Experiences That Can Involve Grief

• Birth control pills or hormone replacement therapy (HRT): weight gain, breast enlargement or tenderness, and changes in fat distribution
• Changes to the body/body image related to medical treatment
  • Surgical interventions: mastectomy, orchiectomy, amputation
  • ​​Corticosteroids: weight gain, "moon face," acne, and fat redistribution (e.g., buffalo hump), muscle wasting or thinning of the skin
  • Androgen deprivation therapy: breast tissue enlargement in males, reduced body hair, weight changes
  • Chemotherapy or radiation: hair loss, weight fluctuation
  • Estrogen therapy: breast development, body fat redistribution
  • Testosterone therapy: facial/body hair growth, voice deepening, acne, hair loss
  • Antipsychotics: may lead to breast tissue enlargement in males and lactation
• Cognitive decline or loss of mental clarity (e.g., dementia, brain injury)
• Diagnosis of a learning disability, mental health condition, or chronic illness
• Gender-affirming care/Denial of gender-affirming care
• Infertility 
• Loss of autonomy or independence (a person who can no longer drive, live alone, or manage daily tasks due to illness)
• Loss of mobility (e.g., after a spinal cord injury or amputation)
• Loss of physical ability due to injury, illness, or surgery
• Loss of professional role or licensure (A clinician who loses their license may grieve not only the job, but a core part of their identity and purpose; illness may preclude working)
• Menopause
• Role changes that affect identity (e.g., no longer a sibling after a sibling’s death)

• Death of someone personally known (e.g., family member, friend, mentor, neighbor)
• Death of a beloved animal
• Death of a large group of people or community
• Death of a public figure (e.g., author, musician, community leader)
• Pregnancy loss

• Not getting a job, promotion, award, or grant
• Career setbacks or academic rejections

• Deportation
• Foster care placement
• Experiencing homelessness
• Forced displacement due to conflict or persecution
• Immigration
• Incarceration
• Military deployment

• Natural disasters
• Loss of home or community
• Loss of normalcy or routine (e.g., during the COVID-19 pandemic)
• Loss of safety due to abuse, violence, systemic harm, or war
• Loss of treasured or sentimental items

• Experiencing moral injury as a provider
• Experiencing harm, harassment, or discrimination and no longer feeling safe in a familiar environment
• Loss of trust in caregivers or healthcare providers (after a medical error or misdiagnosis)
• Loss of trust in the system (provider who advocates for a treatment that’s denied by insurance may feel powerless, grieving their sense of justice or professional integrity)

• Breakups or divorce
• Conflict or disconnection with peers
• Colleagues changing jobs, being laid off, retiring
• Ending of a long-term clinician-patient bond ( discharge, transfer)
• Estrangement from family or friends
• Loss or shift in custody/caregiving roles
• Social exclusion or marginalization

Milestone moments can involve letting go of a previous role, identity, or chapter of life and can bring mixed emotions. For example: 

• Adoption or birth
• Changing jobs
• Graduation
• Marriage
• Moving to a new home
• Retirement