Does the impact of bereavement vary between same and different gender partnerships? A representative national, cross-sectional study

Abstract

Background Data suggest poorer bereavement outcomes for lesbian, gay and bisexual people, but this has not been estimated in population-based research. This study compared bereavement outcomes for partners of same-gender and different-gender decedents. Methods In this population-based, cross-sectional survey of people bereaved of a civil partner or spouse 6–10 months previously, we used adjusted logistic and linear regression to investigate outcomes of interest: (1) positive screen on Inventory of Complicated Grief (ICG), (2) positive screen on General Health Questionnaire (GHQ), (3) grief intensity (ICG) and (4) psychiatric symptoms (GHQ-12). Results Among 233 same-gender partners and 329 of different-gender partners, 66.1% [95% confidence interval (CI) 60.0–72.2] and 59.2% [95% CI (53.9–64.6)] respectively screened positive for complicated grief on the ICG, whilst 76.0% [95% CI (70.5–81.5)] and 69.3% [95% CI (64.3–74.3)] respectively screened positive on the GHQ-12. Same-gender bereaved partners were not significantly more likely to screen positive for complicated grief than different-gender partners [adjusted odds ratio (aOR) 1.56, 95% CI (0.98–2.47)], p = 0.059, but same-gender bereaved partners were significantly more likely to screen for psychiatric caseness [aOR 1.67 (1.02, 2.71) p = 0.043]. We similarly found no significant association of partner gender with grief intensity [B = 1.86, 95% CI (−0.91to 4.63), p = 0.188], but significantly greater psychological distress for same-gender partners [B = 1.54, 95% CI (−0.69–2.40), p < 0.001]. Conclusions Same-gender bereaved partners report significantly more psychological distress. In view of their poorer sub-clinical mental health, clinical and bereavement services should refine screening processes to identify those at risk of poor mental health outcomes.

LGBT+ partner bereavement and appraisal of the Acceptance-Disclosure Model of LGBT+ bereavement: A qualitative interview study

“…This exploratory qualitative interview study is positioned within a social constructivist paradigm, which suggests that learning and knowledge develop from an individual’s interactions with their culture and society. This qualitative study was nested in a larger population-based study (ACCESSCare-B) incorporating a national cross-sectional survey of bereaved same-gender and different-gender partners 29 6–10 months post bereavement.…”

“…Individuals who had registered the death of a civil partner or spouse in England and Wales were invited to participate in the ACCESSCare-B survey. 29 All survey participants were asked whether they would be willing to be contacted for a subsequent one-to-one qualitative interview. A comprehensive demographic variables section was included within the ACCESSCare-B survey.…”

“…Primary quantitative data provides preliminary support for this model, as loneliness, social support and caregiver burden are associated with the intensity of grief, and psychological symptoms are greater for bereaved same-gender partners. 29 The present study aimed to (1) investigate LGBT+ specific experiences of partner bereavement; (2) to examine decision-making processes in relation to disclosure of relationships and identities; and (3) appraise the Acceptance-Disclosure Model of LGBT+ bereavement using primary qualitative data.…”

Project Respect: experiences of seriously ill LGBTQ+ patients and partners with their health care providers

“… 22-25 When interviewed about the barriers and facilitators of advance-care planning, many LGBTQ+ patients have described concerns about whether end-of-life preferences and chosen decision-makers would be supported, as well as the desire to discuss health care decisions outside the clinical setting due to perceived lack of safety. 26 The chosen family members of LGBTQ+ patients—including spouses, partners, friends, and nonbiological surrogates and caregivers—also commonly experience exclusion and bias, 12 , 27-29 leading to adverse outcomes, such as greater psychological distress 30 and disenfranchised grief and bereavement. 30-32 …”

“… 26 The chosen family members of LGBTQ+ patients—including spouses, partners, friends, and nonbiological surrogates and caregivers—also commonly experience exclusion and bias, 12 , 27-29 leading to adverse outcomes, such as greater psychological distress 30 and disenfranchised grief and bereavement. 30-32 …”