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Background: LGBT individuals face multiple disparities and challenges navigating the healthcare system. Most attention on such issues has focused on LGBT youth, leaving older adults as an especially vulnerable population. LGBT older adults are more likely than their heterosexual counterparts to experience poverty, worse mental and physical health, and mistreatment under current care models. Trans older adults represent a particularly underserved group and often have specialized care needs, including hormone therapy and behavioral healthcare. Geriatricians can help improve access to care with increased sensitivity toward and knowledge of LGBTspecific issues. With the unique challenges faced by LGBT older adults in mind, Jefferson Geriatrics, an outpatient practice devoted to the care of older adults, launched an initiative to create more LGBT-inclusive and trans-friendly primary care services in the Philadelphia region.

Objectives: After engaging with our poster, participants will: 1) Understand needs and challenges facing LGBT older adults, focusing on trans older adults 2) Identify best practices for providing trans-competent primary care 3) Explore concerns and challenges facing health care providers and staff in caring for a trans older adult population

Methods: An online survey was administered to healthcare providers and staff in a geriatric primary care practice to assess knowledge and attitudes related to LGBT individuals. Providers underwent cultural competency training pertaining to the care of the LGBT aging community. They also participated in medical competency training in areas such as HIV management and hormone therapy for trans individuals. Finally, a survey was conducted within an LGBT aging community to help gain an understanding of attitudes, perceptions and needs of older LGBT adults.

Conclusions/Impact: There remains much opportunity to improve upon the care of LGBT older adults, in particular trans older adults. In our poster, we describe a model for practice transformation to create a medical home for trans older adults.

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Creating a Medical Home for Trans Older Adults: Challenges, education, and best practices