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In 2019, Bates portrayed American politician Miriam A. Ferguson in the Netflix film The Highwaymen. She also appeared in the Clint Eastwood film Richard Jewell, playing the mother of the title individual, for which she was nominated for a Best Supporting Actress Golden Globe as well as her fourth Academy Award nomination (also in the Best Supporting Actress category).

In 2018, she appeared in two films: in Xavier Dolan's critically panned arthouse film The Death and Life of John F. Donovan and as political activist Dorothy Kenyon in the Ruth Bader Ginsburg biopic On the Basis of Sex. That year, she also guest-starred in the finale of the 11th season of The Big Bang Theory.

On May 11, 2018, Bates led advocates in a Capitol Hill Lobby Day to garner congressional support for further research funding. The next day, May 12, Bates addressed supporters at the first-ever DC/VA Walk to Fight Lymphedema & Lymphatic Diseases at the Lincoln Memorial. She was awarded the 2018 WebMD Health Heroes "Game Changer" Award for her role in raising awareness of this chronic lymphatic disease.

In 2017, Bates starred in the Netflix television series Disjointed, in which she played the character of Ruth Whitefeather Feldman, an owner of a California medical marijuana dispensary. The show aired for two seasons.

On September 20, 2016, Bates received a star on the Hollywood Walk of Fame for her work in the film industry. Her star is located at 6927 Hollywood Boulevard.

In June 2016, the Human Rights Campaign released a video in tribute to the victims of the 2016 Orlando gay nightclub shooting; in the video, Bates and others told the stories of the people killed there.

Bates returned for the fourth season of American Horror Story, Freak Show, this time as Ethel Darling, a bearded lady who performs in a freak show. She subsequently returned again for the fifth season, Hotel, where she played Iris, the hotel's hateful manager. Bates returned for her fourth, and the show's sixth season, Roanoke, playing two characters—Thomasin "The Butcher" White and Agnes Mary Winstead. She received further Emmy Award nominations for each season.

In 2013, she began starring in the American Horror Story series' third season, Coven, as Delphine LaLaurie, an immortal racist who is brought back into the modern world after spending years buried alive. For that role, she won her second Emmy Award, in the category of Outstanding Supporting Actress in a Miniseries or a Movie. Bates claimed that Ryan Murphy, the creator of the series, "resurrected [her] career".

Bates' television work has resulted in 14 Emmy Award nominations, including two for her leading role on the NBC series Harry's Law (2011–12). She won the Primetime Emmy Award for Outstanding Guest Actress in a Comedy Series for her appearance on the ninth season of Two and a Half Men (2012) and the Primetime Emmy Award for Outstanding Supporting Actress in a Miniseries or Movie for her portrayal of Delphine LaLaurie on the third season of American Horror Story (2014). She also received accolades for her portrayal of Miss Hannigan in the 1999 television adaptation of Annie. Her directing credits include several episodes of the HBO television series Six Feet Under (2001–03) and the television film Ambulance Girl (2005).

From 2010 to 2011, she had a recurring guest role on the NBC sitcom The Office as Jo Bennett. Her first lead role on a television series was in David E. Kelley's legal drama Harry's Law, which began airing on NBC on January 17, 2011, but was later cancelled on May 14, 2012. In 2012, Bates made a guest appearance on Two and a Half Men as the ghost of Charlie Harper on the episode "Why We Gave Up Women", which aired on April 30, 2012. This guest appearance resulted in Bates winning her first Emmy Award, in the category of Outstanding Guest Actress in a Comedy Series, following nine nominations.

During this time, she also appeared frequently on television. She starred in ten episodes of the HBO cable television series Six Feet Under for which she received an Emmy Award nomination for Outstanding Guest Actress in a Drama Series in 2003. She also directed several episodes of the series. Bates received yet another Emmy Award nomination, in the category of Outstanding Lead Actress in a Miniseries or Movie, for Lifetime Television's Ambulance Girl (2006), which she also directed.

Bates has successfully battled ovarian cancer since her diagnosis in 2003. In September 2012, she revealed via Twitter that she had been diagnosed with breast cancer two months earlier and had undergone a double mastectomy. In 2014, at the New York Walk for Lymphedema & Lymphatic Diseases, Bates announced via pre-recorded audio that, due to the double mastectomy, she has lymphedema in both arms. That year, Bates became a national spokesperson for lymphedema and chairperson for the Lymphatic Education & Research Network's (LE&RN) honorary board.

In 2002, she received her third Academy Award nomination, again in the Best Supporting Actress category, for performance as an aging free-spirited woman in About Schmidt, opposite Jack Nicholson. A scene in the film, which features Bates completely nude entering a hot tub, was noted by critics and received significant public attention. NPR called it "the scene everyone is talking about". Bates spoke about the scene in several interviews; speaking to Hello!, she said:

Throughout the 2000s, Bates worked consistently in Hollywood cinema, often playing supporting roles in number of mainstream films, such as Rumor Has It... (2005), Failure to Launch (2006), P.S. I Love You (2007), The Day the Earth Stood Still (2008), The Blind Side (2009), and Valentine's Day (2010). In 2006, she directed and co-starred in her feature film directorial debut, Have Mercy (2006), with Melanie Griffith. In 2008, she re-teamed with her Titanic co-stars, Leonardo DiCaprio and Kate Winslet, in Revolutionary Road. In 2011, she portrayed famed art collector Gertrude Stein in Woody Allen's Midnight in Paris.

She received her second Academy Award nomination (and first in the Best Supporting Actress category) for her work as the acid-tongued political advisor Libby Holden in Primary Colors (1998), which was adapted from the book by political journalist Joe Klein. The following year, she was nominated for Outstanding Guest Actress in a Comedy Series for her work in the sitcom 3rd Rock from the Sun as well as for Outstanding Directing in a Miniseries or Movie for her work on the Dashiell Hammett-Lillian Hellman biopic Dash & Lilly. In 2000, Bates received another Emmy Award nomination for her turn as Miss Hannigan in Disney's remake of Annie (1999).

Bates gained wider recognition in 1997 when she portrayed Molly Brown in James Cameron's epic romance and disaster film Titanic, based on the sinking of the RMS Titanic in 1912. The film became the highest-grossing film of all time worldwide in 1998, and remained so for twelve years, until Avatar (2009), also written and directed by Cameron, surpassed it in 2010.

In 1996, Bates received her first Emmy Award nomination for Outstanding Supporting Actress in a Miniseries or a Movie, for her performance as Jay Leno's manager Helen Kushnick in HBO's The Late Shift (1996). That role also earned Bates her second Golden Globe Award win in the category of Best Supporting Actress – Series, Miniseries or Television Film and her first Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Miniseries or Television Movie.

In 1995, Bates began working behind the screen as well, as a director, on several television series; her early directing jobs include episodes of Great Performances, Homicide: Life on the Street, and NYPD Blue.

Soon after, she starred in the acclaimed 1991 film Fried Green Tomatoes, based on the novel by comedic actress Fannie Flagg. For her performance in this film, she received a BAFTA Award nomination. In 1995, Bates played the title character in Dolores Claiborne, another well-received Stephen King adaptation, for which she was nominated for Best Actress at the 22nd Saturn Awards.

Bates was married to Tony Campisi for six years, from 1991 until their divorce in 1997.

Bates' performance as Annie Wilkes in the horror film Misery (1990), marked her Hollywood breakthrough, winning her the Academy Award for Best Actress. Further acclaim came for her starring role in Dolores Claiborne (1995), The Waterboy (1998), and supporting roles in Fried Green Tomatoes (1991) and Titanic (1997); the latter, in which she portrayed Molly Brown, became the highest-grossing film to that point. Bates received nominations for the Academy Award for Best Supporting Actress for her work in Primary Colors (1998), About Schmidt (2002), and Richard Jewell (2019).

Bates' performance in the 1990 horror film Misery, based on the book of the same name by Stephen King, marked her Hollywood breakthrough. The film was a commercial and critical success and her performance as Annie Wilkes was met with widespread critical adulation. The following year, she won the Academy Award for Best Actress and the Golden Globe Award for Best Actress – Motion Picture Drama. The American Film Institute included Annie Wilkes (as played by Bates) in their "100 Heroes and Villains" list, ranking her as the 17th most iconic villain (and sixth most iconic villainess) in film history.

The New York Times wrote that, in the early 1980s, Bates "established herself as one of America's finest stage actresses". In 1983, she was nominated for a Tony Award for Best Lead Actress in a Play for her role in the Pulitzer Prize-winning play 'night, Mother. The stage production ran for more than a year. She found further success on Off Broadway, in Terrence McNally's Frankie and Johnny in the Clair de Lune, for which she won an Obie Award for Best Actress in 1988. McNally specifically wrote the play for Bates. She later succeeded Amy Irving in the Off-Broadway production of The Road to Mecca in 1988. Around this time, she shifted her focus to screen acting, with roles in The Morning After (1986), Summer Heat (1987), and Warren Beatty's Dick Tracy (1990).

After Taking Off was released, Bates didn't work on another feature film until she appeared opposite Dustin Hoffman in Straight Time (1978). Throughout the 1970s, she continued to perform on stage. Her first Off-Broadway performance was in the 1976 production of Vanities. Bates subsequently originated the role of Lenny in the first production of Crimes of the Heart at the Actors Theatre of Louisville in 1979. Beginning in 1980, she appeared in Lanford Wilson's Fifth of July. In 1982, she starred in the Robert Altman-directed Come Back to the Five and Dime, Jimmy Dean, Jimmy Dean with Karen Black and Cher. During this time, she also began working in television, starring in a variety of soap operas such as The Doctors, All My Children, and One Life to Live.

Born in Memphis, Tennessee, she studied theatre at the Southern Methodist University before moving to New York City to pursue an acting career. She landed minor stage roles before being cast in her first on screen role in Taking Off (1971). Her first Off-Broadway stage performance was in the 1976 production of Vanities. Throughout the 1970s and early 1980s, she continued to perform on screen and on stage, and garnered a Tony Award nomination for Best Lead Actress in a Play in 1983 for her performance in 'night, Mother, and won an Obie Award in 1988 for her performance in Frankie and Johnny in the Clair de Lune.

In 1971, Bates was cast in a minor role in the Miloš Forman comedy Taking Off (credited as "Bobo Bates"), her first on screen role in a feature film. Following this, she continued to struggle to find acting roles, later claiming in an interview with The New York Times that more than one casting agent told her that she wasn't sufficiently attractive to be a successful actress:

Kathleen Doyle Bates (born June 28, 1948) is an American actress and director. She is the recipient of numerous accolades, including an Academy Award, two Primetime Emmy Awards, and two Golden Globe Awards.

Bates was born in Memphis, Tennessee, the youngest of three daughters of mechanical engineer Langdon Doyle Bates (July 28, 1900 – March 6, 1989) and homemaker Bertye Kathleen (née Talbert; January 26, 1907 – February 15, 1997). Her paternal grandfather was lawyer and author Finis L. Bates. Her great-great-grandfather was an Irish emigrant to New Orleans, Louisiana, who served as President Andrew Jackson's doctor. She graduated early from White Station High School (1965) and from Southern Methodist University (1969), where she studied theatre and became a member of the Alpha Delta Pi sorority. She moved to New York City in 1970 to pursue an acting career.