2SLGBTQIA+ Affirming Care & Safety Readiness Check

A free help guide from Kind Path Guide

A walk through of the things that decide who gets to speak for you, whose name is on your records, and who will be in the room. Tick anything that is not sorted yet. Nothing here is a test, and nothing here says you are doing it wrong.

Checked 31 August 2026. Some of the ground under this has moved in the past two years, particularly at federal level. Washington's own processes are steadier. Please confirm anything you are about to act on.

Read this first

This is planning, not judgement. Every question is written so that ticking the box means "not sorted yet". Nothing is scored, nothing is stored, and nothing is sent anywhere unless you press Email. If you are on a shared computer, closing the tab clears it.

You do not have to do all of it. Most people who go through this tick a lot of boxes. That is normal and it is not an emergency. The list at the end sorts what you ticked into three tiers, and the top tier is short on purpose.

Skip anything that does not apply. Step 3 turns whole sections off. A twenty year old and a seventy five year old should not be answering the same hundred questions.

Why the paperwork matters more for us

21%of older LGBT people have given care to a friend, against 6 percent of other older adults. Chosen family does the work. Paperwork is what makes a hospital agree.
25%of LGBT people 65 and over live alone, against 15 percent of straight and cisgender people the same age.
88%of LGBT people 45 and over said they would feel more comfortable with long term care if they knew the staff had been trained for it. Asking that question is allowed.

Sources, in plain language. The caregiving figure is from a 2010 MetLife and American Society on Aging study, quoted by the National Academies of Sciences in 2020, and it is the oldest figure here. The living alone figure is from the Williams Institute at UCLA, January 2023, using 2021 and 2022 census survey data. The long term care figure is from AARP's Maintaining Dignity survey of 1,762 LGBT people aged 45 and over, carried out in late 2017.

Step 1. Whose plan is this?

This only heads up your printed list. Nothing is stored.

Step 2. Who is this for?

Pick one

Step 3. Which of these are true?

Tick any that apply. Each one adds questions that would otherwise be beside the point.

Step 4. Which parts do you want to walk through?

All on to begin with. Turn off anything you have already sorted or do not want to think about today.

The walk through

My readiness list

My notes

How the three tiers work

Do first is the short list. These are the things where being unprepared costs you the most, and they are mostly free or nearly free: a health care directive, a durable power of attorney, one person who knows where your papers are, and one number you would actually ring at two in the morning. If you do nothing else on this page, do those.

Next is the ordinary work. Records, documents, finding providers, getting names right. It takes weeks rather than hours, and most of it is a phone call and a form.

When you can is real but not urgent. It is the tier to hand to someone else, or to do in a winter month when there is time.

The one thing to know about Washington law. Washington will change the gender on your licence or state ID and on your Washington birth certificate on your own say so, with no doctor's letter and no court order, and the birth certificate amendment is free. Washington also has a shield law protecting people who receive lawful gender affirming care here, the providers who give it, and the people who help them, from out of state investigations. What changed is federal: since 31 January 2025 the Social Security Administration no longer changes sex designation on its records for anyone, and United States passports currently issue only M or F. Plan around the state processes, which work.

Numbers worth writing down

Who Number What for
Kind Path Guide 360-391-0389 Working out what to do first, or making a call with you. First conversation free.
QLaw Foundation legal clinic 206-483-2725 ext 102 A free half hour with a lawyer, statewide, first Friday and third Monday
CLEAR legal aid 1-888-201-1014 Free civil legal help on a low income, weekdays 9:15am to 12:15pm
CLEAR*Sr 1-888-387-7111 The same, for people 60 and over
Long Term Care Ombudsman 1-800-562-6028 Free advocacy about any care facility, before or after you move in
Island Senior Resources 360-321-1600 Medicaid, caregiving, meals, medical transport, equipment
Island County Superior Court Clerk 360-679-7359 ext 6 Name change filing, including the sealed process
Care Crisis Line 1-800-584-3578 24 hours, Island County, for distress of any kind
988 988 24 hours, call or text, anyone
The Trevor Project 1-866-488-7386 24 hours, LGBTQ+ young people, or text START to 678-678
Trans Lifeline 1-877-565-8860 Peer support by trans people, weekdays 10am to 6pm Pacific
LGBT National Senior Hotline 1-888-234-7243 Someone to talk to, weekdays 11am to 8pm Pacific
Gender Justice League 206-659-5519 Safety planning, emergency help, reporting discrimination
Planned Parenthood, Mount Vernon 877-714-1149 Nearest confirmed gender affirming hormone care, no ferry

Next steps

  1. Print or email your list, so it exists outside your head.
  2. Take the Do first tier only. Ignore the rest for now.
  3. Pick the single cheapest item on it and do that one this week.
  4. Tell one person where your papers are. That step is free and it is the one most often missed.
  5. Put a date in the calendar to look at this again. Once a year is plenty, unless something changes.
  6. If the list feels like too much, ring me and we will take the top three together.

Call or text 360-391-0389. The first conversation is always free.

This is information, not legal, medical or financial advice, and I am not a lawyer. Naming an organisation here is not an endorsement, and Kind Path Guide has no affiliation with any provider named and receives nothing from any of them. Please confirm anything you are about to rely on.