LGBTQ people doubt that their advanced directive will actually be respected by health care providers because of discrimination.”
Ames Simmons, Senior Lecturing Fellow at Duke University

Conversations about emergency or end-of-life care can be challenging, even for those confident in their preferences. Accepting our mortality can be difficult, and relying on someone else to make decisions during a crisis can be daunting. Nonetheless, these discussions are critical to ensure you receive appropriate care.

As individuals who identify as transgender or gender-nonconforming often require specialized healthcare and may encounter discrimination when seeking care, creating advance healthcare plans is crucial. These plans can help ensure all healthcare needs are met, and barriers to care are addressed proactively.

Having an advanced directive in place can also provide peace of mind knowing that both clients and advocates are prepared for various situations.

Get ready to learn about Advance Directives for Transgender Folks on another episode of This Is Getting Old: Moving Towards an Age-Friendly World! Our amazing guest, Ames Simmons, Senior Lecturing Fellow at Duke University, will shed light on why having one is crucial. 

Trust us, this conversation is a must-listen for anyone who wants to ensure their wishes are respected, and their rights are protected.

Key points covered in this episode:

✔️Ames Simmons: Bridging the Gap between LGBT Health Policy and Community-Based Activism

Meet Ames Simmons – a brilliant, queer, white, transgender man with a senior fellowship at Duke University School of Law. He’s diving deeper into LGBT Health Policy & Practice by pursuing a graduate certificate at George Washington University. 

As a champion for community-based anti-racism, anti-violence, and anti-poverty efforts, he’s fighting for justice and collective liberation for transgender people. Ames is a seasoned policy director with impressive experience at the National Center for Transgender Equality and Equality North Carolina. 

He spent seventeen years at a healthcare company, helping uninsured patients get on Medicaid. Ames earned his Juris Doctor degree from Emory University Law School after attending Agnes Scott College. Basically, he’s a rock star.

✔️Break the Taboo: Talking About Advance Directives

As we consider the intersection of LGBTQ and trans/non-binary communities, it’s vital to acknowledge and address our death-denying culture. Death is often taboo and feared, especially within families. We must prioritize increasing advanced practices and initiating difficult conversations sooner to destigmatize this natural part of life.

An advance directive, a.k.a a living will, often merges with the healthcare power of attorney (HCPOA) within a single document. This guide provides healthcare providers with specific instructions, ensuring patients’ preferences are respected. 

✔️The Missing Piece in Transgender Healthcare: Advance Directives

Hey, did you hear the stat? Only 10% of transgender folks have filled out advance directives. Can’t blame them when you’re more focused on finding your next meal or roof over your head. Plus, it’s tough when you don’t have a big support system to rely on for help with healthcare decisions. Let’s spread the word and ensure everyone gets the care they need.

✔️Don’t Diminish Our Identity: Transgender Patients Face Unique Risks in Long-Term Care

Sadly, transgender people are more likely to experience unsupportive families and less-than-stellar medical care. This is especially concerning when facing potential cognitive decline or entering long-term care facilities. We need to stay vigilant and advocate for patients of all identities!

✔️Gender Affirmation, Even When The Mind Fails: Care Options For Trans Folks

Because your identity matters, today and always make your healthcare wishes crystal clear in a living will, regardless of your capacity to make decisions, and don’t forget to state your gender identity too. 

Choose a trusted healthcare agent to protect you from meddling family members and closed-minded individuals. You deserve the best care possible, so don’t be afraid to advocate for yourself!

✔️Don’t Leave Your Healthcare Decisions Up In The Air!

You’ve got style, you’ve got flair, and you deserve to have a say in your healthcare! Transgender folk, make sure you have a plan in place by discussing advance care options with your provider. And for all our older adults and physically challenged comrades, good news: Medicare’s got your back and will cover those important conversations. Take charge of your health – you deserve it!

✔️No One Has to Go Through This Alone: Help Is a Click Away

Hey, healthcare pros and LGBTQ+ fam, if you’re feeling lost on those advance directives, we got you! Check out these handy dandy resources:

  • Medicare’s got your back with reimbursement for 30-minute services on advance care planning (aka filling out those pesky forms). Let them pay you for your expertise!
  • Transgender Law Center’s life planning resources that break down advance directives and guide trans individuals to consider their values and gender identity. 
  • Compassion and Choices also have your back with their LGBTQ engagement project, spreading the word about the significance of advance directives. 
  • And for those in Chicago, The Care Plan is an organization that caters to LGBTQ individuals for end-of-life care and treatment decision-making. 

Don’t leave your future unplanned – take charge with these fantastic resources.

✔️ Want To Get In Touch With Ames? 

Good news, darling – it couldn’t be easier! Simply shoot an email to And if you want to stay in the loop and see what Ames is up to, check out his Facebook, Twitter, and  Instagram or connect with him on LinkedIn. Stay fabulous!

If you have questions, or comments or need help, please feel free to drop a one-minute audio or video clip and email it to me at, and I will get back to you by recording an answer to your question. 

More Resources About Memory And Alzheimer’s Disease …

This Is Getting Old has several other episodes about memory and Alzheimer’s. You can check them out below:



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About Melissa:

Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN. I am a nurse, nurse practitioner, nurse educator and nurse researcher with over 25 years of experience in the aging and long-term care healthcare space. You can visit my website at to learn more about me, how you can work with me directly,
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