Law and livability: interrogating discourses on queer Nigerian asylum seekers and the German asylum law

Introduction: The LGBTQ population, also known as sexual and gender minorities (SGM) has increased risks for some cancers, not because of sexual orientation or gender identity (SOGI), but due to risk behaviors more prevalent in this population. Risk factors include higher rates of obesity, smoking, and alcohol use. The conundrum of these risk behaviors is that they are likely to have developed as a result of perceptions of stigmatization, marginalization, and overt discrimination. Further, the oncology community may not be trained in the unique needs of this population and institutions may not be collecting sexual orientation and gender identity (SOGI) data appropriately or at all. Methods: The presentation will focus on two areas: 1) An overview of the seven cancer sites disproportionately affecting LGBTQ populations, reviewing the current available literature on, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, clinical implications and psychosocial factors related to cancer survivorship and 2) Results from a 38 item, national survey of 500 oncologists knowledge, attitudes, and practice behaviors with LGBTQ cancer patients. Results: Anal, Breast, Cervical, Colorectal, Endometrial, Lung, and Prostate cancer disproportionately affect the LGBTQ community. 153 oncologists (37% response rate) completed the survey. Results showed low rates of knowledge about LGBTQ health; high rates of comfort and confidence in caring for LGBTQ (95%); low rates of collecting SOGI data (11.4% collect sexual orientation; ~19% collect gender identity) Conclusions: Greater acceptance of SGM in the healthcare setting is needed for disclosure to occur more routinely and health care providers to respond to SOGI disclosure in ways that address needs. A welcoming environment conducive to SOGI disclosure is a key element in improving the quality of care. The collection of SOGI and an accurate and thorough sexual history is necessary for LGBTQ patients to receive proper screening, diagnosis and treatment for their cancer healthcare needs. Equally important is ensuring healthcare providers and staff are properly educated on the increased prevalence of risk factors as well as the specific needs of the LGBTQ population in regards to cancer care. Citation Format: Gwendolyn P. Quinn, Matthew B. Schabath, Miles For Moffitt Work Group. Cancer in Sexual and Gender Minority populations. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA20.

This article addresses the concern that decision-making in sexual orientation or gender identity (SOGI) asylum claims in Europe is often unfair, and that one way to remedy this is by improving the guidance provided to decision-makers when interpreting the Refugee Convention in respect of these claims. We begin by interrogating a number of different decision-making guidelines and models to assess whether they contribute to a fairer asylum system. We show that, for claims based on SOGI, success invariably depends on the decision-maker’s assessment as to whether a claimant is, or would be perceived in their home country to be, a member of a SOGI minority, and so belongs to a Particular Social Group. Such focus risks neglecting analysis of the actual risk of persecution. We set out our own recommendation for a fairer approach based on prioritising SOGI-specific Country of Origin Information (COI) and the risk of persecution, rather than focusing on whether applicants are ‘genuinely’ members of a SOGI minority. We argue that this will lead to fairer outcomes that are less likely to be overturned on appeal and more consistent with the Refugee Convention’s spirit and letter.

LGBT+ asylum seekers face multiple challenges in their countries of origin as well as in their host countries. Violence and structural discrimination against this community are common and affect their whole asylum process. Violence and structural discrimination based on sexual orientation and gender identity stress the needs of LGBT+ asylum seekers in particular in regards to reception accommodations. In this study we investigated factors that contribute to the (un)safety of reception accommodations for LGBT+ asylum seekers in Germany. Qualitative semi-structured interviews were conducted with 11 participants from two groups, namely, professionals, and former and current LGBT+ asylum seekers. Thematic analysis was used to analyze the data and revealed multiple factors influencing the safety of LGBT+ asylum seekers in accommodations. These were clustered according to the used frameworks in the categories individual level, physical and social environment, and policies. The factors for (un) safety included amongst others interpersonal violence based on sexual orientation and gender identity, gender-neutral sanitary areas or lockable rooms, community support, and policies that govern where asylum seekers are accommodated, and which protection measures are set up in accommodations. Applying an intersectional lens, transgender asylum seekers were described as more vulnerable than other LGBT+ individuals. The analysis concluded that binding policies are necessary to guarantee safer accommodations for LGBT+ asylum seekers in Germany. Besides, the social cisheteronormative structures that manifest in discrimination of LGBT+ asylum seekers must be structurally deconstructed by, among others, training staff on LGBT+ needs and increase inclusivity among the asylum seeker community and in the host country.Key messagesIn Germany, the European country with the highest number of refugees, LGBT+ asylum seekers face many challenges related to their sexual orientation and gender identity.Several factors interplay in the (un)safety of accommodations for LGBT+ asylum seekers.

Binge drinking disparities between sexual and gender minority (SGM) students and their heterosexual, cisgender peers are well-established. Data limitations have precluded understandings of whether the onset and progression of these disparities differ by grade. Additionally, little is known about whether and how SGM-related binge drinking varies across groups of students coincidingly defined by sexual orientation or gender identity (SOGI), race, and ethnicity. In the current study, we used a large, statewide sample of secondary school students in California to describe the prevalence of binge drinking among subgroups of adolescents at the intersections of grade, race and ethnicity, and SOGI. Data were from the 2017-2019 cycle of the California Healthy Kids Survey, one of the largest statewide cross-sectional surveys of secondary school students in the United States (n = 925 744). We described the grade-specific prevalence rates of past 30-day binge drinking by (1) grade level, (2) race and ethnicity, and (3) SOGI. Predicted probabilities estimated adjusted percentages of students' binge drinking by subgroups. SGM-related binge drinking differences were present early in secondary school. Several subgroups of SGM adolescents with minoritized racial and ethnic identities reported higher binge drinking rates relative to their same-grade, white, non-SGM peers. Prevention and intervention programs must consider developmentally- and culturally-informed strategies to most effectively promote health among minoritized students.

Whether and under what circumstances forced migrants can claim asylum on the basis of their sexual orientation or gender identity (SOGI) are questions that have received much attention in recent years as issues of human security are increasingly considered by scholars, civil society organization (CSO) practitioners, and the international community. Although there is an international institutional framework in place that establishes the bases for claiming asylum, SOGI is not explicitly mentioned, resulting in institutional gaps that potentially expose survivors of SOGI-related human rights violations to the risk of being denied international protection. At the regional level, individual member states within the European Union (EU) can interpret international legislation differently, resulting in inconsistencies in terms of who is granted protection. This situation has mobilized many CSOs to take action and work to create normative change. This article analyses how specific norm-based strategies for change that have been identified in advocacy work addressing other social and political issues are currently being applied to advocate for SOGI as a formal basis for claiming international protection in Europe. The analysis draws upon CSO documents, writings, and discourse in order to identify the norms they criticize and attempt to weaken, and to uncover the alternative norms they promote. Because norms are a key component of both formal and informal institutions, the article sheds light on how CSOs can use norm-based strategies as powerful mechanisms for advancing political and social change.

This two-volume open-access book offers a theoretically and empirically-grounded portrayal of the experiences of people claiming international protection in Europe on the basis of their sexual orientation or gender identity (SOGI). It shows how European asylum systems might and should treat asylum claims based on people’s SOGI in a fairer, more humane way. Through a combined comparative, interdisciplinary (socio-legal), human rights, feminist, queer and intersectional approach, this book examines not only the legal experiences of people claiming asylum on grounds of their SOGI, but also their social experiences outside the asylum decision-making framework. The authors analyse how SOGI-related claims are adjudicated in different European frameworks (European Union, Council of Europe, Germany, Italy and UK) and offer detailed recommendations to adequately address the intersectional experiences of individuals seeking asylum. This unique approach ensures that the book is of interest not only to researchers in migration and refugee studies, law and wider academic communities, but also to policy makers and practitioners in the field of SOGI asylum.

Media and political debates on refugees and migration are dominated by a discourse of ‘fake’ and ‘bogus’ asylum claims. This article explores how this discourse affects in acute ways those people claiming asylum on grounds of sexual orientation or gender identity (SOGI). In particular, the article shows how such a discourse of ‘fakeness’ goes far beyond the well-documented and often inadequate credibility assessments carried out by asylum authorities. By framing the analysis within the context of the scholarship on epistemic injustice, and by drawing on a large body of primary and secondary data, this article reveals how the discourse of ‘fake’ SOGI claims permeates the conduct not only of asylum adjudicators, but also of all other actors in the asylum system, including non-governmental organizations, support groups, legal representatives, and even asylum claimants and refugees themselves. Following from this theoretically informed exploration of primary data, the article concludes with the impossibility of determining the ‘truth’ in SOGI asylum cases, while also offering some guidance on means that can be employed to alleviate the epistemic injustice produced by the asylum system against SOGI asylum claimants and refugees.

We conducted in-depth, semi-structured interviews with LGBTQ+-identified individuals (n = 31) to explore the range of LGBTQ+ perspectives on genomic research using either sexual orientation or gender identity (SOGI) data. Most interviewees presumed that research would confirm genetic contributions to sexual orientation and gender identity. Primary hopes for such confirmation included validating LGBTQ+ identities, improved access to and quality of healthcare and other resources, and increased acceptance in familial, socio-cultural, and political environments. Areas of concern included threats of pathologizing and medicalizing LGBTQ+ identities and experiences, undermining reproductive rights, gatekeeping of health or social systems, and malicious testing or misuse of genetic results, particularly for LGBTQ+ youth. Overall, interviewees were divided on the acceptability of genomic research investigating genetic contributions to sexual orientation and gender identity. Participants emphasized researchers’ ethical obligations to LGBTQ+ individuals and endorsed engagement with LGBTQ+ communities throughout all aspects of genomic research using SOGI data.

Sexual minority youth (SMY) are at higher risk for victimization and suicide than are heterosexual youth (HY). Relatively little research has examined which types of victimization are most closely linked to suicide, which is necessary to develop targeted prevention interventions. The present study was conducted to address this deficit. The data come from the 2011 Chicago Youth Risk Behavior Survey (n = 1,907). Structural equation modeling (SEM) in Mplus evaluated the direct, indirect, and total effects of sexual orientation on a latent indicator of suicidal ideation and behaviors via seven types of victimization. Four indicators of victimization were school-specific (e.g., harassment due to sexual orientation or gender identity (SO/GID), bullying, threatened or injured with a weapon, and skipping school due to safety concerns), and three indicators assessed other types of victimization (e.g., electronic bullying, intimate partner violence, and sexual abuse). Thirteen percent of youth were classified as SMY. Significantly more SMY than HY reported suicidal ideation (27.95% vs. 13.64%), a suicide plan (22.78% vs. 12.36%), and at least one suicide attempt (29.92% vs. 12.43%) in the past year (all P < .001). A greater percentage of SMY reported SO/GID-related harassment, skipping school, electronic bullying, and sexual abuse. Sexual orientation was not directly related to suicidal ideation and behaviors in SEM. Rather, SMY's elevated risk of suicidality functioned indirectly through two forms of school-based victimization: being threatened or injured with a weapon (B = .19, SE = .09, P ≤ .05) and experiencing SO/GID-specific harassment (B = .40, SE = .15, P ≤ .01). There also was a trend for SMY to skip school as a strategy to reduce suicide risk. Although SMY experience higher rates of victimization than do HY, school-based victimization that involves weapons or is due to one's SO/GID appear to be the most deleterious. That SMY may skip school to reduce their risk of suicidal ideation and behaviors is problematic, and schools should be encouraged to enact and enforce policies that explicitly protect SMY from victimization.

Purpose: We sought to evaluate the relationship between adverse childhood experiences (ACEs) and tobacco use, to assess the intersection of sexual orientation or gender identity (SOGI), and to explore risk and protective aspects of mental, social, and community health. Methods: This was a secondary analysis of the sexual and gender minorities (SGM) subsample (n = 1102) from a 2019 Community Health Needs Assessment. Nested binary logistic regression models were created to evaluate associations between ACEs and type of tobacco use: (1) cigarette use versus no cigarette or electronic nicotine delivery systems (ENDS) use, (2) ENDS use versus no cigarette or ENDS use, and (3) dual use versus use of either cigarettes or ENDS. Results: The sample population that reported four or more ACEs and ENDS use had statistically significant adjusted odds ratios (aORs) when adjusting the models for sociodemographic variables (aOR = 2.55; 95% confidence intervals [CIs]: 1.54-4.22), SOGI (aOR = 2.44; 95% CI: 1.46-4.10), current mental health (aOR = 2.23; 95% CI: 1.32-3.75), and social and community health (aOR = 2.19; 95% CI: 1.30-3.71). The sample population that reported poor mental health had statistically significant aORs when adjusting the models for sociodemographic variables, SOGI, and mental health (aOR = 2.26; 95% CI: 1.32-3.89) and social and community health (aOR = 2.06; 95% CI: 1.17-3.54). There was no statistically significant finding related to the other tobacco use variables (tobacco use and dual use). Conclusion: We found that high-risk ACEs were positively associated with cigarette use and ENDS use. SGM populations have differing experiences when considering community and social support.

The aim of this study was to examine drivers of durable viral suppression (DVS) disparities among people with HIV (PWH) using quantitative intersectional approaches. A retrospective cohort analysis from electronic health records informed by intersectionality to better capture the concept of interlocking and interacting systems of oppression. We analyzed data of PWH seen at a LGBTQ federally qualified health center in Chicago (2012-2019) with at least three viral loads. We identified PWH who achieved DVS using latent trajectory analysis and examined disparities using three intersectional approaches: Adding interactions, latent class analysis (LCA), and qualitative comparative analysis (QCA). Findings were compared with main effects only regression. Among 5967 PWH, 90% showed viral trajectories consistent with DVS. Main effects regression showed that substance use [odds ratio (OR) 0.56, 0.46-0.68] and socioeconomic status like being unhoused (OR: 0.39, 0.29-0.53), but not sexual orientation or gender identity (SOGI) were associated with DVS. Adding interactions, we found that race and ethnicity modified the association between insurance and DVS ( P for interaction <0.05). With LCA, we uncovered four social position categories influenced by SOGI with varying rates of DVS. For example, the transgender women-majority class had worse DVS rates versus the class of mostly nonpoor white cisgender gay men (82 vs. 95%). QCA showed that combinations, rather than single factors alone, were important for achieving DVS. Combinations vary with marginalized populations (e.g. black gay/lesbian transgender women) having distinct sufficient combinations compared with historically privileged groups (e.g. white cisgender gay men). Social factors likely interact to produce DVS disparities. Intersectionality-informed analysis uncover nuance that can inform solutions.

ABSTRACTSexual and gender minority (SGM) breast cancer patients have begun embracing the choice to “go flat” or opt out of reconstruction after bilateral mastectomy, though little is known about this population. SGM breast cancer survivors were identified through purposive and referral sampling and invited to participate in a web-based survey containing both closed- and open-ended items. Of the sixty-eight SGM breast cancer survivors aged 18–75 years who completed the survey between May 2015 and January 2016, 25 percent reported “going flat” (flattoppers®). Bivariate analyses revealed that flattoppers® were significantly more likely to have been diagnosed in the past five years, to identify as genderqueer, to have disclosed their sexual orientation or gender identity (SOGI) to providers, and to report participating in lesbian, gay, bisexual, or transgender cancer support groups, compared to other participants. More flattoppers® believed that SOGI mattered in terms of getting the support they needed regarding their cancer; this difference was not statistically significant. Thematic analysis of qualitative comments from flattoppers® revealed themes related to reasons for making this treatment choice, interactions with health-care providers around treatment choice, and physical and emotional outcomes of treatment choice. Providers would benefit from training about SOGI as they relate to treatment choices.

Factors that cause Syrians who may define their sexual orientation or gender identity (SOGI) as lesbian, gay, bisexual, trans, queer, intersex or otherwise (LGBTQI) to flee their homes and move onwards from situations of displacement are complex. So strong is the social stigma against LGBTQI persons in Syria, and much of its neighbouring region, that many Syrians who fear persecution based on their SOGI may nonetheless cite other reasons for moving more broadly related to their experience of conflict, discrimination, socio-economic situation or asylum. Recognising that multiple factors impacting displacement and migration decisions can interact at the same time, evolve over time, be different between groups moving in the same flows, or be perceived differently by the communities through which people move, is characteristic of a mixed migration approach to analysing the movement of different individuals and groups along similar routes. In contrast to prevailing binary analyses of migration as either forced or voluntary, this chapter applies a mixed migration lens to examine the complexity of the decisions made by LGBTQI Syrians to leave their country, move onwards towards Europe, or remain displaced in a neighbouring country. In doing so, it argues that policies recognising the complexity of decisions made by Syrian LGBTQI people on the move may better serve their protection needs than policies based on the assumption that their movement is either forced or voluntary.

Forced migration – no matter how we wish to define it – has been high in the political agendas and debates across the world for several decades. Forced migrants become claimants of international protection, or ‘asylum claimants’, and then find themselves trapped in convoluted, constraining and highly politicised systems. Often accused of being ‘bogus’ asylum claimants, they are also regularly accused of abusing the hospitality of the host country, violating countries’ borders and territorial sovereignty, and simply seeking economic benefits (Ford 2009; UNHCR 2007). Conversely, asylum legal instruments have been repeatedly criticised for inadequately addressing the rights and needs of asylum claimants, therefore preventing those with legitimate claims from being granted protection. These debates have more recently been rehashed in the context of the negotiations behind the Global Compact for Safe Orderly and Regular Migration, a non-legally binding agreement negotiated under the aegis of the United Nations (UN) and endorsed by the UN General Assembly. In this atmosphere of permanent politicised and humanitarian ‘crisis’ (McAdam 2014), a group warranting specific attention is constituted by those asylum claimants presenting a claim based on their sexual orientation or gender identity (SOGI).

LGBTQ people have pioneered major scientific advances, but they face challenges in STEM that ultimately waste human talent and hinder scientific progress. Growing evidence suggests that LGBTQ people in STEM are statistically underrepresented, encounter non-supportive environments, and leave STEM at an alarming rate. Potential factors driving LGBTQ disparities in STEM include bias and discrimination, misalignments of occupational interests with STEM stereotypes, and STEM norms of impersonality that isolate LGBTQ people. LGBTQ retention shares common psychological processes with female and racial minority retention such as STEM identification and belonging. The key barrier to better understanding and addressing LGBTQ challenges in STEM is the lack of sexual orientation or gender identity (SO/GI) demographic data on the U.S. STEM workforce. Policy recommendations include (a) adding SO/GI measures to federal STEM-census surveys; (b) broadening agencies’ definition of underrepresented groups to include LGBTQ people; and (c) incorporating LGBTQ identity into accountability systems and diversity programs at STEM institutions.