Needs of a Silent Minority: Mexican Transgender Asylum Seekers

LGBT Myanmar Migrants in Thailand: Unveiling Diverse Forms of Abuse, Healthy and Unhealthy Coping Strategies

This study investigates the challenges faced by LGBT Myanmar migrants in Thailand, including discrimination and abuse due to their gender identity or sexual orientation, and their coping strategies. Through qualitative interviews with 20 self-identified LGBT Myanmar migrants aged over 18 years who experienced discrimination or abuse in Thailand, the findings underscore the presence of a segment within the Myanmar LGBT migrant community in Thailand subject to discrimination and violence across diverse settings, including workplaces, public areas, and even within their homes. Additionally, the research identified healthy coping strategies like self-soothing thoughts, relaxation activities, and seeking support, contrasted with unhealthy coping strategies such as negative self-talk, rumination, and suppressing one's identity, leading to harmful behaviors and even suicidality. The experiences of severe discrimination and violence among LGBT migrants help this study advocate for policy interventions, such as extending the coverage of the Gender Equality Act to encompass LGBT migrants and implementing mental health support services as a form of secondary prevention. Given the significant contribution of LGBT migrants to various sectors of Thailand's workforce, these measures are essential. However, the existing legislation concerning gender equality in Thailand inadequately addresses the specific concerns of this demographic group.

Racialized Migrant Transgender Women Engaged in Sex Work: Double Binds and Identifications with the Community

Racialized migrant transgender women engaged in sex work represent an understudied population. They face unique challenges resulting from their multiple marginalized identities, such as racialized transmisogyny. Since marginalized communities play a vital role in mitigating systemic stigma, it is essential to expand the literature on the community of this population. The present study used the frameworks of gender minority stress and intersectionality, along with a decolonial and transfeminist approach. Twenty participants aged between 28 and 66 years old (M = 43.15; SD = 10.49) took part in a semi-structured interview. Thematic analysis identified two main areas with ten corresponding themes. "The double bind of community" described the complex dynamics experienced by transgender refugees within their community, including (1) sex work between emancipation and exploitation, (2) non-prescribed treatments for gender affirmation, (3) negative experiences with the community, (4) positive impact of trans organizations, and (5) practical and economic support and exploitation. "The identification with the community" highlighted how participants positively or negatively identified with the community, containing: (6) awareness of one's privileges and oppressions, (7) internalized cisgenderism and assimilation, (8) gender euphoria; (9) sexual objectification, and (10) trans-generativity. The study evidenced the complex dynamics within marginalized communities. Trauma, stigma, and survival struggles can lead to violence and exploitation within the community. However, the community also has the potential to promote positive feelings and generativity. These findings have practical implications for social workers, healthcare practitioners, and researchers, emphasizing the need for appropriate and culturally competent care, including resources for coping with stress, fostering resilience, and facilitating post-traumatic growth.

The Health Needs of Sexual and Gender Minority Migrant Women in the United States: A Scoping Review

Purpose: This scoping review characterizes the peer-reviewed evidence on the health of first-generation sexual and gender minority (SGM) migrant women to the United States and identifies research gaps and future priorities. Methods: On February 1, 2022, the following databases were searched: PubMed (MEDLINE), Embase, CINAHL Plus with Full Text, APA PsycINFO, and PAIS Index. Primary research studies based in the United States, in English, on first-generation SGM migrants (i.e., immigrants, refugees, asylum seekers) were included. Gray literature and review articles were excluded. Health outcome data were not extracted from nonbinary populations nor transgender men. Themes were generated using qualitative content analysis. Results: Thirty-three studies were reviewed, most were qualitative, and 11 focused on transgender women migrants (especially from Latin America), while only one was exclusively on sexual minority women (SMW) migrants. Premigration experiences of violence and discrimination were linked to high prevalence rates of post-traumatic stress disorder, depression, and anxiety. Postmigration stressors included lack of educational and employment opportunities, reduced access to social services, and experiences of stigma and discrimination, which were also associated with the development of depressive symptoms. Transgender women migrants reported not seeking formal medical care, given a lack of gender-affirming services and insurance resulting in reliance on unsafe informal care networks for hormone therapy and feminization procedures. Conclusion: Future interventions should focus on fostering social support networks of SGM migrant women to help improve their mental health outcomes. Research priorities should include studies on SMW migrants and more quantitative research that could identify additional health needs (i.e., sexual health) of SGM migrant women.

Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority - A National population-based study in Sweden

BACKGROUND

To examine health and health-related behaviors in migrant and refugee individuals who identify as sexual or gender minority, and in comparison to their heterosexual peers.

METHODS

The study included 168,952 individuals (aged 16-84 years, males: 45·9%, sexual or gender minorities: 3·1%) who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into Swedish-and Western-born (White) heterosexual, White sexual- or gender minority, migrant heterosexual, migrant sexual- or gender minority, refugee heterosexual, and refugee sexual- or gender minority. Outcomes included mental health (for example suicidal ideation, wellbeing), general health, risky behaviors (risk alcohol use, risk gambling, and substance use), and experiences of violence. Associations between 1) sexual- or gender -ethnic identities and 2) gender-ethnic identities and all outcomes were analyzed using logistic and linear regression adjusting for sex, age, and educational level.

FINDINGS

Being a sexual- or gender minority, regardless of ethnic minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee sexual- or gender minority individuals (OR 2·42, 95 % CI 1·44-4·08). Ethnic minorities (heterosexual and sexual- or gender minority migrants and refugees) had lower odds of drug and risk alcohol use compared to White heterosexual peers but higher odds of risk gambling (1·88, 1·49-2·37 for refugee heterosexuals). Transgender refugees had high odds for risk gambling (8·62, 1·94-38·40) and exposure to physical violence (7·46, 2·97-18·70).

INTERPRETATION

In this national population-based study, sexual and gender minority individuals have worse mental and general health regardless of ethnic minority status. We did not find evidence for worse health in sexual- or gender minority refugees in comparison to migrant, and White sexual- or gender minorities and their heterosexual peers. Transgender individuals (White and ethnic minority) experienced significantly higher levels of physical violence. Public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitise healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities.

FUNDING

We received no external funding for this study and hence the funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit.

A Scoping Review of Health Outcomes Among Transgender Migrants

Purpose

Transgender people constitute diverse populations who experience a range of adverse health outcomes. Despite increasing awareness of adverse health outcomes among migrant populations, there has been a dearth of studies focused on the health of transgender migrants. The goal of this scoping review was to describe common themes and empirical trends in research on the health of transgender migrants and identify gaps for future research and programming.

Methods

Using a systematic review protocol, we searched PubMed, Embase, Scopus, PsycINFO, CINAHL, and Web of Science with a combination of terms to identify empirical articles that examined health outcomes among transgender migrants. The search included studies published as of May 2019.

Results

Twenty of 1666 identified records met inclusion criteria. All studies were cross-sectional, and 50% were quantitative designs, 45% were qualitative designs, and 5% were mixed-methods designs. The majority reported on sexually transmitted infections (55%), violence (40%), and mental health (35%). Qualitative studies were generally high quality, while many quantitative studies had high risk of bias. While some adverse health outcomes may abate, stigmatizing social conditions continue to impact transgender migrant's health postmigration.

Conclusions

Anti-transgender and anti-immigrant stigma may contribute to adverse health outcomes for transgender migrants. Additional research using rigorous inclusive methods to survey a broader range of health domains is needed. The lives of transgender migrants are continuously upended by oppressive policies; therefore, it is vital to continue to expand the breadth of transgender health research.

A Scoping Review of the Experiences of Violence and Abuse Among Sexual and Gender Minority Migrants Across the Migration Trajectory

Violence against sexual and gender minority (SGM) individuals has continued to proliferate globally. Yet, less is known about victimization among subgroups of SGM individuals, especially SGM immigrants, refugees, and asylum seekers. There has been a steady increase in this vulnerable group of migrants over the years, and emerging evidence has pointed to their heightened risk of victimization. We conducted a scoping review of the peer-reviewed literature that examined violence, abuse, and mental health among SGM individuals who migrate internationally. One hundred ninety-nine articles were identified by searching five scholarly databases and hand searching. Twenty-six articles met inclusion criteria. We first used the migration framework, which outlines the distinct phases of the migration trajectory (predeparture, travel, interception, destination, and return), to categorize findings and then identified four overarching themes to capture SGM migrants' experiences at each phase: severe and prolonged violence and abuse related to sexual orientation or gender identity (predeparture); continued victimization and high-risk for sexual violence (travel); detainment- and deportation-related violence and abuse (interception and return); and new manifestations of violence and abuse while living with past trauma (destination). Violence and abuse began in childhood and continued in the host country, where they faced discrimination while managing posttraumatic stress disorder and depression. Findings indicate that SGM migrants are extremely vulnerable to victimization. There is an immediate need for policies to protect SGM individuals worldwide and for affirmative, culturally informed practices to help SGM migrants manage trauma and the structural barriers impeding recovery.

Fighting for inclusion across borders: Latin American Trans women's health in Canada

BACKGROUND

Worldwide, Trans women from Latin America experience some of the highest rates of violence, which has led many to emigrate. There is limited research exploring the experiences of Trans migrants, and most LGBTQI2S + migrant research focuses on immigrant gay men. This study uses the frameworks of Intersectionality and the Social Determinants of Health (SDoH) to examine the impact of migration on the health and wellbeing of Latin American Trans women living in Toronto, Canada.

METHODOLOGY

This qualitative arts-based study included nine participants and used hand mapping, a sociodemographic questionnaire, and focus groups to generate data. Data analysis encompassed inductive and deductive approaches and rigor was maintained through reflexivity and several verification strategies.

RESULTS

While migration was used as a safety strategy, participants' multiple identities as immigrants, Trans women, and Latinas, produced compounded experiences of oppression post-migration. Facing transphobia and xenophobia simultaneously, participants were forced to navigate precarious housing and employment, minimal social capital, and low social position. This limited their ability to exercise power and ultimately caused poor health and wellbeing post-migration; however, participants used sophisticated strategies to resist asymmetrical power relations, actively searching for safety and community participation, and caring for themselves and each other.

CONCLUSION

The participants fought for inclusion across borders of economic exclusion and gender identity, borders of power and social position, as well as geopolitical borders. Their intersectional experiences across these "borders" should be understood in the context of migration without liberation, consumption without income, compounding oppressions, as well as positive intersectionality. While the women's resistance and strength are positive by-products of fighting oppression, they cannot be the solution. Access to health and wellbeing should not be a privilege for some; it must be a right for all.

Violence Inflicted on Latina Transgender Women Living with HIV: Rates and Associated Factors by Perpetrator Type

Many transgender individuals report violence directed against them. This study examined violence inflicted on transgender Latinas with HIV by primary partners, sexual partners and acquaintances/strangers. Logistic regression was used for analysis. 150 transgender Latinas were recruited. Rates of violence from different perpetrator types were 47-50%. For violence by primary partners, social support from cisgender people was associated with a lower likelihood of violence (AOR 0.56; CI 0.32, 0.98; p < 0.05). For violence by sexual partners, a history of childhood sexual abuse was associated with a higher likelihood of violence (AOR 2.64; CI 1.10, 6.34; p < 0.05). For violence by acquaintances/strangers, discrimination was associated with a higher likelihood of violence (AOR 2.84; CI 1.16, 6.94; p < 0.05) and social support from cisgender people with a lower likelihood (AOR 0.58; CI 0.37, 0.92; p < 0.05). Interventions are needed at individual, institutional and systemic levels to eradicate such violence.

Undocumented immigrants and mental health: A systematic review of recent methodology and findings in the United States

This study reviewed the methodology and findings of 44 peer-reviewed studies on psychosocial risk factors associated with mental health outcomes among undocumented immigrants (UIs) in the United States. Findings showed a considerable advancement over the past seven years in the methods and measures used in the included studies. Nonetheless, there is a need for continued methodological rigor, innovative study designs, greater diversity of samples, and in-depth exploration of constructs that facilitate resilience. Identifying avenues to reduce risk in this population is essential to inform intervention and advocacy efforts aimed at overcoming distress from the current U.S. anti-immigrant and socio-political climate.

Suicidal Thoughts and Behaviors Among Transgender Adults in Relation to Education, Ethnicity, and Income: A Systematic Review

Introduction: This systematic review assessed the impact of race/ethnicity, education, and income on transgender individual's lifetime experience of suicidal thoughts and behaviors (SITB) in gray and published literature (1997-2017). Methods: Sixty four research projects (108 articles) were identified in WorldCat, PubMed, and Google Scholar. Articles were included if they were published in Canada or the United States, included original quantifiable data on transgender SITBs, and had ≥5 participants, at least 51% of whom were ≥18 years. Results: Across all projects suicide ideation averaged 46.55% and attempts averaged 27.19%. The majority of participants were Caucasian, whereas the highest rate of suicide attempts (55.31%) was among First Nations, who accounted for <1.5% of participants. Caucasians, by contrast, had the lowest attempt rate (36.80%). More participants obtained a bachelor's degree and fewer an associate or technical degree than any other level of education. Suicide attempts were highest among those with ≤some high school (50.70%) and lowest among those with an advanced degree (30.25%). More participants made an income of $20-$50,000/year and less $10-$20,000 than any other income bracket. Conclusion: SITBs, among the transgender population, are both universally high and impacted by race/ethnicity, educational attainment, and income. These findings may be useful in creating culturally and factually informed interventions for transgender individuals experiencing SITBs and in informing future research on this topic.

Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers

OBJECTIVES

To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States.

METHODS

We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes.

RESULTS

Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion.

CONCLUSIONS

Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.