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. 2022 Nov 9;27(2):636–658. doi: 10.1007/s12119-022-10032-4

Meaning in Life, Death Anxiety, and Spirituality in the Lesbian, Gay, and Bisexual Community: A Scoping Review

Gian Carlo M Ledesma 1,3,✉, Marc Eric S Reyes 1,2, Clarissa F Delariarte 1,4,5
PMCID: PMC9645752  PMID: 36405399

Abstract

The changes in people’s way of life through the years raise questions on how they address existential needs and concerns, particularly those related to life and death and spiritual connections. Through a scoping review, we surveyed studies on meaning in life, death anxiety, and spirituality within the lesbian, gay, and bisexual (LGB) community. We determined the extent to which these variables have been studied among LGB participants. A total of 28 eligible articles were reviewed. Six studies were found about meaning in life, five studies about death anxiety, and 16 studies about spirituality. Results suggest that meaning in life was derived from experiences related to parenthood, couplehood, and work satisfaction. Studies on death anxiety among LGB participants, which date back to the 1980 and 1990s, indicated the need to conduct present studies in this area. The review showed that LGB members distinguished between spirituality and religion, giving them more positive recognition of the former than the latter. The forms of spiritual expression were anchored to religious practices, for some, and other expressions of belief and faith outside the confines of formally established religions. Spiritual expressions generally accorded the LGB members direction and satisfaction in life. Not all segments of the LGB community were represented in the studies. The available studies, dominantly quantitative, centered only on the LGB experience. Target age groups varied across the studies. The review indicates that future studies can work on exploring these existential factors considering the emerging contexts and paradigms. Future research can focus on determining what factors contribute to meaning in life, given the changes in time.

Keywords: LGB, meaning in life, death anxiety, spirituality, scoping, existential

Introduction

Existential dilemmas pose problems related to death, freedom, isolation, and meaninglessness, putting people in intrapersonal, interpersonal, and transpersonal conflicts (Farr, 2021). Using the Existential Positive Psychology Model of Suffering (EPPMS) as a guide (Van Tongeren & Showalter Van Tongeren, 2021), we subscribe to the idea that any form of suffering prompts existential issues among people and that the primary way to address them is through meaning-making amidst challenges. We are interested in finding out how members of the lesbian, gay, bisexual, transgender, plus (LGBT+) communities manage existential problems and relate to suffering as an essential component of health. Binder (2022) labels the state by which people can treat suffering as inevitable and deal with it effectively as existential health. While different existential issues characterize people, we only focus on meaning in life, death anxiety, and spirituality conducted with LGB participants to determine the breadth and depth of research outputs that dealt with these existential topics within the community. Previous studies advanced these factors as common existential issues that generally confront people (Gschwandtner, 2021; Mayers et al., 2005; Thompson, 2007; Webster, 2004).

Meaning in life is a significant component of healthy functioning. People attribute meaning in life to various sources and factors. The way it is achieved differs, considering their unique experiences and contexts (Heintzelman et al., 2020). In the face of negative and positive situations, people find meaning in their different activities, both expressed and implied, which result in realizing their goals (Moore et al., 2000; Wang & Ma, 2021). Defining meaning in life has been a question of scholars through the years. Despite this ambiguity, Martela & Steger (2016) advanced that having value and significance in life, encompassing a broader purpose in life, and determining coherence and sense in the way life is lived are essential characteristics that typify meaning in life. It is an integral component of healthy existential functioning that people must deal with effectively (Schnell, 2010). It was shown that meaning in life is associated with life satisfaction and positive affect (To & Sung, 2016). The question of what constitutes meaning in life has excited different researchers in the past. Grouden & Jose (2014) found that demographic factors play a role in determining life. In their study, family and interpersonal relations were life’s primary sources of meaning. They revealed that younger individuals find personal growth meaningful while older adults regard stability in life and engagement in community activities as significant. Generally, leisure activities negatively predicted the presence of meaning in life, and family and interpersonal relations positively predicted it. People would search for meaning in life by considering factors and situations related to family, health, religiosity, and spirituality (Grouden & Jose, 2015; Wong, 2011) also advanced that positive emotion, achievements, relationships, intimacy, and spirituality are essential sources of life’s meaning. People who set and eventually achieve goals and engage in activities that they are passionate about also contribute to one’s meaning in life. Engaging in formal interventions like life crafting and those techniques taught in positive psychology are also considered helpful (Schippers & Ziegler, 2019). As a core existential idea and instrumental in achieving healthy well-being (Steger, 2018), the need to inquire about the breadth and depth of research on meaning in life within the LGB community proves essential.

Death is another existential idea that invites discomfort among people (Mayer et al., 2021). As an inevitable occurrence, it invites fear and worries among people because of the things left behind in the world. Scholars refer to this uneasiness as death anxiety or the fear of death (Lehto & Stein, 2009; Pandya & Kathuria, 2021). While it is not considered a clinical condition, it can affect individuals negatively, prompting them to develop more serious mental health problems such as permanent anxiety, depression, and greater susceptibility to other illnesses (Martinez-Lopez et al., 2021). The lack of social interaction and preoccupation with intrusive thinking contribute to death anxiety (Or et al., 2021). Further, it has been regarded as a transdiagnostic or encompassing construct that acts as a factor that maintains other psychological disorders (Iverach et al., 2014; Mavrogiorgou & Juckel, 2020; Menzies et al., 2020; Watter, 2018) and other physical illnesses (Otoom et al., 2007; Sherman et al., 2010; Eggen et al., 2020). Practitioners suggest addressing death anxiety can help treat the accompanying disorder or illness. Recently, death anxiety has been identified as a relevant construct due to Coronavirus Diseases 19- (COVID-19) related factors and people’s exposure to pandemic-related situations (Menzies & Menzies, 2020). Consequently, recent studies were centered on the healthcare context, given their exposure to life-threatening and debilitating conditions (Belash et al., 2021; Martinez-Lopez et al., 2021; Meher et al., 2022). It was determined that people had relatively high levels of death anxiety during this time (Ozguc et al., 2021). Research on death anxiety must be conducted as little is known about it in the LGBT + community.

Spirituality is the personal connection that human beings have toward the world. It is a desire for transcendence and a journey toward meaning-making derived from one’s interconnectedness with internal and external forces (Worthington et al., 2011). People experience spirituality within or outside a specific religious affiliation (Benson, 2003; King & Boyatzis, 2015). In simple terms, it is the desire to experience transcendence, introspection, and interconnectedness (Villani et al., 2019). De Brito Sena and colleagues (2021) advanced that it remains a complex construct that overlaps with other concepts. Despite this claim, some studies provide helpful clarifications regarding how spirituality is expressed. In their research, Swinton and colleagues (2017) regarded the fulfillment of wishes among dying patients in an intensive care unit as an essential dimension of spirituality in end-of-life care. They contended that it served as a means for patients to find what matters to them than ruminate on what is the matter with them. The wishes served as means to access spiritual practices such as putting healing stones at the bedside, decorating patients’ rooms, having a trip to the hospital garden, creating keepsakes for remembrance, singing chants, and saying bedside prayers and other rituals. In another study, Norberg and colleagues (2019) found that older people express spirituality through continuous praying, developing intimate relationships with others through music and other celebrations, sharing past experiences, talking about dead relatives, and having the confidence to talk about death and dying peacefully. Earlier research also confirmed that prayer is a clear expression of spirituality. Specifically, praying for oneself, for others, from others, and the collective prayers in services are vital expressions of spirituality (Lagman et al., 2014). Spirituality has been integrated with formal counseling and psychotherapy sessions to help clients improve their psychological dispositions (Hagen et al., 2011; Victor & Treschuk, 2019) describe spirituality and religiosity as overlapping constructs. The former pertains to the intrapersonal, interpersonal, and transpersonal connections while the latter relates to practices grounded on specific groups or sects. In this study, we mainly anchored on spirituality to avoid clear attribution to any religious group activities and touch possibly other related experiences and expressions of the LGB community not grounded exactly on religion.

We reviewed the studies about meaning in life, death anxiety, and spirituality that specifically centered on any sub-group under the lesbians, gays, bisexuals, transgender plus (LGBT+) community. This sexual and gender minority group is exposed to more challenges accessing facilities, services, and other needs than their heterosexual and cisgender counterparts (Medina-Martinez et al., 2021). Consequently, given their distinctive situations, they are prone to experience discriminative behaviors such as stereotyping, denial, refusal, and other abuses (Ayhan et al., 2019). Stigmatization results from the non-traditional conditions that characterize these people (Farr & Vasquez, 2020). These unique experiences, notably those against heterosexual expectations, impact how they experience and express meaning in life, death anxiety, and spirituality (McCann & Brown, 2018). We also compared the insights found with related experiences from the heterosexual community.

Amidst the changing times, it is interesting to determine how scholars have studied meaning in life, death anxiety, and spirituality throughout the years, specifically within this community.

Search Strategy

Scoping reviews essentially lay the ground to identify the breadth and depth of ideas advanced on a particular topic. It is a viable research strategy that informs research gaps worthy of exploring future research endeavors (Arskey & O’Malley, 2005; Cacchione, 2016). While the methods and steps that scholars employ to perform scoping reviews vary across disciplines and purposes O’Brien et al., 2016), the current study followed the relevant key phases described in notable works that used a scoping review process (Arskey & O’Malley, 2005; Levac et al., 2010; Pham et al., 2014). These phases included formulating research questions, identifying and selecting studies, charting the data, and reporting the results.

Stage 1: Formulating the Research Questions

We explored and described available evidence on meaning in life, death anxiety, and spirituality and identified knowledge gaps in these areas (Verdejo et al., 2021). In this scoping review, we posed the following research questions: (1) What is currently known about the meaning in life, death anxiety, and spirituality of LGB people? (2) What studies have been advanced about meaning in life, death anxiety, and spirituality with LGB participants? (3) What age groups and sub-groups have been studied concerning meaning in life, death anxiety, and spirituality within the LGBT + community?

Stage 2: Identify Relevant Studies

We used the following inclusion criteria in this review: (a) The studies should be written in English, providing a uniform way of understanding study contents. (b) The study participants should purely have LGBT + participants or any sub-groups thereof. Studies that indirectly covered LGBT + participants such as those that understood the lived experiences of children of LGBT + parents were also considered. This criterion directly responds to the objective of the research to scope the evidence on the factors within the community. (c) The review included original research articles that provided better means of achieving the review’s objectives. (d) The studies should have studied the exact keywords “meaning in life,“ “death anxiety, " and “spirituality” Other related keywords were also considered that afforded a more stable and more straightforward search strategy for the review. Using Steger’s presence and search for meaning in the life model (Steger et al., 2006; Vieira & Dias, 2021; Yek et al., 2021), we also used the keyword “presence of” " and “search for” meaning in life in our search. For death anxiety, we also used “fear of death, " fear of dying, " and “thanatophobia, " banking on its common notion as the dread and agitation towards dying (Lehto & Stein, 2009; Zhang et al., 2019). We capitalize on Seligman’s notion of spirituality as an entity not necessarily grounded on religion and as a force that allows an individual to relate to the self, others, and the diving being (Yalcin, 2018). In this review, we also included “spiritual experiences” and “spiritual expressions” to assess how the desired population illuminated spirituality in their lives (Norberg et al., 2019).

Studies were excluded in the search if (a) they were written in other languages aside from English, (b) they did not specify participants from the LGB community or had general participants making it challenging to pinpoint results or findings specific to the sexual and gender minority group, (c) they are not original research works such as books, letters, reviews, commentaries, or editorials, and (d) they dealt with other topics other than those specified in the review. We did not set any coverage or scope for the years for the articles and included qualified searches based on the criteria, which allowed for more opportunities to cover as many insights as possible and uncover more research gaps through the years.

We used different online search platforms to find relevant articles, including Web of Science, Google Scholar, and PsycNET. We believed that these databases provided sufficient search returns given the factors reviewed. While no agreed number of databases must be searched for scoping reviews, Armstrong and colleagues (2011) advanced that three electronic databases would suffice for a review.

Stage 3: Study Selection

We initially found 16,171 articles. Duplicate articles from the different databases were removed resulting to 6,302 articles. We read the titles of these studies to ensure that they are grounded on LGBT + perspectives. Studies that did not center on the LGBT + context were removed resulting to 296 articles. We reviewed the abstracts of these studies ensuring that they encompassed the factors of interest of this review. Studies that did not report having actual human subjects were eliminated resulting to 109 articles. The full contents of these articles were scrutinized to ensure that they are aligned with the objectives of the review. The authors expressed agreement or disagreement with the articles under consideration. Studies were excluded at this point because the full-text version of the articles suggested that the LGBT + participants were mixed with heterosexual group, that there were no actual data collected from human subjects, that the factors had a different meaning contrary to the objectives of this review, and that some were not original studies. After the screening, the final count resulted to 28 reviewed articles. We finalized 28 articles that focused on the existential factors. Six studies dealt with meaning in life, five studies centered on death anxiety, and 17 studies tackled spirituality. Ongoing consultation among authors was maintained to ensure that the outcomes reflected the essence of the review. Independent consultants were tapped to vet the final articles (Fig. 1).

Fig. 1.

Fig. 1

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Search Strategy Employed in Reviewing Articles for Meaning in Life, Death Anxiety, and Spirituality

Stage 4: Charting the Data

The 28 articles included one case study, two comparative studies, 16 correlational studies, six qualitative studies, one mixed-methods study, and two longitudinal studies. In organizing the data, we included details from each study such as authors’ names, year, research locale, type of research, number of participants, key aims and objectives, participant characteristics, and the age group, where available.

Study 5: Reporting the Results

We describe the overall outcome of the review. We identified prominent research directions for each factor examined and created a comprehensive interpretation for the results generated in this scoping review. We report our assessment of the evaluation for meaning in life, death anxiety, and spirituality in the succeeding sections.

Results

The review revealed that the variables remain an area for further exploration in the LGB context. Table 1 summarizes the articles included in the scoping study.

Table 1.

Summary of Articles included in the Scoping Review

Psycho-Spiritual Factor Author/Year/Country Type of Article Key aims/objectives LGBT + Subgroup/s Age Group
Meaning in Life Shenkman et al., 2018, Israel Comparative n = 300 To explore differences in meaning in life indicators among middle-aged and older-aged gay fathers and gay non-fathers Gays Middle-aged and Older Adults
Shenkman & Shmotkin 2016, Israel Correlational n = 164 To determine the association between self-perceived parental role and meaning in life among gay and heterosexual fathers Gays Did not specify
Shenkman & Shmotkin 2014, Israel Correlational n = 204 To examine meaning in life associated with gay men’s couplehood and parenthood Gays 19–79 years old
Bos et al., 2020, USA Correlational n = 76 To test the moderating role of meaning in life in the relationship between experienced homophobic stigmatization and coping styles of offspring of lesbian mothers Lesbians Young Adults (25 years old)
Bos et al., 2021, USA Longitudinal n = 72 To assess the long-term impact of homophobic stigmatization on meaning in life among emerging adulthood offspring of lesbian parents Lesbians Young Adults (25 years old)
Allan et al., 2015, USA Correlational n = 171 To test the mediating role of life meaning in the relationship between living a life of calling and job satisfaction Lesbians, Gays, Bisexuals Did not specify
Death Anxiety Templer et al., 1984, USA Comparative n = 260 To investigate death anxiety differences concerning demographic factors Lesbians and Gays 17–87 years old
Franks et al., 1991, USA Correlational n = 115 To determine the association of religious factors with death anxiety of gay men with and without AIDS Gays Did not specify
Catania et al., 1992, USA Longitudinal n = 52 To examine health-seeking and effects of long-term support on death anxiety of gay men with various HIV diagnoses Gays Did not specify
Hintze et al., 1993, USA Correlational n = 94 To examine the association of death anxiety and death depression with state anxiety, trait anxiety, depression, the severity of medical status, and severity of disability among HIV-infected gay men Gays Did not specify
Bivens et al., 1995, USA Correlational n = 167 To determine the level of fear of death and its relation to religiosity Gays and Bisexuals 23–56 years old
Spirituality Dakin et al., 2021, USA Qualitative n = 11 To explore the religious and spiritual experiences of LGBT older adults Lesbians, Gays, Bisexuals, and Transgender People Older adults (60–88 years old)
Stuhlsatz et al., 2021, USA Correlational n = 75 To determine the influence of spiritual and religious engagement, LGBT community involvement, outness, and family support on psychological well-being in a Muslim LGBT context Lesbians, Gays, Bisexuals, and Transgender People Did not specify
Beagan & Hattie, 2015, Canada Qualitative n = 36 To explore experiences related to religiosity and spirituality Lesbians, Gays, Bisexuals, and Transgender People Did not specify
Henrickson 2007, New Zealand Correlational n = 2,269 To examine the relationship of religiosity and spirituality with the identity of LGB Lesbians, Gays, and Bisexuals 40 years and older
Ayten & Anik., 2014, Turkey Qualitative n = 30 To explore the spiritual inclinations of LGBT in a Turkish Islamic culture Lesbians, Gays, Bisexuals, and Transgender People Did not specify
Halkitis et al., 2009, USA Mixed-Methods, n = 497 To explore the religious and religious practices of LGBT people and determine the meanings ascribed to the terms religiosity and spirituality Lesbians, Gays, Bisexuals, and Transgender People Did not specify
Stroud et al., 2015, USA Correlational, n = 336 To determine the interaction of spirituality with the personality to attenuate suicide and self-injury Lesbians, Gays, and Bisexuals Did not specify
Tan 2005, USA Correlational, n = 93 To determine the association of spirituality with adjustment Lesbians and Gays Did not specify
Lassiter et al., 2019, USA Correlational, n = 1,071 To determine the relationships between religion, spirituality, and mental health Gays and Bisexual Men Did not specify
Harari et al., 2014, Israel Correlational, n = 191 To determine the relationship of religiosity and spirituality with the well-being of gays and heterosexual counterparts in the Orthodox Jews context Gays Did not specify
Miller et al., 2006, USA Qualitative, n = 10 To describe how gay men living with AIDS use spirituality in their experiences Gays Did not specify
Dunnuvant et al., 2018, Canada Qualitative To clarify the interconnections and disconnections among sexual orientation, spirituality, and aging Lesbians Older adults
Smith & Home 2008, USA Correlational, n = 318 To examine the role of faith, both religion and spirituality, on sexual satisfaction Lesbians and Bisexual Women Did not specify
Jones 2014, USA Case Study, n = 1 To demonstrate how spirituality can facilitate attachment in psychotherapy sessions Lesbian Did not specify
Varner 2004, USA Qualitative, n = 5 To explore the experiences and effects of spirituality among lesbians diagnosed with cancer Lesbians Did not specify
Singh et al., 2015, India Correlational, n = 60 To assess the impact of spirituality on the relationship between internalized homophobia, depression, anxiety, and stress Lesbians and Gays 20–42 years old
Wright & Stern 2016, USA Correlational, n = 109 To describe the relationship between spirituality, gender normative beliefs, and LGB identity development Lesbians, Gays, Bisexuals Did not specify
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The results showed that most of the studies were conducted within Western contexts. Further, studies have commonly considered lesbians, gays, and bisexuals. The studies focused on different age groups implying that attempts to study various populations within the LGB community have been made in the past. Some studies did not consider age-related information, suggesting that their research did not consider age as a variable in discussing their study outcomes. Among the existential issues focused on in this review, spirituality appeared to have been studied more, followed by the meaning in life, then death anxiety.

Meaning in Life

For meaning in life, three studies solely had gay participants, two studies within the lesbian context, and one study collectively studied lesbians, gays, and bisexuals. Some studies represented young adults, middle-aged adults, and older adults. Three studies were conducted in Israel and the other three in the United States of America. There was a study that covered all age groups, and two studies did not specify a focus for the age groups in their works. These studies were relatively recent, spanning from 2015 to 2021. All studies reported in this review utilized the quantitative approach.

Recent studies on meaning in life conducted among members of the LGB community, notably for lesbians and gays, suggest that meaning in life is derived and inferred from becoming parents. There was a significant difference in meaning in life when researchers compared the scores of middle-aged and older gay adult fathers with scores of heterosexual fathers and other gays in the age range who were not fathers. It is noteworthy to pinpoint that the gay men in this study became fathers in the context of a heterosexual relationship (Shenkman et al., 2018). An earlier study related meaning in life with the self-perceived parental role of gay and heterosexual fathers. In this study, the results for gay gathers were significantly correlated, whereas that for the heterosexual fathers were not (Shenkman & Shmotkin, 2016). The same authors had earlier revealed that gay men who were fathers manifested higher levels of meaning in life and subjective well-being compared to the results of their gay counterparts who were not fathers (Shenkman & Shmotkin, 2014). For children of lesbian couples, who may perceive stigmatization by society because of the unique family set-up, it was revealed that their ability to employ problem-focused and emotion-based coping depended on their perceived levels of homophobic stigmatization and meaning in life. Coping was found more difficult for offspring with low meaning in life levels (Bos et al., 2020). In another study, Bos and colleagues (2021) also found that the long-term homophobic stigmatization of offspring from lesbian couple families during adolescence can be carried over to adulthood. They found this to have a direct relationship with meaning in life. Aside from the context of parenting, Allan and colleagues (2015) had previously advanced that lesbian, gay, and bisexual people who lived a life based on their calling also found meaning in their lives. They add that a supportive workplace climate allowing members of the minority group to live, work as they please, and enjoy what they do all add up to a happy and satisfying life. These studies demonstrate that family relations and careers yield meaning in life within the LGB community.

Death Anxiety

Studies unveiled for death anxiety dated back to the 1980 and 1990 s. There were no recent studies found for death anxiety. One study was conducted in 1984, and the four others were completed in 1991, 1992, 1993, and 1995. All analyses were conducted in the United States of America. The studies generally focused on gays, but one study considered lesbians, and another included bisexuals as part of the participants. These studies did center on particular age groups. Still, two indicated representations for young adults, middle-aged adults, and older adults regarding the age groups described in those studies. All studies reported in this review used the quantitative approach.

While studies on death anxiety abound, it is remarkable to underscore those specific studies dealing with the LGB context dated back to the 1980 and 1990 s. Templer and colleagues (1984) were interested in measuring the death anxiety of lesbian and gay lovers and heterosexual partners, revealing no significant difference between scores of lesbians and gays but significant differences compared to their heterosexual counterparts. In the succeeding years, studies on death anxiety among gay men and bisexuals who contracted HIV (human immunodeficiency virus-acquired) leading to AIDS (acquired immunodeficiency syndrome) became observable in the literature. One study compared the death anxiety of gay men with AIDS against a group of gay men who do not have AIDS. Results revealed that higher death anxiety level was inversely correlated with church attendance, where participants viewed religion as harmful in their situation (Franks et al., 1991). Scholars studied death anxiety, help-seeking, and social support among gay men with HIV diagnosis in another research. Three groups were compared in the study: gay men without HIV diagnosis, symptomatic gay men, and asymptomatic gay men. Gay men who were HIV-positive and symptomatic registered higher death anxiety scores than the two groups, thus implying the needed support given the severity level of one’s illness (Catania et al., 1992). Hintze and colleagues (1993) also found high levels of death anxiety and death depression among HIV-infected gay men saying that the severity of their medical condition and disability is instrumental in dictating their level of death anxiety and death depression. A later study found that death anxiety and fear of premature death were higher among HIV-positive gay men and bisexual individuals (Bivens et al., 1995). The review demonstrated that scholars studied death anxiety primarily within an HIV context among gay men. We were unable to retrieve studies from other contexts in the review.

Spirituality

The articles found on spirituality were mostly conducted in the Western contexts, notably in the United States and Canada. There were two studies with an Asian context, particularly from Turkey and India. The identified studies from 2005 to 2021 imply that spirituality was regularly researched within the community. 13 studies collectively studied at least two sub-groups in one research. These studies included transgender people, which were not observed in the other factors. The studies focused on varying age groups, and some did not consider age as an essential factor in the study since information about this was not specified. Available data showed attempts to study young adults, middle-aged individuals, and older adults. The studies used different research approaches: 35% (n = 6) used qualitative approach, 59% (n = 10) used quantitative approach, and 6% (n = 1) used mixed-methods approach.

Spirituality has been explored differently in the LGB context through the years. Our review validated prominent claims about spirituality and religion being distinct yet related to each other. It was common to see religion being mentioned along with spirituality. In a recent study, 11 self-identifying LGBT older adults expressed how personalized approaches to spirituality supported older adulthood despite encountering harmful experiences with Christianity during their childhood and adulthood stages (Dakin et al., 2021). In their study of 75 LGBT Muslims, Stuhlsatz and colleagues (2021) found that those who were not raised in the Muslim faith had significantly lower levels of psychological well-being when compared to those who were raised in the faith. Their study implies that the longer exposures to faith contributed to increasing spirituality and one’s LGBT community involvement and family support. One’s membership in specific religions also contributed to conflicts and emotional harm among some LGBT members that Beagan and Hattie (2015) interviewed. Their interviews revealed that their prior experiences with religions led them to leave the group and distinguish between religious and spiritual activities. Their study showed how participants could differentiate between religion and spirituality. This finding was consistent with strength-based research conducted among 2,269 LGB people in New Zealand. The respondents reported religious traditions as a hindrance to wellness and happy life.

Conversely, these factors were equated to spirituality (Henrickson, 2007). Ayten and Anik  (2014) supported this distinction by revealing how their interviews with 30 LGBT people, who have no particular religious affiliations, regarded spirituality as instrumental in helping them cope with life adversities. An earlier study by Halkitis and colleagues (2009) also revealed how LGBT people defined religion and spirituality. They primarily conceptualized religion as part of worship activities. In contrast, they equated spirituality with interpersonal, intrapersonal, and transpersonal relationships. Recognizing the vital role that spirituality plays in the lives of LGB people, Stroud and colleagues (2015) showed how it could serve as a protective factor against suicide and self-injury proneness, thus implying the relevance of integrating it in counseling interventions and future research endeavors. There are contrarian viewpoints from another study that revealed spirituality to predict greater heteronormativity and negative identity among the LGB people (Wright & Stern, 2016).

Aside from studies that collectively focused on the LGB community, there were also studies centered on the specific groups in this sexual and gender minority community. The survey of Tan (2005) centered on 93 lesbians’’ and gays’’ spiritual well-being recognizing its essential role in helping them adjust to oppressive life situations. Their study found that the existential aspect of spirituality enabled them to manifest higher self-esteem levels, better acceptance of one’s unique conditions, and manage feelings of alienation. Among gay and bisexual men, Lassiter, and colleagues (2019) concluded that spirituality was negatively associated with depression and positively related to resilience and social support. In the gay context, a study found that spirituality was positively correlated with the emotional well-being of gay Orthodox Jews. Religiosity, which was also measured in the same survey, did not directly connect with the emotional well-being of Orthodox Jews. It concluded that spirituality offers better pathways to emotional relief and benefits than religiosity when facing life uncertainties (Harari et al., 2014). In an earlier study, Miller (2006) found that spirituality helped 10 African-American gay men with AIDS live everyday life with acceptance and reduced feelings of death anxiety.

In the lesbian context, a study found that spiritual experiences profoundly impacted the aging process of older lesbian adults providing clarifications about the perceived disconnections of aging, spirituality, and sexuality (Dunnuvant et al., 2018). In another study with lesbians, Smith & Home (2008) also found that spirituality is positively related to sexual satisfaction and served as a strong predictor. Because spirituality is recognized as an essential component of wellness, Jones (2014) endorsed how the active integration of spirituality in the psychotherapy sessions of a lesbian diagnosed with schizophrenia proved successful in yielding better therapy outcomes. Varner (2004) also expressed that the self-identified lesbians with cancer she interviewed also found support in their expressions of spirituality apart from the religious worship they grew up with. The same recommendations to incorporate spirituality in the treatment planning were also advanced.

Singh and colleagues (2015) argued that pro-social activities might also be necessary to help lesbians and gays with diseases and illnesses and experiencing internalized homophobia manage their condition. Their spiritual experience as manifested in their relationship with the Divine may not be enough to appease their adverse situations. The literature has clearly distinguished religious from spiritual expressions and provided evidence about spirituality as a more resonating construct within the LGB context.

Discussion

Our review demonstrated that there is scholarly evidence about existential matters such as meaning in life, death anxiety, and spirituality within the LGB community. The assessment allowed the identification of research gaps that can serve as areas for exploration of future studies.

The available studies conducted on the meaning in life of gays prominently focused on parenting and couplehood. These studies had a consistent thrust of comparing the meaning in life of gay fathers with heterosexual fathers. Because it is not common to see gay men becoming parents and even conceiving children from the natural process of heterosexual intercourse (Hank & Wetzel, 2018), this reality is viewed as a factor in getting high results on meaning in life among gay men. The unique role that parenthood plays in their lives as members of the sexual and gender minority group is underscored. The literature reviews showed that, in the gay context, scholars studied meaning in life with other constructs like self-perceived parental role and subjective well-being.

Further studies may link meaning in life with other psychological variables. While these studies measured meaning in life among gay men, the studies found in the lesbian context had a different vista in tackling meaning in life. The two studies found notably centered on determining the meaning in life of children with lesbian parents. In these studies, the researchers measured children’s stigmatization and their meaning in life. The latter played a significant role in dictating the meaning of life. These studies suggest that accepting gay and lesbian parenthood may differ. Future studies can be done to understand this better. Gato and colleagues (2020) indicated that lesbians may be at higher risk of a social stigma than gay men because of the delicate role of motherhood and bearing a child. Research that directly studies the meaning of lesbians’ lives is desired in the literature. The sources of meaning in life for the LGB community remain unknown since the studies identified have only concentrated on the meaning emanating from the perspective of family affairs. Other sources or determinants of meaning in life stemming from work, leisure activities, hobbies, interests, and the likes can be explored further. For the general population, meaning in life is inferred from different factors. Heintzelman and colleagues (2020) suggested that it is part of the common experience of people that requires effort to attain it. Further, they contended that it varies based on the culture that shapes a person. Generally, they confirmed that social relationships and happiness are key factors that give meaning in life to individuals. Hughes & Lomas (2021) advanced the question on how young men experience meaning in life. From the participants’ accounts, meaning in life was inferred from recovering from the loss of a son, studying for higher degrees, engaging in service and entrepreneurship, and forgetting painful experiences from childhood. For women, the ability to conceive a child whether through natural or artificial means is a source of meaning in life (Su et al., 2006). In another study, it was found that meaning in life is an essential factor that helps in the management of borderline personality disorders among women. It provides resilience amidst hopelessness (Marco et al., 2017). Zhang and colleagues (2022) advanced that meaning in life, for both men and women, is derived from prosocial behaviors or one’s capability to be of service to others. Among older men and women, daily activities, health problems, psychosocial functioning, and social support contribute to their meaning in life (Golovchanova et al., 2021). It is interesting to underscore that certain factors that give meaning to life among men and women are reported in the scholarship since these factors remain unknown among LGBT + people. Available materials can signify that situational factors impact the meaning in life of both LGBT + people and their heterosexual counterparts.

With the COVID-19 pandemic, studies on death anxiety abound in the literature. However, the reviews demonstrated that none of the recent studies attempted to shed light on death anxiety in the LGB context. A study suggested that age was a significant predictor of death anxiety among women but not among men (Assari & Lankarani, 2016). Older women were also found to demonstrate higher levels of death anxiety than older men (Zana, 2009). These studies are suggesting that gender plays a role in the determination of death anxiety. It will be interesting to see what results will be generated if the same study will be conducted including LGBT + participants. Scholars have also studied death anxiety with participants who manifest terminal illness, disorders, and other communicable diseases (Cho & Cho, 2022; Laciner et al., 2022). Examples of conditions where death anxiety was studied among participants include obsessive-compulsive disorder (Menzies et al., 2020), schizophrenia (Mavrogiorgou & Juckel, 2020), and cancer (Liu et al., in press). It was earlier advanced that men have higher will to live than men which supports the other research advances that death anxiety is more pronounced among women than men (Carmel, 2001). Notably, studies on death anxiety concerning the general population have centered on participants with specific conditions. This is a similar thrust among studies that centered on participants from the LGBT + community. In this review, we found similar study features wherein death anxiety was studied among LGB people with HIV-AIDS, a condition that was particularly attributed to this community even during earlier times. The review showed that studies on death anxiety in the LGB context dated back mainly to the 1980 and 1990 s. Researchers did these studies when certain parts of the globe were experiencing the HIV-AIDS epidemic (Global Health Policy, 2021). More researchers did death anxiety studies then centered on the situations of gay men because of their proneness to contract HIV prominently due to their engagement in sexual activities (Rodriguez, 2020). It is also interesting to learn about the death anxiety of the other sub-groups within this sexual and gender minority group aside from the ones prominently reported about gays. While current studies about the mental health of LGB people abound, it will be interesting to note in future studies how death anxiety factors in as a factor that affects it. Other studies can also consider different scenarios or situations that may incite death anxiety since there was a considerable gap in years since the last research on death anxiety in the LGB context was pursued.

The articles on spirituality aptly set the distinction between religion and spirituality in the LGB context. In the studies, it is common to see that LGB people perceived religion as oppressive and restrictive in fully expressing one’s identity. Studies regarded spirituality as a supportive factor that enabled them to deal with life’s challenges and hurdles more effectively. Scholars advanced more studies on spirituality with lesbian participants than with gay participants. The studies with gay participants offered remarkable insights that spirituality can provide them emotional relief from life uncertainties. Because religions advocated for heteronormativity, for the most part, the gays mostly found support for spirituality. The lack of studies in this area may be the point of departure for future research. While studies on spirituality in the lesbian context appear to outnumber those centered on the gay context, there was a noticeable gap in the years that these studies were conducted. Significant jumps in the publication of these studies can signal that spirituality among lesbians can still be explored further. It was important to underscore how spirituality was seen as an essential need of aging lesbians. It aided them in the aging process. It was a notable predictor of sexual satisfaction. It was also a factor in developing resilience amidst the patriarchal society and a critical success component in psychotherapies. Given the changes in people’s way of life at present, it is of interest to see how the spiritual needs of lesbians have also changed over time.

Considering non-LGBT + contexts, a recent study focused on how spirituality predicted life satisfaction of the general population during the COVID-19 pandemic. As a psychosocial resource, Esteban and colleagues (2021) recognized the important role that spirituality plays in promoting positive mental health amidst the challenging time. Similarly, this factor is also viewd as a supportive factor even in non-LGBT + contexts. Further, the scholarship documents more studies on spirituality conducted among women. These studies viewed spirituality as a protective factor that helps in managing life conditions of women suffering from specific conditions like HIV (Grodensky et al., 2015), alcohol and marijuana substance abuse (Drabble et al., 2022), cancer (Rached et al., 2022). Spirituality was also studied as a factor that helps in promoting positive body image of women (Tiggermann & Hage, 2019). While studies on the LGBT + context focused more on highlighting how they differently perceived experiences with religiosity and spirituality, the studies on non-LGBT + studies directly studied how spirituality could help improve life dispositions of patients diagnosed with specific conditions. This is indicative that religion is not considered a sensitive issue among non-LGBT + participants.

The review confirmed previous notions about religion and spirituality being two distinct human experiences (Dakin et al., 2021; Halkitis et al., 2009). Among the articles, it was common to see that participants identified better with spirituality than religion. Spirituality is also correlated with other psychological variables, which signifies its essential role in different layers of human experiences. Using this discovery, it is interesting to find their specific spiritual expressions and experiences since these details were not reported thoroughly in the studies documented herein.

Conclusion

The review showed that scholarship had given attention to the existential experiences of the LGB community. While existential experience can be viewed from various vistas, this review explored it from the lenses of meaning in life, death anxiety, and spirituality. Because the studies were dominantly conducted in the Western countries, more studies in these areas are recommended in the Eastern counterparts. Given that cultural differences may play a significant role in determining outcomes for these factors, it is recommended to bring studies on existential topics to other locales.

The significant jumps in the years of publications also raise flags on the timeliness of available information pertinent to the factors. It is time to advance studies in this area, given the outdated details available in the literature. While recent information is available for meaning in life and spirituality, with some studies conducted as recently as 2021, the scope of the investigation can still be expanded to know more about these factors. Future studies can investigate actual activities and critical actions that LGB people do regarding these existential matters since narratives and expositions in the available accounts do not elucidate this matter. The focus is on lesbians, gays, and bisexuals, where specific studies are available. Studies on the other members of this diverse community should be carried out more in future research. Studies about bisexuals, transgender people, and queer + individuals are significantly lacking. We have also noted more quantitative studies being conducted on the covered areas is a good starting point for exploration for future qualitative research to be undertaken.

Limitations and Future Directions

This scoping review is not without limitations since we treated existential experiences only from the perspectives of meaning in life, death anxiety, and spirituality. We might have missed details from other authors who afforded and studied such experiences from other vistas. The studies found on other databases not considered in this endeavor may provide more key search results. We are limited only to the studies finalized from the selected databases. Extending the scoping endeavor to other databases will help in enriching the search results of the present work. We did not include the studies written in other languages besides English in the search. The use of different search keywords related to the topic may be done to incorporate other materials that did not make it into this review. Future studies can take insights from this research as their point of departure in future research projects. Future research can collectively put together these existential experiences as a research topic worth exploring through a multi-methods approach. Working on specific age groups and sub-groups within the community can be a good direction for future research.

Funding

No funding was received for conducting this study.

Data Availability

not applicable.

Code Availability

not applicable.

Declarations

Conflicts of interest/Competing Interests

The authors have no conflicts of interest to declare relevant to the content of this article.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.

Consent for publication

Not applicable.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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