This paper focuses on three issues: (1) gender seems to structure life chances so that women and men end up with quite different fates in later life; (2) maintaining a sense of adequate masculinity seems to remain very important to men until the end of life, and most women also seem to need to experience themselves as feminine, but are less threatened by gender-incongruent qualities; and (3) the gender system probably affects the quality and quantity of care available to people as health challenges are confronted later in life. More women survive to be old; unfortunately these additional years are often marked by poverty, ill health, and solitude. Older women are more likely to be widowed, and older men are more likely to be married. There is substantial evidence that the basic sense of gender identity is established in early childhood. Many men describe actions as good providers and protectors for their families as evidence of their masculinity. Many women define their femininity in terms of their actions as nurturing mothers and wives. Whatever gender-incongruent qualities are acknowledged are evaluated within the context of one's basic masculinity or femininity. Quantity and quality of care available to elders reflects the persistent gender structures of society's social arrangements and individuals' personal gender identity. (LLL)