Grief experiences among LGBTQ+ populations: a scoping review.

Abstract

Context: LGBTQ+ individuals face grieving processes complicated by minority stress, structural discrimination, and fears related to disclosure of their sexual orientation or gender identity, which leads to disenfranchised grief within healthcare systems that remain heteronormative. Recent literature on palliative care highlights inequities in access, a lack of recognition of chosen families, and gaps in professionals' LGBTQ+ cultural competence.

Objective: To explore research published between 2021 and 2026 on grief and bereavement-related experiences among LGBTQ+ adults in healthcare and palliative care settings, identifying the main topics addressed and knowledge gaps relevant to clinical practice.

Methods: A scoping review was conducted following the framework of Arksey and O'Malley and the recommendations of the Joanna Briggs Institute and reported according to PRISMA-ScR. Original articles were searched for in 6 databases (February 2026). Independent double screening (k = 0.87) with removal of duplicates. Primary empirical studies on grief and bereavement-related experiences in LGBTQ+ adults in healthcare or palliative care settings were included, including studies on end-of-life communication, advance care planning, disclosure processes, and bereavement-related support when they provided identifiable primary data. Data were extracted using structured templates and analyzed through inductive thematic analysis.

Results: Seven primary empirical studies were included, with qualitative designs predominating. The evidence was mainly produced in English-speaking countries. Four main themes were identified: minority stress, complexities of disclosure, disenfranchised grief, and gaps in professional training. Critical gaps included underrepresentation of transgender people, a scarcity of quantitative data, an absence of intersectional perspectives, and concentration in Western contexts.

Conclusions: Grief and bereavement-related experiences of LGBTQ+ adults in healthcare and palliative care settings appear to be profoundly shaped by structural dynamics of stigma, the invisibility of the chosen family, and training deficits in LGBTQ+ cultural competence. These findings suggest the need to develop institutional protocols sensitive to disclosure preferences, formally recognize the chosen family in end-of-life decisions, and incorporate mandatory training in LGBTQ+ competencies into curricula and continuing education programs. Future research should prioritize longitudinal and interventionist designs, intersectional approaches, and studies in non-Western contexts.