From Hell to Heaven? Lived experiences of LGBTQ migrants in relation to health and their reflections on the future

Abstract

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources.

Keywords:

• LGBTQ
• qualitative method
• health promotion
• civil society
• migrants

Introduction

Over 250 million people worldwide are migrants or refugees for economic, political, social or other reasons (UNHCR 2020). According to the International Organization for Migration (IOM 2021), migrant is an umbrella term for a person who moves away from their usual residence, whether within a country or across an international border, temporarily or permanently, for various reasons. The definition of a refugee is not only a person with a well-founded fear of persecution upon return to their home country, but also those in real danger of having their right to life violated upon return or who risk torture or inhumane and degrading treatment.

Apart from events and processes such as war, ethnically motivated conflict and climate change, having a gender and/or sexuality perceived as ‘socially unacceptable’ may motivate an individual to seek refuge in another country. Lesbian, gay, bisexual, transgender and queer (LGBTQ) people in particular face traumatic and victimising experiences of discrimination and violence (Alessi, Kahn, and Van Der Horn 2017; Alessi et al. 2018) as well as criminalisation and persecution to varying degrees of severity (UNHCR 2020). According to the International Lesbian, Gay, Bisexual, Trans, and Intersex Association (2019), consensual same-sex acts, for example, are punishable with imprisonment in 70 UN member states and death in six UN member states (including Iran and Sudan). Moreover, in 32 UN member states, freedom of expression for LGBTQ people is restricted (ibid.). As a result, migration to another country may be appealing, and being granted asylum can make the difference between life and death for some LGBTQ people. That said, the irregular status of migrants, especially asylum-seeking migrants, and associated economic and social marginalisation, offers one explanation why migrants are at greater risk of health problems (De Vito et al. 2015).

Civil society plays a key role in supporting immigrants in challenging situations (Ambrosini and Van der Leun 2015), including the integration of newly arrived citizens (Fredriksson, Geidne, and Eriksson 2018). Civil society organisations in particular provide support to economically and socially disadvantaged groups, helping to build social capital (Field 2005). In Canada, such groups have taken on an important role as political advocates for migrants, ensuring issues of diversity and cultural pluralism figure in public debate (Schmidtke 2018). Although civil society organisations may advocate for immigrants, few of them challenge the central notions that underlie government policy (Ambrosini and Van der Leun 2015). It is within this context that LGBTQ migrants to Sweden seek support from organisations such as the Newcomers groups organised by the Riksförbundet för homosexuellas, bisexuellas, transpersoners och queeras rättigheter (RFSL, The Swedish Federation for Lesbian, Gay, Bisexual, Transgender and Queer Rights).

In 2017, Sweden was the fourth-largest recipient of asylum applications in the EU (Eurostat 2018). As the result of increased migration, the proportion of gay men and lesbian women in Sweden who were born outside Europe has increased (Forte 2019). One reason for this may be the positive response in Sweden with respect to discrimination against LGBTQ people (Hooghe and Meeusen 2013). However, there are many challenges that migrants in general (Zacheus 2010) and LGBTQ migrants in particular (Murray 2014; Pachankis et al. 2017), face when arriving at a new culture.

On the one hand, LGBTQ migrants must engage with a new society and often a new language, which impacts their attitudes and identities (Zacheus 2010) via a process that is potentially accompanied by xenophobic and racist experiences (Pachankis et al. 2017). On the other hand, LGBTQ migrants must deal with the stigma and minority stress associated with belonging to a sexual and/or gender minority (Panchankis et al. 2017), while at the same time meeting the expectations of a grateful ‘migration-to-liberation-nation’ narrative within the new homeland (Murray 2014). Additionally, LGBTQ migrants may still face stigma and abuse in asylum destination countries due to populist backlash (ILGA 2019); when meeting former persecutors in asylum accommodation or homonormative expectations within the LGBTQ community in Sweden (Wimark 2021); and regarding the Swedish Migration Board’s normative expectations of what it means to be LGBTQ, and lack of uniformity in the assessment of LGBTQ asylum cases (Gröndahl 2020). Hence, integrating into the new home country may be a particularly challenging task for LGBTQ migrants, characterised by experiences of dependence, precarity and lack of freedom (Alessi et al. 2020).

There is growing scientific evidence for an increased risk of physical and mental illness among LGBTQ people in general (Lick, Durso, and Johnson 2013). For LGBTQ migrants, their diverse and intersecting structural jeopardy adds to the vulnerability related to stigma and minority stress that native LGBTQ people experience (Fox, Griffin, and Pachankis 2020). LGBTQ migrants are at particular risk of becoming distressed, not least because of their probable exposure to violence and abuse due to their sexual orientation (Alessi et al. 2020; Shidlo and Ahola 2013) and experiences of social isolation in the new country (Logie et al. 2016; Fox, Griffin, and Pachankis 2020). This situation may result in a higher suicide risk and other detrimental mental-health outcomes, such as acculturative stress, anxiety, depression and sleeping disorders, as well as post-traumatic stress disorder (PTSD) and other complex trauma syndromes (Shawel-Abebe, Lien, and Harsløf-Hjelde 2014; Lecerof et al. 2016; Eriksson-Sjöö et al. 2012). Even worse, sexual health and physical health may be threatened (Roth, Boström and Nykvist 2006; Institute of Medicine 2011; Eliason and Chinn 2018).

There is a need for more knowledge about the lived experience of LGBTQ migrants to ensure good reception and facilitate social integration (UNHCR 2020). In this respect, health plays a vital role, as it is regarded as a prerequisite for participation, integration and belonging in society and civil society organisations (Esses, Hamilton, and Gaucher 2017) and hence, may be considered as laying the foundations on which to build a future in the new home country. Against this background, this study aimed to explore the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during their migration process and their reflections about the future.

Conceptual and theoretical approach

In our view, health is a positive concept and resource for everyday life characterised by multidimensional well-being, related to and dependent on social and personal potentials and physical capacities and existential meaning-making capabilities (WHO 1986; Melder 2011). Such a perspective aligns with Antonovsky’s (1979) salutogenic perspective on health, which focuses on resources for health, not the risks of disease. Starting from this perspective, it was possible to interrogate the existing literature on LGBTQ health while also considering the narratives of study participants and their orientations towards health promotion. Utilising Kickbusch’s (2007) notion of Western health societies—in which health assumes the position of a ubiquitously relevant concept—we assumed that all narrated influences on someone’s subjective experience of health were relevant and significant for health.

Method

Design

Interpretative phenomenological analysis was adopted in this study because of its concern for, and focus on, participants descriptions and perspectives from their own experience (cf. Larkin and Thompson 2012; Smith, Flowers, and Larkin 2009). In our view it is uniquely well-suited to an exploration of LGBTQ migrants’ perceptions of health and their reflections on the future (cf. Smith, Flowers, and Larkin 2009). All the authors are experienced in the use of qualitative research methods and have experience of research regarding migrants, civil society, health, well-being and health promotion.

Setting

The RFSL is a non-profit organisation that was founded in 1950 (RFSL 2020). Its mission is to monitor, develop and advocate for LGBTQ rights in Sweden. RFSL is a democratic organisation in which an annual congress is the highest decision-making body. It is a national association with 36 regional associations and approximately 7000 members. In 2014, Newcomers groups were introduced, which aim to strengthen voices and identities through meetings in which newcomers can be supported, share experiences, and extend their social networks. At present, there are 16 active Newcomers groups in Sweden.

Sample

The study was conducted with participants in three Newcomers groups situated in a small town, a middle-sized town and a big city respectively. Purposive sampling was used to select informants. Out of a total of 90 people approached at information meetings within the three groups, 11 LGBTQ migrants (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) agreed to participate, of whom five were living in the small-town, four in the large city, and two in the middle-sized city at the time of the interviews.

Information about the study and participants’ rights was given orally and in writing (in Swedish and English), and written informed consent was obtained. With the support of professional translators, the information was given orally by translators to participants, in the participants’ mother tongue. Six potential participants declined to participate due to feelings of insecurity. They were afraid of being identified, thereby risking being pursued and, in some cases, feeling fear for their lives.

Nine participants had come to Sweden as LGBTQ migrants due to safety issues in relation to sexuality in their country of origin: one due to war and one due to political persecution. At the time of the study, three participants had received asylum, and eight were still in the asylum process. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria and Uganda (Table 1).

Table 1. Study participants.

Newcomer (pseudonym) ST = small-town BC = big city MC = middle-sized city	Country of origin	Asylum status	Gender identity/sexuality	Language of interview
Daryan (BC)	Kurdistan	Granted	Transgender/gay	Swedish
Sergej (BC)	Ukraine	Granted	Male/gay	Swedish
Luki (BC)	Guinea	Granted	Male/gay	English
Ali (ST)	Iraq	Seeking	Male/gay	English
Grace (ST)	Uganda	Seeking	Female/lesbian	English
Samuel (ST)	Nigeria	Seeking	Male/gay	English
Boris (MC)	Russian Federation	Seeking	Male/gay	Swedish
Miro (ST)	North Macedonia	Seeking	Transgender/gay	English
Luisa (ST)	Nicaragua	Seeking	Female/bi-sexual	English
Tariq (BC)	Pakistan	Seeking	Male/gay	Translated to Swedish from Dari
Wafa (MC)	Syria	Seeking	Male/gay	Translated to Swedish from Arabic

The project was approved by the Regional Ethics Review Board in Lund, Sweden (dnr2018/734).

Data production

Semi-structured interviews were used to capture LGBTQ migrants’ experiences (Smith, Flowers, and Larkin 2009). To reduce power imbalance between researchers and participants and the inadvertent imposition of Western cultural norms, we found it crucial to acquaint ourselves with the context and participants. To learn more about the Newcomers groups, establish relationships, and contribute to feelings of safety, the researchers visited several Newcomers meetings at local RFSL venues. Through meetings consisting of open sessions, informal gatherings and conversations, we got to learn more about the groups’ participants before beginning the research study.

The interviews were conducted by four researchers: two heterosexual native Swedes (one man, one woman), one non-binary lesbian Swedish-German migrant, and a Costa Rican female visiting graduate student. One interview was held by phone, and ten more at the local RFSL venue, to create a feeling of safety for participants (Merriam 2009). A total of 11 interviews took place in Swedish (n = 3), English (n = 6), and two with a translator from an authorised translation bureau participating via telephone. Questions related to participants’ health situation, life circumstances in their home country prior to migration, the process of migrating to Sweden, experiences participating in the Newcomers group, and reflections about the future. Interviews lasted between 30 and 90 min. All interviews were audio-recorded and transcribed verbatim by a professional transcriber in either Swedish or English, depending on interview language, and checked for accuracy by the interviewer. Additionally, the accuracy of two interviews translated from Arabic and Dari was checked by an independent reviewer.

Data analysis

The data were analysed using interpretative phenomenological analysis in line with the approach outlined by Smith, Flowers, and Larkin (2009). The first and the last authors took the lead in developing a close, line-by-line analysis of each participant’s transcript to capture a first impression. Then, a comprehensive set of descriptive and conceptual codes and comments associated with particular words and phrases was developed individually. Similarities and differences in these codes were then interpreted as emergent tentative themes. These tentative themes were compared to create superordinate themes that captured the experiences of the participants.

At every stage, the thematic structure was developed through detailed interpretations that emerged from participants’ narratives. Themes and subthemes were revised and discussed several times to ensure adequate understanding before the final development of three themes and nine subthemes. Although the first and last authors performed the analysis, each step was discussed with other members of the research group to reach consensus. While the analytical process may seem linear, it involved going back and forth between decontextualisation and contextualisation, which created analytic depth. Illustrative quotations are used to exemplify each of the themes, giving voice to participating LGBTQ migrants.

Findings

Three main themes as detailed below were identified based on the lived experiences of LGBTQ migrants.

Past: from daily stress to the fear of being killed

Participants described shared challenges in life including living with the fear of being killed. Ill-health can be a consequence of living with fear, including anxiety, stress, depression, and suicidal tendencies. Participants also shared experiences of cultural imprisonment and feeling forced to adhere to prevailing conservative religious norms. Their narratives included feelings of anxiety and stress about how the laws, religion and culture in their country created a dangerous situation for them. Same-sex relationships were not tolerated in participants’ home countries, and participants’ sexual orientation justified exclusion from their community, threats and even harm.

I’m homosexual … Which is not legal in my country … the situation was too bad, because you know, according to our religion, according to our laws … it is not legal. Because when you are homosexual there, you have to be in hiding, you know? To not be caught, and put in jail, and probably tortured. (Luki)

Participants’ narratives described their struggles with war or the threat of political persecution. Many had been threatened, and some had experienced bodily harm. Participants were scared and forced into silence, putting their families in danger when their sexual orientation was accidentally revealed. Their narratives revealed situations in which they had been assaulted, tortured, imprisoned and feared for their lives. ‘I was in jail several times, and I was declared an idiot’ (Boris). And ‘I have had those nightmares … you know, I’ve been tortured once … because I have been in jail’ (Luki).

Participants spoke about putting their families in danger and described friends been killed for being homosexual. Some revealed near-death personal experiences: ‘I was caught […] it was the same day, they killed my partner instantly … my mom was there, and so much is the respect for mothers, they cannot kill a child when the mother shouts out … you understand’ (Samuel). Participants also described feelings of shame and the longstanding effects of assault: ‘It’s embarrassing for me to say I was raped […] that really happened, I don’t know why […] having to talk about the rape is yet another assault’ (Luisa).

The stories told by participants reveal the links between discrimination and assault: ‘Firstly we get discrimination and … stress, and death threats from families … if the family chases you away in the society or community, people don’t accept you’ (Grace), and ‘My brother prevented my cousin from slaughtering me. When he [my cousin] hit me, the knife was pointing at my chin, and there are still scars here’ (Wafa). They also spoke about friends who had taken their own lives, depression and suicidal thoughts: ‘When you are alone always thinking, you feel depressed … I was rejected, and then I [thought] just [to] take my life, I know that, so I was very depressed’ (Samuel).

Present: safety, belonging and resources to support the transition to a new life

Study participants’ experiences illuminated how life can change for the better when other people offer care and support, engendering a sense of safety and facilitating trust. Grace said: ‘I went to RFSL to see, I told them [about] my situation and everything, and then … the Newcomers’ group has always helped me because I have told them what I’m going through’. Participants described experiencing emotional support from the group together with a sense of belonging As Luki put it, ‘Yeah, I think that’s the most important thing … feeling like I am with my family, you know’ (Luki). They also experienced being able to move more freely, strengthened by the companionship provided by the group. As Sergej expressed, ‘I can walk around town without fear of bullying, and I feel pride and power when I am with a strong group when we walk together in the city’. To be a part of Newcomers and meet others played a major role in enhancing a sense of self-worth because participants felt they did not have to be ashamed of who they were.

In Newcomers, I feel that everyone is the same; we are no different. I feel a little different outside of this place [in Newcomers], but in this place, I feel like everyone else, like a family. We are together, and I am not ashamed to be here. (Tariq)

LGBTQ migrants spoke positively of the opportunity to attend college, learn the Swedish language, and learn about Swedish traditions and culture from the LGBTQ community and friends. This strengthened their ability to integrate into society on their own terms. As Daryan described it,

Two years ago, I could not speak Swedish. I did not work and had not entered the community. Then I only had RFSL, Homan [an LGBTQ group with participants from the Middle-East], a language café,¹ and a church. [They were] just the ones I talked to, but now it’s completely different. I am in the community and know the language. I’ve worked with theatre and movies, so it’s entirely different for me now. All of my friends are Swedish, or they were born here.

Migrants experienced relief when they found they were able to be open about their sexual orientation and be true to themselves, no longer having to be silent or hide for fear of harassment and oppression. As Grace described it,

Society is okay, they are accepting, they’re not judgemental … you’re not going to hide like ‘Oh, I have to hide about this’ ‘Oh I have to’—no, here you live your life, you live freely. So, we’re not living in fear like we used to … yeah.

Participants also described finding out that not all Swedish people are as open to sexual diversity as RFSL and the Newcomers groups. They shared experiences of being questioned and mistreated and the need to, once again, to raise their guard. Participants also described their life in government refugee facilities as challenging, as they sometimes met people with the conservative religious norms common in the home country that had they left. Even racist experiences were reported:

I’m Black, they’re white, so there’s always this difference between colours. I read more about Sweden; I heard they have no racism in Sweden actually, but I have been, and I’ve seen that’s a little bit of a lie, some of them are not nice, some of them are nice I know that … We are human, so such is life; there’s always gonna be discrimination. (Samuel)

Future: making a positive difference or being afraid of what’s ahead

Participants’ future perspectives entailed dreams of making a positive difference. On the other hand, some participants still in the migration process feared what the future might entail.

LGBTQ migrants seeking and granted asylum alike had a strong urge to defend the right to choose a way of life or career pathway. They described how their own experiences of being hurt, violated and exiled nourished the wish to help others. They also talked about wanting to help other LGBTQ people feel free by fighting myths and assisting others to be their true selves. The notion of giving back, in gratitude for the help they themselves had received from RSFL and the Newcomers group, was central to their narratives:

I have been here for a year; I have been allowed to volunteer because I have studied, I have learned Swedish … I interpreted a bit for people who were new and stuff. And when they get to know me, they say, you’re nice too, you are social and talk, take care of them and stuff … so I have been able to volunteer and help newcomers. (Daryan)

Participants described a willingness to do good and make the world a better place by working for human rights. Even though they could return to their home country, participants wanted to enable other LGBTQ people to experience the freedom they had experienced themselves: ‘I want to work again in human rights […] a big dream really, part of it was to work again, but [also to] support [others] somehow … from a distance’. (Luisa). Participants wanted to be leaders, improve society, and lend a helping hand to future LGBTQ migrants:

I think maybe next year I want to be a politician in the government. I want to be a

leader, and I want to give a hand and help out […] I always help out with people who come who are new, who don’t know anything. I always help them, show them where the offices are (in this city), show them where they can go and start learning the language. Because it’s important, so I always give a hand, so I like being a leader. (Grace)

Some participants seeking asylum described how they had a constant feeling of being questioned and out of place in their new lives. The complexity of migration process offered reason to be sceptical and unsure of the future. Their experiences included being in limbo throughout the migration process. Participants lived in fear of being sent back to their home country or meeting the ‘wrong people’ at an interview at Migrationsverket [the Migration Authority]:

“I’m still under migration, I’m still under investigation” (Miro), and “migration know (my) story … you know, in the interview [I] say what happened. Still, they want to know details like when they raped [me], what they were saying when they were raping you. It’s hard, I mean … they rape me … I told them they hit me, everything they did to me, but like more and more details, it’s not so easy. And when they ask, it’s so hard you know, and they say, ‘We need a strong story’, like more, I say, ‘What more?’, they broke my arm, they had me one month, they raped me … what more can I say?” (Luisa)

Some asylum-seeking participants talked about life on the run. They recounted feeling caught in no-man’s-land, unable to go to the doctor, being ineligible for healthcare, unable to work without a work permit, and lacking someone to confide in. Returning home was not an option, as they feared being killed:

Sometimes it’s hard because I want to live and have a family, I had a son, but then it’s … why do we have to run always? Maybe because they know we run away, they keep doing it. It’s something I’m fighting inside because I still want to go and keep fighting, but I’m … at the same time I’m so afraid. (Luisa)

Discussion

This study contributes to discussion of the links between sexuality, sexual health and rights, and growing interest in understanding aspects of life that can be broadly defined as ‘sexual’. Participants in the study described experiences of a past life in a home country that condemned their sexuality, forcing them into a daily existence filled with stress and the fear of being killed. Such findings are in line with those reported elsewhere (see, for example, Alessi 2016; De Vito et al. 2015; Eriksson-Sjöö et al. 2012; Lecerof et al. 2016; Shawel-Abebe, Lien, and Harsløf-Hjelde 2014).

The vulnerability of LGBTQ migrants is especially true for those seeking asylum (Forte 2019; Fox, Griffin, and Pachankis 2020; Lick, Durso, and Johnson 2013; Shawel-Abebe, Lien, and Harsløf-Hjelde 2014). This signals the value of structural intervention to ensure LGBTQ migrants are eligible to receive support and for preventive efforts (Kahn et al. 2018; Logie et al. 2016) as well as individual support to enable LGBTQ migrants agentically to acquire new knowledge (Thomas and Springhart 2017) and effect change within the system (Lewis 2019). Importantly, working towards change may contribute positively to LGBTQ migrants’ sense of contribution and coherence (Antonovsky 1979).

Findings also point to experiences during the migration process that influence transition to life in the host country. From a positive perspective, LGBTQ migrants highlighted how participation in a civil society group provided the opportunity to meet people who cared for and supported them. This enabled them to make new friends, be more open about their sexuality, and be considered ‘normal’ as an LGBTQ person. This sense of social inclusion has been highlighted elsewhere (e.g. by Schmidtke 2018 in Canada), and resonates with notions of social support as a generalised resistance resource (GRR) (Antonovsky 1979), contributing to a sense of empowerment (Tengland 2008) and enhancing health and well-being. Previous research has drawn attention to role of social support in promoting self-esteem and development among LGBTQ people (Kwon 2013; Snapp et al. 2015). Moreover, not only receiving but also giving support may provide meaning in LGBTQ migrants’ lives, encouraging positive ideas about the future and motivating them to excel and self-actualise, despite enduring the struggles of forced migration (cf. Alessi 2016).

According to migrants in this study, reflections about the future included both the intention to make a positive difference, as well as being afraid of what might lie ahead. This past mixture of favourable and unfavourable experiences may yield risks and resources for the future at each stage of the migration process.

Participants also expressed the need to escape several limiting expectations, including expected gratitude for liberation from homo-/transphobia in their homelands (Murray 2014). Simultaneously, asylum-seeking LGBTQ migrants described having fear for the future, as they needed to present a certain, pre-framed ‘authentic’ story to be deemed trustworthy and obtain a residence permit from Swedish Migration Boards (Gröndahl 2020).

Moreover, LGBTQ migrants described significant difficulties or potential future problems in Sweden, a finding which is in line with previous research (Misund Dahl et al. 2020). Some migrants felt like second-class citizens and experienced relatively poorer health in the new country (Fang et al. 2015), a possible consequence of the uncertain, irregular status, and economic and social marginalisation (De Vito et al. 2015).

Awareness of the interaction between vulnerability and potentiality is a major contribution of this study (cf. Alessi 2016). On the one hand, the study provides proof of the well-known challenges that LGBTQ migrants face and the vulnerability they experience. On the other hand, it highlights the potential and resourcefulness that LGBTQ migrants possess and, in part acquire, by going through the very process of migration and asylum seeking.

Limitations

Like all research, this study has its limitations. Some of these relate to sampling issues. Because we recruited participants already connected to a support network, we may not have included the experiences of those who are more isolated. The typicality of informants’ views and experiences could have been assessed by the inclusion of LGBTQ migrants who were not newcomers. Six LGBTQ migrants declined to participate due to safety concerns. The inclusion of their perspectives may also have produced a fuller account.

Other limitations derive from the small number of participants, making comparisons difficult across country of origin, context of settlement, and other factors that might allow a more intersectional analysis. Although this study was not a comparative investigation, we found differences in experience depending on the asylum status of the participant. Further research into similarities and differences between asylum seekers and asylum granted migrants is therefore warranted.

Finally, the composition of the research team, which comprised mainly cisgender Swedish members, may have influenced the questions asked and the responses given.

Conclusion

LGBTQ migrants’ health-related journeys and reflections about the future were complex, being informed by favourable and unfavourable lived experiences. In combination, these become risks and resources for personal development, which play out during the asylum-seeking process. Based on our findings, we recommend the avoidance of deficit-focused perspectives in work with LGBTQ migrants. Instead, we suggest an approach focusing on strengths and personal resources. This may better support their hopes for the future and strengthen the agency to excel, despite the struggles of forced migration. Ultimately, LGBTQ people are best characterised not by deficits, but as individuals who are also strong and resourceful, and as learners and teachers alike who seek change, and who can bring change to society. Within this context, health-promoting approaches directed towards meaningfulness and empowerment likely work best. While adopting these approaches may be challenging for some health and social service providers, engaging with them will likely prove more beneficial in supporting to LGBTQ migrants to play their role in Swedish society.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding was received from Swedish Agency for Youth and Civil Society (0718/18).

Notes

1 A language café is a place where people can meet for informal conversation in a new language but without any structured programme or formal educational structure.