Your Voice, Your Choice: Why LGBTQIA+ Individuals Need Robust Healthcare Directives

Andrew Mertzenich
Jan 16
5 min read

When you're facing a medical emergency, the last thing you want is for your chosen family to be turned away at the hospital door, or for medical decisions to fall into the hands of estranged relatives who don't understand or respect your identity and relationships. For LGBTQIA+ individuals in the Illinois-Wisconsin Stateline region, robust healthcare directives aren't just good planning—they're essential protection.

Why Healthcare Directives Matter Even More for LGBTQIA+ People

Despite marriage equality and the expansion of legal protections in recent decades, LGBTQIA+ individuals still face unique vulnerabilities in healthcare settings. Without proper legal documentation, you may encounter:

Exclusion of chosen family. Hospitals may default to biological family members for visitation and decision-making, even when those relationships are strained or nonexistent. Your partner, best friend, or chosen family members could be denied access when you need them most.
Misgendering and deadnaming. Without clear directives, medical staff may use incorrect names and pronouns, particularly if legal documents haven't been updated or if family members intervene.
Decisions that don't align with your values. From end-of-life care to gender-affirming treatments, healthcare decisions are deeply personal. Without advance directives, those choices could be made by people who don't understand or respect your identity, relationships, or wishes.
Legal challenges to your relationships. Even married same-sex couples can face pushback from unsupportive family members who may challenge a spouse's authority to make medical decisions.

The Power of Proper Planning

Healthcare directives give you control over who makes medical decisions on your behalf and what those decisions should be. In both Illinois and Wisconsin, the primary documents you need are:

Healthcare Power of Attorney (HCPOA): Names the person you trust to make medical decisions if you cannot
Living Will/Declaration: Specifies your wishes regarding life-sustaining treatment and end-of-life care

These documents ensure your voice is heard, your identity is respected, and your chosen decision-makers have the legal authority they need.

Illinois vs. Wisconsin: Know Your State's Requirements

If you live near the Stateline, you might work in one state and live in another, or maintain significant ties to both. Understanding the differences in each state's laws can help you plan appropriately.

Illinois Healthcare Directives

Healthcare Power of Attorney: Illinois uses the Illinois Power of Attorney Act, which allows you to designate an agent to make healthcare decisions. Your agent can make all healthcare decisions unless you specifically limit their authority. Illinois law recognizes your right to name anyone you choose—spouse, partner, friend, or family member. You can also name successor agents in case your first choice is unavailable.

Living Will: Illinois has a statutory form for a Living Will (also called a Declaration), which addresses preferences for life-sustaining treatment when you have a terminal condition or are permanently unconscious. You can specify whether you want treatments like artificial nutrition and hydration, mechanical respiration, and cardiopulmonary resuscitation.

Mental Health Treatment: Illinois also allows you to create a Declaration for Mental Health Treatment, which can specify preferences for psychiatric medications, emergency interventions, and who should be notified during a mental health crisis. This can be particularly valuable for LGBTQIA+ individuals who want to ensure affirming care.

Witnesses and notarization: An Illinois Healthcare Power of Attorney must be signed by you and witnessed by one adult, or notarized. The witness cannot be your agent or alternative agent.

Wisconsin Healthcare Directives

Power of Attorney for Healthcare: Wisconsin law allows you to create a Power of Attorney for Health Care, designating someone to make healthcare decisions when you're unable to do so. Like Illinois, you can name successor agents and provide specific instructions or limitations.

Living Will (Declaration to Physicians): Wisconsin's Living Will addresses your wishes regarding feeding tubes and other life-sustaining procedures when you're in a persistent vegetative state or terminally ill with no reasonable chance of recovery.

Witnesses: A Wisconsin Power of Attorney for Health Care must be signed by you and witnessed by two adults (a different number than in Illinois). Neither witness can be your healthcare agent, and at least one witness cannot be a healthcare provider or an employee of a healthcare facility where you're receiving care.

Key Differences to Consider

Portability concerns: While healthcare directives from one state are generally respected in another, having documents that comply with both Illinois and Wisconsin law provides extra protection if you regularly cross state lines for work, medical care, or family visits.

Formatting and language: Each state has its own statutory forms and preferred language. Documents drafted specifically for your state of residence are more likely to be immediately recognized and honored by healthcare providers.

Mental health provisions: Illinois has more explicit statutory provisions for mental health advance directives, which may be important for comprehensive planning.

Divorce and revocation: Both states automatically revoke your ex-spouse's authority under a healthcare power of attorney if you divorce, but having updated documents that reflect your current wishes is always best practice.

Beyond the Basics: Additional Protections for LGBTQIA+ Individuals

To maximize your protection, consider these additional steps:

HIPAA Authorization: This allows your chosen people to access your medical information, even when you're conscious and able to make decisions. This can be crucial for partners or chosen family members who want to stay informed and involved in your care.
Hospital Visitation Authorization: While the healthcare power of attorney typically includes visitation rights, a specific authorization can prevent confusion or resistance from hospital staff.
Document your identity: Include language in your directives about your correct name, pronouns, and gender identity. While this isn't legally required, it can help ensure respectful care.
Choose affirming agents: Select agents who understand and respect your identity, relationships, and values. Have explicit conversations with them about your wishes regarding gender-affirming care, chosen family involvement, and any other LGBTQIA+-specific concerns.
Update regularly: Review and update your documents after major life changes such as new relationships, relocations, or changes in your healthcare wishes.
Keep documents accessible: Give copies to your agents, your doctor, and keep a copy in an easily accessible place at home. Consider carrying a wallet card indicating that you have advance directives and where they can be found.

Don't Wait: Protect Yourself Today

Healthcare crises don't wait for convenient timing. Whether you're 25 or 85, single or married, healthy or managing chronic conditions, having robust healthcare directives in place provides peace of mind and protection. This is especially true in the current political and social climate, where LGBTQIA+ rights remain contested in many areas. Legal documents provide a shield that good intentions alone cannot match.

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