LGBTQI + Migrants: A Systematic Review and Conceptual Framework of Health, Safety and Wellbeing during Migration

Abstract

The health and safety of LGBTQI+ migrants or migrants who are of diverse sexual orientation, gender identity or expression (SOGIE) remains an under-studied area, particularly for the period during transit from their place of origin to destination. This systematic review aims to describe the literature on the health risks and consequences among SOGIE migrants during transit and examine their access and use of services. Six peer-reviewed databases and websites of nine large migration organisations were searched to identify the literature on forced migrants and sexual and gender minorities. Twenty English-language studies from 2000–2021 were included and analysed drawing on a conceptual framework. Studies emerged from six regions and the majority of research participants identified as gay men. In general, quality appraisal demonstrated studies as either medium or high quality. Findings suggested five common themes associated with SOGIE health and well-being, including: daily exposure to discrimination, harassment and violence; coping, social support and resilience; access to services; mental health; and physical and sexual health. Depression, anxiety and post-traumatic stress disorder (PTSD) were prevalent amongst SOGIE migrants, particularly when associated with detention or camp environments, and were exacerbated by social isolation. Barriers to accessing healthcare were identified and specific sexual health services were often found lacking, especially for trans persons. Unsurprisingly, during transit, SOGIE migrants are very likely to experience the double marginalisation of their migrant or minority status and their gender identity. Results indicate that services for SOGIE migrants need to tailor service access and support approaches to respond to the particular health and protection needs of SOGIE individuals in each setting.

Acceptable but not always accessible. Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium

“…Our data also shows that that participants' intersecting identities led to a high mental health burden. Consistent with other studies (34,41,44,45) sexual minority experiences in the country of birth and socio-economic adversity in the country of residence in uenced sexual agency and HIV prevention behavior including PrEP uptake. Community connectedness and social support (34) are often mentioned in the literature as protective factors, which is also in line with our results.…”

“…Mental health problems have been well-documented among sexual minorities (37)(38)(39)(40) and migrants (41)(42)(43), most often caused by minority stress, discrimination and racism. Our data also shows that that participants' intersecting identities led to a high mental health burden.…”

Post‐migration psychosocial experiences and challenges amongstLGBTQ+ forced migrants: A meta‐synthesis of qualitative reports

“…Similar findings have been reported in other reviews highlighting microaggressions and violence enacted by co‐ethnic communities and mainstream white LGBTQ+ spaces, leading to daily challenges, social exclusion, serious health‐related consequences, and risk‐taking behaviours (Alessi, Cheung, et al, 2021; Haghiri‐Vijeh & Clark, 2022 ; Sadika et al, 2020 ). In itself, forced migration and having to seek asylum is a life‐changing events associated with considerable psychological sequelae (Li et al, 2016 ; Yarwood et al, 2022 ). Our findings confirm that the target population not only experience a range of general challenges in the post‐migration period—regardless of their sexual orientation, gender identity and/or gender expression—but also faces specific burdens related to their multiple intersecting identities, orientations, and social positions.…”

“…Those identifying as LGBTQ+ and are forced migrants have intersecting social or minority identities that shape their situation and can present unique converging stressors. According to previous research, being forced to migrate to another country because of your sexual orientation, gender identity, and/or gender expression is a significant personal undertaking involving substantial risks and health‐related consequences during the transit (Yarwood et al, 2022 ). These persons are likely confronted with various health‐related challenges in society when seeking asylum and resettling.…”

Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium

“…Mental health problems have been well-documented among sexual minorities [ 37 – 40 ] and migrants [ 41 – 43 ], most often caused by minority stress, discrimination and racism. Our data also shows that that participants’ intersecting identities led to a high mental health burden.…”