LGBTQIA+ Inclusive Advance Care Planning in Australia

Advance Care Planning (ACP) gives all Australians the opportunity to outline their preferences for future medical care, ensuring their values and wishes will be honored if they are unable to communicate. For lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexually or gender-diverse (LGBTQIA+) people, ACP is especially important given unique experiences and challenges in healthcare settings—ranging from privacy needs, chosen family structures, and risk of discrimination to the importance of inclusive, affirming services. This expert guide details the principles, resources, and protections integral to LGBTQIA+ ACP in Australia, synthesizing current official guidance and digital solutions to support dignity and equality for all.

1. LGBTQIA+ Health and Advance Care Planning: The Foundation

1.1 LGBTQIA+ Health Overview

The Australian Government explicitly recognises LGBTQIA+ health as a priority, guided by national frameworks that protect rights and promote equitable access. Information from the Department of Health can be found at LGBTIQ+ Health.

1.2 Advance Care Planning Definition

ACP allows people to record their values, preferences, and wishes for care, and to appoint who can speak for them (such as a partner or chosen family member) if they become unable to do so. ACP gives LGBTQIA+ people power to define care that respects their identities and key relationships (Advance Care Planning Australia – LGBTIQ+ Communities).

2. Inclusive Language, Chosen Family, and Identity Respect

2.1 Inclusive Language

ACP conversations must use inclusive, gender-affirming, and non-assumptive language. For example:

Use correct pronouns and names.
Allow people to describe their families and key supporters in their own terms.
Avoid assumptions about sexual orientation, gender identity, or biological family relationships.

2.2 Chosen Family Recognition

“Chosen family”—friends, partners, or others who provide primary emotional and practical support—may not be legally recognized as “next of kin.” ACP documentation is essential for formally nominating these important people for healthcare and decision-making roles. Service providers should ensure that chosen family are respected in accordance with the person’s wishes (ACON – Healthy Ageing: Advance Care Planning).

2.3 Affirming Gender and Sexual Diversity

Trans and gender-diverse people should have their gender identity, legal names, and pronouns accurately documented and respected in all clinical and legal records. ACP can note preferences around gendered care, privacy, bodily autonomy, and support persons.

3. Privacy and Discrimination Protections

3.1 Privacy and Data Security

Australian law, including the Health Privacy Act and related statutes, protects all individuals’ health information, ensuring confidentiality and secure handling of sensitive identities and preferences (HealthDirect LGBTIQ+ Health). This is critical for people who may risk discrimination if LGBTQIA+ status is inadvertently shared.

3.2 Protection Against Discrimination

Federal and state anti-discrimination laws make it unlawful for health and aged care providers to deny services or treat people less favourably because of sexual orientation, gender identity, or intersex status. Policies ensure care is delivered in a safe, respectful, and inclusive manner.

3.3 Culturally Safe Healthcare Environments

The National Safety and Quality Health Service Standards include explicit cultural safety requirements. Health services must ensure environments where patients feel seen, respected, and protected from discrimination (Cultural Safety Standard).

4. Inclusive Advance Care Planning Processes

4.1 Person-Centred, Affirming Communication

ACP discussions should start with open-ended questions about what matters most to the individual, including identity, relationships, traditions, and boundaries about care. Professionals should undergo LGBTQIA+ cultural competency training, maintain non-judgemental attitudes, and adapt care to each person’s context.

4.2 Documenting Advanced Directives

Important points in legally and ethically valid ACP documentation include:

Appointing a substitute decision-maker (including chosen family)
Explicitly recording gender identity and support needs
Detailing care preferences tied to sexual orientation, partner involvement, privacy, and family inclusion

Legal forms should be checked for inclusivity and the flexibility to describe non-traditional family or relationship arrangements (Advance Care Planning Australia – LGBTIQ+ Communities).

4.3 Marriage Equality and Family Recognition

Since the implementation of marriage equality in Australia, same-sex partners are legally recognised for healthcare decision-making. However, not all LGBTQIA+ relationships involve legal marriage, and clear documentation of the patient’s wishes remains important.

5. Aged, Palliative, and End-of-Life Care for LGBTQIA+ Australians

LGBTQIA+ people may have unique palliative care needs based on their life experiences, fears about discrimination, or history of exclusion from services.
Aged care services must respect choices about who is involved, visitation, spiritual care, and the expression of sexuality and gender.
Planning can include spiritual and community-specific rituals to ensure holistic, affirming care.

Further reading: Palliative Care Australia and ACON Healthy Ageing.

6. Evaheld: Digital Inclusion, Security, and Empowerment

Modern digital ACP platforms like Evaheld enable comprehensive, secure, and inclusive planning specifically designed for diversity:

6.1 Transparent and Secure Storage

Evaheld’s digital secure vault ensures ACP documents are safely stored, only accessible to those with explicit consent. Sensitive details—such as chosen family status or trans identity—are protected per strict privacy standards.

6.2 Flexible and Inclusive Documentation

Evaheld’s templates and digital forms allow users to:

Specify chosen family members, partners, and friends in substitute decision-maker roles
Detail identity-affirming care requirements
Upload supporting documents or personal statements

6.3 Rights and Representation

All care preferences and legal directives can be shared with healthcare teams and advocates. Evaheld’s architecture ensures people’s wishes are honored even if hospital or aged care staff lack prior knowledge of LGBTQIA+ needs.

6.4 Provenance and Revision Tracking

Evaheld provides a permanent, auditable history of edits and accesses, supporting the security of consent and accuracy of representation.

Plan ahead with confidence — create your free Advance Care Plan in the Evaheld Legacy Vault to record your healthcare wishes, appoint decision-makers, and give your loved ones clarity, comfort, and peace of mind.

7. Resources for LGBTQIA+ Inclusive Advance Care Planning

8. Key Points for Professionals and Services

Always use inclusive, affirming language and avoid assumptions.
Proactively ask about “chosen family,” partners, and nomination of decision-makers.
Incorporate LGBTQIA+-specific ACP resources into practice and staff training.
Guarantee privacy and confidentiality at every step.
Respect legal recognition of relationships, but allow for broader definitions of family and support.
Offer digital ACP solutions such as Evaheld for secure identity, preference documentation, and access management.

9. Conclusion

LGBTQIA+ inclusive Advance Care Planning in Australia empowers people to be seen, safe, and respected—honoring the importance of chosen family, privacy, autonomy, and dignity at every stage of life and care. National resources and laws support equality and non-discrimination, while digital solutions like Evaheld make it possible for every Australian to record, revise, and share their wishes in secure, inclusive ways. As healthcare continues to evolve, upholding these principles is essential for building trust, relieving suffering, and delivering truly ethical, person-centred care for the LGBTQIA+ community.

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