Lessons on Older LGBTQ Individuals’ Sexuality and Spirituality for Hospice and Palliative Care

Abstract

Hospice and palliative care are in the beginning stages of providing inclusive care to older lesbian, gay, bisexual, transgender, queer (LGBTQ) patients. This inclusivity is exceedingly more pressing given the growing population of out and aging LGBTQ individuals. Hospice and palliative literature recognizes that spirituality and religion can be fraught topics for LGBTQ patients. A few resources are available to help providers give more inclusive care. Few in hospice and palliative care, however, explicitly outline the direct connection for LGBTQ elders between their sexuality and their spiritual lives. 16 LGBTQ individuals born before 1964 were interviewed in the Colorado Front Range. Keeping with the tradition of critical theory, participants were asked “is there a connection for you between your sexuality and your spirituality? if so, what?” The interviews were analyzed using a qualitative conceptual content analysis method. All 16 participants responded that there was a connection for them. The participants expanded on this connection using five themes in their answers: the sexual act itself is spiritual; their authentic LGBTQ journey as spiritual; love/attraction is spiritual; spirituality and sexuality are inseparable; and finally, noting the ineffability of the sexuality-spirituality connection.

Keywords

sexuality LGBTQ spiritual care chaplaincy cultural competency hospice and palliative care lesbian gay bisexual transgender queer critical theory

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References

Tan

. The importance of spirituality among gay and lesbian individuals. J Homosex. 2008;49(2):135–144.

Swartz

Fruhauf

. The meaning of spirituality in end-of-life decisions among LGBT older adults. In: Orel

, ed. The Lives of LGBT Older Adults: Understanding Challenges and Resilience. American Psychological Association; 2015.

Griebling

. Sexuality and aging: a focus on lesbian, gay, bisexual, and transgender (LGBT) needs in palliative and end of life care. Curr Opin Support Palliat Care. 2016;10(1):95–101.

Hordern

Street

. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007;186(5):224–227.

Acquaviva

. LGBT-Inclusive Hospice and Palliative Care. Harrington Park Press; 2017.

Cloyes

Hull

Davis

. Palliative and end-of-life care for lesbian, gay, bisexual, and transgender (LGBT) cancer patients and their caregivers. Semin Oncol Nurs. 2018;34(1):60–71.

Metlife Mature Market Institute®2, The Lesbian and Gay Aging Issues Network of the American Society on Aging. Out and Aging: The MetLife Study of Lesbian and Gay Baby Boomers. Journal of GLBT Family Studies. 2010;6(1):40–57. Accessed October 3, 2017. doi:10.1080/15504280903472949.

VandeCreek

. Defining and advocating for spiritual care in the hospital. J Pastoral Care & Counsel. 2010;64(2):1–10.

Puchalski

Vitillo

Hull

Reller

. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. 2014;17(6):642–656. PMID: 24842136; PMCID: PMC4038982.

10.

World Health Organization. Defining Sexual Health Report of a Technical Consultation on Sexual Health. World Health Organization; 2006. https://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf?ua=1. Accessed October 15, 2020.

11.

Harding

Introduction: standpoint theory as a site of political, philosophic, and scientific debate. In: Harding

, ed. The Feminist Standpoint Theory Reader: Intellectual & Political Controversies. Routledge; 2004:1–15.

12.

Lorde

Uses of the erotic: the erotic as power. In: Lorde

, ed Sister Outsider. The Crossing Press; 1984:53–59.

13.

Woods

. “Sittin” on top of the world’: The challenges of blues and hip hop geography. In: McKittrick

Woods

, eds. Black Geographies and the Politics of Place. South End Press; 2007:46–81.

14.

Anzaldúa

now let us shift…conocimiento…inner work, public acts. In: Keating

, ed. Light in the Dark/Luz En Lo Oscuro: Rewriting Identity, Spirituality, Reality. Duke University Press; 2015:117–159.

15.

hooks bell. Choosing the Margin as a Space of Radical Openness. In: Harding

, ed. The Feminist Standpoing Theory Reader: Intellectual & Political Controversies. Routledge; 2004:153–159.

16.

Hill Collins

Learning from the outsider within: the sociological significance of black feminist thought. In: Harding

, ed. The Feminist Standpoint Theory Reader: Intellectual & Political Controversies. Routledge; 2004:103–126.

17.

Hsieh

Shannon

. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–1288.

18.

Palmquist

. Content analysis.Writing@CSU. Published 1993. Updated 2020. Accessed April 16, 2020. https://writing.colostate.edu/guides/guide.cfm?guideid=61

19.

Janesick

. “Stretching” Exercises for Qualitative Researchers. 3rd ed. SAGE Publications, Inc; 2011.

20.

Columbia University Mailman School of Public Health. Content Analysis. Population Health Methods. https://www.publichealth.columbia.edu/research/population-health-methods/content-analysis#software. Published 2019. Updated 2020. Accessed October 15, 2020.

21.

Kvale

Doing Interviews. SAGE Publications, Ltd. Published 2007. Accessed October 2, 2017. doi:10.4135/9781849208963.