ABSTRACT
AIMS: To explore the experiences of seeking asylum and its impact on mental health among sexual minority forced migrant cisgender men living in Sweden. METHODS: Exploratory qualitative study based on individual semi-structured interviews with 15 adult gay and bisexual cisgender men recruited via a combination of purposeful, convenience and snowball sampling. Data were analysed with systematic text condensation through a collaborative approach with three migrants with lived experience. RESULTS: Seeking asylum had been an emotionally challenging journey for the participants in this study, involving several procedures that negatively impacted mental health. Being expected to disclose intimate information during asylum interviews had been a significant challenge, alongside needing to wait through long periods in uncertainty with little information about the progress of their asylum case. The behaviours and attitudes of professionals involved in the legal procedures had been a central aspect, as participants encountered interpreters and caseworkers who acted disrespectful and homophobic during asylum interviews. Participants mentioned that the behaviours of interpreters and the accuracy of the interpretation could influence the outcome of asylum claims and how comfortable they felt in sharing information. Thus, participants emphasized the importance of adequate and accurate interpreter services. CONCLUSIONS: Sexual minority men are faced with an unfamiliar and emotionally challenging position when seeking asylum and undergoing asylum interviews. The findings highlight the importance of adequate competence among professionals involved in asylum interviews, including interpreter utilization. Research is needed to determine effective methods to support these men throughout their asylum process.
ABSTRACT
AIM: To explore experiences of social and health professional support among sexual minority forced migrant men. DESIGN: Exploratory qualitative study. METHODS: Individual semi-structured interviews were conducted in 2023 with 15 participants recruited through convenience, purposive and snowball sampling. Interviews were audio recorded, transcribed and analysed with systematic text condensation in a collaborative process between researchers and experts by lived experience. RESULTS: The first category was 'desiring support along a road with challenging intersections'. Participants encountered a harsh reality and dangers in the host country. They sought social connections and communicated with others whilst in a social labyrinth within a new and reserved society. Although social support was desired and highly appreciated, the process involved a spectrum of both belonging and exclusion. The second category was 'navigating uncharted waters when seeking affirming health services'. A range of barriers to health services were encountered in a complex health system. Participants emphasized the importance of safe and affirming spaces that accommodate the vulnerability of disclosure. CONCLUSION: Ensuring respectful and affirming support for sexual minority forced migrants is essential. Barriers in accessing health services need to be addressed, including informing about rights and ensuring safety. IMPLICATION FOR THE PROFESSIONAL AND PATIENT CARE: Nurses and other health professionals can consider social support as a potentially valuable resource for health promotion. However, there is a need for more research investigating its mental health effects. IMPACT: The intersectional disadvantages and discrimination encountered by sexual minority forced migrants call attention to the need for further advancements in inclusion health and affirming care. REPORTING METHOD: This study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: Three sexual minority forced migrants were members of the research team. They were involved in the data collection, analysis and reporting in close collaboration with researchers.
ABSTRACT
The aim of this study was to explore health professionals' descriptions and interpretations of post-migration mental health and societal challenges among forced migrants with diverse sexual orientations, gender identities and gender expressions. Participants representing seven professions were recruited by a combination of convenience, purposive and snowball sampling. Data were collected through focus groups and individual interviews, analysed with systematic text condensation in a collaborative process involving researchers, clinicians and migrants with lived experiences. Participants described a challenging trajectory for migrants, as migrants venture through an uncertain and demanding journey impacting their mental health. Needing to deal with legal requirements, stressful circumstances and normative expectations during the asylum process were highlighted as major challenges, along with exposure to discrimination, violence, abuse and lack of psychosocial safety. Participants described significant psychological distress among migrants, including loneliness and shame. Challenges were also recognised related to exploring, accepting and expressing sexuality and gender. Loneliness and shame are major challenges in need of further attention in research, which could be addressed through the development and evaluation of actions, programmes and interventions to provide peer support.
ABSTRACT
BACKGROUND: In many countries, forced migrants can seek asylum based on persecution and danger related to self-identifying as having diverse sexual orientations, gender identities, and gender expressions; herein defined as lesbian, gay, bisexual, transgender, queer, or other non-heterosexual orientations, non-cisgender identities, gender expressions and/or reproductive development considered beyond cultural, societal or physiological norms. Nurse education has a significant role in promoting cultural competence among future health professionals. OBJECTIVES: To explore the experiences and views regarding education about forced migrants with diverse sexual orientations, gender identities, and gender expressions, among students and lecturers in nurse education. DESIGN: Explorative qualitative study with focus group discussions. SETTINGS: Swedish nursing programs. PARTICIPANTS: Final-year nursing students and lecturers (n = 25 participants) at nursing programs were recruited with convenience and snowball sampling. METHODS: Semi-structured digital focus group discussions (n = 9) were audio recorded and transcribed verbatim. Data were analyzed with inductive qualitative content analysis. RESULTS: Promoting a broader understanding regarding societal structures and preparing students to provide culturally sensitive care were considered as essential components in nurse education. Challenges and problems involved a need for increased awareness, the associated topics and target populations seldom being addressed, and a need for improvements within clinical placements. Participants suggested the utilization of external resources, presented a range of different specific learning activities that would promote in-depth understanding, and articulated a need for overarching decisions and guidelines regarding mandatory inclusion in nurse education. CONCLUSIONS: Students and lecturers describe several challenges and problems that need to be addressed in regard to forced migration, sexual health, and inclusion health. There seems to be a need for utilization of external competence in learning activities as well as establishing clearer guidelines, which may increase the quality of education and better prepare future nurses to support patients with diverse backgrounds and identities.
Subject(s)
Education, Nursing , Sexual and Gender Minorities , Transients and Migrants , Humans , Male , Female , Gender Identity , Focus Groups , Sexual BehaviorABSTRACT
AIMS: Synthesize qualitative research to illuminate the post-migration psychosocial experiences amongst LGBTQ+ forced migrants. DESIGN: Meta-synthesis of qualitative reports. DATA SOURCES: Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English-language reports containing empirical qualitative findings about post-migration experiences and published 10 years prior to the searches, based on migrants as the primary source. REVIEW METHODS: Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse-midwife researchers and experienced clinical professionals, reports were analysed with a two-stage qualitative meta-synthesis including an inductive qualitative content analysis. RESULTS: The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta-synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships. CONCLUSION: After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research. IMPACT: Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength-building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
