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LGBT Forced Migrants

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Abstract

Many persons with diverse sexual orientations or gender identities are forced to flee their countries due to persecution or discrimination. Service providers who assist such migrants would benefit from gaining knowledge about the immigration process, as well as about pre- and post-migration factors that affect the physical and mental health of their clients. In addition, migrants who flee their home countries for fear of persecution due to sexual orientation or gender identity very often have a history of experiences that make integration into their new countries difficult. This chapter will begin with a review of the immigration process for forced migrants in the USA and an overview of research on forced migrant health, followed by a discussion of the ways in which the experiences of forced migrants who flee persecution or discrimination on the basis of sexual orientation or gender identity differ from those of other forced migrants. We will end with a case example that highlights specific challenges faced by this group.

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References

  1. Eastmond M. Stories as lived experience: narratives in forced migration research. J Refug Stud. 2007;20(2):248–64.

    Article  Google Scholar 

  2. Martin DC, Yankay JE. Refugees and asylees: 2013. East Asia. 2014;16(18,000):19-000.

    Google Scholar 

  3. Office of Planning, Analysis, and Statistics, Executive Office of Immigration Review. FY 2015 statistics yearbook. Falls Church: US Department of Justice; 2016. p. J1–K3.

    Google Scholar 

  4. Acer E, Chicco J. US detention of Asylum seekers: Seeking protection, finding prison. Human Rights First; 2009. Available from: https://www.humanrightsfirst.org/wp-content/uploads/pdf/090429-RP-hrf-asylum-detention-report.pdf.

  5. Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294(5):602–12.

    Article  CAS  PubMed  Google Scholar 

  6. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.

    Article  CAS  PubMed  Google Scholar 

  7. Burnett A, Peel M. Health needs of asylum seekers and refugees. Br Med J. 2001;322(7285):544.

    Article  CAS  Google Scholar 

  8. Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365(9467):1309–14.

    Article  PubMed  Google Scholar 

  9. Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–67.

    Article  Google Scholar 

  10. Miller KE, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010;70(1):7–16.

    Article  PubMed  Google Scholar 

  11. Steel Z, Silove D, Phan T, Bauman A. Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet. 2002;360(9339):1056–62.

    Article  PubMed  Google Scholar 

  12. Sabin M, Cardozo BL, Nackerud L, Kaiser R, Varese L. Factors associated with poor mental health among Guatemalan refugees living in Mexico 20 years after civil conflict. JAMA. 2003;290(5):635–42.

    Article  PubMed  Google Scholar 

  13. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379(9812):266–82.

    Article  PubMed  Google Scholar 

  14. Silove D, Steel Z, McGorry P, Miles V, Drobny J. The impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants. Compr Psychiatry. 2002;43(1):49–55.

    Article  PubMed  Google Scholar 

  15. Chu T, Keller AS, Rasmussen A. Effects of post-migration factors on PTSD outcomes among immigrant survivors of political violence. J Immigr Minor Health. 2013;15(5):890–7.

    Article  PubMed  Google Scholar 

  16. Goldfeld AE, Mollica RF, Pesavento BH, Faraone SV. The physical and psychological sequelae of torture: symptomatology and diagnosis. JAMA. 1988;259(18):2725–9.

    Article  CAS  PubMed  Google Scholar 

  17. Lerner E, Bonanno GA, Keatley E, Joscelyne A, Keller AS. Predictors of suicidal ideation in treatment-seeking survivors of torture. Psychol Trauma. 2016;8(1):17–24.

    Google Scholar 

  18. Oosterhoff P, Zwanikken P, Ketting E. Sexual torture of men in Croatia and other conflict situations: an open secret. Reprod Health Matters. 2004;12(23):68–77.

    Article  PubMed  Google Scholar 

  19. Keatley E, Ashman T, Im B, Rasmussen A. Self-reported head injury among refugee survivors of torture. J Head Trauma Rehabil. 2013;28(6):E8–13.

    Article  PubMed  Google Scholar 

  20. Keatley E, d'Alfonso A, Abeare C, Keller A, Bertelsen NS. Health outcomes of traumatic brain injury among refugee survivors of torture. J Head Trauma Rehabil. 2015;30(6):E1–8.

    Article  PubMed  Google Scholar 

  21. Mollica RF, Lyoo IK, Chernoff MC, Bui HX, Lavelle J, Yoon SJ, Kim JE, Renshaw PF. Brain structural abnormalities and mental health sequelae in South Vietnamese ex–political detainees who survived traumatic head injury and torture. Arch Gen Psychiatry. 2009;66(11):1221–32.

    Article  PubMed  Google Scholar 

  22. Itaborahy LP, Zhu J. State-sponsored homophobia. ILGA. 2016;11:36–37.

    Google Scholar 

  23. Landau J. Soft immutability and imputed gay identity: recent developments in transgender and sexual-orientation-based asylum law. Fordham Urban Law J. 2004;32:237.

    Google Scholar 

  24. Gruberg S, West R. Humanitarian diplomacy: The U.S. asylum system’s role in protecting global LGBT rights. Center for American Progress; 2015. Available from: https://cdn.americanprogress.org/wp-content/uploads/2015/06/LGBTAsylum-final.pdf.

  25. Nerses M, Kleinplatz PJ, Moser C. Group therapy with International LGBTQ+ clients at the intersection of multiple minority status. Psychol Sex Rev. 2015;6(1):99–109.

    Google Scholar 

  26. Shidlo A, Ahola J. Mental health challenges of LGBT forced migrants. Forced Migr Rev. 2013;1(42):9.

    Google Scholar 

  27. Hopkinson RA, Keatley E, Glaeser E, Erickson-Schroth L, Fattal O, Nicholson Sullivan M. Forced migrants persecuted for lesbian, gay, bisexual, and transgender identity. J Homosex. Under Review. 2016 (In press) http://www.tandfonline.com/doi/full/10.1080/00918369.2016.1253392

  28. Herman JL. Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. J Trauma Stress. 1992;5(3):377–91.

    Article  Google Scholar 

  29. Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics. 2009;123(1):346–52.

    Article  PubMed  Google Scholar 

  30. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68(5):748.

    Article  CAS  PubMed  Google Scholar 

  31. Briere J, Kaltman S, Green BL. Accumulated childhood trauma and symptom complexity. J Trauma Stress. 2008;21(2):223–6.

    Article  PubMed  Google Scholar 

  32. Cloitre M, Stolbach BC, Herman JL, Kolk BV, Pynoos R, Wang J, Petkova E. A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress. 2009;22(5):399–408.

    Article  PubMed  Google Scholar 

  33. Cook, A, Blaustein, M, Spinazzola, J, van der Kolk, B, editors. Complex trauma in children and adolescents. National Child Traumatic Stress Network. Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services; 2003. Retrieved from: http://www.nctsn.org/sites/default/files/assets/pdfs/ComplexTrauma_All.pdf.

  34. Grove NJ, Zwi AB. Our health and theirs: forced migration, othering, and public health. Soc Sci Med. 2006;62(8):1931–42.

    Article  PubMed  Google Scholar 

  35. GLMA. Guidelines for care of lesbian, gay, bisexual, and transgender patients. San Francisco: Gay and Lesbian Medical Association; 2006.

    Google Scholar 

  36. Adams KM, Gardiner LD, Assefi N. Healthcare challenges from the developing world: post-immigration refugee medicine. BMJ. 2004;328(7455):1548–52.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kim SH, Schneider SM, Kravitz L, Mermier C, Burge MR. Mind-body practices for posttraumatic stress disorder. J Investig Med. 2013;61(5):827–34.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Akinsulure-Smith AM. Using group work to rebuild family and community ties among displaced African men. J Spec Group Work. 2012;37(2):95–112.

    Article  Google Scholar 

  39. Kira IA, Ahmed A, Wasim F, Mahmoud V, Colrain J, Rai D. Group therapy for refugees and torture survivors: treatment model innovations. Int J Group Psychother. 2012;62(1):69–88.

    Article  PubMed  Google Scholar 

  40. Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, Narasiah L, Kirmayer LJ, Ueffing E, MacDonald NE, Hassan G. Evidence-based clinical guidelines for immigrants and refugees. Can Med Assoc J. 2011;183(12):E824–925.

    Article  Google Scholar 

  41. Center for Disease Control and Prevention. Summary checklist for domestic medical examination for newly arrived refugees. Atlanta; 2012. http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/checklist.html.

  42. Bertelsen NS, Selden E, Krass P, Keatley ES, Keller A. Primary care screening methods and outcomes among Asylum seekers in New York City. J Immigr Health Under Rev. 2016 (In Press). doi:10.1007/s10903-016-0507-y

  43. Olson CK, Stauffer WM, Barnett ED. Newly arrived immigrants & refugees. Atlanta: Centers for Disease Control and Prevention; 2015 [cited 2015 Jul 10]. Available from: http://wwwnc.cdc.gov/travel/yellowbook/2016/advising-travelers-with-specific-needs/newly-arrived-immigrants-refugees.

  44. Keller A, Lhewa D, Rosenfeld B, Sachs E, Aladjem A, Cohen I, Smith H, Porterfield K. Traumatic experiences and psychological distress in an urban refugee population seeking treatment services. J Nerv Ment Dis. 2006;194(3):188–94.

    Google Scholar 

  45. Silove D. The psychosocial effects of torture, mass human rights violations, and refugee trauma: toward an integrated conceptual framework. J Nerv Ment Dis. 1999;187(4):200–7.

    Article  CAS  PubMed  Google Scholar 

  46. Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z. Anxiety, depression and PTSD in asylum-seekers: associations with pre-migration trauma and post-migration stressors. Br J Psychiatry. 1997;170(4):351–7.

    Article  CAS  PubMed  Google Scholar 

  47. Rasmussen A, Keatley E, Joscelyne A. Posttraumatic stress in emergency settings outside North America and Europe: a review of the emic literature. Soc Sci Med. 2014;109:44–54.

    Article  PubMed  PubMed Central  Google Scholar 

  48. De Jong JT, Komproe IH, Van Ommeren M, El Masri M, Araya M, Khaled N, van De Put W, Somasundaram D. Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA. 2001;286(5):555–62.

    Article  CAS  PubMed  Google Scholar 

  49. Tang SS, Fox SH. Traumatic experiences and the mental health of Senegalese refugees. J Nerv Ment Dis. 2001;189(8):507–12.

    Article  CAS  PubMed  Google Scholar 

  50. Ichikawa M, Nakahara S, Wakai S. Cross-cultural use of the predetermined scale cutoff points in refugee mental health research. Soc Psychiatry Psychiatr Epidemiol. 2006;41(3):248–50.

    Article  PubMed  Google Scholar 

  51. Sachs E, Rosenfeld B, Lhewa D, Rasmussen A, Keller A. Entering exile: trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India. J Trauma Stress. 2008;21(2):199–208.

    Article  PubMed  Google Scholar 

  52. Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. The Harvard Trauma Questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992;180(2):111–6.

    Article  CAS  PubMed  Google Scholar 

  53. Lhewa D, Banu S, Rosenfeld B, Keller A. Validation of a Tibetan translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire. Assessment. 2007;14(3):223–30.

    Article  PubMed  Google Scholar 

  54. Myer L, Smit J, Roux LL, Parker S, Stein DJ, Seedat S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STDs. 2008;22(2):147–58.

    Article  PubMed  Google Scholar 

  55. Oruc L, Kapetanovic A, Pojskic N, Miley K, Forstbauer S, Mollica RF, Henderson DC. Screening for PTSD and depression in Bosnia and Herzegovina: validating the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist. Int J Cult Ment Health. 2008;1(2):105–16.

    Article  Google Scholar 

  56. Rasmussen A, Verkuilen J, Ho E, Fan Y. Posttraumatic stress disorder among refugees: measurement invariance of Harvard Trauma Questionnaire scores across global regions and response patterns. Psychol Assess. 2015;27(4):1160.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kaaya SF, Fawzi MC, Mbwambo JK, Lee B, Msamanga GI, Fawzi W. Validity of the Hopkins Symptom Checklist-25 amongst HIV-positive pregnant women in Tanzania. Acta Psychiatr Scand. 2002;106(1):9–19.

    Article  CAS  PubMed  Google Scholar 

  58. Lavik NJ, Hauff E, Solberg Ø, Laake P. The use of self-reports in psychiatric studies of traumatized refugees: validation and analysis of HSCL-25. Nord J Psychiatry. 1999;53(1):17–20.

    Article  Google Scholar 

  59. Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P. Validation of the multiple language versions of the Hopkins Symptom Checklist-37 for refugee adolescents. Adolescence. 2007;42(165):51.

    PubMed  Google Scholar 

  60. Anderson NB. Evidence-based practice in psychology. Am Psychol. 2006;61(4):271–85.

    Article  Google Scholar 

  61. Castro FG, Barrera Jr M, Steiker LK. Issues and challenges in the design of culturally adapted evidence-based interventions. Annu Rev Clin Psychol. 2010;6:213.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Crumlish N, O’Rourke K. A systematic review of treatments for post-traumatic stress disorder among refugees and asylum-seekers. J Nerv Ment Dis. 2010;198(4):237–51.

    Article  PubMed  Google Scholar 

  63. Ehntholt KA, Yule W. Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma. J Child Psychol Psychiatry. 2006;47(12):1197–210.

    Article  PubMed  Google Scholar 

  64. Reading R, Rubin L. Advocacy and empowerment: group therapy for LGBT asylum seekers. Traumatology. 2011;17(2):86–98.

    Article  Google Scholar 

  65. Cloitre M, Koenen KC. The impact of borderline personality disorder on process group outcome among women with posttraumatic stress disorder related to childhood abuse. Int J Group Psychother. 2001;51(3):379–98.

    Article  CAS  PubMed  Google Scholar 

  66. Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;2(2):2.

    Google Scholar 

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Correspondence to Rebecca Hopkinson MD .

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Hopkinson, R., Keatley, E.S. (2017). LGBT Forced Migrants. In: Eckstrand, K., Potter, J. (eds) Trauma, Resilience, and Health Promotion in LGBT Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-54509-7_11

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  • DOI: https://doi.org/10.1007/978-3-319-54509-7_11

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