LGBTQ+ asylum seekers and their mental health

LGBTQ+ asylum seekers and their mental health

Pride month is a time to reflect on the barriers and stigma faced by LGBTQ+ asylum seekers and also an opportunity for us, clinicians, to help. LGBTQ+ immigrants faces numerous obstacles and legal exclusions, often leading them to flee their country of origin due to fear of persecution.

LGBTQ+ asylum seekers are subject to violence and persecution in their country of origin. Sadly, in many instances, their family members are responsible for this violence, usually because of homophobia or transphobia.

Preparing for the journey

People flee to the U.S. because they cannot live safely in their home countries. They are in danger of persecution, prosecution, imprisonment, blackmail, discrimination, torture, sexual assault, and in some cases death based on their actual or perceived sexual orientation or gender identity.

Some asylum seekers make preparations in advance of their journey. Others make a snap decision to leave home when an opportunity arises, arriving with few resources. Some only decide to apply once they are already in the U.S., while others who fled to the United States have never heard of “asylum,” or at least are unaware that they might qualify.

The U.S. Asylum Process is Complicated

The process of seeking asylum is complicated, but for a sexual minority or transgender individual is even more. LGBTQ+ asylum seekers have likely concealed their sexual orientation or gender identity for safety reasons.

But to gain asylum, they must convince decision makers they are in fact LGBTQ+ and would be persecuted in their home country. This ignores the fact that they may also face discrimination in their ethnic immigrant communities and in mainstream U.S. society if others are aware of their LGBTQ+ identity.

In addition, the asylum process requires asylum seekers to prove that they have suffered past persecution or have a “well-founded fear of persecution,” a process that can be retraumatizing. 

Disclosing sexual violence, complying with the compressed timelines for filing for asylum, and feeling forced to come out before they are ready can be psychologically damaging for LGBTQ+ asylum seekers (Kahn & Alessi, 2017).

How we can help

Clinicians can assist asylum seekers by preparing them to give their testimony and helping them cope with past traumas and retraumatization.

Although many LGBT+ asylum seekers are referred to individual psychotherapy by their legal counsel to prepare for the asylum process and to mitigate risks for retraumatization, many decline due to fear, shame, and cultural barriers, among other factors.

It is imperative to establish safety and stability for the client in both the treatment setting and the broader environment. It is especially relevant for clinicians to be mindful of past rejection and abuse the client may have experienced that can challenge the therapeutic relationship.

Clients may face stigma for seeking treatment and require assurances about privacy and confidentiality. They may need to be connected to legal services to help with their asylum claim and to social services for basic needs such as food and housing, since they are not legally permitted to work in the United States while their asylum case is pending.

In addition to helping clients prepare to give their persecution narrative as a part of their asylum case, therapists may also provide counseling to those whose asylum claim has been granted. Such clients may need support to process their loss of family, community, and/or country. They may also need support with integrating into U.S. society and building new social networks.

Resilience promotion

Despite the trauma experienced by LGBTQ+ asylum seekers and the challenges they have faced, many exhibit a great deal of resilience. Many LGBTQ+ asylees cope through staying hopeful and positive, using legal and community services, receiving support from loved ones, drawing on their religious faith, or giving back to help others.

The process of migration and leaving everything behind and the act of applying for asylum require a great deal of courage. A comprehensive perspective that includes resilience is recommended to help the LGBTQ+ asylum seeker identify with narratives of strength through adversity rather than victimization.

Culturally relevant psychosocial interventions can help LGBTQ+ ayslees identify their strengths and resilience rather than focusing on pathology. With support, LGBTQ+ persons can successfully overcome trauma, adapt to their new environment, and lead full lives.


Mental health issues and needs of LGBTQ+ asylum seekers are significantly understudied, because it is a complex issue. It is important to us clinicians to keep studying to understand the unique issues that affect these individuals not just LGBTQ+.

In my interview with Luis Cornejo, LMFT and founder of  PsychoSocial, a multimedia platform that strives to highlight issues impacting the LGBTQ, POC, and other disenfranchised groups, he explains the importance of education really well.

“Education. I won’t say it’s the only or sure-fire way to be proficient, however, it’s a start. Understanding the unique issues that affect these individuals not just LGBTQ+, but also as immigrants.“

It is also important to know about other resources, Cornejo says about this: “Research opportunities, programs, and support for clients. This can make a huge difference and build trust within the therapeutic relationship. Many of my past clients had various needs when it came to immigration, legal issues, financial difficulties, health, and other areas.”

Cecilia Racine: Immigration Evaluation Therapist

I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 500 evaluations and work with dozens of lawyers in various states. Immigrants are my passion, I believe they add to the fabric of our country.

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