Ayca Kosanak
Eighty-four million people worldwide have been forced to flee their homes (UNHCR, 2021). Living as displaced people inside or as refugees outside their home countries. The highest number of displaced people in the world since WWII. Along with the struggles all refugees endure, LGBTQ refugees face significant struggles in addition. Needing special care and protection, especially by providing access to adequate healthcare.
Figure 1: LGBTQ Pride flag (froedtert, 2022)
Struggles of LGBTQ Refugees from the middle east and north Africa
Most refugees originate from and reside in the middle east and north Africa. With Syria being the biggest source and Turkey the biggest host country (UNHCR, 2021). As a refugee, may speaking a different language than the host country, trying to integrate into a new culture and society, besides dealing with trauma, as quickly as possible as often demanded, is tough and exhausting. In addition, identifying as LGBTQ in any part of the word significantly affects levels of discrimination, harassment, and victimization (Freeman, 2018). All these factors leave this specific group of individuals at greater risk of health issues and therefore in special need of medical attention. To support this a report examining the experiences of LGBTQ refugees in the middle East and North Africa shows that LGBTQ refugees were largely not registered with UNHCR and faced challenges related to employment, life threats and language. Their greatest needs included legal counseling, education, emergency assistance and healthcare (Freeman, 2018).
Personal safety issues and legal problems
LGBTQ refugees face significant threats to their personal safety. Worldwide cases of discrimination, abuse, and rape, often in facilities provided by governments or aid organizations are being reported. Especially Queer women suffer from gender-based violence. In different cases, fellow refugees, host community members, or even aid workers themselves have committed these crimes (Deem, 2019). Further, they often live in legal limbo. Seventy-one countries criminalize same-sex relationships, including the origin countries of many refugees, such as Syria and Myanmar. Eleven countries punish same-sex relationships with the death penalty (Human Dignitiy Trust, 2022). Yet LGBTQ refugees often cannot find asylum abroad. For example, Individuals seeking asylum on the basis of gender identity or sexual orientation often see their claims rejected. This because of the widespread disbelief and the burden of proof of their claims (Henley, 2020).
Adequate health services
Access to adequate Healthcare should be guaranteed for all. Like SDG 3, which addresses good health and well-being, demands. Unfortunately, many LGBTQ refugees struggle to find adequate health services. LGBTQ groups face higher risk of specific physical health concerns, such as HIV infections among gay men. More broadly, LGBTQ refugees struggle to find physical and mental healthcare with providers they trust. Many express concerns speaking with healthcare professionals, for fear that doctors or therapists will break confidentiality in countries where LGBTQ groups face persecution. These factors leave LGBTQ refugees at higher health risk, but without care they can trust (Deem, 2019). A Study examining the struggled of LGBTQ refugees in the middle east and north Africa supports this. Nearly half experienced life threats. One of fifth are facing difficulties accessing health facilities. Refugees in Istanbul were three times more likely to face difficulty accessing health facilities than in other cities. One in four LGBTQ refugees surveyed reported healthcare needs. Many open-ended comments in their survey speak specifically to their health status and inability to access medical facilities or afford necessary medication. They further asked questions on mental health, physical health, and sexual health. Mental healthcare was needed by one in six LGBTQ refugees surveyed. Nearly one in six LGBTQ refugees surveyed required physical healthcare and one in ten report sexual healthcare needs (Freeman, 2018). As mentioned before Turkey is a major host country. Although being LGBTQ is not criminalized there, they face significant negative biases. For example, different studies examining the discrimination LGBTQ Individuals may face in the health sector specifically in Turkey concluded similar results. Showcasing the struggles LGBTQ individuals may face in their hosting countries. Overall participants reported alarming rates of identity-discrimination and non-disclosure when accessing health care. Participants also reported high rates of postponing care as they felt they would be subjected to LGBTQ-based discrimination. On top Transgender individuals face additional healthcare challenges (Apalı et al. 2021). Furthermore, Nurses were found to have negative attitudes toward LGBTQ individuals (Aslan et al. 2021).
Inability to provide protection and recommendations
It is evident that special protection and prioritization of LGBTQ Groups are needed to ensure that these people are not overlooked and have a change to life a good life. They must feel supported, and their voices need to be elevated, especially from governments and society. So that they don’t feel threatened to get the health service they desperately require and are entitled to receive. As Deem (2019) has nicely put it “Yet, humanitarian organizations and governments have chosen not to prioritize LGBTQ groups. Whether because of lack of funding, competing interests, or other reasons, especially aid organizations have created a service gap that leaves millions at risk. Moreover, since most humanitarian work takes place in countries that do not respect LGBTQ rights, advocates of LGBTQ refugees will face countless social and political obstacles to change.”. There are some recommendations that could help and are stated in the spectra Project Report (Freeman, 2018), which examines the struggles of LGBTQ Refugees: “All governments and aid organizations working with LGBTQ refugees must ensure to cultivate an ethos of equality. All organizational goals should reflect these values and staff should be trained in welcoming LGBTQ refugees to safety. To be inclusive of all members of its society, governments should fully embrace the tool of diversity in creating strong, efficient, and free societies. Also, persistent data collection on the experience of LGBTQ lives is necessary. After years of silence, telling these stories globally can help us all learn from mistakes and work towards equitability. Develop resources tailored to LGBTQ refugees to ensure their safety and development. This mainly includes housing, healthcare, and education. Revaluation of the UNHCR’s initiatives is needed to involve LGBTQ communities. Legal progress on refugee and asylum rights for LGBTQ individuals is needed so that the rights of people and responsibilities of governments are never called into question.”.
Sources
Apalı, Ö., Baba, İ., Bayrakcı, F., Değerli, D., Erden, A., Peker, M., Perk, F., Sipahi, İ., Şenoğlu, E., Yılmaz, S., Zengin, N. & Akgül, S. (2021). Experience of sexual and gender minority youth when accessing health care in Turkey. International Journal of Adolescent Medicine and Health, 33(6), 445-448. https://doi.org/10.1515/ijamh-2019-0206
Aslan, M. and Paslı Gürdoğan, E. (2021), “The nursing community’s discriminatory attitude towards LGBTQ individuals”, International Journal of Human Rights in Healthcare, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJHRH-11-2019-0087
Deem, P. (2019). Responding to the Needs of LGBTQ Refugees. LGBTQ Policy Journal. Abgerufen von https://lgbtq.hkspublications.org/2019/05/22/responding-to-the-needs-of-lgbtq-refugees/
UNHCR. (2021). Refugee Data Finder. Abgerufen von https://www.unhcr.org/refugee-statistics/
Freeman, C. (2018). The Hell is Here: Being an LGBTQ Refugee in the Middle East & North Africa. In SPECTRA Project. https://doi.org/https://doi.org/10.7916/D8NG633M
Henley, J. (2020). LGBT asylum seekers’ claims routinely rejected in Europe and UK. the guardian. Abgerufen von https://www.theguardian.com/uk-news/2020/jul/09/lgbt-asylum-seekers-routinely-see-claims-rejected-in-europe-and-uk
Human Dignitiy Trust. (2022). Map of Countries that Criminalise LGBT People
Froedtert. (2022). Health Care for the LGBTQ Community. Abgerufen von https://www.froedtert.com/lgbtq