Disenfranchised Loss After the Death of Partner in the LGBT Community

Dirt road through pine trees

The death of a spouse in the heterosexual population has received a significant amount of attention in the thanatological literature, and is often considered the most stressful event an individual can experience in his or her lifetime (Holmes-Rahe Life Stress Inventory, 1967).  Although the LGBT community is beginning to receive more attention in death studies, the unique factors that can complicate the bereavement process for surviving partners are rarely addressed in mainstream psychological literature or graduate training programs.  Instead, LGBT issues surrounding bereavement are found in specialty journals such as the Journal of Gay & Lesbian Social Services, Death Studies, and Omega.  The lack of awareness of normal and complicated bereavement in any population is in part a reflection of our death denying culture (a full exploration of the dynamics associated with the lack of death education is a little outside the scope of this article, but at least must be mentioned).  Add the stigmatized nature of a gay, lesbian, or bi-sexual relationships and you have a perfect recipe for disenfranchised grief.

What does “disenfranchised grief” mean?  It is defined as the grief that occurs when a person experiences a loss that is not, or cannot, be openly acknowledged, publicly mourned, or socially supported.  The relationship is deemed unimportant, replaceable, or stigmatized.  It can either be ignored or openly rejected or disapproved of.  As a result, the bereaved are not given full permission to grieve the loss publicly.  They are denied the right to grieve, denied the social support essential to overcoming their loss, and deprived of the social validation in order to heal.  The belief is that the bereaved is expected to resume his or her life as though nothing has happened. 

As a result, gay and lesbian relationships and the bereaved partners are often overlooked.  Society recognizes more kin-based relationships and roles, such as children, parents, siblings, and extended family members.  Therefore, relationships that are not kin-based, such as friends, caregivers, pets, and lovers, are subject to disenfranchisement.  The additional complicating dynamics of being gay greatly increases the risk of not being recognized or validated.  Imagine being the partner of a dying or deceased gay, lesbian, or transgendered person.  Not being legally married or supported, you are denied the rights and opportunities for support that are easily given to heterosexual couples, such as legal rights, involvement in funerary rituals and planning, and transitional roles (e.g., being a “widow” or “widower”, orphan, etc.).  The intense negative affect, exclusion from care and support for the dying, lack of social support, exclusion from funeral rituals, and practical and legal difficulties are all major contributors to complicated bereavement responses.

Let us also consider the epidemic of HIV/AIDS as well, since the gay male population in industrialized nations is still the most affected community with this debilitating and terminal illness (Oram, Bartholomew, & Landolt, 2004).  Even with the advent of medical interventions and treatments, AIDS is still chronic and progressive.  Now that the progression of the illness has been slowed by the efficacy of antiretroviral therapies, the life expectancy of HIV positive men has increased dramatically.  This has come as a mixed blessing.  When AIDS represented a relatively fast progression, one could plan for decline of functioning and eventually death.  Now the lengthy remissions offer hope while still create problems due to the less predictable course the disease can take.  Because those affected can have more time before they die, the chance of experiencing multiple secondary psychosocial losses increases as well.  The social stigma, homophobia, fear of contracting HIV and the individual and community wide disenfranchisement in the LGBT population can lead to trauma and adjustment problems following the loss of a partner with AIDS.  With each new opportunistic illness, the HIV+ partner and his significant other may grieve as the opportunistic illnesses are illustrative of one’s continued failing health.  Furthermore, the significant others that are the caregivers for their HIV infected partners (which most often is the case) may also be HIV+ which further complicates the bereavement process.  The bereavement process is continually compromised by progressive decline in functioning and death of peers.  “The pandemic of AIDS further exacerbates the problem, resulting in not just individuals but whole communities burdened by the grief of their losses” (Oram et al., 2004, p.61).  The multiple, ongoing individual and community wide losses are coupled with the aforementioned complicating factors leading to an unending source of grief, also known as bereavement overload.  Klein (1993) termed this series of losses “a perpetual fall.”     

Regardless of what has lead to the illness or death of one’s partner, several repercussions may ensue.  For example, the death may lead the bereaved to disclose his or her sexual orientation (in either partner) to unsupportive family, friends, or social institutions which can create further isolation.  The surviving partner may feel guilty about his or her own good health, but have worries that they too will someday contract an illness that will lead to a death similar to his or her lover.  If the bereaved is HIV+, for example, and he was the one who infected the partner, the resulting guilt can lead to significant depression, guilt, and possibly suicidal ideation.  

One’s ability to come to terms with the loss is influenced by his or her coping style, resources available, and the social support network (Lazarus and Folkman, 1984).  Gay men and women are less likely than their heterosexual counterparts to turn to their family-of-origin for emotional support, and instead tend to turn to the support networks comprised of friends and partners in the gay community.  Therefore, if the surviving partner’s social support is compromised (as may be the case with multiple peer deaths, poor social systems, or the psychological and physical withdraw of peers and family as the ill person nears the end of his or her life) the grieving experience may be further compounded.  Even those who do support the individual/family may hold their own reactions to the loss that are unconsciously interfering with appropriate support.  Perhaps they do not understand the unique nature of a disenfranchised loss and therefore act in a way that is associated with non-disenfranchised losses.  This oversight often results in the surviving partner feeling misunderstood and unsupported with the unique nature of bereavement in the LGBT community unintentionally minimized. 

What we do know is that unsupportive social interactions greatly increase avoidant coping, which in turn can result in complications as the partner is adjusting to the loss.  Responses from others can be:

avoiding contact

discouraging communication or expressing feelings

giving unsolicited advice

making rude or insensitive comments

expressing inappropriate expectations about the person’s grief responses

 

The responses of the bereaved following the death of a partner when his or her social support is not available, or he or she is experiencing a disenfranchised loss, may therefore be complicated resulting in the surviving partner acting or feeling in the following ways:

not even recognizing that they have the right to grieve

anger

guilt

desperation

loneliness

hopelessness

numbness

repression and denial

depression

isolation

preoccupation with the deceased

searching behavior

use of avoidant strategies (drugs, etc)

 

What can the surviving partner do to cope and process the death of his or her partner?  In one study (Oram, et. al., 2004), the five top coping strategies include: 1) support of friends; 2) “time heals”; 3) spirituality; 4) accepting the loss, and; 5) support of a partner.  The least commonly endorsed items included counseling and support groups.  However, it is important to note that the least helpful interventions were considered ‘moderately helpful’, indicating that more formal therapeutic support can be somewhat helpful.

In regard to strategies and implications for therapists, the central tasks are to validate the loss, provide opportunities to recognize and explore the loss, and help find meaningful ways to mourn and reach resolution.  The careful assessment as to the nature of the loss and the extent of the deficiencies in the areas of recognition and support is also vital.  The development of coping strategies that are needed to complete tasks fall in the following four areas:

catharsis

validation to the meaning of the loss

resolution of any guilt

internalization of memories of the relationship while reinvesting in new relationships

In conclusion, the disenfranchisement experienced by those in the LGBT population is overwhelming.  Lack of social support, stigma, stereotypes, fear, fear of his or her own untimely death, multiple and continuous losses, shame, and guilt complicate the bereavement process in ways that those who are not gay may never experience.  It is imperative than not only therapists be aware of the therapeutic implications of death of a partner in the LGBT community, but as informed members of a wider community also be an advocate for social change and global awareness in regard to the disenfranchised nature of partner loss.   

 

 

 

References

 

Holmes, T. & Rahe, R. (1967).  Homes-Rahe social readjustment rating scale. Journal of Psychosomatic Research. Vol II.

Klein, S. (1993).  Grief and multiple losses.  Being Alive Newsletter, 8, 1-4.

Lazarus, R. & Folkman, S. (1984).  Appraisal and coping.  New York: Springer Publishing Co.

Oram, D., Bartholomew, K., & Landolt, M. (2004).  Coping with multiple AIDS related loss among gay men. Jounral of Gay

                & Lesbian Social Services, 16(2), 59-72.

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