Addressing sexual violence against LGBTIQ+ individuals in humanitarian settings


Despite a steady increase of research and scholarship on sexual and other forms of gender-based violence (GBV) against individuals who are lesbian, gay, bisexual, transgender, intersex, queer/questioning (LGBTIQ+), in conflict and other humanitarian settings, evidence about what works to adequately develop competent, survivor-centric and intersectional humanitarian responses for these individuals and groups remains scarce.

As part of a series of webinars focused on specific populations that humanitarian responses do not always serve adequately, in mid-February the alumni of the Course on ‘Addressing Sexual Violence in Conflict and Emergency Settings’, gathered online with experts to share reflections, dilemmas, experiences and promising practices on how to improve research and actions, for and with, survivors who have diverse sexual orientations, gender identities, gender expressions, and sex characteristics (SOGIESC).

What do we know about sexual violence against LGBTIQ+ individuals in conflict and emergency settings?  Where can our teams start from to adopt an intersectional approach to sexual violence prevention and response, and work meaningfully and competently for and with LGBTIQ+ individuals who are victims of sexual violence and other forms of violence and discriminations? How can we avoid doing harm and adopting an ‘add on’ and homogenizing approach to a very diverse group? These were some of the questions that were put to the speakers and debated with the audience.

Discussions started from looking at the existing evidence on sexual violence against LGBTIQ+ people.  Patricia Ollé Tejero, current student of the course and Senior UN programme and prevention advisor at the All Survivors Project (ASP), presented findings from an exploratory desk-based research she has conducted on conflict-related sexual violence against LGBTIQ+ people in terms of scale, nature, contributing factors, impacts and access to responses for this population.[1] Patricia highlighted the pathologisation and criminalisation of diverse SOGIESC as key factors which have contributed to the institutionalisation and social legitimation of prejudiced-based views around gender and sexuality, both in law and healthcare.  Drawing upon examples from very diverse contexts, she invited participants to reflect on the high vulnerability of LGBTIQ+ people to sexual violence in contexts of conflict and political violence, and on the need to adopt an intersectional lens to understanding their realities and experiences. Not all LGBTIQ+ people are equally vulnerable to sexual violence in conflict, certain factors including age, ethnicity, socio-economic circumstance and the visibility of diverse gender expression often playing an important role in increasing individuals’ vulnerability to violence. Specific contexts such as deprivation of liberty, displacement settings and the association with armed forces or armed groups are also known to heighten participants’ exposure to risks of victimisation.

The importance of terminology around diverse SOGIESC came up as a crucial aspect in the way in which the issue and the work with this group are framed. As pointed out by Henri Myrttinen, international researcher and practitioner with a long experience on transforming harmful gender norms and responding to the needs of LGBTIQ+ populations, it is crucial to understand what lies behind the acronyms that we commonly use, be it LGBTIQ+ or SGBV. The term “LGBTIQ+” covers a wide range of identities, experiences, vulnerabilities and agency, and we need to be careful not to assume that it is a homogenous group because we risk invisibilising the diversity of experiences and realities that exists across and within groups. Furthermore, the range of violence and forms of discrimination under the “SGBV” umbrella needs to be considered as well. While much of the focus is often on sexual violence, persons of diverse SOGIESC often also face a wide range of homo-, lesbo-, trans- and bi-phobic, gender-based violence, from micro-aggressions of verbal and emotional abuse, to structural and economic discrimination over to harassment, extortion and various forms of physical violence, all the way to murder. These forms of violence – and the constant threat of them – need to be addressed and acknowledged alongside sexual violence. The forms of discrimination are also cumulative, with for example women of diverse SOGIESC not only facing abuse and discrimination because of their sexual orientation or gender identity and expressions, but also for being a woman in a patriarchal society, or LGBTIQ+ refugees facing xenophobia in addition to anti-LGBTIQ+ discrimination. 

Language around diverse SOGIESC also has implications in the way we approach individuals and groups and shape our partnership with the communities we work with; we therefore have to be highly conscious of the need to use appropriate, non-discriminatory, inclusive language. Apart from being an issue of respect, it is also an essential first step to building trust and creating a safe space for survivors of different forms of SGBV and discrimination, who have often had to endure a lifetime of abusive and discriminatory language. Thus, using the appropriate terminology and inclusive language is not just a ‘nice to have,’ but an essential first step to care provision. All staff in an organisation, from senior management to security guards, drivers and cleaners, need to be trained in using inclusive and non-discriminatory language, as it is impossible to predict who would be a potential survivors’ first point of contact, and trust, which takes a long time to be built, can be lost very quickly by the use of inappropriate or discriminatory language at the outset.

Speakers also highlighted barriers LGBTIQ+ survivors face in accessing humanitarian responses.

These include mandatory reporting requirements particularly in contexts where consensual same-sex sexual conduct is criminalised as well as lack of training and sensitivity towards the diverse needs of LGBTIQ+ people by healthcare personnel. Casey O’Connor currently leads Médecins Sans Frontières (MSF) “LGBTIQ+ Inclusion in health setting” initiative to ensure that LGBTIQ+ patients have access to dignified, safe and appropriate healthcare. She pointed out how many LGBTIQ+ people avoid the health system because of their previous experiences with healthcare providers and clinic staff – this has led to great health disparities for this population, resulting in late presentation for highly treatable diseases.  This has been true for other populations such as racialised people in several contexts, the medical system being the cause of greater disease burden due to bias in treatment. Creating safe access to services and saf(er) spaces for people with diverse SOGIESC is often left to individual commitment and initiative in many humanitarian settings instead of organisational directive and programmatic inclusion, and although LGBTIQ+ people exist everywhere, they will be in small numbers at a humanitarian intervention level. 

A key ally here are the local SOGIESC rights groups and activists, who are often best placed to understand the local context, its risks and entry points, all of which are essential for a do-no-harm approach. Depending on the context, many will have local organisations, others will work remotely having immigrated for safety but have deep knowledge and local contacts that can provide expertise. However, this work by local activists and organisations does need to be resourced and cannot be taken for granted. 

Other promising practices in creating safe services that respond to the needs of LGBTIQ+ survivors were shared by speakers and experts. In 2017 the Thai Red Cross created the “Transgender Health and Wellness Centre”, the first transgender-specific sexual health clinic with trained transgender personnel. In 2016, the Women’s Refugee Commission (WRC) partnered with MOSAIC to pilot a project to support Iraqi, Syrian, Palestinian and Lebanese transgender women living in Beirut. MOSAIC currently provides a range of health, MHPSS, legal and other support services to any persons of diverse SOGIESC across the spectrum, including to refugees, migrants, migrant workers and members of the local community. 

The needs of LGBTIQ+ refugees, asylum seekers and migrant populations were also discussed more in depth during the debate.  Humanitarian actors working in displaced settings are seeing increasing numbers of LGBTIQ+ individuals who have left their home countries to escape persecution from laws criminalising people with diverse SOGIESC for safer countries but who are being detained in transition countries for long periods of time, with greater vulnerability and less support mechanisms than they had even in their home country.  Besides responding to the medical needs and trauma of targeted attacks with compassionate, non-blaming care, there is a need for shelter provision that is safe – and once ‘outed’, this can be a repeated ordeal for more ‘visible’ SOGIESC, needing repeated referrals to safe housing.  Unless humanitarian organisations recognize and address the unique needs of this community in these displaced settings, particularly around SGBV and GBV, they will utterly fail this population. 

Sharing her experience in MSF operations for the refugee response in Eastern Europe, Luise Jaehne, a midwife working in sexual violence prevention and response, shed light on how organizational policies and procedures, from data collection management forms to staff to clinical protocols to training approaches, can sometimes reflect organisational deep-seated assumptions around gender and sexuality and ultimately fail to reflect the complexity of LGBTIQ+ refugee survivors accessing healthcare services. On her “quest” to queer SGBV medical humanitarian work, Luise pointed out how crucial it is for organisations to be aware of often unconscious hetero-normative approaches when developing programmes, creating access to services for survivors, or facilitating trainings on topics such as SGBV. On a practical level, simple measures such as consistently applying inclusive language, being non-assuming and non-judgmental, as well as being approachable as a service provider can have a significant impact when trying to reach individuals from the LGBTIQ+ community.

Many humanitarian organisations have addressed the particular vulnerabilities of the LGBTQI+ population in their policies and procedures but it is unclear how much these policies are used in field settings due to individual bias. Colby Fortin, who has worked in helping organisations develop inclusive frameworks and language from a SOGIESC perspective and who has served as sexual assault crisis counselor with LGBTIQ+ populations, highlighted the importance survivor-centered data security and psychological first-aid practices. Additionally, she discussed the importance of sustainable practices like mentorship, burn-out prevention, and proper knowledge documentation in continuing to advance LGBTIQ+ survivor inclusion.

As mentioned previously, changes in programme activities that address the needs of LGBTIQ+ population are generally the result of individual commitment and initiative.  Once these changes are made, the sustainability of those efforts are dependent on humanitarian agencies ensuring that personnel following continue with the work started –  it is too easy for the focus and efforts to be lost if the commitment is personnel dependent.  Affirmative recruitment for LGBTIQ+ issues needs to be in place as programmes are developed to create institutional history as opposed to incumbent interest.  This goes hand in hand with organisations mainstreaming LGBTIQ+ issues and needs in directives, manuals, guides, and Standard Operating Procedures (SOPs) for both emergency and other interventions.

The webinar provided our course community with a safe space to jointly reflect and self-reflect about humanitarian actors’ experience, roles and responsibilities in developing competent responses for LGBTIQ+ survivors in different humanitarian settings. While specific humanitarian guidance is increasingly being formulated to address the needs of these groups of survivors, the evidence base to inform responses in various sectors needs to further grow, as does creating continuous occasions for professional reflection, exchange and capacity building.

These reflections also point at ways in which our course “Addressing Sexual Violence in Conflict and Emergency Settings” could further develop meaningful language, content and partnership from a SOGIESC perspective, contributing to strengthening our students’ skills and competence to create intersectional survivor-centric responses that are safe and effective for a wide range of survivors and groups.

The authors

Casey O’Connor (she/her) has worked as project coordinator and other operations roles with Médecins Sans Frontières (MSF) projects since 2011.  Currently, Casey is the Project Lead for LGBTQI+ Inclusion in Health Projects TIC, a movement-wide initiative to reduce barriers to dignified care for LGBTQI+ patients.   She is also co-coordinator of MSF Rainbow Network, an internal network focused on support for MSF LGBQTI+ staff and the organization’s responsibility for duty of care. 

Colby Jeannine Fortin (any pronouns) is a fellow at Universitas Gadjah Mada in the Cross-Religious Cultural Studies and English Literature Departments. She recently served as the Save the Children US Miles-Mulcahy Gender Equality Fellow GBV specialist and has experience working with LGBTIQ+ populations as a sexual assault crisis counselor and consent and diversity educator. Colby has brought an LGBTIQ+ inclusive framework to these projects. Colby is especially interested in how legally marginalised LGBTIQ+ survivors can access post-GBV care outside conventional justice systems that criminalise them through democratised art.

Henri Myrttinen (he/him) is a Lead Associate with Gender Associations International Consulting, and has over two decades of experience in working on issues of gender, peace and security, working for various NGOs, research institutes and as a consultant for international organisations. Much of his work has been in conflict-affected settings, including GBV prevention and response with a particular focus on transforming harmful gender norms and responding to the needs of LGBTIQ+ populations. He has published extensively and has a Ph.D. in Conflict Resolution and Peace Studies from the University of KwaZulu-Natal in South Africa.

Luise Jaehne (she/her) is a midwife who has been working with MSF since 2018 in the fields of Sexual and Reproductive Health (SRH) and Sexual and Gender-Based Violence (SGBV). Luise worked with queer survivors for the first time in early 2022 when working in Eastern Europe with MSF. Luise attended the “Addressing Sexual Violence in Conflict and Emergency Settings” Course in 2021.

Patricia Ollé Tejero (she/her) is Senior UN Programmes and Prevention Advisor at All Survivors Project (ASP). Since 2020 she has coordinated ASP’s work in Colombia where she engages with victim/survivor networks, LGBTI+ organisations and transitional justice mechanisms. She has also conducted research on sexual violence against LGBTI+ people in Colombia and other situations of conflict. Patricia is a current student in the “Addressing Sexual Violence in Conflict and Emergency Settings” Course.

Laura Pasquero (she/her) is the Director of the Course “Addressing Sexual Violence in Conflict and Emergency Settings” organised by the Geneva Centre of Humanitarian Studies.

The Alumni network of the Course “Addressing Sexual Violence in Conflict and Emergency Settings” includes students, former participants, teachers, partners and allies of the Course. The Network creates a space for reflection and ongoing peer learning, centering practitioners’ expertise and collaboration, and aiming to improve responses for survivors and their communities.

[1] Findings from this study will be published in an upcoming academic article.