THE MISSING MIDDLE

Why Mid-Life Care Leavers Remain Invisible

After more than eight decades of inquiries into Australia’s out-of-home care systems, with over 50 official reports examining everything from institutional abuse to policy reform since 1945, you’d think we would have gotten it right by now. You’d think that somewhere in those thousands of pages, someone would have noticed the gaping hole in support for people like me: care leavers in mid-life who are still living with the consequences of decisions made about us when we were children.

But here’s what I’ve learned through years of research and lived experience: we are the missing middle. We exist in a policy vacuum between youth transition services (which typically end at 21, or 25 if you’re lucky) and aged care support (which begins at 65). For those of us navigating our 30s, 40s, and 50s, the systems that once controlled our lives have simply walked away.

The Reality of Being Unseen

In practice, most local service providers cut off access by age 21 or 22, regardless of what state legislation might promise. And even when services exist on paper, few are genuinely care-informed or inclusive. I’ve heard countless stories from care leavers who’ve been turned away from trauma programs or denied equitable access to community services because we lack formal recognition. We’re told our trauma isn’t recent enough, our needs aren’t specific enough, or we simply don’t fit the funding criteria.

This invisibility isn’t accidental. Mid-life care leavers aren’t counted as a distinct demographic in most data collection efforts. Without data, there’s no funding. Without funding, there’s no service planning. Without services, we remain invisible. It’s a perfect circle of systemic neglect.

When Trauma Doesn’t Age Out

What many people don’t understand is that the legacy of early life trauma doesn’t diminish with time. For many of us, it becomes more acute during mid-life. The abuse, institutional neglect, family disconnection, and systemic abandonment we experienced as children don’t stay neatly compartmentalized in the past. Complex PTSD, burnout, and health deterioration are common experiences in this cohort, yet we’re repeatedly told we’re too old for youth services and too young for anything else.

I’ve witnessed the ongoing systems harm firsthand. Discrimination and misunderstanding by medical professionals, community health providers, and emergency services continue to retraumatize this group. Many of us report being dismissed, disrespected, or actively harmed because practitioners have no framework for understanding our backgrounds or the cumulative impact of institutional care.

The Gendered Reality: Women and Girls in the Missing Middle

Mid-life women care leavers face vulnerabilities that are uniquely compounded by gendered social and economic disadvantage. Many of us have survived gender-based violence both inside and outside of care systems, and we continue to navigate the long-term impacts of this trauma without adequate support.

Health and Bodies

Women care leavers frequently report complex health conditions related to childhood neglect, sexual abuse, coercive medical procedures, and lack of access to reproductive healthcare. These experiences are often misunderstood or dismissed entirely by health practitioners who have no training in the care leaver experience. Our medical histories are fragmented, our consent has been violated, and our pain is too often minimized.

Economic Exclusion

Many mid-life women care leavers have experienced disrupted education, coercive caregiving roles, or long periods of informal labor and underemployment. Our economic exclusion is rarely recognized in employment services or women’s leadership programs. We’re expected to compete in systems that assume everyone had a stable foundation to build from.

Navigating Multiple Barriers

Most generalist support programs aren’t gender-informed, and few women’s services are care-informed. This leaves mid-life care-experienced women navigating multiple barriers simultaneously, with no dedicated support pathway. We fall between the cracks of every system.

Motherhood Under Surveillance

Many women care leavers are mothers who live with the persistent fear of child protection intervention based solely on our histories, regardless of our current stability or parenting capacity. This fear isn’t irrational. It’s based on documented patterns of intergenerational surveillance and removal. Some of us avoid services altogether due to mistrust, stigma, or the very real risk of being watched, which means we miss out on preventative support that could benefit our families.

The Policy Gap We Keep Falling Through

Australia has invested in youth transitions from care. We’re slowly embedding trauma-informed principles in aged care. But for the decades in between, there is no coordinated national strategy, no formal recognition in NDIS frameworks or mainstream health services, and no culturally safe or trauma-aware service pathways for Aboriginal and Torres Strait Islander care leavers in this age range.

The consequences are predictable and devastating: heightened rates of mental ill-health, housing instability, and socioeconomic exclusion. Reduced access to trauma-informed primary healthcare and therapeutic services. Disengagement from systems that are perceived as unsafe or judgmental. And the continuation of intergenerational disadvantage, with many children of care leavers entering out-of-home care themselves, repeating the cycle we thought we’d escaped.

What Needs to Change

After years of research and advocacy, I know what needs to happen. We need formal recognition of care leavers aged 26 to 64 as a priority cohort across all relevant federal and state policy frameworks. Not aspirational statements, but actual, funded recognition.

We need targeted research to quantify the needs and outcomes for this age group across health, housing, justice, and service access, with data disaggregated by gender. We need to expand trauma-informed practices across general medical, community health, and emergency services, with gender-specific training that acknowledges our unique experiences.

We need investment in peer-led initiatives and resource hubs that support healing, economic inclusion, and lived experience leadership for mid-life care leavers, including targeted programs for women and gender-diverse people. And we need to be included in national data collection efforts through bodies like the Australian Institute of Health and Welfare (AIHW) and in Royal Commission follow-up work, capturing longitudinal outcomes and service usage with attention to gender-based trends.

Moving Forward

The missing middle isn’t an oversight. It’s a systemic failure. We live with the impacts of state intervention long after the systems that removed us have moved on to the next cohort, the next inquiry, the next report.

Without urgent recognition, policy will continue to fail us, compounding trauma and undermining Australia’s stated commitment to redress, justice, and equity. Mid-life care leavers, especially women, must be seen, counted, and supported. Not just remembered in inquiry reports, but respected and resourced in practice.

This is the first conversation in what I hope will be an ongoing series exploring the experiences and needs of care-experienced women across the lifespan. Because our stories matter. Our needs are real. And our invisibility is a choice that systems continue to make.

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About the Author

Kayt McGeary CEP is a Lived Experience Systems Strategist, Margins Advocate, and Forgotten Australian care leaver working to create awareness and systemic change for care-experienced people in Australia.

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Resources and Further Reading

For information on the history of inquiries into out-of-home care in Australia, see the Australian Institute of Health and Welfare (AIHW) reports on child protection and out-of-home care available at: www.aihw.gov.au

For information on the Royal Commission into Institutional Responses to Child Sexual Abuse and its recommendations, visit: www.childabuseroyalcommission.gov.au