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TRANSPARENT, (from left): Jeffrey Tambor, Judith Light, 'Oh Holy Night', (Season 3, ep. 305, aired
Maura Pfeffermann in Amazon show Transparent. Courtesy of Amazon—Everett Collection

David Satin was born in 1934 in St. Paul, Minneapolis. When he was five years old, he says, he had a revelation: He was a girl. It took five decades to tell anyone, but one night when Satin was 60, at a bar with his son, he revealed the secret.

“Thanks,” the son said. “We’ve been waiting for you to tell us.”

Today David Satin goes by the name of Barbara Satin. And at 83, she’s making the most of her final years. She works as a transgender activist, helping other people like her come out and find support.

That’s why she is up in arms over a recent change that she says will silence the older transgender community. The Trump administration has eliminated a question on gender identity from the federal government’s annual National Survey of Older Americans Act Participants -- which is used to measure the needs of seniors and establish the appropriate services for them.

“The biggest problem we face as older transgender people is that we’re so unknown,” Satin says.

The question’s removal has many LGBT activists worried that it will become harder for the aging Stonewall generation to access the services provided under the Older Americans Act -- things like home aides, meal-delivery and transportation services -- which advocates say transgender seniors badly need, given their unique health issues and risk for discrimination.

The questions were removed from the survey for practical reasons only, says a spokeswoman for the Administration for Community Living -- the government agency that administers the survey.

“Unfortunately, because extremely few people identified themselves as LGBT, there were not enough respondents for the data to be statistically reliable or reportable,” the spokeswoman wrote in an email. “Under the Paperwork Reduction Act, we are required to do everything we can to minimize the burden of information gathering.” (There are some 220,000 transgender people over the age of 65 in the U.S. and more than 2 million lesbian, gay and bisexual seniors, various researchers have found.)

Population data can help trigger government action, activists say. When an earlier survey by the Center for Disease Control showed that LGBT people were smoking cigarettes at higher rates than other individuals, for instance, anti-tobacco campaigns targeting LGBT people took off and the CDC ran advertisements encouraging LGBT people to quit smoking. And under the Obama administration, the Justice Department used data that showed transgender students endure high levels of bullying to issue guidance to schools around the country, including tolerant bathroom policies.

“A population that has unique needs like the LGBT elders is more likely to have those needs met if there is some form of quantification of what those needs are,” explains Gregory Angelo, president of the Log Cabin Republicans, a conservative gay and political organization.

Nine years ago, Eva Skye, 65, came out as a woman. She’s been signing petitions at the building for LGBT seniors where she lives in Chicago, to get the question of gender identity restored to the survey.

“It’s un-American,” Skye says. “I can vote, but I can’t be on a survey?”

Transgender seniors face the same challenges that other older people face, but often to a sharper degree, Skye says. Isolation is one common problem: When she came out, for example, her family stopped talking to her. Many of the other transgender seniors she lives with also lost friends and family members when they came out, she says.

Transgender people are more likely to be unemployed, and to be living in poverty, researchers have found. Some employers are still hesitant to hire a transgender person, Skye says -- let alone one with wrinkles or a cane.

Some activists fear that the survey change is part of a greater decline in government data on -- and, by extension, services for -- LGBT Americans.

When this year's survey was first released in March, for instance, it lacked questions on both sexual orientation and gender identity -- although the sexual orientation question was reinstated after some 100 organizations and 14,000 people wrote letters to the Administration for Community Living.

More broadly, a government survey of people with disabilities recently eliminated its questions on both sexual orientation and gender identity; and the U.S. Census Bureau has reversed course on adding questions on sexual orientation and gender identity.

“When you’re trying to make a claim about discrimination or inequity, having government data is the gold standard to advocate government change,” says Laura Durso, a researcher on LGBT issues at the Center for American Progress, a liberal think tank. “This is a way to keep yourself from being accountable to an entire population.”