Work

Two-Eyed Seeing in LGBTQ+ aging research: critical lessons from research with Two-Spirit and Indigenous LGBTQ+ people aging with HIV

Year: 2026

Type: article

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.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1965121