An elderly female (MTF) transgendered patient had developed metastatic cancer. Chemotherapy had failed and had left her profoundly weak and infirmed. Estranged from her family, she had only a few friends to rely on but then only intermittently so. Hospice admitted her to their IPU and, with supportive care, her overall status did improve. However, now she was in a dilemma. She was well enough to leave the unit but not well enough to go home. Too poor to afford a single room, the patient was unable to be placed. Chronic care facilities viewed her as if she were both male AND female. This prohibited her placement with a roommate. As she was physically female she wished to have a female roommate; the facilities saw her as originally 'male' and either could not or would not comply. In the end, she remained at the hospice center for the remainder of her life. While the hospice provided her with exemplary care, the obstacle of society's views on gender prevented her from ever leaving the unit.