People of all colors: Palliative care for the LGBTQIAPN+ population

Abstract

This essay critically reflects on access to and the quality of palliative care for the LGBTQIAPN+ population. Although essential for quality of life, these services are accessed by only 12% of the global population in need of them, a figure that becomes even more concerning among vulnerable groups, such as the LGBTQIAPN+ community. Historically, health care systems, shaped by colonialist and cisheteronormative paradigms, have perpetuated structural inequalities by neglecting cultural and identity-specific needs. In Brazil, despite inclusive public policies such as the National Policy for Comprehensive LGBT Health Care, a gap remains between legislation and practice. Health professionals still demonstrate insufficient preparedness to adequately address the specific needs of this population, exhibiting both implicit and explicit prejudice. The “discourses of no” (no difference, no knowledge, no willingness) systematically operate as mechanisms of exclusion, rendering identities invisible and disregarding family structures and grieving processes within this community. To overcome these barriers, adopting a decolonial and affirmative approach to palliative care is imperative. This perspective requires continuing education for health professionals, recognition of diversity, the use of inclusive language, and respect for support networks and “chosen families.” Decolonizing health care practices is an essential step toward building an equitable, ethical, and humanized health care system that actively values diversity and respects the dignity and individuality of all people, especially those historically marginalized and stigmatized.