Conducted as part of the larger research project A Safer Future, this qualitative study explored their health and wellbeing while residing in Sweden. The study provides valuable insights into their resilience, while highlighting the structural and social barriers.
Titled "Voices from the Margins: A Qualitative Study Exploring Components Influencing Psychosocial Health and Wellbeing Among Gender Minority Forced Migrants", the study is based on individual interviews with forced migrants living in Sweden. It investigates how different circumstances such as social exclusion, access to healthcare, and behaviors among others in society shape their health and living conditions. The study is conducted by a team consisting of persons with lived experience of forced migration, researchers, and clinical representatives. As one of the first studies of its kind in the Scandinavian countries, it highlights the urgent need for tailored support for this population.
Navigating through barriers in society
Participants talked about various challenges encountered when trying to establish themselves in the Swedish society. While they valued a general openness and safety for LGBTQ+ individuals in Sweden, they faced significant challenges in navigating the asylum process and securing stable housing and employment. These structural barriers, coupled with financial instability and the pressure to adapt quickly, contributed to stress and uncertainty about their future.
Structural issues create significant burdens for this population. There is an urgent need to address these barriers to ensure that sexual and gender minority forced migrants are not left in the margins of society, says Tommy Carlsson who is associate professor and project leader.
The mental weight of loneliness and social exclusion
Loneliness emerged as a significant issue affecting mental health and wellbeing. Many had lost their previous social networks. They struggled to form new meaningful connections due to fears of rejection, cultural differences, and language barriers. Being new in Sweden involved difficulties finding friends they could confide in. As a gender minority individual, they faced transphobia in social interactions.
Loneliness is an impactful issue and a highly relevant public health concern that requires further attention. The double minority status experienced as a trans or nonbinary forced migrant involves multiple risks of discrimination and marginalization, says Maria Gottvall who is one of the researchers behind the study.
Hindered access to health services and healthcare discrimination
Low access to health services was another critical area of concern. Participants described difficulties in navigating the healthcare system, including language barriers and long waiting times. When health services were successfully accessed, participants described negative encounters with some health professionals. These experiences left them feeling dismissed or judged. The negative experiences also impacted their willingness to seek healthcare in the future. On the other hand, the study also highlighted the positive impact of affirming and empathetic healthcare services.
The fact that participants had encountered discrimination and transphobia in healthcare settings raises the question of how to achieve health equity. Affirming care is about creating spaces where people feel safe and respected. Health professionals need to stand for openness and inclusivity so that people feel comfortable seeking healthcare, says Tommy Carlsson.
Resilience and future research
Remarkable resilience was displayed among participants, despite the adversities they had faced. Hope and a desire to establish themselves in the Swedish society were expressed. This included learning the language, pursuing education, and securing employment. Mindfulness and physical activity were helpful to maintain mental health. The study highlights peer support as an important facilitator for reduced loneliness.
Participants showed a determination to rebuild their lives, focusing on personal growth and leaving behind the challenges of their past. Engaging in meaningful and validating social support was very important, says Maria Gottvall.
The study underscores the importance of addressing structural barriers and mental health disparities. Peer support emerged as a highly valued resource that could significantly enhance wellbeing. In the following years, the research team behind this study will continue by developing and evaluating a peer support intervention for sexual and gender minority forced migrants resettling in Sweden. You can read more about that here.
Our findings demonstrate the need for targeted psychosocial interventions. Improving access to affirming healthcare and reducing social isolation should be prioritized areas. Right now, we are engaged in a longitudinal collaboration with the target population to increase knowledge about the impact and applicability of peer support. We look forward to continuing our research exploring how to support migrants living in Sweden, says Tommy Carlsson
This study is part of the program A Safer Future, which aims to improve the psychosocial health and wellbeing of forced migrants experiencing intersectional disadvantages in Sweden. One focus population in the project is sexual and gender minority forced migrants, including trans, non-binary, and gender non-conforming individuals.
The publication is written by Maria Gottvall, Rummage Isaac, Osszián Péter-Szabó, Ronah Ainembabazi, and Tommy Carlsson. It is published in the scientific journal Scandinavian Journal of Public Health.
To read the full paper, please click here.
