Quality health services and health research tailored for sexual and gender minority forced migrants: perspectives of migrants with lived experience and health service providers

BACKGROUND: In many settings, sexual and gender minorities experience severe persecution and are left with the only option to flee to another country. The aim of this study was to explore perspectives on what constitutes post-migration quality health services and health research tailored for sexual and gender minority forced migrants, according to the views of migrants with lived experience and health service providers. METHODS: This was a qualitative exploratory study with embedded public contribution through close collaboration with migrants representing the target population. Study participants were recruited through purposeful and snowball sampling (forced migrants n = 17, service providers n = 20). Semi-structured interviews were transcribed verbatim and analyzed with systematic text condensation. RESULTS: Open doors and open minds in health services were identified as overarching cornerstones for quality health services. Participants consistently emphasized the need for accessible and welcoming health services, highlighting specific concerns about language barriers and fear of discrimination. A key element was the significance of sufficient awareness and reflection among health professionals who foster client comfort through affirming and individualized care. The importance of upholding confidentiality and privacy was underscored, considering the internalized shame and traumatic experiences represented within the population. High degrees of representation and in-depth considerations of intersectional nuances were identified as overarching cornerstones for health research. A high degree of embedded representation and inclusive approaches in research was highlighted. A need for research that will uncover intersectional mental health burdens and living conditions was articulated, alongside a need for research focusing on interventions that will promote equitable and tailored health services. CONCLUSIONS: This study highlights the urgent need for health services to adapt to the complex and intersecting needs of underserved populations such as sexual and gender minority forced migrants. For quality health services to be achieved, it needs to be grounded in equitable access, intersectional awareness, affirming relationships, and safeguards for safety and confidentiality. Future research needs to prioritize inclusionary and participatory approaches, investigate specific subgroup needs, address multidimensional burdens, and focus on effective and pragmatic support interventions.