Traumatic Stress Among LGBTQ Refugees from the Middle East, North Africa, and Asia Who Migrated to Europe

Background and Purpose: More than a half million refugees from Syria, Iraq, and Afghanistan fled to Europe in search of protection in 2015. Among the most understudied of this population are those identifying as LGBTQ. These individuals have not only fled war but also violence due to their sexual and gender identities. At the same time, LGBTQ individuals from other parts of the Middle East and North Africa have also migrated to Europe to escape persecution. The purpose of this mixed-method study was to understand how traumatic stress shaped the migration experiences of LGBTQ refugees from predominantly Islamic societies who migrated to Austria (n=19) and the Netherlands (n=19).

Methods: Purposive sampling was used to recruit 38 participants between the ages of 18-53 from community organizations. Participants migrated from Syria (n=10), Iran (n=7), Iraq (n=5), Lebanon (n=4), Egypt (n=3), Pakistan (n=3), Jordan (n=2), Chechnya (n =1), Palestine (n=1), Somalia (n=1), and Tajikistan (n = 1). They identified as gay (n=24), trans female (n=5), lesbian (n=3), bisexual (n=3), queer (n=2), and trans male (n=1). The majority (89.5%) were raised Muslim, while the remainder were raised Christian or Druze (10.5%). Participants resided in Europe between 2 months and 4 years (Mdn=20 months) and spoke English (n=25) and Arabic (n=13). We used the PCL-5 with Criterion A to assess for PTSD. The alpha for participants completing the PCL-5 in English was .92 and for Arabic was .86. Additionally, we conducted in-depth interviews to track participants’ migration experiences over time. Interpreters were present for interviews with Arabic speaking participants. Grounded theory (Charmaz, 2014) was used to analyze the data. To enhance methodological rigor, we engaged in: memoing throughout the coding process, negative case analysis, and data triangulation by comparing interview data with memos and PCL-5 results (Padgett, 2017).

Results: Eighty-nine percent of participants reported that their most traumatic event occurred during pre-migration, while 11% experienced this event during their migration to Europe. Sixty-five percent of participants reported that their most distressing event was associated with their sexual or gender identities. Twenty-four participants (65%) met criteria for a provisional diagnosis of PTSD. We identified three themes from the interviews: fleeing violence, abuse, and shattered family bonds; pursuing safe haven: travel and interception; and arriving in a land of contradictions. Findings demonstrated that violence and abuse began in participants’ countries of origin and continued in Europe by other refugees and immigration officials. Further, participants in refugee camps still needed to hide their identities from other refugees. Those who were discovered experienced violence and/or abuse, which made them feel like they were still in their countries of origin. 

Conclusions and Implications: LGBTQ refugees are at high risk of experiencing violence and abuse based on their sexual and gender identities. Findings underscore the need to put mechanisms in place to assist them during humanitarian emergencies (e.g., training refugee assistance workers, translators, immigration adjudicators). These mechanisms may help LGBTQ refugees cope with trauma and also prevent retraumatizing them. Policies must also be instituted to ensure LGBTQ refugees are protected from violence at all stages of migration.