When a Same-Gender Partner Dies: Grief, Recognition and Support

When a same-gender partner dies, the grief is the grief anyone feels for a partner; what differs is what surrounds it. The only population-based survey, from England and Wales, found more psychological distress among people bereaved of a same-gender spouse or civil partner, and research from many countries describes relationships left unrecognised by families, services and the law.

For a lesbian, gay, bisexual or trans person whose partner has died, the practical questions of bereavement (who is told first, whose name goes on the paperwork, who decides about the funeral, who is asked how they are coping) can turn on whether other people saw the relationship as real. Some will have been out for decades; others kept the relationship quiet at work or from relatives, and now face a death that few around them know to acknowledge. This study gathers what is known, from where, and what is still unmeasured.

The one population sample finds more distress after a same-gender partner dies

Most evidence comes from small interview studies. The exception is a survey run with the UK's Office for National Statistics, which used death registrations to invite every civil partner or same-gender spouse who registered a partner's death in England and Wales between 9 September 2017 and 8 January 2018, alongside a random sample of people whose different-gender spouse or civil partner had died. Its authors describe it as the first study to compare the two groups using representative population-based sampling^[1].

Among 233 same-gender and 329 different-gender bereaved partners, surveyed 6–10 months after the death, 66.1% and 59.2% respectively screened positive for complicated grief on the Inventory of Complicated Grief, and 76.0% and 69.3% screened positive for psychological distress on the General Health Questionnaire (GHQ-12). These are screening thresholds, not diagnoses. After adjusting for age, gender, relationship length, ethnicity, religion, expectedness of the death and earlier trauma, people bereaved of a same-gender partner had 1.67 times the odds of screening positive for psychological distress (95% CI 1.02–2.71). The difference for complicated grief (adjusted odds ratio 1.56, 95% CI 0.98–2.47) did not reach statistical significance^[1].

When loneliness, social support, the strain of caring and discrimination were added to the models, the gap narrowed (odds ratios 1.28 and 1.36, neither significant). The survey was cross-sectional, and the authors note the difference could partly reflect the higher distress lesbian, gay and bisexual people report in general, generally attributed to a stigmatising social environment. Either way, they conclude, the disparity persists through a partner's death and points to a need for additional support^[1].

Because a partner's death is typically registered as such only for married couples and civil partners, the study reached people open enough to have formalised their relationship; the authors call it striking that differences appeared even here. Only 15 participants were from a minority ethnic group and three were trans, so the findings say little about them^[1].

A Danish register study (1989–2022) found that surviving same-sex partners may have a higher risk of dying in the three years after the death than surviving mixed-sex partners, although significance depended on the comparison group; after three years the disadvantage ended or reversed. The authors suggest minority stress, lack of social support and partners' similar health may contribute^[3]. The published abstract gives no effect sizes, so this study shows a direction, not a measured gap.

The same team also looked at time and money. Both groups had given very high levels of unpaid care in the three months before the death, a mean of 122 hours a week, and 85% of those in paid work missed some work before and after the death. Same-gender partners' formal healthcare costs after the death were higher, by £79 over three months (95% CI £2–£156); there were no other significant differences between the groups^[4]. The wider picture of work after a death is covered in our study of bereavement and work.

Grief that others do not see: recognition, disclosure and family

The clearest finding across the qualitative research is that the pain of losing a partner is universal, and the extra weight comes from outside. A 2016 systematic review of 23 articles reporting on 13 studies found additional barriers and stressors for LGBT people: homophobia, failure to acknowledge the relationship, additional legal and financial issues, and the “shadow” of HIV or AIDS. From this its authors built the Acceptance-Disclosure Model, in which bereavement is shaped by whether the relationship was disclosed and acknowledged in life and after the death^[5]. Researchers call grief that others do not acknowledge “disenfranchised grief”.

Interviews with 21 LGBT+ people in England whose civil partner or spouse had died supported that model. Participants described a lack of recognition of their loss, inappropriate questioning, unwanted disclosure of gender history, and fears of discrimination when seeking support; some hid their identity and their bereavement to keep relationships intact^[6]. A 2026 scoping review of 18 studies, mostly qualitative and from high-income countries, found the same themes: invisibility of the relationship, managing disclosure, social isolation and the role of chosen families, with particular vulnerabilities among older, bisexual and trans people^[7].

The experience is not uniform. In interviews with 23 gay, lesbian and bisexual people in Spain, gay men described visible relationships and wide social support during grief, while lesbian women more often described invisible relationships and family and social rejection^[8]. In the United States, 16 lesbian, gay and bisexual women aged 60–85 described biological families ranging from accepting to merely tolerant, and family or friends who either “disappeared” or gave critical support after the death; participants coped by creating or seeking out families of choice^[9].

Fewer of the usual supports to fall back on

Studies of older heterosexual widows describe resilience built on close ties with adult children and extended family^[9]; US national surveys suggest that fits LGB older people less well. In a nationally representative sample of 3,567 older Americans (2015–16), older LGB adults were significantly lonelier than heterosexual adults, mainly because they were less likely to have a partner, and to a lesser extent because of lower family support^[10]. In a survey of 2,444 LGB adults aged 50 and over, those living alone reported more loneliness than those living with a partner or spouse, even after accounting for other factors^[11]. And in the 2022 Health and Retirement Study (11,828 older adults), lesbian and gay people with at least one child were about 27 percentage points less likely than heterosexual people to count on children or grandchildren for future care, and about 10 percentage points more likely to count on non-kin^[12].

None of these studies measured bereavement directly, but they suggest that when a same-gender partner dies, the network left is more likely to be friends and chosen family, whom services may not recognise. Our study of older widowed people sets out what is known about loneliness and living arrangements after a partner's death in the wider population.

Where the law does not recognise the couple, neither does the system around a death

Whether a surviving partner is treated as next of kin depends on where they live. Since the Netherlands first recognised same-sex marriages in 2001, nearly 40 other jurisdictions, mostly in Europe and the Americas, have legislated for gay and lesbian couples to marry, with Thailand and Liechtenstein added in 2025^[13]. In much of the world, no such recognition exists. In Japan, where same-sex marriage is not legal, some municipalities issue “partnership certificates” that offer social recognition without legal recognition^[14]. In China, an analysis of the death administration system describes it as familistic: it designates family members from heterosexual marriages as the only legitimate agents, denying same-sex partners the right to manage after-death arrangements and inherit assets^[15].

Even where marriage is available, many couples have not married. In a 2014 US survey of 1,821 LGBT adults aged 50 and over who lived in states that had legalised same-sex marriage, 24% were legally married, 26% were partnered but unmarried, and half were single. The legally married reported better quality of life and more economic and social resources than unmarried partners^[16]. Among 202 gay-identified men aged 44–75 in Los Angeles, part of a long-running US HIV cohort, being legally married was significantly protective for mental health, over and above having a domestic partner^[17]. These are associations, not proof that marriage itself protects, but they suggest legal status shapes the resources a surviving partner can draw on.

The 2016 review identified legal and financial issues as one of the distinct stressors of LGBT partner bereavement^[5]. No study we found has counted, in any country, how often surviving same-gender partners are excluded from decisions about the funeral, the estate or the home. That is a gap in the evidence, not evidence that it does not happen.

Care before the death shapes bereavement after it

For many couples, care before the death carries into bereavement. In a UK study of 40 LGBT people facing advanced illness, participants described heteronormative assumptions, homophobic and transphobic behaviour, and past discrimination carried into later care. The authors concluded that despite legislative change, discrimination and exclusion in health care persist; acknowledging and including partners in critical discussions was among the things that helped^[18].

In the United States, Project Respect surveyed seriously ill LGBTQ+ people, partners and widowed partners recruited through LGBTQ+ organisations (a self-selected sample). Accounts of poor care fell into six themes, including discriminatory behaviour towards partners; trans patients described discrimination that disregarded or belittled their identity^[19]. A systematic review of 13 studies of LGBTQ+ people with serious illness, most from North America, found experiences driven by fear of discrimination, providers' assumptions, social isolation and undignified deaths, and preferences for chosen families to be included in decision-making^[20].

This matters for bereavement because, as the authors of the English and Welsh survey note, perceived poor quality of care before a death predicts worse outcomes for carers afterwards; they argue that care before death must be inclusive of same-gender partners^[1].

A generation bereaved many times over: the legacy of HIV and AIDS

UNAIDS estimates that 44.2 million people (range 33.8–61.1 million) have died from AIDS-related illnesses since the start of the epidemic, and 570,000 in 2025 alone^[2]. These are modelled global figures for everyone affected, not a count of gay and bisexual men. For gay communities hit early, HIV often meant repeated bereavement at a time when relationships had no legal standing; the 2016 review counted the “shadow” of HIV or AIDS among the distinct stressors of LGBT partner bereavement^[5].

In 1985, interviews with 180 gay men whose lover or close friend had died of AIDS found grief symptoms similar to those of bereaved spouses and parents; those who had been carers, and those with inadequate help with caring, reported more intense grief^[21]. A cohort of 746 gay men interviewed every year from 1985 to 1991 found significant effects of AIDS-related bereavement on psychological distress in each year, though their intensity and duration diminished over time^[22]. Among gay men followed for a year, experiencing two or more close losses in the previous year was linked with significantly higher distress, and the authors described multiple close losses as “rather common” among HIV-positive gay men^[23].

That history has not gone away. In a 2009–10 study of midlife and older gay men, excessive HIV bereavements were one of the sexual minority stresses detrimental to mental health^[17]. And a prospective study of 74 bereaved gay men, assessed before and up to 18 months after a partner or close friend died of AIDS, found that changes in minority stress (internalised homophobia, discrimination and expected rejection) were linked with depressive symptoms, substance use and HIV risk behaviour, while features of the bereavement itself, such as the length of the partner's illness, were largely unrelated^[24]. The finding echoes the modern English and Welsh survey, where the gap narrowed once loneliness, support and discrimination were taken into account^[1].

What the evidence asks of us

The research is small, but its recommendations are consistent and mostly low-cost.

• Recognise the partner from the first contact. Services should not assume a partner's gender or a family's shape. ACCESSCare's ten recommendations are, its authors say, simple and low cost^[18]; the 2023 English interview study sets out five recommendations for inclusive bereavement practice, including sensitive exploration of support needs aligned with each person's preferences about disclosure^[6].
• Formally include chosen family. Reviews call for chosen families to be recognised in end-of-life decisions, protocols that respect disclosure preferences, and LGBTQ+ competence training for clinicians^[20][25].
• Screen and support bereaved same-gender partners. The English and Welsh study's authors recommend that clinical and bereavement services refine screening to identify those at risk of poor mental health outcomes^[1].
• Close legal gaps. Researchers studying older LGB adults recommend eliminating discriminatory policies against same-sex partnerships^[11]; in China, researchers argue the death administration system needs to move away from its family-centred bias^[15]. Project Respect's authors call for standards of non-discriminatory care, and staff training that covers partners, families and friends^[19].
• Fund the missing research and make it readable. A 2026 review of seven recent studies found trans people underrepresented, quantitative data scarce and research concentrated in Western countries^[25]. Of 66 articles on LGBTQ+ inclusive palliative, end-of-life and bereavement care published between 1990 and 2022, only 21% were open access, so the evidence services need is often behind a paywall^[26]. Linked death registration and register data, as used in England, Wales and Denmark, could be used elsewhere.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. It uses “LGBTQ+” for the wider community, and keeps each study's own terms (“same-gender”, “same-sex”, “LGB”, “LGBT+”) when reporting its results, because those terms describe who the study actually included.

Why we're publishing this

LGBTQ+ people whose partner has died can face both the death and a world that does not always see the relationship that ended. We wanted to set out, with every figure sourced, what the research shows, so that the organisations supporting them can cite it when they ask services, employers and governments to recognise surviving partners, and so that gaps in the evidence are named rather than mistaken for an absence of need.

How to read this data

The evidence is thin and uneven. Only one study has compared the mental health of bereaved same-gender and different-gender partners using a representative sample: the English and Welsh survey drawn from death registrations in 2017–18. Its response rate was about 41.3% among same-gender partners and 23.8% among different-gender partners, it was cross-sectional, and it could include only married couples and civil partners, so it cannot show cause and may not represent partners who were not out or not legally recognised^[1]. The Danish register study covers a whole population but reports only the direction of its findings in the abstract we could read^[3]. The US loneliness and future-care figures come from surveys of older people, not studies of bereavement.

Most of the qualitative studies interview between 16 and 40 people, mostly in high-income countries; they describe experiences well but cannot say how common they are. The HIV-era studies are small and decades old. The UNAIDS figure is a modelled global estimate with a wide uncertainty range. Almost nothing is known about trans and bisexual people whose partner has died or about LGBTQ+ people from minority ethnic groups, and very little research comes from outside Western, high-income countries^[25].

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual person or relationship. If you are worried about yourself or someone close to you, please speak to a GP or another qualified professional.

Sources

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