Health professionals share insights on health and life situation among forced migrants identifying as LGBTQ+

Exploratory method in collaborative research

Group discussions and individual interviews were conducted with health professionals working in facilities focused on refugee health and sexual health. Researchers engaged in discussions and interviews with seven professions (including nurses, counselors, and psychologists). The collected material was analyzed in close collaboration between researchers, forced migrants with personal experience of coming to Sweden as LGBTQ+, and clinical representatives. Analyzing the material in close collaboration with the target group is novel in this field of research. The approach involved researchers and migrants working as colleagues and equal partners, where different perspectives were considered during the analysis. Working with individuals who are experts through their own lived experiences enriched the work. For the researchers, it provided valuable insights into a population in society that is seldom heard and may not always can make their voices heard. For the migrants working as research assistants, the work was an opportunity for reflection about other refugees as well as their own experiences.

- Working with researchers and professionals was eye-opening for us. Working together in this way contributes to a deeper understanding of the perspectives of health professionals regarding supporting LGBTQ+ refugees. It gave us insight into how far we have come but also what remains to be done, say two of the research assistants with lived experience who collaborated with the researchers.

Multidimensional challenges for forced migrants seeking safety

According to health professionals, forced migrants are confronted with an uncertain and demanding situation after arriving in Sweden. Health professionals emphasized the significant challenges refugees face in managing legal requirements, stressful circumstances, and normative expectations during the asylum process. Discrimination, violence, abuse, and lack of psychosocial security were raised as serious issues. Participants highlighted the risk of sexual violence and exploitation. Overall, the societal situation was considered to negatively impact the mental health of forced migrants.

- Our research provides insight into the complex challenges faced by migrants with non-conforming identities and expressions. The disadvantages and challenges span all levels of society and are clearly linked to norms and multifaceted minority status. It is evident that the asylum process itself constitutes a stressful situation, and societal normative expectations put additional pressure on individuals. These individuals face racism as well as homophobia and transphobia in society, which shapes their health and opportunities for a good life. It is crucial that we understand the various health challenges this target group experiences to design effective support measures, says Tommy Carlsson, a midwife, associate professor, and project leader.

Mental health issues and the need for additional support interventions

The study illustrates the extensive mental consequences that forced migrants may experience upon arrival. Health professionals highlighted the vulnerability related to being both an asylum seeker and identifying as LGBTQ+, simultaneously. According to participants, loneliness and shame are central aspects and often prominent in clinical settings. A conclusion in the study is that there is a need for the development of interventions and programs that evaluate peer support among refugees.

- The study not only provides insights into existing challenges but also points to areas where further research is needed. A deeper understanding of how loneliness and shame affect these migrants is crucial for creating long-term solutions that can improve their health and well-being. We saw that peer support can be beneficial, but more research is needed, says Maria Gottvall, a midwife and researcher.

The  project A Safer Future explores how healthcare, education, and research can be developed to better support refugees who identify as LGBTQ+. The project is funded by Forte.

You can read the publication here