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24  LGBT+ partner bereavement: an in depth qualitative interview study and appraisal of the Acceptance-Disclosure Model of LGBT+ bereavement
  1. Katherine Bristowe,
  2. Liadh Timmins,
  3. Debbie Braybrook,
  4. Steve Marshall,
  5. Alexandra Pitman,
  6. Katherine Johnson,
  7. Elizabeth Day,
  8. Paul Clift,
  9. Ruth Rose,
  10. Deokhee Yi,
  11. Kathryn Almack,
  12. Richard Harding,
  13. On behalf of the ACCESSCare B study
  1. Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London


Introduction Support from social networks is vital after the death of a partner. Lesbian, gay, bisexual and/or transgender (LGBT+) people can face disenfranchisement and isolation in bereavement. The Acceptance-Disclosure Model of LGBT+ bereavement posits that LGBT+ bereavement experiences are shaped by the degree to which individuals feel able to disclose their bereavement to others, and how that disclosure is responded to.

Aims To investigate LGBT+ specific experiences of partner bereavement; determine decision-making processes regarding disclosure of relationships/identities; and appraise the Acceptance-Disclosure Model of LGBT+ bereavement using primary qualitative data.

Methods Exploratory in-depth qualitative interview study positioned within a social constructivist paradigm. Data were analysed using reflexive thematic analysis.

Results Participants: 21 LGBT+ people from across England bereaved of their civil partner/spouse. Findings: Participants described LGBT+ specific stressors in bereavement: lack of recognition of their loss; inappropriate questioning; unwanted disclosure of gender history; and fears of discrimination when accessing support. Direct questions about LGBT+ relationships and identities can feel confrontational due to fears and experiences of discrimination. LGBT+ people demonstrate agency in their decisions regarding disclosure of identities and relationships, with the extent of disclosure varying across social networks. Challenges were described due to intersections between LGBT+ identities and other aspects of culture or self. Some chose to hide their relationship and bereavement to retain relationships and avoid disenfranchisement. These findings provide primary evidence to support the Acceptance-Disclosure Model of LGBT+ bereavement.

Conclusions LGBT+ people face additional stressors in bereavement. Not all LGBT+ people want to talk directly about their relationships/identities. Sensitive communication is required to build trust, and explore support needs, in line with preferences around disclosure of identities.

Impact Five recommendations for inclusive practice are presented. Further research should consider the utility of the Acceptance-Disclosure Model to inform understandings of bereavement experience for other minoritised or marginalised groups.

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