They want government funding to be boosted to ensure better training for aged care and medical staff. "Trans people often aren't well informed about their human rights and are embarrassed or struggle to do something about discrimination when it happens. "They feel the consequences of complaining will make the situation worse rather than address the injustice that has taken place," said Brenda Appleton from Transgender Victoria. The study, commissioned by La Trobe University's Australian Research Centre in Sex, Health and Society, in conjunction with Transgender Victoria and The Gender Centre, involved in-depth interviews with 15 trans men and women, detailing the barriers they face in accessing healthcare, employment and aged care services. Many said seeking medical treatment was often an ordeal as they frequently faced prejudice and had more knowledge of trans health issues than their doctors.

*Alfred said when he went to hospital in the late 1990s staff went on strike and refused to treat him because he was trans. "I was in emergency, I woke up naked and in a room and they had me in a four-bed ward. All the beds had been taken out, everything, and I was in the corner and basically no one came near me." *William said a dentist told him, "We just don't look after people like you", while Sandy was forced into psychiatric treatment and electro convulsive therapy. "One psychiatrist taught me to lie to my father, to other psychiatrists to protect myself. That was sort of the beginning of creating an alter ego with myself trapped inside. I got married three times, had four children, tried very hard to be 'normal'," Sandy said. Employers still discriminating against trans community

Many reported they had lost their jobs, particularly if they had transitioned in the workplace. Appleton, who is co-chair of Minister for Equality, Martin Foley's LGBTI taskforce, said these issues were still a problem for trans and gender diverse people today. "I have many friends who have been discriminated against in the workplace and they don't complain because they fear if they take action against their employers it will mark them as a trouble-maker for the rest of their working life," she said. "We are also seeing that in the aged care sector and as more people are confident to be themselves and express their gender as they feel it, a lot more education and training will need to be provided to try and rectify the discrimination that is still taking place." Transgender Victoria and Gay and Lesbian Health Victoria have been conducting training for staff in aged care facilities for the past year but funding for the education programs runs out in June next year.

Another common complaint from study participants was the entrenched discrimination in documentation laws, which they say is leading to "forced sterilisation" for many trans people. In Victoria, someone who is biologically female must undergo a full hysterectomy in order to have their birth certificate changed to male. But many people feel they do not require radical surgery to live as their affirmed gender and want the laws changed to make it easier for people to be themselves. For older trans people entering aged care services and hospitals, where there are often gender segregated wards, there are fears they will be forced into a ward that does not match their identity. Study co-author J.R Latham said as a trans man he found the research very difficult to conduct because it highlighted the "devastating stigma, discrimination, prejudice, rejection and barbaric treatment" many trans people had faced.

"While our young people are finding their voices and feeling empowered to speak up and assert their rights, which is fantastic, far fewer older trans people are in this position," he said. The research will be launched at the national LGBTI ageing and aged care conference in Melbourne on Oct 26. Mr Foley said: "We know that, after a lifetime of battling homophobia and discrimination, trans people who are growing older often encounter new kinds of discrimination. Some older members of this community suffer problems including ongoing conflict with families and loved ones, refusal of care and forced treatment. This has to change. "Everyone deserves to be treated with dignity at every stage of their life. As Minister for Equality and Minister for Ageing, I am committed to building a system of care that is LGBTI-friendly. Ageing trans people should not be forced back in the closet just because they are older." *Names have been changed

For help: QLife on 1800 184 527, 5.30pm to 10.30pm, 7 days a week jstark@fairfaxmedia.com.au Follow Jill on Twitter