When Dignity Isn’t Guaranteed: LGBTQIA+ Deathcare

Feb 10

You don’t need me to tell you the LGBTQIA+ community is constantly under scrutiny for simply existing. But what happens when someone needs support the most. When they’re sick, scared, tired, and running out of time?

Imagine being at the end of your life and realizing the hardest part might not be pain.

It might be paperwork.

It might be the way a clinician looks past your partner and asks your estranged parent what they want.

It might be hearing your name used with tenderness by the people who truly know you… and then watching it disappear the moment a form is handed over.

You’re not afraid of dying.

You’re afraid of being erased.

What Stigma Can Cost

The AIDS crisis gave the world an inside look at how misinformation, fear, and judgment can shape care, and how stigma isolates people when they need community most.

That history is not just history. It’s a warning.

Because when a group of people has repeatedly been judged, misunderstood, or punished for existing, end-of-life planning stops being a “nice to have.”

It becomes essential protection.

Identity Stolen in Plain Sight

Here’s the truth that sits under these fears: when you can’t speak for yourself, the world can decide your story is negotiable.

Even after death, trans and nonbinary people are frequently misgendered in official records. In a Multnomah County / Portland metro-area study, researchers found more than half of transgender and nonbinary people in the dataset were misgendered on death certificates.

“Just paperwork” until you picture this:

You’re the partner. The best friend. The chosen family. You’re already shattered with grief, and now you’re staring at an official record that insists your person was someone else.

A wrong name. A wrong gender. A public document that becomes a permanent version of your loved one that you can’t easily undo.

That’s not a clerical error.

That’s erasure in black ink.

Even Our Icons

Take Marsha P. Johnson, a Black queer trailblazer, a luminous presence in the movement, someone whose life has held countless people through shame and survival. She used she/her pronouns, and described herself using the language available to her at the time.

And yet, so often, even after death, there’s an impulse to rename, re-label, and rewrite queer lives into something easier to digest.

This is the same fear, just wearing a different mask:
When you can’t correct the record, someone else will decide what’s “real.”

We’ve seen this pattern with other queer figures too, like Billy Tipton—a jazz musician who lived as a man for most of his adult life, and whose death was followed by public outing and sensationalized coverage that often misgendered him and eclipsed his artistry.

That’s what we are protecting when we talk about end-of-life planning.

Because dignity should be automatic, not earned, not argued for.

Chosen Family Doesn’t Automatically Count

Many LGBTQIA+ folks build family through love, survival, and community because biological family wasn’t safe, affirming, or present.

But systems don’t always recognize chosen family by default. Legal barriers can block people from caregiving leave, medical decision-making, and even funeral and disposition decisions, especially if legal documents aren’t in place.

So many queer people carry a specific fear into illness and dying:

“What if the people who didn’t love me get the final say?”

There’s Still A Gap

Yes, there are more affirming providers than ever before. Yes, queer-led deathcare spaces are growing. But there is still a gap—especially for people who are trans, gender-expansive, estranged, isolated, or without family support.

And because the systems aren’t consistently built for us, queer deathcare often becomes a two-part task:

Find affirming care
Put protection in writing

That isn’t fair. But it is powerful, and overtime we can make a change.

What You Deserve

Let’s say it plainly:

You deserve care that treats your identity as non-negotiable.

You deserve:

to be called by your name, even when you can’t advocate for yourself
to have your partner/chosen family treated as family
to have your body handled with respect
to have your gender presentation honored (clothing, hair, makeup, binder/tucking/packing choices—whatever is you)
to have your remembrance reflect the truth
to have your documentation reflect you as accurately as your jurisdiction allows—and to have advocates who know why that matters

Practical Protections You Can Do Right Now

1) Choose your decision-maker on purpose.
Complete an advance directive / healthcare proxy and name someone who will protect your wishes and your identity.

2) Write the “identity protection” paragraph.
Include your name, pronouns, who is allowed in the room, and what respect looks like for your body and presentation.

3) Plan for after-death authority.
Health care documents don’t always cover who controls funeral and disposition decisions. Depending on where you live, you may need additional authorization. (If you’re not sure, this is where an affirming deathcare professional or legal resources can help.)

4) Make a one-page “In Case of Emergency” sheet.
Keep it in your phone, and give it to your chosen people:

Who speaks for you
Who should be contacted
Who should not be involved
Your chosen name/pronouns
Your preferences for rituals, visitors, and care

Small steps like these can prevent enormous harm.

Resources (A Starting Place)

If you want a step-by-step guide built with LGBTQIA+ realities in mind:

A Closing Truth

Queer people have always been here.

Not as a trend. Not as a debate. As human beings full of their unique love, artistry, friendships, beliefs, tenderness, grief, just like everyone else.

Wanting your name, your pronouns, your people, and your story honored is just the baseline. You deserve care that honors you fully.

If you need help finding affirming resources or putting your wishes in writing, or along any step in your journey I’m here for you.

Amorous Gardner https://eternalstardeathcare.com