Objective: Neuropsychological evaluations in a geriatric population have an assortment of challenges due to increased risk in the population for chronic/acute medical conditions, varied psychiatric disorders, and chronic negative lifestyle behaviors, all which impact one's cognitive functioning. One relatively new challenge is conducting cognitive evaluations within an elderly transgender population. There is a considerable lack of specific normative data in neuropsychological evaluations for transgender individuals due to the prevalence of binary gender categorization in current scoring protocols. However, a reasonable question is whether gender is such a significant normative factor, as the field of neuropsychology once thought?

Method: The current article reports on these issues in the context of a case of an 85-year-old transgender female who was referred to an outpatient neuropsychology service due to cognitive and functional declines.

Results: Her performance on the neuropsychological evaluation indicated significant decline across many of the cognitive domains measured. When using binary male and female normative data, scores did not statistically differ across the majority of the domains.

Conclusions: Overall, it was difficult to determine nuanced gender differences due to the patient's marked cognitive impairment. Potentially, differences may be more obvious in a less impaired individual.