Mental Health and Well-Being of LGBTQ+ Refugees in Comparison to LGBTQ+ Host Country Population

Abstract Introduction LGBTQ+ refugees are likely to experience heightened mental health burdens and lower levels of well-being when compared to LGBTQ+ individuals without refugee experience. Still, the distinctive psychological mechanisms explaining their heightened levels of distress remain understudied. We examined the mental health and well-being of LGBTQ+ refugees in comparison to LGBTQ+ host country individuals in Germany and explored whether disparities are potentially mediated by proximal and distal minority stress. Methods In 2019, LGBTQ+ refugees ( n 1 = 139) and LGBTQ+ Germans ( n 2 = 262) participated in a cross-sectional online survey. Using path analysis, we compared mental health burdens (symptoms of depression/anxiety, post-traumatic stress) and well-being (life satisfaction, self-esteem) to understand how these variables are mediated by proximal (internalized homophobia, heightened vigilance) and distal minority stress (experiences of discrimination). Results LGBTQ+ refugees reported higher mental health burdens and lower life satisfaction yet no differences in self-esteem. Distal minority stress (discrimination) mediated the link between LGBTQ+ refugee status and symptoms of post-traumatic stress. Proximal minority stress mediated both heightened symptoms of depression/anxiety and lower well-being for LGBTQ+ refugees. Conclusions Linked to experiences of minority stress, LGBTQ+ refugees in Germany might be at a heightened risk for increased mental health burdens and lower well-being. Compared to host-country LGBTQ+ communities, LGBTQ+ refugees might experience different profiles of minority stress, including more distal minority stress. Policy Implications Both administrators and the local LGBTQ+ community need to be aware of the particular vulnerability and needs of LGBTQ+ refugees for protection and safety (e.g., housing) and the prevention of exploitation.