{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:50:07Z","timestamp":1792054207689,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008673","name":"Center for AIDS Research, University of California, San Diego","doi-asserted-by":"publisher","award":["P30 AI036214"],"award-info":[{"award-number":["P30 AI036214"]}],"id":[{"id":"10.13039\/100008673","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aging transgender adults experience unique medical and social challenges, but limited data exist regarding healthcare needs and priorities. Identifying these can help guide transgender\u2010informed, patient\u2010centered care and aging research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We employed a modified, two\u2010round Delphi method with a consensus committee to identify clinical and research priorities for aging transgender adults. Expert panelists with experience in transgender, geriatric, and\/or HIV care and research rated 15 clinical and 7 research topics using a 5\u2010point Likert scale. Consensus was defined as &gt;\u200980% of expert panelists ranking a topic as \u201cVery important\u201d or \u201cExtremely important.\u201d Following Round 1, a consensus committee of older transgender adults reviewed topics and write\u2010in suggestions and could elevate, reinstate, or add priorities by unanimous agreement. Topics selected by the committee advanced to Round 2 for expert panel ranking, followed by consensus committee review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010eight expert panelists completed Round 1, and 31 completed Round 2. After Round 1, 11 clinical and 3 research topics reached consensus. Following consensus committee review, 10 clinical and 6 research priorities advanced to Round 2. After final review, the highest\u2010ranked clinical priorities were \u201cProvider knowledge on the unique needs of older transgender adults,\u201d \u201cEvaluation of social isolation, loneliness, and social support networks,\u201d and \u201cProvider\/clinic knowledge of social, legal, financial, and mental health resources for transgender persons.\u201d The highest\u2010ranked research priorities were \u201cClinical implications of long\u2010term gender\u2010affirming hormone therapy and hormone cessation,\u201d \u201cBiologic mechanisms of hormone therapy on aging and aging outcomes,\u201d and \u201cHealth, social, and structural needs of older transgender persons.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using a community\u2010engaged modified Delphi approach, this study identified key clinical and research priorities for older transgender adults. Findings highlight the importance of provider knowledge, social support, and addressing knowledge gaps in gender\u2010affirming care and aging. These results provide direction for future research and best practice guidelines for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70771","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:35:27Z","timestamp":1792053327000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Modified Delphi Process to Identify Clinical and Research Priorities for Aging Transgender Adults"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7667-5635","authenticated-orcid":false,"given":"Megan","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Medicine University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maile Young","family":"Karris","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"J. L.Herman A. R.Flores andK. K.O'Neill \u201cHow Many Adults and Youth Identify as Transgender in the United States? \u201dThe Williams Institute UCLA School of Law 2022."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2022.11.018"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/10547738241231054"},{"key":"e_1_2_11_5_1","volume-title":"Improving the Lives of Transgender Older Adults: Recommendations for Policy and Practice","year":"2012"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010024\u201015319\u20104"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaf048"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18563"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac142"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618\u2010024\u201002353\u2010y"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2022.2100644"},{"key":"e_1_2_11_12_1","unstructured":"D.Khodyakov \u201cGenerating Evidence Using the Delphi Method \u201dOctober 17 2023 https:\/\/www.rand.org\/pubs\/commentary\/2023\/10\/generating\u2010evidence\u2010using\u2010the\u2010delphi\u2010method.html."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13297"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.70470"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004326"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(19)30269\u20103"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182413057"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/10497323251342162"},{"key":"e_1_2_11_20_1","volume-title":"Guidelines for the Primary and Gender\u2010Affirming Care of Transgender and Gender Nonbinary People","author":"UCSF Gender Affirming Health Program, Department of Family and Community Medicine, University of California San Francisco","year":"2016"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2023.12.003"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004294"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnab067"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2017.0262"},{"issue":"4","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1097\/SAP.0000000000003233","article-title":"Long\u2010Term Outcomes After Gender\u2010Affirming Surgery: 40\u2010Year Follow\u2010Up Study","volume":"89","author":"Park R. H.","year":"2022","journal-title":"Annals of Plastic Surgery"},{"issue":"5","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"S501","DOI":"10.1097\/SAP.0000000000003157","article-title":"Gender\u2010Affirming Surgeries: A National Surgical Quality Improvement Project Database Analyzing Demographics, Trends, and Outcomes","volume":"88","author":"Scott K. B.","year":"2022","journal-title":"Annals of Plastic Surgery"},{"issue":"2","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/01.GOX.0001114472.07165.aa","article-title":"P73. Impact of Age on Complications and Outcomes in Gender\u2010Affirming Surgery: An Analysis of the National Surgical Quality Improvement Program Database","volume":"13","author":"Paige Wyatt H.","year":"2025","journal-title":"Plastic and Reconstructive Surgery. Global Open"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116572"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igaf103"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2025.2522244"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2026.2697291"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70771","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70771","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70771","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:35:30Z","timestamp":1792053330000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":30,"alternative-id":["10.1111\/jgs.70771"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70771","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2026-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jgs.70771"}}