Barriers and facilitators faced by hospital chaplains in communicating with lesbian, gay, bisexual, transgender and questioning patients.

Abstract

Chaplains address religious, spiritual and existential issues with heterosexual patients but critical questions arise of whether chaplains do so with lesbian, gay, bisexual, transgender and questioning (LGBTQ) patients, too, and if so, how. Chaplains were interviewed for ∼1 h each. Four spontaneously discussed LGBTQ issues. Chaplains described several challenges communicating with LGBTQ patients. These patients may confront existential, spiritual/religious questions, but be wary of religion, and hence of chaplains, whom they may thus reject. Chaplains can help LGBTQ patients, addressing existential, spiritual and/or religious issues and related parental rejections these patients may then face. Yet LGBTQ patients vary widely: while some eschew chaplains, others are receptive. These providers may also not always know patients' LGBTQ status, and may vary in sensitivity towards these issues, and not always succeed in overcoming families' religion-based homophobia. Chaplains can potentially help LGBTQ patients in crucial ways, but face obstacles that need to be carefully recognized, examined and addressed through, practice, research and enhanced education of chaplains, medical staff, patients, family members and others. Chaplains and other providers should be more aware of, and ready to address the potential existential, spiritual and religious issues that LGBTQ patients may confront.