Caring For Transgender Patients on Hospice

By Lisa Pahl, LCSW

Gender-affirming end-of-life care is a basic human right.

It is the responsibility of each end-of-life provider to educate ourselves on how to care for transgender individuals. It is NOT the responsibility or duty of transgender individuals to educate us.


Lack of knowledge and understanding from healthcare professionals can lead to bias and and discriminatory behaviors. It is the responsibility of the healthcare providers to learn how to provide gender-affirming care. 


Healthcare providers should introduce themselves using their name and pronouns, then ask the patient for their name and pronouns. This helps reduce the power imbalance and can help to develop trust. 


Healthcare professionals should uphold and support daily routines that match the patient's gender identity. Providers should support ongoing use of hormone therapy throughout end-of-life.


If residing in a hospice home or other facility, trans patients may encounter discrimination from other hospice patients, families and staff. It is crucial to check in frequently on how safe the individual feels and help address any issues that arise so that they feel supported and safe. 


Professionals should avoid asking insensitive questions not related to the person's care needs or well-being. Do not ask questions related to prior name or surgery status. Respect that the person is the gender that they say they are. 


Education is key for healthcare professionals in providing gender-affirming care at end-of-life. Hospices need to provide specific education to staff on trans-inclusive care. 


An advance directive is crucial as often the chosen decision maker is not a blood relative. Transgender Law Center has created specific end-of-life planning paperwork for transgender individuals. 


Each transgender patient is unique and their care should be individualized,  based on their situation and preferences. It is up to us, the end-of-life providers to ensure that trans patients die with dignity and respect. 


Source: Stat News. August 22, 2023. “How to Take Care of Trans Patients at End of Life”.

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