Two-Eyed Seeing in LGBTQ+ aging research: critical lessons from research with Two-Spirit and Indigenous LGBTQ+ people aging with HIV
10 affiliations
- 1Center on Aging, University of Hawai'i at Manoa
- 2Department of Epidemiology, Tufts University
- 3Department of Behavioral and Social Sciences, Brown University
- 4College of Doctoral Studies, Grand Canyon University
- 5The Raven Collective, LLC
- 6Community Engaged Research Council, Providence-Boston Center for AIDS Research
- 7School of Health Sciences, University of Northern British Columbia
- 8TSET Health Promotion Research Center and Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences
- 9The Reunion Project
- 10Special Initiatives and Partnerships, SAGE
Abstract
Background: Dominant approaches to aging and public health research are often misaligned with Indigenous understandings of health and well-being, particularly in their limited attention to cultural, spiritual, and relational dimensions. Two-Eyed Seeing integrates the strengths of Indigenous and Western knowledge systems, offering a framework for addressing health disparities and advancing health equity. This approach has informed culturally responsive health strategies, including those for Indigenous people with HIV.
Objectives: This article critically reflects on the application of Two-Eyed Seeing in a study involving Indigenous Two-Spirit and LGBTQ+ (2S/LGBTQ+) people aging with HIV. We offer methodological reflections, lessons learned, and insights into how this approach can enhance HIV and aging research, practice, and health equity.
Methods: Drawing from participant insights, Community Advisory Board (CAB) feedback, community observations, and researcher reflexivity, we critically examined the application of Two-Eyed Seeing throughout the research process, including relationship building, research design, data collection, analysis, and interpretation.
Findings: Through reflexive engagement, we generated three key methodological insights: (1) Two-Eyed Seeing challenged Western public health narratives that characterize Indigenous 2S/LGBTQ+ communities as “hard to reach,” emphasizing relational accountability and trust building; (2) engagement with Indigenous Knowledge Holders and CAB members fostered transformative mentorship, strengthening the researcher’s community connectedness and understanding of relational accountability; and (3) explicit and ongoing reflexivity helped interrogate and disrupt traditional power dynamics between the “researched” and the researcher, fostering more reciprocal and community-centered knowledge production.
Conclusion: Two-Eyed Seeing offers a meaningful framework for advancing culturally responsive HIV and aging research with Indigenous 2S/LGBTQ+ communities. Beyond integrating knowledge systems, this approach emphasizes relational accountability, mentorship, and critical reflexivity as essential to challenging harmful research practices and addressing power imbalances. These insights may offer practical considerations for researchers seeking to advance health equity through culturally grounded, community-engaged approaches.
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BibTeX
@article{bryer2026twoeyed,
title = {{Two-Eyed Seeing in LGBTQ+ aging research: critical lessons from research with Two-Spirit and Indigenous LGBTQ+ people aging with HIV}},
author = {Chase M. Bryer and Jordan P. Lewis and Alexandra B. Collins and Madina Agénor and Trudie Jackson and Itai Jeffries and Paul Goulet and Nathan Lachowsky and Julia McQuoid and Jeff Berry and Sherrill Wayland and Jeffrey Proulx},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1965121},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1965121/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Two-Eyed Seeing in LGBTQ+ aging research: critical lessons from research with Two-Spirit and Indigenous LGBTQ+ people aging with HIV
AU - Chase M. Bryer
AU - Jordan P. Lewis
AU - Alexandra B. Collins
AU - Madina Agénor
AU - Trudie Jackson
AU - Itai Jeffries
AU - Paul Goulet
AU - Nathan Lachowsky
AU - Julia McQuoid
AU - Jeff Berry
AU - Sherrill Wayland
AU - Jeffrey Proulx
PY - 2026
DA - 2026/10/21
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1965121
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1965121/full
AB - Background: Dominant approaches to aging and public health research are often misaligned with Indigenous understandings of health and well-being, particularly in their limited attention to cultural, spiritual, and relational dimensions. Two-Eyed Seeing integrates the strengths of Indigenous and Western knowledge systems, offering a framework for addressing health disparities and advancing health equity. This approach has informed culturally responsive health strategies, including those for Indigenous people with HIV. Objectives: This article critically reflects on the application of Two-Eyed Seeing in a study involving Indigenous Two-Spirit and LGBTQ+ (2S/LGBTQ+) people aging with HIV. We offer methodological reflections, lessons learned, and insights into how this approach can enhance HIV and aging research, practice, and health equity. Methods: Drawing from participant insights, Community Advisory Board (CAB) feedback, community observations, and researcher reflexivity, we critically examined the application of Two-Eyed Seeing throughout the research process, including relationship building, research design, data collection, analysis, and interpretation. Findings: Through reflexive engagement, we generated three key methodological insights: (1) Two-Eyed Seeing challenged Western public health narratives that characterize Indigenous 2S/LGBTQ+ communities as “hard to reach,” emphasizing relational accountability and trust building; (2) engagement with Indigenous Knowledge Holders and CAB members fostered transformative mentorship, strengthening the researcher’s community connectedness and understanding of relational accountability; and (3) explicit and ongoing reflexivity helped interrogate and disrupt traditional power dynamics between the “researched” and the researcher, fostering more reciprocal and community-centered knowledge production. Conclusion: Two-Eyed Seeing offers a meaningful framework for advancing culturally responsive HIV and aging research with Indigenous 2S/LGBTQ+ communities. Beyond integrating knowledge systems, this approach emphasizes relational accountability, mentorship, and critical reflexivity as essential to challenging harmful research practices and addressing power imbalances. These insights may offer practical considerations for researchers seeking to advance health equity through culturally grounded, community-engaged approaches.
SN - 2296-2565
ER -