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Access to grief and bereavement services and support from social networks is important to avoid adverse bereavement outcomes such as prolonged grief symptoms. LGBT+ bereaved partners may experience additional stressors and barriers to support related to incorrect assumptions by clinicians about relationships, lack of acknowledgement of the depth of the relationship or discrimination.
In an attempt to reduce adverse bereavement outcomes for this population, Bristowe (2023) and colleagues conducted a research study with a three-fold aim: to investigate LGBT+ specific experiences of partner bereavement; to examine decision-making processes in relation to disclosure of relationships and identities; and to appraise the Acceptance-Disclosure Model of LGBT+ bereavement.
Acceptance-Disclosure Model of LGBT+ bereavement posits that the experience of bereaved LGBT+ people is shaped by the extent to which individuals feel able to disclose the nature of their relationship to others, and the degree to which that relationship is accepted.
This exploratory qualitative interview study included 21 individuals who were bereaved of a same-gender partner or spouse in England. The median relationship duration was 19 years, with a range of 7-61 years. Interviews were recorded, transcribed and analyzed in two phases: an inductive reflexive thematic analysis to explore bereavement experiences and sources of support; and deductive reflexive thematic analysis was conducted to appraise the Acceptance-Disclosure Model of LGBT+ bereavement.
The study found that LGBT+ bereaved partners described universal experiences of partner loss but also experiences that appeared to be specific to the LGBT+ groups, including inappropriate questioning, disclosure of gender history against their wishes, and fears of discrimination or rejection. Further, the findings related to disclosure of relationship status provide some primary evidence to support the Acceptance-Disclosure model of LGBT+ bereavement.
The authors highlight that direct questions about relationships and identities may be viewed as confrontational for LGBT+ people due previous experiences of discrimination.
Respecting autonomy regarding disclosure, can support person-centred care. Based on the findings, the authors provide five recommendations for inclusive care of LGBT+ people facing bereavement.
- Avoid making assumptions about individuals and relationships, because incorrect assumptions can be damaging, particularly in bereavement.
- Use the relationship label(s) (e.g. partner) and pronouns (e.g. she/her) that individuals themselves use, and ask if you do not know.
- Explore sources of personal and social support by asking: Who in their lives is important to them? Who is aware of their bereavement, and the nature of that loss? This information will help you to understand the true nature of support available from family, friends, social networks and employers, and also ensure you do not inadvertently disclose their relationship to others against their wishes.
- Be cognisant and respectful of the hesitancy and fears individuals may have around accessing formal bereavement support.
- Facilitate connections with local bereavement support services, and make the first introduction if required, to allay fears and enable individuals to access the support they need.
Source: Bristowe, K., Timmins, L., Braybrook, D., Marshall, S., Pitman, A., Johnson, K., … & Harding, R. (2023). LGBT+ partner bereavement and appraisal of the Acceptance-Disclosure Model of LGBT+ bereavement: A qualitative interview study. Palliative Medicine, 37(2), 221-234.
