A Framework for Clinical Practice With Sexual and Gender Minority Asylum Seekers

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In many countries around the world, sexual and gender minority individuals experience gross human rights violations and therefore must conceal their identities to survive. Without adequate protections, these individuals are forced to flee to countries such as the United States and Canada. By the time sexual and gender minority asylum seekers (SGMAS) arrive in these countries, they may suffer from depression, posttraumatic stress disorder, and complex trauma. SGMAS may struggle with these mental health problems while also attempting to navigate the difficulties of migration (e.g., locating housing and employment, filing an asylum claim). The extant literature on refugee and sexual and gender minority populations, however, may not provide adequate guidance to therapists who assist SGMAS. Therefore, this article presents a framework for clinical practice with SGMAS. This framework is informed by research on complex trauma, minority stress, acculturation/integration, and resilience. The 3 components of the framework are establishing safety and stability in treatment and in the environment, developing skills for managing the asylum claims process, and providing strategies for dealing with the challenges of resettlement. These components are intended to help clients to heal from trauma, handle the demands of acculturation, and cope with minority stress.

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