Forgotten Wishes: End of Life Documents for Trans People with Dementia at the Margins of Legal Change

Researchers and community organizations have incited trans people to engage in end of life planning, including the preparation of legal documents to express their wishes regarding their gender identity (pronouns, appearance, etc.) in case of legal “incapacity” in the context of dementia. We contend that such end of life planning, and its associated documents, contain cisnormative and cognonormative presumptions, as they are based on a stable notion of gender identity that favors biographical continuity and they presume that the self pre-dementia is better equipped to make decisions than the self with dementia. We illustrate this argument using a hypothetical case study, elucidating the various forms of epistemic injustice that are shaped by and shape those presumptions. We conclude by offering reflections, based on an intersectional, trans-affirmative, crip-positive and age-positive approach, to encourage the agency of trans people living with dementia during their end of life.