Background There is strong evidence of discriminatory healthcare to seriously ill lesbian, gay, bisexual, transgender, and queer people, plus other sexual and gender identities (LGBTQ+). Aim The aim is to describe positive, affirming, and culturally competent healthcare to seriously ill LGBTQ+ patients and their spouses, partners, and widows. Design The authors conducted a cross-sectional study using an online survey. The data for this report are the responses to three open-ended questions describing care that was respectful, affirming, and competent provided the data. Settings/Subjects There were 290 LGBTQ+ persons with a serious illness and their spouses, partners, and widows, recruited from a wide range of organizations in the U.S. that serve LGBTQ+ communities. Results There were numerous reports of respectful, affirming, and competent care, including: healthcare providers who were open about discussing a respondent’s LGBTQ+ identity and their specific health concerns; intake and assessment forms that included pre-specified choices for sexual orientations and gender identities; using correct names, pronouns, and gender; healthcare providers who identified as LGBTQ+ or signaled being an ally; and treating spouses, partners, and widows respectfully and including them in decision-making. Conclusion Culturally competent care is important for all individuals with a serious illness, particularly for those who identify as LGBTQ+. Such care builds trust, minimizes misunderstandings, and encourages meaningful communication with patients, thus increasing treatment effectiveness and patient satisfaction. Healthcare providers and healthcare systems are encouraged to become informed about caring for LGBTQ+ patients. Technology and inclusive intake forms and assessments may also contribute to making patients feel validated by using questionnaires that include questions about sexual orientation and gender identity. More can be done to educate healthcare professionals to provide culturally competent care to LGBTQ+ people and there are models for such training.
Berkman et al. (2026) studied this question.