Terminally ill individuals should be provided quality palliative care (PC) to enhance their quality of life. LGBTIQ+ people are often exposed to increased stressors throughout their life which may make health service engagement particularly difficult. This study is part of the LGBTIQ+ Health Australia National Palliative Care Project funded by the Department of Health and Aged Care. This paper explores the second phase of this research that sought to investigate what people who are LGBTIQ+ report as barriers and enablers to PC engagement. In the first phase, the same research questions were considered through brief survey responses from a large community sample (n = 837). To provider a deeper and more nuanced understanding of the topic this phase considered the voice of thirteen participants who are LGBTIQ+ across Australia (some of whom were or had worked as health professionals). Semi-structured interviews were conducted with participants and responses were subsequently analysed using thematic analysis. 
 

Barriers and enablers were reported at institutional, relational and individual levels. At an institutional level, barriers concerned religious influences, limited access to services and legal barriers; while increased services, legal protection, and inclusive policies and procedures were perceived as enablers to PC engagement. At a relational level, reported barriers included lack of control over personal relationships, unprofessional or discriminatory staff, however, connection to family, and/or chosen family and/or partner(s) and/or friends, and professional, inclusive and competent staff interactions were perceived as enabling factors. Finally, individual factors that presented as barriers were denial of autonomy and choice, the need to disguise being LGBTIQ+ and unmet HIV/AIDS treatment needs; while maintaining patient autonomy and choice, and the facilitation of various intersectional needs and death needs acted as enablers to PC engagement. The results of this study can be used to inform policy and/or training and practice for health professionals engaging with LGBTIQ+ populations.