, only
reports data in terms of Christianity, Judaism, and Islam. Data reported by the ARDA (2000) does
not include individuals who identify with so-called “Eastern” faith traditions (Witten, 2002a),
Paganism, Wicca, or myriad other possible religious traditions or spiritual orientations (Connor &
Sparks, 2004; Kaldera, 2002; Teh, 2001; Witten, 2002a).
The religious identities of those five FTM respondents (38.5%) who were able to match
their identity with one of the choices provided were Pagan, Quaker, Buddhist, Atheist, and
Agnostic. For the TLAR survey, 64% (n = 200) were able to match with one of the choices
provided. One of the remaining eight FTM respondents (7.7%) chose “None” as his religious
orientation. This is lower, but not inconsistent with the larger TLAR survey in which 14%
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responded with none as their choice. The other seven (53.9%), who could not identify their
religious orientation from the choices given, chose “Other” and wrote in a number of alternative
religious orientations, which were as follows: “Christian” (reported by two respondents); “Church
of Christ,” “Methodist,” “Spiritual,” “combination of beliefs,” and “just spiritual, not religious.”
The TLAR survey respondents who chose the “Other” (24%) category, wrote in over 30
additional options including such choices as, “Christian/santaria, Colonial alliance church,
Discordian, Goddess worship, Krishna conscious, LDS, my own beliefs, Neo-Pagan Celtic, Native
American, Non-specific spirituality, Wiccan Solitary, and Pagan/nature-based.”
Religious upbringing of the TLAR and FTM respondents was equally varied. 90.2% of the
TLAR respondents were able to identify their religious upbringing from the options available;
Agnostic, Atheist, Jewish, Christian faiths, Buddhist, Taoist, Muslim/Islam, Alternative Healing
Circles. Nine (69.2%) of the FTM respondents were able to identify their upbringing from the
choices
given.
These
nine
were:
Roman
Catholic
(n=2),
Protestant
(n=4),
Pentecostal/Charismatic, Mormon, and Quaker. One of the remaining four respondents chose
“None.” The other three chose “Other” and wrote in the following: “Baptist,” “Christian:
Baptist,” and “Christian.” TLAR respondents wrote in an additional 12 options for religious
upbringing.
FTM God Constructs
FTM survey respondents were also asked to qualitatively describe their individual Godconstructs. Table [2] illustrates all thirteen of the respondents’ reported God-constructs in relation
to their religious upbringing and current religious orientation. We observe that there is a broad
diversity of God-construct from the traditional Judeo-Christian-Islamic to Eastern belief structures
through Pagan, Agnostic and Atheist.
Spirituality & Religiosity in the Aging Transgender Community
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Results from the Fetzer (Fetzer, 1999) instrument, which made up the remainder of the
religiosity/spirituality portion of the survey, are not reported at this time, as many of the
participants were not able to complete these sections. One individual who left these portions
blanks indicated in the margin of the survey:
(Table 2 Approximately Here)
• I tried to do this survey for you, but I cannot continue to answer the
questions as worded. You continually refer to a higher power as a
conscious being and although I believe in a higher power – I do not
believe it has intelligent direction.
Similar problems were reported in the TLAR survey, in which some respondents reported:
• I believe in a higher power, but I have no religious affiliation
• I have a non-specific spirituality
In addition to those who left these sections blank, some of those who did answer the questions
qualitatively expressed difficulty in doing so.
DISCUSSION
The second major conclusion of this study is that conventional instruments such as the
Fetzer Multidimensional Measurement of Religiousness/Spirituality (Fetzer, 1999) are not
sufficient for studying religiosity/spirituality/faith in the female-to-male (FTM) transgender
population. This result, for a more general transgender-identified population, is supported in the
work of the TLAR Survey Wave 1 (Witten & Eyler, 1997; Witten, 2004).
One emergent theme that seems to explain this conclusion is the prevalence of non-Judeo
Christian-Islamic religious identities within the FTM population
Spirituality & Religiosity in the Aging Transgender Community
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• Most of the questions were more applicable to conventional western
monotheistic spirituality and many didn’t make sense for my belief
system,
commented one FTM respondent. Kaldera (2002) notes this prevalence for polytheistic religions
and faith tradition with gender-fluid or gender ambiguous deities. This dynamic makes sense
given the body of research demonstrating a tendency for minority individuals to either practice
religious traditions different from that of their upbringing or to adopt alternative interpretations of
their current faith to reinforce, support, and normalize their minority, and often stigmatized,
identities (Connor & Sparks, 2004; Kaldera, 2002; Nagayama Hall, 2001; Sullivan-Blum, 2004; Teh,
2001; Winter, 2006; Witten, 2002a).
Moreover, a number of the FTM and the TLAR participants possessed religious beliefs
that defied categorization, even by the respondents themselves. Many of these individuals chose
the “Other” option when asked about their religious orientation and subsequently described
religious orientations ranging from “spiritual” to “a combination of beliefs,” thereby supporting
the adaptive and creative nature of the FTM religiosity/spirituality/faith base. Others chose
“None,” not finding a choice in the rather extensive list given that adequately captured their belief
system. One respondent who chose “None” described their religious belief system as follows:
I feel like I pushed christianity away b/c [because] it was so beat into
my brain as a child . . . I found myself later on still feeling like there is
some sort of energy that connects us & I agreed w/ [with] some
aspects of many religions but never all of any one. Praying in general
to whatever has helped me to deal w/ [with] day to day of being a
transexual person” [sic].
Spirituality & Religiosity in the Aging Transgender Community
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Another emergent explanation for the inapplicability of the Fetzer instrument in FTM
populations is that even those individuals who self-identified as Christian (Protestant, Roman
Catholic, and Mormon) did not report god-constructs congruent with those held by conventional,
mainstream Christian denominations. These respondents reported highly ethereal images God; in
contrast to the anthropomorphic imagery dominant in European and North American
Christianity. Only one respondent out of the 13 reported an image of a God who
• walks & dwells among us here on Earth,
and even he diverged from conventional divinity imagery by adding,
• God is not some being or entity in the sky. . .
It is also possible that there are generational cohort effects that are entangled with the
religious/spiritual/faith systems of the respondents. For example, younger individuals may be
disenchanted with classical religiosity/spirituality/faith constructs currently available and find it
necessary to reinvent their own structures at a much earlier point in their lives. What we do not
know is whether or not they maintain these reinvented belief systems until later ages (although the
TLAR research appears to support this to some extent), or whether or not they revert to their
earlier belief systems acquired during their upbringing. Thus, instruments such as the Fetzer may
apply during some periods of the life course and not during others or not at all.
STUDY LIMITATIONS
This study possesses a number of limitations. The first is that all questions relating to
violence, coping and meaning-making around violence were asked retrospectively. Therefore,
responses were dependent upon the respondent’s ability to accurately recall what happened during
and after highly traumatic events across their lifetime. Many of the inconsistencies in retrospective
reporting were alleviated by asking respondents to first describe any incidents of social
Spirituality & Religiosity in the Aging Transgender Community
Page 21 of 38
mistreatment they had experienced and then later in the survey again by asking them to classify
and describe the incidents based on what portion(s) of their identities (e.g., race, sexual orientation,
gender identity, etc.) might have motivated the perpetrators.
A second limitation of this study is its small sample size (n = 13), impacting the
researchers’ ability to generalize the results. This sample size does, however, demonstrate two
important points.
First, a 33% response rate demonstrates that FTMs are willing to assist
researchers in this type of scholarly work (Witten, 2007), even a study which promises no
immediate benefits to the participants. Second, this sample represents mostly Caucasian, middle
class, FTM individuals who are reasonably well-adjusted to living as transgender people. These
individuals also possess a strong social/support network via their participation in groups such as
the two used to gather study participants. If individuals who possess ethnic/racial privilege,
financial stability, and a social/support network reported such grave statistics with regard to
victimization and such frustration with conventional religiosity instruments, one can reasonably
presume that the less privileged conditions of most transgender people would exacerbate both
their experiences of violence and their frustration with the survey instrument used.
Using the term “Female-Male Transgender (FTM)” in the study’s title also presented
difficulties that were somewhat unique to transgender-identified populations. The term “FTM” is
understood operationally by the researchers. However, the scope of what is considered “FTM”
may not have been clear to the diverse groups of people whose participation would have benefited
this study. The post-modern de-construction of gender which defines transgender communities
and defies conventional gender binarism makes the use of binary vernacular like “female-to-male”
a limiting factor in this study. For instance, a chromosomally female individual who works as a
drag king while still identifying primarily as a woman may or may have felt eligible to participate.
Many of those individuals who did participate described their gender identity with words such as
Spirituality & Religiosity in the Aging Transgender Community
Page 22 of 38
“queer” and “boy” to simultaneously give a more nuanced description and to challenge a binary
system that did not accurately reflect their complexity gender identities. In future studies, the
problem of language is one that the researchers wish to address in a more careful way so as to
gather a sample that is as large and representative as possible.
Very few scholarly studies have been published on the religiosity/spirituality of
transgender people. In addition, none of these studies have focused exclusively on female-to-male
(FTM) transgender individuals. The current literature studies consist primarily of male-to-female
(MTF) transgender-identified individuals. While the experiences of MTFs are in some ways
analogous to FTMs, they are by no means identical. FTMs are presented with many unique
challenges and social/cultural obstacles. Therefore this study serves as a catalyst for further
research. It’s findings both highlight the ineffectiveness of current psychometric instruments in
FTM populations and present the violence and abuse life experiences of FTMs to a scholarly
audience for the first time, illuminating areas of research that beckon to be explored.
Two basic, research needs have been identified through this research project:
(1) a
thorough ethnographic investigation of the particular religious/spiritual/faith beliefs of FTMidentified populations, as well as (2) a re-construction of conventional religiosity instruments to
develop an instrument applicable to the lives and experiences of FTMs and transgender-identified
persons in general. Such an instrument would incorporate the effects of non-binary, fluid gender
identity on the evolution of religious belief and expression. Deeper studies would allow for the
gathering of information that would better inform all healthcare practitioners dealing with FTMidentified persons, as well as the more general transgender-identified population, particularly with
respect to the lifecourse needs of these populations around issues of religiosity/spirituality and
faith.
Spirituality & Religiosity in the Aging Transgender Community
Page 23 of 38
Having said all of this, it is the researchers’ hope that the results detailed in this study and
the research catalyzed through its publication will ultimately benefit FTMs by giving scholars a
glimpse into FTMs’ identities and experiences, including experiences of violence and abuse. It is
also the researchers’ goal to encourage the development of more culturally-sensitive research
studies to provide greater visibility for FTMs as well as greater access to quality medical and
mental health services that truly meet the unique needs of this population. Lastly, we hope that
researchers will develop more culturally sensitive research for the larger transgender-identified
population as a whole. As one of the TLAR survey respondents so profoundly stated in her
closing comments to the survey:
• I am not a disease. I am not an experimental animal. I am not damned to
burn in eternal hellfire. I am a human being who has been forced by
society to live with a dreadful debilitating birth defect for far too long.
Spirituality & Religiosity in the Aging Transgender Community
Page 24 of 38
ACKNOWLEDGEMENTS
First and foremost, we would like to thank the FTM survey respondents as well as the TLARS
survey respondents. Without their honesty and willingness to participate in this research effort, we
would be unable to provide any information on this subject of importance. Next, we would like to
thank Drs. Andrew Achenbaum, Monika Ardelt, A. Evan Eyler, Martha Horn, Neil Krause, Susan
McFadden, Ellen Netting, Gary Reker, Lars Tornstam and Brian de Vries for their numerous
discussions, provision of measurement instruments, and reprints. Their enlightenment graces this
research effort. TMW would also like to acknowledge Dr. Michael Sheridan for her teachings and
her enormous impact on the author's early interest in spirituality and Social Work.
CONTACTING THE PROJECT
To find out more about the TranScience Research Institute, the research being sponsored,
conducted, and/or to participate in any of its projects, you may visit the TSRI website at
http://www.transcience.org/
or
you
may
reach
[email protected] or [email protected]
.
Dr.
Tarynn
M.
Witten
at
Spirituality & Religiosity in the Aging Transgender Community
Page 25 of 38
REFERENCES
Abdel-Khalek, A.M. (2004). The Arabic scale of death anxiety (ASDA): Its development,
validation, and results in three Arab countries. Death Studies, 28, 435-457.
Ai, A.L. (2000). Spiritual well-being, spiritual growth, and spiritual care for the aged: A cross
faith and interdisciplinary effort. Journal of Religious Gerontology, 11 (2), 3-28.
Anderson, N.B., Bulatao, R.A. and Cohen, B. (2004). Critical perspectives on racial and ethnic
differences in health in late life. Washington, D.C.: National Academy Press.
Association of Religious Data Archives. (2000). Religious Congregations and Membership Study,
2000. Retrieved December 27, 2006, from
http://www.thearda.com/Archive/Files/Descriptions/RCMSCY.asp
Belongia, L. & Witten, T.M. (2006). We don’t have that kind of client here: Institutionalized
bias against and resistance to transgender and intersex aging research and training in elder
care facilities. Amer. Pub. Health Assoc. Gerontological Health Newsletter, Fall 2006. [available at
http://www.transcience.org/]
Birren, J. E. & Schaie, K.W. (Eds.). (2006). Handbook of the Psychology of Aging. Burlington,
MA: Elsevier Academic Press.
Bradford, J., Ryan, C., & Rothblum, E. (1994). National Lesbian Health Care Survey:
Implications for mental health care. Journal of Consulting and Clinical Psychology, 62 (2), 228242.
Brennan, M. & Heiser, D. (2004). Spiritual assessment and intervention with older adults: Current
directions and applications. Binghampton, N.Y.: Haworth Pastoral Press.
Campesino, M. & Schwartz, G. E. (2006). Spirituality among Latinas/os: Implications of
culture in conceptualization and measurement. Advances in Nursing Science, 29 (1), 69-81.
Spirituality & Religiosity in the Aging Transgender Community
Page 26 of 38
Cassell, J. (1998). The surgeon in the woman’s body. Cambridge, MA: Harvard University Press.
Cicirelli, V.G. (2002). Fear of death in older adults: Predictions from terror management
theory. Journal of Gerontology: Psychological Sciences, 57B (4), P358-P366.
Comstock, G. (1989). Victims of anti-gay/lesbian violence. Journal of Interpersonal Violence, 4
(1), 101-106.
Connor, R.P. & Sparks, D.H. (2004). Queering creole spiritual traditions: Lesbian, gay, bisexual,
and transgender participation in african-inspired traditions in the americas. Binghampton, N.Y.:
Harrington Park Press.
Creighton, S. (2001). Surgery for intersex. Journal of the Royal Society of Medicine, 94, 218-220.
Crowther, M.R., Parker, M.W., Achenbaum, W.A., Larimore, W.L. & Koenig, H.G. (2002).
Rowe and Kahn's model of successful aging revisited: Positive spirituality - The forgotten
factor. The Gerontologist, 45 (2), 613-620.
Daaleman, T.P., Frey, B.B., Wallace, D. & Studenski, S.A. (2002). The spirituality index of
well-being: Development and testing of a new measure. Journal Family Practice, 952-961.
Daaleman, T.P., Perera, S. & Studenski, S.A. (2004). Religion, spirituality, and health status in
geriatric outpatients. Annals Family Medicine., 2 (1), 49-53.
Daaleman, T.P. & VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care.
Journal of the American Medical Association, 284 (19), 2514-2517.
Doyal, L. (2001). Sex, gender, and health: the need for a new approach. British Medical Journal,
323: 1061-1063.
Eyler, A.E. & Wright, K. (1997). Gender identification and sexual orientation among genetic
females with gender-blended self-perception in childhood and adolescence. International
Journal of Transgender, 1(1): http://symposion.com/ijt/ijtc0102.htm
Feldman, J. & Bockting, W. (2003). Transgender Health. Minnesota Medical Association,
Spirituality & Religiosity in the Aging Transgender Community
Page 27 of 38
Retrieved 26 May 2005 from
http://www.mmaonline.net/publications/MNMed2003/July/Feldman.html
Fetzer Research Institute. (1999). Multidimensional Measurement of Religiousness/Spirituality for Use
in Health Research: Report of the Fetzer Institute/National Institute on Aging Working Group.
Kalamazoo, MI: Fetzer Institute.
Finlon, C. (2002). Substance abuse in lesbian, gay, bisexual and transgender communities. J.
Gay & Lesbian Social Services, 14 (4), 109-116.
Gallo, J.J., Bogner, H.R., Fulmer, T. & Paveza, G.J. (eds.). (2006). Handbook of geriatric
assessment. Sudbury, MA: Jones and Bartlett Publishers.
Gender Education and Advocacy. (2005). Transgender Day of Remembrance: About DOR.
Retrieved 20 February 2006 [available at
http://www.gender.org/remember/day/what.html]
Greene, R.R. (1986). Social work with the aged and their families. New York, NY: De Gruyter
Press.
Greenberg, Julie A. (1998). Defining male and female: Intersexuality and the collision between
law and biology, Arizona Law Review, 41 (2), 265-328.
Grossman, A.H., D’Augelli, A.R., & S.L. Hershberger. (2000). Social support networks of
Lesbian, Gay, and Bisexual adults 60 years of age and older, J. Gerontol., 55B (3), P171-P179.
Haley, W.E., Allen, R.S., Reynolds, S., Chen, H., Burton, A. & Gallagher-Thompson, D.
(2002). Family issues in end-of-life decision-making and end-of-life care. American Behavioral
Science, 46, 284-298.
Hartsock, N. C. M. (1995). The Feminist Standpoint: Developing the Ground for a Specifically
Feminist Historical Materialism. (in) N. Tuana and R. Tong (Eds.) Feminism & Philosophy
(69-90). Boulder, CO: Westview Press.
Spirituality & Religiosity in the Aging Transgender Community
Page 28 of 38
Hatch, R.L., Burg, M.A., Naberhause, D.S. & Hellich, L.K. (1998). The spiritual involvement
and beliefs scale: Development and testing of a new instrument. Journal of Family Practice, 46
(6), 476-486.
Hays, J.C., Meadon, K.G., Branch, P.S. & George, L.K. (2001). The spiritual history scale in
four dimensions (SHS-4): Validity and reliability. The Gerontologist, 41 (2), 239-249.
Healthy People 2010. (2000). Healthy People 2010. Pittsburgh, PA: U.S. Government Printing
Office, Superintendent of Documents, PO Box 371954.
Herek, G. et al. (2002). Victims’ experiences in hate crimes based on sexual orientation.
Journal of Social Issues, 58 (2), 319-339.
Hodge, D.R. (2005). Epistomological frameworks, homosexuality, and religion: How people of
faith understand the intersection between homosexuality and religion. Social Work, 50 (3),
207-218.
Horn, M.J., Piedmont, R.L., Fialkowski, G.M., Wicks, R.J. & Hunt, M.E. (2003). Sexuality and
spirituality: The Embodied Spirituality Scale. Theology & Sexuality, 12 (1), 81-102.
Hunter, S. (2005). Midlife and older GLBT adults: Knowledge and affirmative practice for the social
services. New York, NY: Haworth Press.
Idler, E.L., Kasl, S.V. & Hayes, J.C. (2001). Patterns of religious practice and belief in the last
year of life. Journal of Gerontology: Social Sciences, 56B (6), S326-S334.
ISNA (2007). Intersex Society of North America, http://www.isna.org/
Jacobs, S-E., Thomas, W. & Lang, S. (eds). (1997). Two-Spirit people: Native American gender
identity, sexuality and spirituality. Urbana, IL: University of Illinois Press.
Jones, J.W. (1996). In the middle of this road we call our life: The courage to search for something more. San
Francisco, CA: HarperSanFrancisco.
Kaldera, R. B. (2002). Hermaphrodeities: The transgender spirituality workbook. Philadelphia, PA:
Spirituality & Religiosity in the Aging Transgender Community
Page 29 of 38
Xlibris Corporation.
Kanuha, V. (1990). Compounding the triple jeopardy: Battering in lesbian of color
relationships. Special issue: Diversity and complexity in feminist therapy: I. Women and
Therapy, 9 (1/2), 169-184.
Kausch, O. (2002). Cocaine abuse in the elderly: A series of three case reports. Journal of
Nervous and Mental Disease, 190 (8), 562-565.
Kaye, L.W. (ed.) (2005). Perspectives on productive aging: Social work with the new aged.
Washington, DC: NASW Press.
Kehoe, M. (1989). Lesbians over sixty speak for themselves. New York: NY: The Haworth Press.
Kennedy, G.J., Kelman, H.R., Thomas, C. & Chen, J. (1996). The relation between religious
preference and practice to depressive symptoms among 1,855 older adults. Journal of
Gerontology: Psychological Sciences, 51B (6), P301-P308.
King, M., Speck, P., & Thomas, A. (2001). The Royal Free Interview for Spiritual and
Religious Beliefs: Development and validation of a self-report version. Psychological Medicine,
31, 1015-1023.
Kraaij, V., Arensman, E., & Spinhoven, P. (2002). Negative life events and depression in
elderly persons: A meta-analysis. Journal of Gerontology: Psychological Sciences, 57B (1), P87-P94.
Krause, N. (2002). A comprehensive strategy for developing closed-ended survey items for
use in studies of older adults. Journal of Gerontology: Social Sciences, 57B (5), S263-274.
Krause, N. (2003). Religious meaning and subjective well-being in late life. Journal of Gerontology:
Social Sciences, 58B (3), S160-S170.
Krause, N. (2006a). Gratitude toward God, stress and health in late life. Research on Aging, 28
(2), 163-183.
Krause, N. (2006b). Exploring the stress-buffering effects of church-based and secular social
Spirituality & Religiosity in the Aging Transgender Community
Page 30 of 38
support on self-rated health in late life. Journal of Gerontology: Social Sciences, 61B (1), S35-S43.
Krause, N. & Ellison, C.G. (2003). Forgiveness by God, forgiveness of others, and
psychological well-being in late life. Journal for the Scientific Study of Religion, 42 (1), 77-93.
Krause, N. & Shaw, B.A. (2000). Role-specific feelings of control and mortality, Psychology and
Aging, 15(4), 617-626.
Kubzansky, L.D., Berkman, L.F., & Seeman, T.E. (2000). Social conditions and distress in
elderly persons: Findings from the MacArthur studies in successful aging, Journal of
Gerontol., 55B (4), P238-246.
Langer, N. (2000). The importance of spirituality in later life. Gerontology and Geriatrics Education,
20 (3), 41-50.
Levin, J.S. (ed.). (1994). Religion in aging and health: Theoretical foundations and methodological
frontiers. Thousand Oaks, CA: Sage Publications.
Litwin, H. (2001). Social network type and morale in old age. The Gerontologist, 41 (4), 516524.
Lombardi, E., Wilchins, R., Priesling, D., & Malouf, D. (2001). Gender violence: transgender
experiences with violence and discrimination. Journal of Homosexuality, 42 (1), 89-101.
Lyyra, T-M. &
Heikkinen, R-L. (2006). Perceived social support & mortality in older people. Journal of
Gerontolology: Social Sciences, 61B (3), S147 – S152.
MacKinlay, E. (ed.). (2006). Aging, spirituality and palliative care. Binghampton, N.Y.: Haworth
Pastoral Press.
MacKinlay, E. & McFadden, S.H. (2004). Ways of studying religion, spirituality, and aging: The
Social Science approach. Journal of Religious Gerontology, 16 (3/4), 75-90.
McGrath, P. (2003). The religiosity and the challenge of terminal illness. Death Studies, 27, 881-
Spirituality & Religiosity in the Aging Transgender Community
Page 31 of 38
899.
Moberg, D.O. (ed.). (2001). Aging and spirituality: Spiritual dimensions of aging theory, research,
practice and policy. Binghampton, N.Y.: Haworth Pastoral Press.
Nagayama Hall, G. C. (2001). Psychotherapy Research with Ethnic Minorities: Empirical,
Ethical, and Conceptual Issues. Journal of Consulting and Clinical Psychology, 69 (3), 502-510.
Parker, M.W., Bellis, J.M., Bishop, P., Harper, M., Allman, R. M., Moore, C. & Thompson, P.
A multidisciplinary model of health promotion incorporating spirituality into a successful
aging intervention with African-American and White elderly groups. The Gerontologist, 42 (3),
406-415.
Peacock, J.R. & Poloma, M.M. (1998). Religiosity and life satisfaction across the life course.
Social Indicators Research, 48, 321-345.
Pinquart, M. & Sorenson, S. (2000). Influences of socio-economic status, social network, and
competence on subjective well-being in later life: A meta-analysis, Psychology and Aging, 14
(2), 187-224.
Pryzgoda, J. & Chrisler, J.C. (2000). Definitions of gender and sex: The subtleties of meaning,
Sex Roles, 43 (7/8), 553-569.
Ptringle, K.E., Ahern, F.M., Heller, D.A., Gold, C.H., & Brown, T.V. (2005). Potential for
alcohol and prescription drug interactions in older people. Journal of the American Geriatric
Society., 53 (11), 1930-1936.
Rautio, N., Heikkinen, E., & Heikkinen, R-L. (2001). The association of socio-economic
factors with physical and mental capacity in elderly men and women, Archives Gerontology and
Geriatrics, 33, 163-178.
Reese, D.J. (2001). Addressing spirituality in hospice: Current practices and a proposed role for
transpersonal Social Work. Social Thought, 20 (1/2), 135-161.
Spirituality & Religiosity in the Aging Transgender Community
Page 32 of 38
Reker, G.T. (2001). The life attitude profile revised (LAP-R). Peterborough, Ontario, Canada:
Student Psychologists Press.
Reuters News Service (2006). Centenarians say faith source of longevity.
http://www.reuters.com/archive/2006/2006-8-10
Rowe, J.R. & Kahn, R.L. (1997). Successful aging. The Gerontologist. 37 (4), 433-440.
SAMSA. (2003). A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and
Transgender Individuals. U.S. DHHS, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Treatments. DHHS Publication No. (SMA)
03-3819.
Sims, A.M. (2007). Gender non-conformists: Male and female reconsidered. [available at
http://www.gpac.org/press/asap_2007.01.24.html]
Sisk, J. (2006). Fear and loathing: Hate crimes against GLBT individuals. Social Work Today,
May/June: 22 – 26.
Smedley, B.D., Stith, A.Y., and Nelson, A.R. (eds.) 2003. Unequal treatment: Confronting racial
and ethnic disparities in health care, Washington, D.C.: National Academies Press.
Stuckey, J.C. (2001). Blessed assurance: The role of religion and spirituality in Alzheimer's
disease caregiving and other significant life events. Journal of Aging Studies, 15, 69-84.
Sullivan-Blum, C. R. (2004). Balancing acts: Drag queens, gender and faith. Journal of
Homosexuality, 46 (3/4), 195-209.
Teh, Y. K. (2001) Mak Nyahs (Male Transsexuals) in Malaysia: The Influence of Culture and
Religion on their Identity. IJT 5 (3), http://www.symposion.com/ijt/ijtvo05no03_04.htm
Tirrito, T. (2000). The spirit of collaboration: Social Work/The Church/Older Adults. Social
Thought, 19 (3), 59-76.
Tornstam, L. (2005). Gerotranscendence: A developmental theory of positive aging. New York, NY:
Spirituality & Religiosity in the Aging Transgender Community
Page 33 of 38
Springer Publishing Co.
U.S. Census Bureau. (June 20, 2006). Religion. Retrieved December 27, 2006, from
http://www.census.gov/prod/www/religion.htm
Warner, M. (1997). Tongues united: Memoirs of a Pentecostal boyhood. (in). Que(e)rying
religion. (eds.). Comstock, G.D. & Henking, S.E. New York, N.Y.: Continuum Press.
Wink, P. (1999). Addressing end-of-life issues: Spirituality and inner life. Generations, XXIII (1),
75-80.
Winter, S. (2006). Language and identity in transgender: gender wars and the Thai kathoey. (in)
Lin, A. (ed.). Everyday struggles in language, culture, and education: Problematizing identity.
Mahwah, NJ: Lawrence Erlbaum
Witten, T.M. (2002a). The Tao of Gender. Atlanta, GA: Humanics Publishing Group.
Witten, T.M. (2002b). Geriatric care and management issues for the transgender and intersex
populations. Geriatric Care and Management Journal, 12 (3), 20 – 24.
Witten, T.M. (2003). Transgender aging: An emerging population and an emerging need.
Review Sexologies, XII (4), 15-20.
Witten, T.M. (2004). Life course analysis: The courage to search for something more: Middle
adulthood issues in the transgender and intersex community. Journal of Human Behavior in a
Social Environment, 8 (3-4), 189-224.
Witten, T.M. (2005a). Birth Sex is Not Gender. Comments on “Efforts to address gender
inequalities must begin at home.” The Lancet, 366 (9496), 1505.
http://www.thelancet.com/journals/lancet/article/PIIS0140673605676052/
comments?action=view&totalComments=1
Witten, T.M. (2005b). TransPanthers: The graying of transgender. American Psychological
Association, Division 44 Newsletter, 21 (3), 12-13.
Spirituality & Religiosity in the Aging Transgender Community
Page 34 of 38
Witten, T.M. (2006). End-of-Life Concerns for Transgender Elders and Their Caregivers:
Graceful Exits. OutWord, 13 (1), 3-7.
Witten, T.M. (2007a). Under and non-representation of sex and gender minorities in U.S.
research studies. PLOS Medicine, submitted. Available as a free download at
http://www.transcience.org/.
Witten, T.M. (2007b). Gender identity and the military – Transgender, transsexual and
intersex-identified individuals in the U.S. armed forces. [available as a free download at
http://www.palmcenter.org/. The longer report is available for download at
http://www.transcience.org/.]
Witten, T.M., Ekins, R.J.M, Ettner, R., Harima, K., King, D., Landén, M., Nodin, N.,
P'yatokha,V., & Sharpe, A.N. (2003). Transgender and transsexuality. (in) Ember, C.R. &
Ember, M. (eds.) The Encyclopedia of Sex and Gender: Men and Women in the World's Cultures.
New York, N.Y.: Kluwer/Plenum.
Witten, T.M. & Eyler, A.E. (1997). HIV, AIDS and the elderly transgendered/transsexual:
Risk and invisibility, presentation at the 1997 Gerontological Society of America,
Cincinnati, OH.
Witten, T.M. & Eyler, A.E. (1999). Hate crimes and violence against the transgendered. Peace
Review, 11 (3), 461-468
Witten, T.M. & Eyler, A.E. (2007a). Transgender gerontology and geriatrics: towards
successful aging. To appear in: Principles of Transgender Medicine and Surgery, Haworth Press,
2007. [available at http://www.transcience.org/]
Witten, T.M. & Eyler, A.E. (2007b). Transgender aging. To appear in: The Handbook of GLBTI
Aging, Johns Hopkins University Press, 2007.
Witten, T.M., Eyler, A.E. & Weigel, C. (2000, Winter). Transsexuals, Transgenders, Cross-Dressers:
Spirituality & Religiosity in the Aging Transgender Community
Page 35 of 38
Issues for Professionals in Aging, OutWord. Electronically available at
http://www.asaging.org/LGAIN/outword-063.htm
Witten, T.M. & Whittle, S.P. (2004). TransPanthers: The graying of transgender and the law.
The Deakin Law Review, 9 (2), 503-522. Electronically available at
http://www.deakinlawreview.org/currentIssue.php
Zhang, Z. & Hayward, M.D. (2001). Childlessness and the psychological well-being of olderpersons. Journal of Gerontology, 56B (5), S311-S320.
Spirituality & Religiosity in the Aging Transgender Community
Page 36 of 38
LEGENDS FOR TABLES
1. Table [1]: Religious/Spiritual orientation choices given to respondents. Respondents were
asked to provide descriptions of their religious/spiritual/faith orientation if they checked
the box marked “Other.”
2. Table [2]: Religious upbringing, current religious orientation, and God-constructs of the 13
FTM-identified respondents. Spelling and grammar retained as written.
Spirituality & Religiosity in the Aging Transgender Community
[ ] Atheist
[ ] Unitarian Universalist
[ ] Agnostic
[ ] Pagan (all denominations)
[ ] Jewish
[ ] Scientology
[ ] Roman Catholic
[ ] Protestant
Page 37 of 38
[ ] Mormon
[ ] Seventh-day Adventist
(Including Anglican/
Episcopalian)
[ ] “Fundamentalist”
[ ] Pentecostal/Charismatic
[ ] Buddhist
[ ] Taoist
[ ] Muslim/Islam
[ ] Hindu
[ ] Christian Scientist
[ ] Quaker
[ ] Alternative Healing Circles
[ ] None
[ ] Other:__________
Table 1: Religious/Spiritual/Faith orientation choices given to respondents. Respondents were
asked to provide descriptions of their religious/spiritual/faith orientation if they checked the box
marked “Other.”
Spirituality & Religiosity in the Aging Transgender Community
Current Religious
Orientation
Religious
Upbringing
Other: Christian
Roman Catholic
Other: Church of
Christ
Other: Baptist
Other: Christian =
United Methodist
Other: Christian =
Baptist
Pagan
None
Other: Spiritual
Protestant
Other: a combination
of beliefs
Protestant
None
Mormon
Other: just spiritual,
not religious
Pentecostal/Charis
matic
Quaker
Quaker
Other: Christian
Other: Christian
Atheist
Roman Catholic
Agnostic
Protestant
Buddhist
Protestant
Page 38 of 38
God-construct
(all are direct quotations from respondents)
I have never given the image of God any thought. When I think of
God as a physical being, I think of Jesus Christ – a man of hebrew
[sic] heritage.
God is in all and through all. God is a parent
Mother/Father/Everything God. God is not some being or entity in
the sky, but God walks . . . here on Earth.
God is not a man or woman. God is an entity . . . to me God is a
power. A spirit. . . God is humanity.
I find encouragement and divinity from all aspects of life and find
that certain aspects can be grouped together and idealized in
traditional pantheological dieities [sic].
Science teaches that all things are made up of moving particles.
Movement creates energy. Those energy fields all touch & overlap.
Therefore my belief is that what man call god is actually all things
connected & surrounded by that energy.
anything [sic] & everything. God is omnipresent. god [sic] is male &
female. my [sic] idea of God/a Higher power is parralell [sic] to that
of mainstream protestant [sic] ideas.
I think we are all vessels of energy. We get recycled when we die.
No one god controls this its more a universal law theory.
I don’t rule anything out. I think that if we were supposed to know
[the image of God], we would know beyond a show of a doubt; like
we know how to breathe. I think our creation is beyond our
understanding. . .
I have no particular image. I see God or the potential for God in all
people and in the natural world.
I don’t know
I go back and forth on the existance [sic] of God. I want to believe in
Her/Him/It, but the skeptical side of me has too many doubts about
an all-powerful being actually existing.
I believe that their [sic] is some form of higher power, which
different cultures/faiths may view or express slightly differently. For
me, that higher power is best described through the Christian verison
[sic] of God.
loving Universe with a sense of humor who cares deeply about me
[sic]
Table 2: Religious upbringings, current religious orientations, and God-constructs of the 13
FTM-identified respondents. Spelling and grammar retained as written.