Aspirus Media Center

The Importance of Advance Care Planning in the LGBTQ+ Community


Michaela Tong, MD, Aspirus Family Medicine Physician.

More than 39 million people in the U.S. are age 65 years or older. 2.4 million of those identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+), according to the American Psychological Association (APA).


LGBTQ+ Health Awareness Week, observed this year between March 20-24, aims to promote the health and well-being of the LGBTQ+ community, as well as educate the public about the unique health risks and challenges that serve as barriers of access and retention to health care.


Although significant social and legal changes have prompted increased visibility of this growing population, LGBTQ+ elders have faced decades of stigmatization, lack of identity-affirming treatment and experiences of discrimination. These experiences can reinforce social isolation and avoidance of needed health care and social services later in life.


“It’s absolutely necessary for all community members to have access to culturally-responsive health services, regardless of sexual orientation, gender identity and/or gender expression,” says Michaela Tong, MD, Aspirus Family Medicine Physician. “There are some unique health care considerations for LGBTQ+ patients even though their needs are in many ways identical to those of non-LGBTQ+ patients.”


One of those notable differences is familial relationships.


“LGBTQ+ patients may have an interpretation of family that falls outside of traditional or biological relations. Instead, they may have close friends or partners that aren’t recognized by the model of traditional policy, thought or practice in our society.”


Dr. Tong adds “when it comes to end-of-life care, it doesn’t really matter what the patient’s relationship is to their chosen family because Wisconsin is not a ‘next of kin’ state. What that means is that if a patient does not designate another person to speak to his/her/their health care wishes, the responsibility would transfer to the hospital’s ethics board.” This is true for both LGBTQ+ patients and their non-LGBTQ+ peers.


Authority to act on another’s behalf regarding health care decisions, otherwise known as the health care power of attorney (POA), is documented in a legal contract signed by the patient, according to the Greater Wisconsin Agency on Aging Resources (GWAAR). If there is no designated POA at the time of medical care, a patient’s friend, family or spouse can petition for guardianship, but it will come at a high cost and can take months in the court system.


“What’s important to note is that designating a power of attorney puts the decision-making power into the patient’s hands - and the hands of people they trust,” says Dr. Tong. “Signing legally binding documents such as an advance directive can help ensure that your wishes are carried out and that your chosen POA is empowered to speak on your behalf.”


Everyone is encouraged to start their advance care planning in the event of a medical emergency where they are unable to advocate for themselves. Start today and request an “Advance Care Planning Kit” be sent to you by calling the Aspirus Customer Contact Center from 8:00 am to 5:30 pm at 715-847-2380 or 800-847-4707. For more information about advance care planning, visit


If you need gender-affirming medical care, you are welcome at Aspirus Health Family Medicine Residency Program. The faculty, residents and staff at Aspirus Wausau Family Medicine have been trained in culturally sensitive and gender-affirming care. To make an appointment, call (715) 675-3391.



Back to all Posts

This record has been viewed 197 times.