Intermittent homelessness from an early age is one of a complex cluster of obstacles to reaching old age faced by the queer community that many other demographic categories never have to contend with. Others include elevated exposure to HIV/AIDS and diseases like hepatitis; chronic financial instability; inadequate, inaccessible, or discriminatory health care; and physical and mental abuse from family, friends, and society at large. Yet as the U.S. population ages rapidly, so, too, will LGBTQ community members.

Those of us who live long enough to need help with cooking our meals, washing our hair, getting dressed—activities of daily living, or ADLs in nursing home speak—can turn to our unmarried eldest daughter still living at home (jk), our retirement funds (lol), home health aides (whose services can cost from $13 to more than $30 an hour, times twenty-four hours a day, times seven days a week), or long-term care facilities (funded by health insurance, if you’ve got it, or Medicare and Medicaid, as long as it lasts).

The nursing home industry is defined by the word care, but it is often run in a way that diminishes the humanity of its clients—and not only on the basis of their identity.