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LGBTIQ inclusion remains a global challenge, with persistent social, economic, and political barriers restricting access to education, employment, healthcare, and civic engagement while reinforcing systemic inequalities. Yet even in the context of enabling laws and policies, there exists a broad range of individual and community experiences of actual inclusion. Thus, we complemented a focus on quantitative indicators of inclusion with in-depth exploration of the lived experiences of intersectionally diverse LGBTIQ+ individuals in the Asia-Pacific region.
Methods
This study employs a Delphi approach, enriched by community-based participatory research (CBPR) principles. This ensured that the research was collaborative and grounded in the lived experiences of community stakeholders. In May 2024, seven focus group discussions were conducted with academic and community experts (n=35) from Thailand, the Philippines, Taiwan, Hong Kong, and Canada to examine LGBTIQ inclusion across the domains of Education, Economic Wellbeing, Health, Personal Security & Violence, Political & Civic Participation, and Family. Academic and community experts were recruited through purposive and snowball sampling and identified asexperts in at least one domain, and sponsored to attend a forum in Bangkok, Thailand. Transcripts were analyzed using Braun and Clarke’s reflexive thematic analysis with ATLAS.ti, integrating inductive coding with a deductive framework. Findings were systematically compared with the UNDP LGBTI Inclusion Index to identify areas of alignment and gaps between participants’ perspectives and the Index’s benchmarks.
Results
Findings highlight many areas of convergence with the UNDP LGBTIQ Inclusion Index indicators as well as new aspects that are not reflected across the six domains: In Education, participants emphasized inadequate access to mental health resources in educational settings. For Economic Well-being, in addition to workplace discrimination, participants articulated limited financial autonomy for gender-affirming care. In Health, beyond outright discrimination, discussions reflected persistent stigma, breaches of privacy and confidentiality, and lack of culturally competent care, especially for transgender and non-binary individuals. For instance, a physician requesting “a patient to come out to his family...didn’t respect privacy and...confidentiality.” In Personal Security & Violence, participants highlighted diffuse forms of harm, such as media-driven stigma and familial rejection, which fall outside the Index’s legal scope: “Physical pain can be like 5-minutes...but psychological pain...is forever.” In Political & Civic Participation, participants expressed concerns about covert repression where individuals can go “to jail just for sharing something on Facebook.” Familial inclusion emerged as a key concern in the Delphi process, underscoring the “right to have children...[and] equal benefits like parental leave.”
Conclusions and Implications
Comprehensive policies and institutional reforms must extend beyond symbolic recognition to reflect and address the lived realities of LGBTIQ individuals, particularly those most vulnerable to exclusion, such as transgender and non-binary individuals and older LGBTIQ people. In developing countries, economic hardship exacerbates inequitable access to healthcare and employment, requiring targeted anti-discrimination policies in each domain. Policymaking and advocacy efforts should meaningfully engage LGBTIQ communities to create sustainable and culturally responsive interventions, while future research should center these communities’ diverse perspectives and focus on region-specific initiatives that advance LGBTIQ inclusion across sociopolitical contexts.