For SOGI claimants, being accommodated in rural areas is especially diffcult due to their intersectional experiences of homophobia, racism and transphobia (Marlen, legal advisor; Mariya, NGO worker). However, being located in a town or city was no guarantee that claimants felt safe (Sect. 8.4). For instance, Lutfor (UK) experienced homophobia and racism in Manchester, hearing things like 'go back to your country' and 'look at the ugly fags'. Janelle (UK) talked about her experiences of transphobia on the streets of Sheffeld, which might not be separate from other forms of hate crime, as TGEU highlights:

While xenophobia, racism and Islamophobia are on the rise [in Europe], trans asylum seekers and refugees are even more vulnerable to discrimination or violence. (...) Trans asylum seekers and refugees often face intersectional discrimination on the basis of their gender identity and expression, gender, race or ethnicity, religious background, migrant status and perhaps other factors as well. (TGEU 2016, p. 8).

With regard to being accommodated in rural areas, we have focused on examples from Germany, as in Italy and the UK not many participants discussed this issue. In Italy, some NGO workers and lawyers mentioned the issue of SOGI claimants being accommodated in rural areas, like Anna (LGBTIQ+ group volunteer) who said that SOGI claimants 'are scattered, lost in places that are not accessible by public transport'. Being housed rurally was seen as problematic especially because of the diffculties of accessing LGBTIQ+ support and attending events (Anna, Antonella, and Jonathan, all LGBTIQ+ group volunteers; Livio, lawyer). It was generally seen as counter-productive for integration to accommodate claimants in rural areas: '[B]ecause many structures are completely isolated from society, so how can we involve migrants, integrate them if in a year they are dispersed in the mountains' (Susanna, social worker). A number of SOGI claimants told us that they were accommodated in small towns or villages (Diarra, Gbona, Ken, Kennedy, Odosa), and they briefy talked about issues such as not being able to access LGBTIQ+ events (Odosa, Italy) or organisations (Ken), and having poor mobile phone connections (Kennedy). However, they did not talk in depth about these experiences and some, like Diarra liked living in a small town.

In the UK, some claimants had been dispersed to smaller towns, but these generally had good transport links and therefore mobility and accessing LGBTIQ+ support and groups was not a signifcant issue. However, here we heard many accounts of homeless and destitution, to which we turn now.

#### **8.6 Homelessness and Destitution**

When we analysed our feldwork data, it was shocking to see how many of our participants had experienced homelessness during or after their asylum claims in the UK, where destitution can happen at four points for claimants:

on arrival, before making a claim; when they claim asylum and there are administrative errors and S95 [section 95 subsistence support] doesn't come through; during the application, when problems arise including trying to live on a very small S95 sum; and after the decision – even if it's positive, when support ends, but especially for people who are Appeal Rights Exhausted, the majority of whom become destitute (Gareth, consultant, UK).

For those who are classifed as Appeal Rights Exhausted (ARE) but remain in the UK, the risk of becoming destitute is high following the removal of section 4 support under the Immigration Act 2016. Research by the Refugee Council showed that a high number of those using their destitution services came from fve countries: Sudan/South Sudan, the Democratic Republic of Congo (DRC), Eritrea, Somalia and Zimbabwe. With the exception of DRC, homosexuality is illegal in all these countries (Ramón Mendos 2019; Refugee Council 2012). While issues of homelessness and exploitation are likely to be common to all asylum claimants, they take a specifc form for SOGI claimants. SOGI claimants who do fnd themselves ARE but stay in the UK are more likely than others to fnd it diffcult to seek support from families and community organisations, where they may experience discrimination. They may also be more vulnerable to sexual exploitation when they become destitute (Meggs, focus group no. 1, Manchester, UK; Melisa, NGO worker).

The participants who told us about their experiences with homelessness, stayed in different places over night. Selim slept a couple of nights in a cemetery; Mary and Zaro were homeless for 1 month and slept in a park in London; Meggs spent a night on a night bus, when she was evacuated from her accommodation. Lutfor was evicted from his house, after his claim was refused and before he submitted a fresh claim. He was homeless and slept in different parks; in 4 days he lost everything, including his papers. He talked about being out of place as an Asian person:

oh, I mean, it is a real experience when I was living in the street. I saw people around me who are homeless, nobody is Indian or Asian, and you know in homeless people they have a like, community like this, but I was outcast from this, so I was travelling on my own.

When he submitted his papers, he was allowed back into his old accommodation: 'Same house. When I was homeless my room was empty, but I don't know why they made me homeless. When I went to court appeal to London, they send me to the same home'.

Research on housing and homelessness experiences of LGBT people seeking asylum in 2009 found that SOGI asylum claimants were at a particular disadvantage, as 'most interviewees lived with people who would take them into their own accommodation on a rent-free basis, knowing their sexuality and often expecting sexual favours in return' (Bell and Hansen 2009, p. 16). Bell and Hansen's report (2009) demonstrates the importance of collecting data on homelessness from an intersectional perspective; however, there is no more recent research on LGBTIQ asylum claimants' and refugees' experiences of homelessness. A survey commissioned by The Guardian in 2017 found general high levels of destitution and homelessness among newly-recognised refugees, but did not discuss any SOGI-related experience (Refugee Council 2017). A report commissioned by the Metropolitan Community Church of North London (Dyck 2019, pp. 12, 48) touches upon housing issues, and especially SOGI claimants' fear of being 'outed' when staying with family or people who are not LGBTIQ+-affrming and potentially losing their accommodation.

As Melisa (NGO worker) explained, when SOGI claimants experience violence and harassment in asylum accommodation, they often prefer to leave their accommodation and be homeless, as they are afraid to report the abuse suffered and risk having to continue to live in the same accommodation if no action is taken to address the issues. People may also be afraid to report to the police because of their experiences in their country of origin (also Sabrina, NGO worker, Germany).  In terms of women, we have seen a lot of domestic servitude, where LGBT women are looking after children, doing domestic chores, and just for a roof over their head. Sometimes they are given a little bit of money but sometimes they are not (Melisa, NGO worker).

SOGI claimants may be afraid to access general housing charities, where they would have to disclose their sexuality or be worried that they would have to share accommodation with people who are homophobic (Debbie, NGO worker). Trans claimant Amber was homeless for two-and-a-half months after falling out with their ex-boyfriend. They slept at friends, strangers, moved around, and sometimes did not even have a blanket: 'I did get involved with sex work and asked strangers for money to help me get by, it was one of the darkest time in my life if I'm honest'. Kamel (Italy) also risked being homeless because, as a trans claimant, accommodation centres based on a binary ratio were not able to ft them in.

Irma (UK) had to leave NASS accommodation and became homeless because her benefts had been cut and she received a letter ordering her to move out: 'I was crying. Nowhere to go. It was hard. And it is a journey'. Before becoming homeless, Lutfor lived in a houseshare without paying rent, and cooked and cleaned for his housemates in exchange for board and lodging, explaining that 'sometimes we can even offer our services for free, just so that we can get accommodation' (focus group 6, Manchester). Sadia (UK) lived in someone's garden house and did housework for them and looked after their children.

Meggs (focus group no. 1, Manchester, UK) talked to other young bisexual and lesbian women in preparation for a conference presentation she was giving on the topic and was shocked to hear about their experiences of destitution:

And in those cases, on the refusals the judge will have clearly said, "I believe she has been raped", "I believe she is HIV+", it is sensitive issues that they believe on, but still they kick that kind of a person out of the accommodation.

Women would often end up in abusive relationships 'because you have got nowhere to go, you just have to put your head down and just go along with everything they do' (Meggs, focus group no. 1, Manchester; see also Chap. 9). Many other participants in the UK would have ended up homeless, and in potentially exploitative situations, if they had not received help from friends and LGBTIQ+ or LGBTIQ+ friendly organisations (Diamond, Ibrahim A., Edith, Miria, Martin, Jayne, Ximena, Stephina).

One of the key triggers for destitution is the transition period, after people are granted international protection: 'So, on the Monday you get your letter from the Home Offce saying you have been granted leave to remain. On the Tuesday you have a party, a month later you are homeless' (Oliver, NGO worker). In fact, for many of our participants, issues with accommodation and homelessness were not resolved once they received refugee status, but in some cases, were made worse, as we now discuss.

#### **8.7 Housing After the Asylum Claim Process**

Most research on SOGI asylum focuses on the time during the asylum process, but it is also important to look at what happens when SOGI claimants are fnished with their asylum claims. In all three countries life is not necessarily becoming easier after the asylum claim.

In Germany, the social isolation that SOGI claimants face during the asylum process often continues after their claims have been successful due to the residence obligation legislation (Sect. 8.2). The requirement to stay in the same municipality where the claim was processed (as it is the case in some federal states) is especially

diffcult for SOGI refugees (Marlen, legal advisor). As Noah (NGO social worker) described: 'I do not want to live in [town x] as a gay man. I would perish there. There is nothing there'. Again, under special circumstances, people can request permission to move to a different area. For instance, at the time of the interview, Bebars, a trans claimant with refugee status, had been waiting for 4 months to receive a response to his relocation request. He regularly had to travel almost 3 h to see his doctor (for hormone treatment, etc.), who was based in the city where he would like to move to. He had also signed up for a German language class where he lived, but had been waiting for almost a year and still had not been given a place.

The downside of living in larger cities however is that it is generally diffcult for anyone to fnd affordable and acceptable housing, but SOGI refugees face multiple layers of discrimination in the housing market (Frank S., legal advisor; Diana, Ibrahim, Milad, Zouhair). They may have to stay in asylum accommodation for years (Ibrahim), if they do not fnd alternative accommodation, and there is often no social housing available (Finn, representative of a German municipality). In addition, council housing is tied to the legally established rental levels ('Mietspiegel'), but property owners often request more for their fats (Juliane, public offcial).

While all refugees are likely to face discrimination, for SOGI refugees there are often additional issues, for instance if they are visibly trans (Frank S., legal advisor), or when 'there is a mismatch' between their gender expression and their ID document, thus trans refugees face more challenges than other refugees, or other trans people, when trying to fnd housing because of the intersection of their gender, their legal status, their race, ethnicity or religion (TGEU 2016, p. 10).

Diana was looking for a fat in Berlin for about 7 months after being granted international protection. She said that there were always around 40 people at the fat viewings and 'obviously Germans were in front'. When she fnally found a fat, she told us it was because she had an advantage, as the estate agent was a lesbian. In larger and more expensive German cities, the situation is particularly diffcult, as 'the housing market looks very bad anyway and obviously refugees have no chance at all' (Thomas, NGO volunteer). As William described it:

we the people who are Black, it's very hard to get a house to stay. To the extent that when you get a house, an apartment up there, and the Markler [estate agent] tells the property owner that "you know what, the person who is coming to this house is a Black man, or a Black woman or a Black family", they say "eh, eh, eh, I don't have a house.

Mayi (focus group no. 4, Bavaria) also thought that once you have been granted international protection, 'you look for a room.  Then you can never get a house'. As Diana described, the situation is rendered more diffcult because refugees have a blue (rather than red) passport and only 3-year residence permit, and property owners are ignorant and fearful of this type of documentation.

There is a dearth of organisations specifcally tasked with helping (SOGI) refugees to fnd housing (Diana, Alphaeus, William), but the LGBTIQ+ community can sometimes help in this regard. Rainbow Refugees Munich have managed to get some of their members into housing through private contacts (Thomas, NGO volunteer).  Marhoon was lucky that when he received refugee status and collected his papers, the public authorities asked him where he wanted to live in the federal state, and he chose the biggest city in the state: 'I think maybe they know in the document that I'm gay and atheist, so they will not send me to a village'.

Houseshares are very common in Germany (called 'Wohngemeinschaft'). Halim, Alphaeus, Fares, Zouhair, Ahmed and Rolla (focus group no. 6, Lower Saxony) all lived in this type of accommodation. Yet, when people are severely traumatised, it is more diffcult for them to fnd a fat or a room in a houseshare, and they then need to stay in asylum accommodation, where they have to share rooms, for a long period, despite the likely negative impact on their mental health and recovery (Frank S., legal advisor).

In Italy, life after being granted international protection may be diffcult too. Limited support is provided to refugees unless they are accommodated through SPRAR. Some kind of support is sometimes granted in CAS accommodation, but this depends on the specifc CAS. Even when people are supported by SPRAR accommodation, it is not guaranteed that they will be able to fnd housing. For instance, Alain A. was moved to SPRAR after he was granted refugee status, but he was worried about fnding a place where to live: 'And I have seen so many people in the project and they leave, they don't have a place to stay and they stay on the street. And now, I am thinking like, when I leave, where will I go to'. He explained that SPRAR would cover the costs for initial accommodation, but people need to obtain a housing contract. He was worried that because he was so young, he would not be able to obtain one.

Those not moving into SPRAR accommodation on receiving status risk eviction from the reception centre irrespective of the availability of alternative accommodation. Usually claimants have 6 months from being granted international protection to look for alternative accommodation, but we also heard of occasions where claimants had to leave earlier. For instance, Just Me (focus group no. 3, northern Italy) had to leave the reception centre very suddenly:

I wasn't even told I am going to leave, it was just early in the morning, they came with the letter from the Questura [police local headquarters] say that I have to leave today, now. I have to take my bag and things. So strange. Yes, I wasn't informed maybe in three days' time you are going to leave, or I should know what to do. It was so sudden. (…) to say you have to leave the camp, you are going to the city, into the community, without no work, without no place to stay, with nothing, without not even money to even get support yourself or your wellbeing.

In addition, nobody informed Just Me that he could apply for a place at SPRAR. He added that he was 'strong enough not to force myself into doing something, into committing crime or going against the law. But it is not easy'. Once homeless, he tried to survive with the help of friends and his supporting group, and then lived on a farm, where he worked (focus group no. 3, northern Italy). During the focus group, his dire situation and the pain that he felt recounting this experience was evident. His eyes were empty and every word he pronounced was followed by silence. Everyone in the group was emotionally affected by his account.

Many claimants also thought that because of racism, it was more diffcult for refugees to fnd housing. Silver said that he would like to fnd a job and a room in a houseshare, but thought that this would be diffcult as a Black gay refugee:

I mean, if I were an Italian, when I see Blacks, maybe like they do things that are bad, maybe then I have to be afraid. I do the same. Whites think that Blacks are all the same, but it is not. There are Blacks who are better than others, but Italians think they are all the same.

Indeed, Giulia (LGBTIQ+ group volunteer) said that their organisation has witnessed 'many young people who have obtained the documents to whom nobody rents, even if they have a job, because they are Black'. Kamel also described how some private property owners said 'we rent to Italians' and 'only to Italians'. Cyrus (focus group no. 2, northern Italy) described accompanying a friend to rent housing, but the man who showed them the accommodation said to them 'the owner of the house told me not to give the house to foreigners, to Blacks, not to give the house to Blacks', which Cyrus promptly qualifed as discriminatory and abnormal.

In the UK, housing problems are not necessarily resolved when SOGI claimants are granted international protection. The transition period can be especially diffcult for claimants in the UK, who, as mentioned above, have only 28 days to leave their asylum accommodation. Debbie and Gary (NGO workers) explained that sometimes offcial documentation does not come through in time for the person to move to the general benefts system. There are other obstacles too, for instance, delays in issuing the UK identity card without which individuals cannot access housing and benefts. Refugees are likely to fnd it diffcult to rent accommodation in the private sector following the extension of immigration responsibilities to private landlords (Home Offce 2016). A survey by the Residential Landlords Association in 2018 found that 'half of landlords are now less likely to consider renting to someone without a British passport because of the government's Right to Rent policy' (Smith 2017). In March 2019, the UK High Court ruled that this legislation was incompatible with Article 14 read with Article 8 of the ECHR.13

When their asylum support stops many claimants become homeless and have to turn to friends and family – something which may be harder for SOGI minorities, leaving them more dependent on food banks and charities (Basedow and Doyle 2016, p. 43). Research with 50 lesbian and gay refugees in London and Manchester found the majority living below the poverty line (Micro Rainbow International 2013). Most reported feeling discriminated against on the basis of their sexual orientation both in their country of origin and the UK. The isolation resulting from being member of a sexual minority can lead to low self-esteem, depression or other mental health problems (Micro Rainbow International 2013). For many individuals:

<sup>13</sup>*R (Joint Council for the Welfare of Immigrants) Claimant and Secretary of State for the Home Department* [2019] EWHC 452 (Admin). Appeal against this decision was allowed in *The Secretary of State for the Home Department v R (on the application of) Joint Council for The Welfare of Immigrants* [2020] EWCA Civ 542 (21 April 2020).

the land of opportunity merely represents a downward social mobility ladder. It emerged from the study that often the material circumstances and conditions to live a "dignifed life" in the new country were far worse than those the refugee had in their country of origin (Micro Rainbow International 2013, p. 28).

The dispersal policy is also problematic here. SOGI claimants might have established social support networks and are then dispersed and moved away from that source of support: 'So you could end up being quite isolated in a small town somewhere just because of the vagaries of the system' (Gary, NGO worker). In addition, when applying for council housing in a particular area, people need to demonstrate ties to the community, but if they have only lived for 2 years in that area, they will not be eligible for council housing and will then need to fnd private accommodation (Melisa, NGO worker).

Thus, life does not necessarily become easier once SOGI claimants are granted international protection. Short timeframes to leave asylum accommodation makes life hard especially in Italy and the UK, while in all three countries they may face transphobia and racism on the housing market. Separate SOGI accommodation may help to make life a little easier for SOGI claimants, especially during, but also after the asylum process.

#### **8.8 SOGI Accommodation**

Because of the discrimination SOGI claimants experience in shared accommodation, most participants thought that '[t]o open centres for only LGBT community, it is one of the best ideas. Yes, it is one of the best ideas, because it is an environment where they will feel safe' (Alain A., Italy). In our European-wide survey for people who support SOGI claimants, 65% of the respondents considered the provision of separate accommodation for LGBTIQ+ people seeking asylum or who have been granted asylum to be a good idea (8% did not think so, and 27% were not sure). All three of our case countries have some LGBTIQ+ accommodation established, however limited, and some of our participants had experience of living in such type of accommodation (Michael, UK; Amber, UK; Mahmoud, Germany; Prince Emrah, Germany).

In Germany, since 2015 NGOs have put pressure on the federal governments to fund specifc LGBTIQ+ accommodation projects and in many cities such projects have been established. The largest of these is an LGBTIQ+ accommodation centre in Berlin, run by the NGO Schwulenberatung ('Gay Counsellling'), which accommodates 122 SOGI claimants (Nina, legal advisor). Other signifcant LGBTIQ+ accommodation centres are located in Dresden and Leipzig, which each accommodate approximately 100 SOGI claimants, and in Chemnitz, which accommodates approximately 80 SOGI claimants (Thomas, NGO volunteer). In other cities, such as Frankfurt am Main, Cologne and Hannover, there are either 'offcial' accommodation centres or beds in fats for SOGI asylum claimants, and in some other cities there are unoffcial arrangements to the same effect (Awadalla and Rajanayagam 2016; Benirschke 2016; Queer.de 2017; The Local 2016). In Cologne, SOGI claimants are seen as a vulnerable group and specifc fats are offered, accommodating 20–25 people in total (Ibrahim). Hannover accommodates nine SOGI claimants in smaller fats (Kadir, NGO worker; Matthias, social worker; Juliane, public offcial), and Frankfurt am Main has an accommodation centre for SOGI claimants that accommodates 21 SOGI claimants and with social workers based there (one fulltime equivalent, according to Knud, NGO worker). In some of these accommodation centres people need to share rooms (Berlin, Frankfurt am Main), and as participants argued, the aim should then be to move people on as quickly as possible into private accommodation, as shared accommodation, whoever one's room-mate, is 'just an extreme burden for all people and therefore also for LGBTI and maybe even in particular for LGBTI, having to share a room with people over such a long period of time' (Nina, legal advisor).

Specifc LGBTIQ+ accommodation was not supported in all federal states. For instance, the Bavarian government did not provide it. In Nuremberg, there was only a small amount of LGBTIQ+ accommodation (20 places), and the city of Munich had agreed to create 19 places for LGBTIQ+ claimants (in smaller fats), but had only made eight available at the time of our feldwork. This was a very small allocation in comparison to other federal states (Thomas, NGO volunteer).

However, claimants who had lived in SOGI accommodation facilities did not always have positive experiences. For instance, Prince Emrah (Germany) experienced physical violence in the SOGI accommodation centre in Berlin, and had their nose broken by another resident. They were critical of the LGBTIQ+ accommodation centre and said that while they had faced discrimination in the general accommodation centre, in the LGBTIQ+ centre it had been worse. Mahmoud had also lived in LGBTIQ+ accommodation for 18 months. He told us that he felt that not everyone there was a member of a SOGI minority, and that he had lots of problems with other residents (Awadalla and Rajanayagam 2016; Benirschke 2016; Queer.de 2017; The Local 2016).

Some participants favoured smaller LGBTIQ+-specifc accommodation, for example, fats or houseshares (Frank S., legal advisor; Kadir, NGO worker). This was the approach taken in Hannover and Cologne, where the 'idea was to have separate fats in the city, so they [residents] feel integrated, they feel they are in a home place, but they have social workers who always check up on them' (Ibrahim). And although in Germany we learned of many more SOGI asylum accommodation projects than in Italy and the UK, participants still felt that the LGBTIQ+ accommodation that existed was insuffcient.

In Italy, two reception projects specifcally for SOGI minorities have been developed by the two main Italian LGBTIQ+ NGOs. A proposal by the transgender organisation MIT – Movimento Identità Transessuale ('Transexual Identity Movement') has led to the opening of the frst facility for transgender asylum claimants and refugees in Italy (QMagazine 2017). The project 'Raise the Difference – Accogli la differenza' was funded by local and central authorities, including the national anti-discrimination offce (UNAR). MIT is in charge of the management of the centre and assists, together with the social cooperative Camelot, in hosting asylum claimants during and after the RSD procedure. While it is the frst European reception centre dedicated to people claiming asylum on grounds of their gender identity and is part of the SPRAR reception system, it does not seem to be permanent (its contract being regularly renewed on a temporary basis). Moreover, it can only host a few claimants and by no means meets the needs of trans claimants in the whole of Italy.14 The second SOGI accommodation project in Italy aims to open a reception facility based on collaboration between local authorities and the NGO Arcigay (national umbrella LGBTIQ+ rights platform). Apart from these two initiatives, there is a centre already open in the northern Italy, run by the social cooperative Kaleidoscop, but it caters only for gay men and is not reserved for those claiming international protection (it also hosts Italian gay men disowned by their families, for instance).15 Moreover, this centre too has limited capacity.

In the UK, in 2017 the NGO Micro Rainbow International opened its frst safe house for SOGI claimants and refugees in London, with a second safe house subsequently established in the West Midlands.16 The demand for this accommodation exceeds availability, and there is a waiting list. After being homeless for 2 months, Amber was offered a space at one of the Micro Rainbow accommodation facilities, 'where it's all safe and for the frst time in months I could inhale the air with a clear head, because it is with other LGBT asylum seekers and refugees and I don't have to worry about my safety anymore'. Melisa (NGO worker) talked about the importance of their accommodation for their clients. For instance, one of the clients who moved in told them that they 'can't believe I am in a space where I can fnally be free to be myself'. They also said that 'I couldn't sleep when I was there [previous accommodation], because the other person had the bed opposite and they kept wondering if they are going to wake up and attack them'. Melisa (NGO worker) explained that the organisation frst aimed for a larger accommodation facility, but smaller fats had the advantage that they were less visible.

In general, many of the asylum claimant and refugee participants were in favour of LGBTIQ+ specifc accommodation to feel safe and not have to hide their SOGI (Ham and Stephen, focus group no. 2, Bavaria, Germany; Ken, Kennedy, Odosa, Gbona, Buba, Moses, Mamaka, all in Italy; Nice guy, focus group no. 1, Italy), and many of the NGO workers were supportive of such projects (Antonella, Diego, Riccardo and Giulia, all LGBTIQ+ group volunteers, Italy; Mara, lawyer, Italy). As one survey respondent argued:

LGBTQI asylum seekers need to have a place where they can feel safe and supported; this is often not the case where they are placed in NASS housing, with potentially homophobic housemates, a situation which contributes to further stress and sometimes mental health problems (S130, LGBTIQ+ organisation member, UK).

<sup>14</sup>No offcial information is, however, available, due to the choice of the MIT – the association that manages this centre – to ensure the privacy of the guests (especially in light of the new political context).

<sup>15</sup>This information has been collected during a conversation with Giorgio Dell'Amico, SOGICA Advisory Board member, who has been directly involved in these projects.

<sup>16</sup> https://microrainbow.org/housing/.

Some participants argued that accommodation specifcally for trans claimants was also important (Celeste, social worker, Italy; Kamel, Italy). Kamel (Italy) felt that because of their heightened visibility, trans claimants are in particular need of separate accommodation:

It's something I often say – we trans people need a special structure for us. Not a male structure, not a feminine structure. I will not accept to ft into a feminine structure, but neither will I be in a male structure.

There was also some caution expressed that the visibility of larger LGBTIQ+ centres might increase the risk of violence, if homophobic or right-wing groups fnd out about their location (Maryia, NGO worker, Germany). In the focus group discussions we held, there were different opinions on LGBTIQ+ housing. While in some groups, participants cheered enthusiastically and applauded the idea (focus groups no. 3 and 4, Bavaria, Germany), or generally liked the idea (focus groups no. 2, 3 and 4, northern Italy), in others there was less consensus. For instance, in focus group no. 1 in Hesse, Germany, Emroy said that after having lived with three heterosexual men who would make homophobic comments, and worrying whether he would wake up the next day, he would be happy to live in LGBTIQ+ accommodation. For Sandy, in contrast, LGBTIQ+ housing was not so important; it was more important to be housed near LGBTIQ+ organisations, groups and people. In other focus groups, it was also argued that the visibility of LGBTIQ+ accommodation centres may make them unsafe (focus group no. 4, northern Italy; Nelo, Italy), and that it should not be mandatory for SOGI claimants to be separately housed (focus group no. 2, northern Italy).

As well as those who were undecided, there were also some voices against the creation of separate accommodation centres for SOGI claimants. For instance, for Siri (Italy) the need was not obvious, as in Italy, the same rules and regulations about how to behave apply to everyone. Giulio (LGBTIQ+ group volunteer, Italy) also argued that when there are problems in a reception centre, more work needs to be done in that centre. In his view, segregating SOGI claimants would also give a wrong impression: 'an LGBT person does not relate all his life with LGBT people'. He agreed that there needed to be accommodation for particular vulnerable claimants, but that this should focus on an 'all-round vulnerability... not only linked to being [a member of a] SOGI [minority]'. Silvana (judge, Italy) was also against the idea as 'it would ghettoise them'. Instead, there should be 'cultural mediators' in the centres, who 'are indispensable to try to mediate the differences that are still huge', not only in terms of SOGI but also in terms of religion, politics and other differences that occur between any individuals forced to share living space. Others saw the main problem as simply that of shared asylum accommodation: 'I think people whenever possible should get out of camps as soon as possible, because it's not good for people, it's a solution but it's a temporary solution, and it doesn't help people feel like their safety and individuality' (Halim, Germany).

 Yet, these spaces are not only sexualised but also gendered, racialised, classed, and so on, and

organisations providing SOGI housing often do not pay suffcient attention to the intersecting identities of the people living in these facilities.  These are also different people. Since we did not think about it in the beginning, that these are also different people from different countries of origin, what just connects them is that they are just gay, and they also handled it quite differently.

Some of the NGO workers we interviewed stressed the point that SOGI asylum claimants and refugees are not a homogenous group and that there are differences related to language, education, etc. Even having eight people living in a fat (like in Hannover) can be challenging, similarly to a student houseshare (Kadir, NGO worker). In other SOGI accommodation centres, it was also reported that people sometimes did not get on with each other. Louis (NGO volunteer) described potential tensions within the community of SOGI refugees – between gay men and trans people for instance, owing to preconceptions about gender roles. So, from an intersectional perspective, such differences between SOGI claimants need to be born in mind and duly considered. As in general, it '[d]epends on the situation; some feel safe[r] in separate housing some don't; it should be offered and then be up to the person' (S141, LGBTIQ+ organisation member, Germany).

Rather than establishing SOGI accommodation projects as akin to 'ghettos' (Chiara, NGO worker, Italy), some participants suggested establishing LGTIQ+ friendly, rather than LGBTIQ+ accommodation (Nicola, LGBTIQ+ group volunteer, Italy). Some participants preferred mixed accommodation to help SOGI claimants integrate with wider society (Celeste, social worker, Italy; Marhoon, Germany; Nicola, LGBTIQ+ group volunteer, Italy; William, Germany), or suggested LGBTIQ+ accommodation as only a short-term or temporary measure (Alphaeus, Germany; Halim, Germany; Mariya, NGO worker, Germany). In fact, the LGBTIQ+ accommodation centre in Berlin was intended as just such a temporary solution for claimants in the asylum process, but became a longer-term solution for individuals unable to fnd move-on accommodation or needing continuing social and psychological support (Nina, legal advisor, Germany).

Focus group no. 5 in southern Italy began with members agreeing with the idea of LGBTIQ+ accommodation centres, but concerns developed, with some even arguing that such provision would constitute discrimination:

Alain B: It's not good.

Dev: It's discrimination.

Although not everyone was in favour of specifc LGBTIQ+ accommodation, the majority of our participants felt that the current provisions that exist were not suffcient. Like any other LGBTIQ+ space, the construction of these spaces is on the basis of a shared sexual identity and can foster certain forms of homonormativity. We now look at very different kinds of spaces, namely spaces of incarceration, and how these were experienced by our participants.

#### **8.9 Detention**

As we have addressed in Chaps. 4 and 5, questions of vulnerability are paramount when looking at issues of detention. In our survey, 23% of SOGI claimants were detained; 15% for less than a month and 8% for more than 6 months. There were stark differences with regard to the experiences of detention in the three case countries. This is no surprise as Germany and Italy are both bound by the current Reception directive, which restricts the use of detention, while the UK is bound by the original Reception directive, which does not refer to detention (Chap. 4).

As discussed in Chap. 4, detention is not a signifcant issue in Italy except for the situation of 'irregular migrants' in centres of identifcation and expulsion. Similarly, in Germany, detention is not a widespread practice, only affecting a very limited number of asylum claimants. Amongst our participants in Germany, only a few people had had experiences of detention (Emroy, Junior and Sandy, focus group no. 1, Hesse; Angel; Shany; Trudy Ann), and in most cases they were detained only briefy at the time of their arrival. One of these participants was from Morocco, and the others were from Jamaica. The maximum time someone had spent in detention was 2 weeks. While most participants did not have positive experiences of accommodation overall, those participants who had been detained were positive about the conditions and the staff in detention centres. For instance, Angel was detained for a week at Frankfurt airport after she arrived, and astonishingly she described this experience as the best she had with regard to living conditions:

Since I've been here the best living condition was Frankfurt, even though that was the detention centre. And yet, still, that was the cleanest, the most, under the circumstances, the most comfortable, the most liveable, everything. Even though you couldn't go out on the road and see people.

This was confrmed by other participants who had had similar experiences (focus group no. 1, Hesse). Junior – who stayed in the detention centre in Frankfurt airport for about 2 weeks (sharing a room with other gay men) – said that whereas he felt safe and 'there were people there who protected me and everything', this changed once he arrived at the reception centre, where 'it was like, no-one cares about me'. The difference was that in the detention centre there was a church group, security offcers and workers 'that treat us or treat me how I'm suppose... as a human, how I feel I'm supposed to be treated. So yes, I felt like I was safe'. Junior also felt that staff in the detention centres 'looked out' for gay people and protected them. Participants in the focus group agreed that they were well looked after in the detention centre, something that was not the case in subsequent accommodation facilities. Emroy told us he thought that if the security or police offcials from his detention centre had made the decision on his claim, he would have been granted international protection. Sandy had wanted to take the interpreter she had in the detention centre with her to the main interview, because the interpreter spoke:

perfect English, she explained everything to me and let me understand that, you know, "this is what we're going to do, this is what we want to know, you don't have to go into details, leave that for your big interview, just tell us your main reason why...". She was really nice.

Trudy Ann was in the same detention centre with her girlfriend for a week after they arrived: 'It was kind of okay, but worrying. Feel like a prisoner. But then we have to go through that process anyway'. Some of the other people in the centre 'would make up them faces' when they saw them, but a security person told her not to 'pay them any mind because [in] Germany [being LGBTIQ+] is not taboo'.

In the UK, detention is far more widespread than in Germany or Italy. Moreover, the treatment of immigration detainees in general has long been a concern, also gaining media attention.17 For instance, an undercover documentary in 2015 by Channel 4 News highlighted the mistreatment of women detainees at Yarl's Wood and staff referring to them as 'animals', 'beasties' and 'b\*\*ches' (Channel 4 News 2015). The UN special rapporteur on violence against women was refused entry to Yarl's Wood in 2014.18 In 2018, a BBC Panorama programme revealed malpractice and abuse by staff at Brook House, a centre run by G4S (Shaw 2018). Crucially, in 2018, the High Court found that some conditions at Brook House did not comply with the Equality Act 2010 or the ECHR.19 The account of one of our survey respondents illustrates this mistreatment:

This was my worst nightmare. At frst I was in [an] open dormitory with about 50 people. Just like beds in [a] hall. Then taken to another detention. To be honest I really don't want to talk about it. I was told to take off my clothes to be checked. I remained totally naked (C59, UK).

There have been concerns about 'vulnerable' detainees in particular. In 2008, the Independent Asylum Commission expressed concern that 'LGBT detainees are not adequately protected in detention' (Independent Asylum Commission 2008, p. 84). The Shaw report on the welfare of vulnerable people in detention was commissioned by the then Home Secretary Theresa May and published in 2016. Replies to Freedom of Information requests in 2016 showed that a minimum of 76 SOGI asylum claimants were detained throughout the UK between 1 January and 18

<sup>17</sup> In 2008, the Independent Asylum Commission expressed concern that 'LGBT detainees are not adequately protected in detention' (2008, p. 84).

<sup>18</sup>See Parliamentary Question on 6 May 2014 by Lord Ramsbotham asking 'why the United Nations special rapporteur on violence against women was refused access to Yarl's Wood immigration detention centre while on an offcial visit to the United Kingdom.' The Government's answer was that the visit 'was never agreed as part of this fact-fnding mission' (House of Lords 2014).

<sup>19</sup>*Hussein v Secretary of State for the Home Department & Anor* [2018] EWHC 213.

November 2016 (UK Parliament 2017). Lesbian women and transgender people appear particularly vulnerable to mistreatment in detention. It has been estimated that 340 lesbian women are detained each year (House of Commons et al. 2015). Yet, while the Shaw report highlighted instances of bullying and harassment of LGBT detainees, it recommended only that 'transsexual people should be presumed unsuitable for detention' (Shaw 2016, p. 194). Moreover, as discussed in Chap. 4, there are acknowledged inconsistencies in the way the term vulnerability is understood and used.

Research by UKLGIG and Stonewall also found that 'LGBT asylum seekers face discrimination and harassment in detention centres' and that '[t]rans asylum seekers face particular threats of violence in detention' (Stonewall and UKLGIG 2016, p. 8). This is the case in particular when they are placed in detention centres that do not relate to their gender identity but the sex on their passport. As Zadeh (2019) argues: 'Detention centres are possibly the most dangerous places in the country for LGBT+ people'.

Allan, a lawyer, pointed out that SOGI claimants do not only face homophobic abuse in detention, but their vulnerability also makes it more diffcult to work on their claim, for instance if they 'are worried about a fax from UKLGIG coming in'. Preparation for their cases is also more diffcult: phone and internet access is limited, many websites are blocked in detention centres, and the remote location of the centres means that detainees often cannot get support to retrieve the evidence that they may need (Singer 2019, p. 11; Stonewall and UKLGIG 2016, p. 25).

Often the lawyers assigned to SOGI claimants in detention (if they do not already have one) may not have experience with SOGI cases or have limited time available to prepare often complex cases (Stephina). While SGW (focus group no. 4, London) was in detention, her solicitor dropped her case. She said he told her that 'he can't do anything else'. She told us:

All that was going in my head was deportation, that was what I was thinking, because I think a few weeks after I got there, there was a charter fight and I just saw how many women were taken out and deported and I just thought that would be me. So, it was, it was, it was hard, it was very painful, and I had now realised that I was getting more depressed the way I got in, but what else can you do.

She was not able to fnd another solicitor, so she 'ended up having to be in the detention centre sitting before a judge, with my little paperwork, you know'. She felt that this situation 'has progressively gotten worse now with the strains with the legal aid. So that is a big problem'.

Nine of our asylum claimant and refugee participants in the UK spoke of their direct experiences with detention (Irma, Lubwa, Luc, Lutfor, Miria, Patti, SGW, Stephina, Wabz), and there may have been others who did not talk about it in our interviews with them. Several NGO participants also talked about their examples of clients being detained (Chloe; Amelia; Ashley; Oliver). We heard that people were detained for variable but often considerable periods, ranging from 1 week (Miria) to a shocking 32 months (Luc). The duration of detention is not surprising, as the UK is the only country in the EU that does not have a time limit on detention (Chap. 4).

Yet, as NGO worker Oliver told us, it is not always clear what the reasons are for detaining someone. He always assumed that the decision to detain somebody was based on the potential risk of absconding, but then witnessed examples of 'inappropriate use of detention', for instance, when one woman seemed to have been detained purely for the purpose of collecting proof of her nationality and issuing her with a travel document (even though she was released afterwards): 'I don't know what that was about'.

Lutfor thought that LGBTIQ+ people should not be detained, as they have faced 'too much violence for their sexuality'. Because of the fears they have around their sexual orientation, and the diffculties of talking about it, they should instead be offered counselling. When Lutfor applied for asylum, he found that he 'was not welcome at all', but instead treated 'like a criminal' and put into detention. His lawyer made an application for bail on the basis that he was vulnerable and 'fortunately they accepted the bail and they released me on like the next day'.

Hearing participants' accounts of detention raises questions about the kinds of 'abuse of the system' and 'risks to the public' invoked by the Home Offce to justify indefnite detention (Chap. 4). All nine UK participants who were detained were subsequently released with no explanation and proceeded with their asylum claims. Nor did the NGO workers we interviewed have any SOGI (or other) claimants who had been detained before being removed from the UK, though there were situations that came close: 'I have on a couple of occasions been on the phone to someone as they are boarding, being boarded on a plane, before the next injunction to get them off has come through' (Ashley, psychotherapist). Amelia (NGO worker) also had a similar experience:

I mean, certainly it has come very close sometimes, yes, there was quite a few members detained and a couple of members, you know, were very close to the plane… sort of booked on a fight and it has been right down to the wire a couple of times.

It is noticeable that most of the SOGI claimants we interviewed were supported by NGOs and, therefore, perhaps had a higher chance of being released from detention. Meggs told us that three women at the Lesbian Immigration Support Group (LISG) had been detained when they signed in with the authorities, as requested to do regularly and got support immediately:

So, unless the organisations that are out there know you are in there, then they will start to, to do the petition for you to fght for you, so that you can be released while you are waiting on your claim, then it helps a lot. But if no one knows anything about you, defnitely you are gone.

 Usually women were detained when they went to report at the Home Offce centre Dallas Court in Greater Manchester, which some were required to do every fortnight or every month and 'then the next time they go to Dallas Court to sign on and it is just, it just keeps that fear, all wrapped up'. This fear was described by Edith, who had not been detained, but said that she was 'afraid of being detained and because I have suffered even being in jail in Kenya, I don't like even going to Home Offce itself, it makes me sick'.

It is clear that the absence of a time limit for detention 'adds to the already traumatising experience of the government taking away your liberty' (Zadeh 2019). Even after their release, the experience of incarceration often continues to have a detrimental effect on claimants' physical and mental wellbeing (Zadeh 2019). Miria, who was detained in Yarl's Wood when she claimed asylum, does not remember much from her time in detention, only that she mostly stayed in her room and was comforted by a young woman who she met there. Even though she was detained for 'only' a week:

by that time when I got out of that detention, I was just touching the walls to walk, I couldn't manage to stand on my own, I was very weak, very sick, because I was not eating. I was not sleeping, so it wasn't, it was really, really bad time. It was really, really hard time for me.

As Meggs (focus group no. 1, Manchester), who had not been detained herself but had seen the effects on friends, explained:

So, they will be going through NHS counselling, maybe for the whole year or for two years and taking antidepressants, and all things like that, because of the tortures that they experienced back home. So, and then it becomes a process you slowly get to trust people (…). On First Wednesday [social support group in Manchester] sometimes, something about 80 or 60 of us were going to counselling. And then when you are up there, when you are trying to fnd your feet for your own health and beneft, then you get detained.   So that particular person has to start again, with the counselling, if she will ever recover, suicidal thoughts and all that.

Meggs also spoke about the irony of the government supporting SOGI claimants with their mental health by providing them free NHS counselling, while then destroying that mental health recovery work and worsening the trauma by detaining asylum claimants. As Lubwa (focus group no. 1, Manchester), who was detained for 2 months, explained:

I remember when I was in detention, like, I felt like I am being targeted for no reason and (…) my emotional state was so bad, like, and I wanted to like, you know, commit suicide and I said I wanted, I don't want to live anymore, I just want to like kill myself, and get away from it.

Lubwa did not understand why he had to be detained. He told us that his solicitor was convinced that Lubwa did not need to be in detention, and wrote to the Home Offce to say her client was vulnerable. Lubwa met all bail conditions (including a fnancial guarantor and accommodation), but offcials argued that he was likely to abscond, and it was only when a judge intervened that he was freed from detention:

At the end they have to give me bail, so all I wonder is why would you waste my two months inside, why? Because now I still go for counselling, because it is, it wasn't something good for me and, you know, you have got nightmares, you have got like, you know, it was bad experience over there and I feel like I was the one who faced torture and everything I faced, I faced like I was the victim of like torture back home as well, so as here, and why would you put me in prison. I wasn't a criminal, I have not done any crime, I was the one who was at risk.

Lutfor said he felt lucky because he was detained for only 26 days (as other people in detention had told him that people usually stay for 3 or 4 months before they even obtain legal advice) and he thought that the 'staff there who was working there, they were really nice (…) the detention, I don't know, it affected me somehow'. However, he told us that he had '[t]raumatic distress, I didn't want to go out, I don't want to talk to anyone. Then, after therapy, I went for therapy, counselling, then I found LGBT Foundation, I start to come here, talk to them, then I start to do voluntary works'. Recovering from a period in detention is clearly a long and arduous journey, which is added to a usually already diffcult set of mental and physical issues. This will be further explored in the next chapter.

#### **8.10 Concluding Remarks**

If we defne the 'right to adequate housing' as including respecting the dignity of the person and ensuring equality and non-discrimination (UNHCR 2013, sec. 1), then we can say that this right is not respected or implemented in all its dimensions when it comes to asylum accommodation for SOGI claimants in Germany, Italy and the UK. There are often poor material conditions in reception and accommodation centres and SOGI claimants have to live in accommodation and in areas where they experience homophobia, transphobia, racism and disablism, and at times intersecting discrimination.

There are no specifc policies relating to the accommodation of SOGI claimants in Germany, Italy or the UK. Yet all three countries have seen the establishment of LGBTIQ+ accommodation projects, however limited and whether managed by the state or NGOs or by a partnership of the two. Campaigns for LGBTIQ+ accommodation can be delicate and contentious, potentially reinforcing stereotypes that other (non-SOGI) asylum claimants are sexist and homophobic, feeding a homonationalist depiction of an LGBTIQ+-welcoming Europe (in contrast to homophobic countries of origin). This discourse risks homogenising both SOGI and non-SOGI claimants. Our theoretical and analytical frameworks, explored in Chap. 3, debunk such simplistic binaries, and many participants helped us gain a more sophisticated understanding of such complex realities.

While it is important to demonstrate the specifc needs of SOGI claimants in accommodation centres, and perhaps campaign for SOGI housing, from an intersectional perspective these needs should be assessed on an individual basis. It is important to avoid homonationalist discourses that depict (White) Western nations and people as liberated and gay-friendly and (non-White) non-Western nations and people as homophobic and transphobic. There is a danger that the struggles of LGBTIQ+ refugees are instrumentalised for racist discourses (Awadalla and Rajanayagam 2016). As Maryia (NGO worker, Germany) pointed out, simplistic distinctions between LGBTIQ+ refugees on the one hand, and homo and transphobic refugees on the other, do not correspond to reality:

Because I think it's a lot more complex and there are a lot of differences within very different social groups and other things like "race", class, education, health, all sorts of things play a role too, so for sure it is very important to talk about what kind of discrimination people experience among each other in the accommodation, but it is more important to look at how the society receives them, how it treats them, and what opportunities there are, so to speak, to start a new life.

We therefore rather want to consider asylum accommodation centres to be like many other spaces, namely heteronormatively structured. As geographers of sexualities have shown, everyday spaces (such as the street, the home, the workplace) are constituted as heterosexual through repetitive heterosexual performances (Bell and Valentine 1995; Johnston and Longhurst 2009; Valentine 1996; Chap. 3).

SOGI claimants may also have specifc needs because of other dimensions of their identity, such as religion (as in Marhoon's case, Germany) or disability (Betty, Germany). One claimant referred to 'being out of category' being LGBTIQ+ and also being a refugee (Zouhair, Germany). While SOGI claimants often experienced diffculties in their accommodation, they were also often lucky to have effective support structures in place (at least in urban areas). Many participants were helped by LGBTIQ+ organisations, for example, when they were homeless, or when they were harassed or victimised in their accommodation. Such practical and emotional support was indispensable to SOGI claimants' well-being. As has been highlighted, community support is invaluable to decrease isolation (TGEU 2016).

From our interviews, it also became clear that authorities (and housing providers) need greater awareness of and sensitivity to the housing needs of SOGI claimants, in particular the issues of where (and with whom) individuals are housed. Particularly in Germany, many of our participants experienced extreme social isolation, often accommodated in rural areas, where they encountered homophobia, transphobia and racism. The UNHCR 'Resettlement Assessment Tool' for LGBTI refugees describes that: 'In most cases, LGBTI refugees will gravitate towards major urban centers as they offer greater opportunities for social support networks, and more specifc resources. However, LGBTI refugees can be successfully resettled to more rural communities' (UNHCR 2013, p. 12). Our research shows that this is often diffcult, and all the LGBTIQ+ claimants and refugees we talked to, who were living in rural areas, were quite isolated and preferred to live in more urban areas. However, also cities can do more to 'foster cultures of diversity and inclusion', for instance through cultural festivals and neighbourhood gatherings (Ruckstuhl 2016, p. 5).

While NGOs campaign for LGBTIQ+ accommodation centres and generally smaller accommodation centres, some participants were concerned that the far right trends in Germany and Italy will not make things better, and reforms introduced in the meantime have indicated that such concerns are warranted. In Germany, as of January 2020, claimants have to stay for up to 24 months in 'arrival centres' in Bavaria, and this might become the case in other federal states. In Italy, support offered in accommodation during the asylum process is also likely to diminish with recent reforms only offering SPRAR accommodation to people who have been recognised refugee status. In the UK, we will have to see what impact Brexit will generally have on asylum policies.

We now turn to an analysis of the range of physical and mental health issues SOGI claimants face, as well as challenges they deal with in relation to work and education.

#### **References**

**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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## **Chapter 9 Health, Work and Education**

*You think I don't value what I lost, to come and start from zero? I went to school for ffteen years and I come here to kindergarten here in Deutschland?*

(William, Germany)

*[s]ome people go to bed for money, you know those kind of people, they want to eat and they need house, you understand.* (Edoardo, focus group no. 3, northern Italy)

*I know that self-medicating is not illegal but there are risks to it, but as long as you know what you're taking and confdent enough which I am, go for it. I have some complications with it in the past, but I need to keep going as it's good for my mental health and it alleviates my gender dysphoria massively.* (Amber, UK)

#### **9.1 Introduction**

In this chapter, we look at the experiences of SOGI minorities who are claiming asylum or who have reached the end of the asylum process in relation to health, work and education. We defne these three spheres broadly, including, for example, volunteering and impacts from having experienced sexual violence torture, as well as sex work. Ostensibly, LGBTIQ+ asylum claimants experience the same diffculties in applying for work and accessing health and education as most other asylum claimants. In reality, this is not always the case. Here, referring back to our theoretical underpinnings, including intersectionality, highlights some particular areas of need, in many cases relating to the discrimination they encounter on the basis of SOGI in addition to other characteristics. As with the previous chapter, we again show that SOGI minorities encounter particular problems outside the legal asylum process as well as within it.

To provide some context, we frst briefy outline the international legal framework relating to the needs and entitlements discussed in this chapter, developing the contours of international protection that were identifed in Chap. 4. While the 1951 Refugee Convention defnes employment and educational entitlements for refugees (Articles 17–19 and 22), it does not address the rights of individuals while their claim is being assessed. Here, the main reference is the recast 2011 Reception Directive and in the case of the UK, the 2003 Reception Directive, underpinned by the ECHR and the CFR, as well as other international human rights treaties and domestic laws, all of which may complement or exist in tension or confict with one another (Chap. 4).

During the period that individuals are claiming asylum, the recast Reception Directive requires member states to: provide education to children in line with that of nationals (Article 14); grant access to employment within nine months from the date of application for protection with some qualifcations, including that member states may prioritise citizens and nationals (Article 15); and offer emergency healthcare and treatment for 'serious mental disorders' (Article 19). General provisions also require member states to consider the specifc needs of vulnerable persons, including those 'who have been subjected to torture, rape or other serious forms of psychological, physical or sexual violence…' (Article 21), and to assess whether claimants have such 'special reception needs' (Article 22) (Chap. 5).

While all three of our case study countries have some version of a welfare state system (Ferrera et al. 2013; Kennett and Lendvai-Bainton 2017), they also all have legislation and regulations in place controlling access to healthcare, employment and further education based on immigration status (European Commission 2020). Full discussion of these is beyond the scope of this chapter, although some details will be mentioned below. However, it is important to keep sight of the fundamental rights relating to health, employment and education under the ECHR and wider IHRL that all individuals are entitled to on a non-discriminatory basis (UNHCR 2020). We emphasise this universality precisely because of the failure to apply 'every day' human rights instruments to asylum claimants and refugees. Indeed, there are many international instruments that do not distinguish between citizens, nationals, asylum claimants and refugees and, when considering access to health, work and education, these need to be better recognised and vindicated.

In Sect. 9.2, we discuss health, beginning with access to healthcare and continuing to consider access to specialist treatment, where the needs of transgender people were clearly a particular concern, as well as those with HIV support requirements.  We then identify some of the specifc mental health issues that we heard about from our participants. Section 9.3 discusses work and defnes it broadly to include voluntary work and community involvement (Section 9.3.2) as well as sex work and the sexual exploitation some of our participants experienced (Section 9.3.3). We also look at other kinds of exploitation that our participants encountered. The chapter concludes with a short discussion about education and training where there were relatively few SOGI-specifc concerns compared to other areas.

#### **9.2 Physical and Mental Health**

#### *9.2.1 Access to Healthcare*

We begin by considering the access to basic health care by SOGI minorities claiming asylum which, of course, is the same as that of any claimant. Health entitlements for asylum claimants and refugees vary between and within the countries under comparison.

In Germany, asylum claimants have only restricted access to healthcare, defned as 'necessary medical and dental treatment' for 'acute illnesses and pain conditions'.1 As the law is not clearly defned, health professionals and local authorities have some leeway; however, the main obstacle is the need for asylum claimants in many municipalities, but not all, to secure a health insurance voucher – 'Krankenschein' – from social welfare offces, something that is diffcult for people accommodated in rural areas. Those without a voucher are likely to encounter delays in health provision, and may even be refused treatment (ECRE, AIDA & Asyl und Migration 2019, pp. 85–86). In Italy, asylum claimants and benefciaries of international protection must register with the National Health Service and should then enjoy the same treatment as Italian citizens. On registration, asylum claimants receive a European Health Insurance Card, but delays and obstacles to issuing this have been aggravated by the 2018 asylum reform (ECRE, AIDA & ASGI 2019, p. 104). In the UK, asylum claimants are entitled to register with a medical General Practitioner (GP) and receive free hospital treatment; however, individuals often experience diffculty in accessing these healthcare entitlements (ECRE, AIDA & Refugee Council 2019, pp. 74–75; EHRC 2019).

Reception service-providers may be charged with responsibility for informing asylum claimants about their health entitlements and putting them in contact with doctors and other health services. This form of support also took place in the CAS and SPRAR centres in Italy, prior to the reforms restricting access to healthcare benefciaries of international protection (ECRE, AIDA & ASGI 2019, p. 80). In the UK, the companies contracted to provide accommodation for asylum claimants (Serco, Mears Group and Clearsprings) are also responsible for supporting individuals through the asylum system, including explaining how to register with a local doctor and access other National Health Service (NHS) treatment (ECRE, AIDA & Refugee Council 2019, p. 58).

Nonetheless, in all three countries under comparison, access to healthcare is reported as inconsistent from one location to another. In Germany, there is a health insurance card scheme but it has only been implemented in some municipalities (ECRE, AIDA & Asyl und Migration 2019, p. 85). In Italy, practices vary throughout the country and from one reception centre to another; for example, exemptions from medical charges are reportedly not applied in Lazio, Veneto and Tuscany in the same way as in Piedmont and Lombardy (ECRE, AIDA & ASGI 2019, p. 105). In

<sup>1</sup> §4 of Asylbewerberleistungsgesetz (AsylbLG, Asylum Seekers Benefts Act).

the UK, charges for those without leave to remain were introduced in April 2015 (ECRE, AIDA & Refugee Council 2019, pp. 75–76). Not only does the UK government's policy of dispersal of asylum claimants disrupt continuity in healthcare (EHRC 2019, p. 7), but there are also national differences: in Scotland, all asylum claimants, including those whose claims have been refused, are entitled to full free healthcare, while in England, free hospital treatment is theoretically not available to asylum claimants who are not receiving benefts (Piwowarczyk et al. 2017).

In all countries under comparison, regional differences, language barriers, repeated changes in entitlements and lack of awareness by both providers and receivers of healthcare are reasons why many refugees and asylum claimants are unable to access the healthcare they need, particularly given that asylum claimants often experience poverty to a degree that damages their health (EHRC 2018). Yet, SOGI minority individuals face some particular obstacles. There is not as much understanding of these obstacles as is needed – research on the physical and mental health of SOGI minorities rarely addresses asylum, while research on the health of migrants and refugees rarely covers SOGI issues (Ohonba 2017, p. 1; Piwowarczyk et al. 2017, p. 724).

In a rare piece of research concentrating on the health of SOGI asylum claimants, the UNHCR identifed '(p)rejudicial health care and lack of access to HIV prevention and treatment' as particular concerns, and also pointed out that '(t)ransgender individuals often do not have access to the treatment they need, including transitionrelated care' (UNHCR 2013, p. 4). The particular problems in the area of health for SOGI claimants that arose in our research related to: trans people's healthcare needs (Sect. 9.2.2); torture diagnosis and treatment (Sect. 9.2.3); and mental health (Sect. 9.2.4).  HIV status was also a factor highlighted by participants, though not necessarily in the context of lack of provision in the host country.

#### *9.2.2 Access to Specialist Treatment*

Problems of access to appropriate healthcare were most evident for transgender participants in our research, corresponding to reports by NGOs (Action for Trans Health 2015). Delays in obtaining the documents necessary to access treatment are a particular problem for transgender people who may have started or wish to start regular hormone treatment. Furthermore, '[w]orryingly the immigration detention centre protocols do not explicitly mandate access to hormones and other transition related healthcare' (Action for Trans Health 2015). Transgender Europe also points out that:

Many trans refugees are likely to have already started HRT [hormone replacement therapy] before arriving in Europe, either under medical supervision or by self-medicating using hormones purchased through the black market. (…) Interrupting hormone intake can have serious consequences and is by defnition a decision to be taken by the individual concerned,

#### 9.2 Physical and Mental Health

on medical advice. (…) The continuation of HRT and all necessary monitoring is therefore essential to ensure the health and wellbeing of trans asylum seekers and mitigate against the risks of self-medication (TGEU 2018).

In addition, and in particular for trans people who are detained in Immigration Removal Centres in the UK, there are often defciencies in access and provision:

The protocol allows trans people in detention centres to wear wigs, packers, binders, and breast-forms. Unlike the protocol for UK prisoners, these do not have to be provided by the institution, so it is likely that many trans detainees will be forced to make do with makeshift equipment/prosthetics (Action for Trans Health 2015).

Participants in all countries highlighted diffculties in access to and continuity of hormone treatment. In Germany, there are daunting complexities for trans people claiming asylum and trying to access treatment that is designed for German citizens. The provision of only basic healthcare is a 'bitter' problem for people who have had hormone treatment in their country of origin or transit and are unable to continue with it in Germany (Noah, NGO social worker). Furthermore, medical practitioners and NGO workers struggle to provide support in specialist areas, especially when there are also language and cultural barriers (Leon, NGO worker).

Even when individuals are granted refugee status, 'it remains a common struggle to wrest these funds from the health insurance funds and fnd doctors who follow this path' (Noah, NGO social worker). One individual, Bebars, was told by his doctor that health insurance would not continue to cover his hormone treatment, because he had not received suffcient psychotherapeutic care; he needed to see a psychotherapist for three months, otherwise he would need to pay for treatment himself. Surgery for gender reassignment is covered through health insurance only after completion of a year and a half of psychotherapy (Nina, legal advisor). People who had come to Germany via Turkey are often particularly affected:

They come here, they stop their hormone process. It is easy for them to have it in Turkey, you just directly go to the pharmacy. You can directly have your hormones. It's not like here, where it's a procedure. As a result of this and other reasons, we heard of people choosing to go back to Turkey (Ibrahim, Germany).

In Italy, access and cost were also concerns, as were regional variations. Whereas in Emilia Romagna treatment was free:

in Sicily, in Calabria, Naples, in Milan, they pay. Not only the ticket to visit and do the analysis, but also the hormones. And hormones are expensive! For example, if we talk about Nibido, which is a drug for testosterone, hormones that trans FtM take every three months, with the safety of the endocrinologist, I mean, it even reaches 150–200 euros! (Kamel, Italy).

As a result, Kamel, a transgender claimant, was no longer receiving the medical supervision he needed for hormone treatment, had heart problems and his weight had reached almost 100 kg. He pointed out that '[a] refugee who escaped from war or from any other country is stressed and suffers… he's not a prince charming who comes with a bag full of money'.

#### Amber had started transitioning before she came to the UK:

and then for the whole two months when I was homeless, I couldn't get any bridging hormones because my pills has run out. I didn't bring enough, because I didn't have time to get that from Malaysia before I fy. So the whole two months, I was really struggling on how to, what do I do, because I had no pills and my body is going backwards now. Because I made the decision to transition because it was either transitioning or, or I would kill myself.

GPs are advised to collaborate with a Gender Identity Clinic (GIC) to provide 'effective and timely' treatment for trans patients. They may provide bridging prescriptions, which are 'intended to mitigate a risk of self-harm or suicide' (General Medical Council 2020). However, in 2019 it was reported that 'GPs are facing increasing diffculties addressing patient requests for "bridging" prescriptions, particularly for those patients who have self-started medication, including medication which they have procured over the internet'(General Medical Council 2020, p. 6). Trans asylum claimants are likely to feel the impact of this acutely, perhaps compounded by language and communication problems, disruptions in hormone treatment received in countries of passage, and dispersal to areas within the UK particularly lacking in expertise.

Amber's experience exemplifes the diffculties caused by frequent relocation in conjunction with inconsistencies in GP support. As she explained: 'You just have to hop [between] GPs if they aren't helpful, because it's up to them to prescribe this kind of hormones'. She had registered with a GP in Canterbury who had referred her to a Gender Identity Clinic (GIC), but she had not been prescribed any medication. Amber then moved to Croydon temporarily before moving on again to Essex, where she registered with another doctor. During this period, she had diffculty obtaining a prescription for bridging hormones and felt 'really stressed out and frustrated about how I was treated'.

Because accessing NHS treatment had been diffcult, Amber had been selfmedicating with supplies from friends:

I know that self-medicating is not illegal but there are risks to it, but as long as you know what you're taking and confdent enough, which I am, go for it. I have some complications with it in the past, but I need to keep going as it's good for my mental health and it alleviates my gender dysphoria massively.

Amber ended up resorting to private healthcare and explained she had been lucky enough to have friends willing to cover some of her medical costs. Registering with a private doctor cost Amber an initial set-up fee of GBP50, a monthly registration of GBP25, plus there were costs for prescribed medication. She was unable to afford initial counselling and, as she was already self-medicating, she knew what she wanted. Looking ahead, she was on the waiting list for treatment and intended to request removal of her Adam's apple and full body laser hair removal. Breast augmentation would need to be done privately.

The common experience for trans people was of inconsistences in access and provision within and between countries, meaning that individuals were dependent on luck in fnding individual doctors who would support them. Others resorted to non-regulated private sources and, for some, the lack of access to continuous

hormone treatment caused them to leave the EU (as we heard from Ibrahim, UK; Ximena, UK; Jules, staff member at ILGA-Europe).

While a greater number of our participants shared with us problems relating to hormone treatment, we also talked to several individuals with an HIV diagnosis, for whom access to medical treatment was also a priority and a cause of anxiety. As Susan (focus group no. 3, Bavaria, Germany) explained:

I don't have medicine, I don't have anything. They told me I have to go to some doctor. I went to that doctor. Doctor wants insurance. I have to come back to the same doctor. That doctor told me I have to wait. HIV, I have to take medicine every day. Every day! I don't have medicine, they told me I have to go. I walk, I walk, I walk… Whenever I go to the hospital they give me insurance for three months, so on 10th it's going to be the last insurance, if the government does not put meds on me.

HIV status was also a factor in some individuals' asylum claim. Diamond was studying hotel management in the UK and near completion of his course when he was diagnosed with HIV and found himself unable to cope with his studies:

But when I realised I am HIV [positive], I was scared because (…) I know now you need every six month or yearly to get a check-up what is your CD4 count viral and some point you need a medication even so what, defnitely the doctors and the people will come to know [if I returned to my country of origin], so that is why I decided to claim asylum in UK, so at least I can get a right here and I can continue with my studies and even medication I can get it, without any problems. Back home that is a really very big problem.

However, this was not enough to eliminate his fears about his future: he told us that when he returned home from the group he would have daydreams about people killing or beating him and was unable to sleep at night. The impact of trauma on people's mental health, including their ability to sleep, is something we look at again below.

#### *9.2.3 Experiences of Sexual Violence and Torture*

While statistics are not available, many asylum claimants experience sexual violence and torture as part of the experiences that lead to their fight. One study suggests that more than a quarter of 'forced migrants' in high-income countries are torture survivors (Sigvardsdotter et al. 2016, p. 47).2 There is also evidence of higher rates of sexual trauma among SOGI asylum claimants (Alessi et al. 2016; Hopkinson et al. 2017; Reading and Rubin 2011). Similarly, one small-scale study found that of 'the 61 LGBT asylum seekers identifed, 66% had experienced sexual violence as part of their persecution history' and there was a signifcantly higher incidence of suicidality among this group (Hopkinson et al. 2017, p. 1658). If torture is defned as broadly as it should be under Article 3 ECHR jurisprudence, then we would argue

<sup>2</sup>The target population for this review – forced migrants – was taken to include refugees, quota refugees, internally displaced persons (IDPs), persons under temporary protection, asylum claimants and people whose asylum claims were refused (Sigvardsdotter et al., 2016, p. 43).

that many more individuals from SOGI minorities claiming asylum should be recognised as having experienced torture or the threat of torture in the form of rape and other forms of sexual violence, beatings or in other ways than is the present case.

Our fndings confrm this body of literature. One survey respondent in Germany reported that '[m]y front teeth and right arm were broken and they hurt time to time' (C55). We heard about individuals surviving mock executions (Frank S., legal advisor, Germany). In Italy, NGO workers and volunteers have worked with children who had been raped (Chiara, NGO worker). In the UK, one participant told us he 'thanked God' that he had marks on his body from torture, as they had been the basis for a doctor providing verifcation of his trauma (focus group no. 1, Manchester, UK). The degrading expectation that asylum claimants display their scars to show credibility has already been discussed (Chap. 7).

While many asylum claimants experience torture, it came up repeatedly as part of SOGI asylum claimants' reasons for fight (Chap. 5). A policy worker with a mainstream refugee agency in the UK, when asked about the specifc needs and experiences of SOGI asylum claimants, said: 'maybe more people claiming on those grounds [have] experienced sexual violence and torture' (Eleanor, NGO worker).

Lesbian, bisexual and trans women claiming asylum and with refugee status in the UK told us of being raped, sometimes by family members:

[T]he whole community is mocking me, talking about me, you know, and some girls were even saying what kind of, because, everybody expects that when you get to a certain age as a girl you get married to man. So they would always mock me, like, what kind of man is going to want a girl that has been, you know, damaged by her father.

 Two women had had children as a result of being sexually abused, children who were either still in the country of origin or with them in the UK.

A UK barrister, speaking of her clients who were claiming asylum on SOGI grounds, told us: 'There is a signifcant proportion of people who have experienced torture. I cannot put a percentage on it, but it is signifcant' (Annabelle, barrister and NGO chair, UK). She connected this with the mental health problems that many of these individuals experienced:

In the many years of working in this feld, I have met only a couple of LGBTQI claimants who did not report at least some degree of mental ill health normally associated with their experiences in their country of origin, even where those do not amount to physical abuse (long term fear, isolation, discrimination...).

In the UK, medical professionals in NGOs such as Freedom from Torture and the Helen Bamber Foundation provide asylum claimants and refugees who have experienced torture, with expert counselling and, on the instruction of the legal representative, also write medico-legal reports for individuals to inform the decision-making process. However, as the demand for medico-legal reports and specialist therapeutic support is signifcant, there can be a long wait for the reports and, if the claimant does not qualify for legal aid, they may be unaffordable or unavailable to claimants – particularly at the initial decision-making stage:

Some lawyers will also be hesitant to arrange for these reports earlier than the appeal stage, because the Legal Aid Agency may refuse to grant funding on the basis that such move would be pre-emptive, that is, "why should we fund a report to prove your client's case, when there is no proof that the HO will refuse their claim?" (Mateo, solicitor and NGO worker, UK).

This contributes to unnecessary delays in the asylum process. Individuals who have experienced violence and sexual abuse in private, as is often the case in SOGI asylum claims, are unlikely to have documentary evidence to support their claim and then 'everything turns on their account which might be rejected for reasons of lack of coherence or consistency, which should be expected from a torture victim or a person suffering from poor mental health' (Annabelle, barrister and NGO chair, UK). Medico-legal reports will be particularly important in such cases, but as they are, usually only available at the appeal stage, it is likely that many strong claims for protection will initially be refused only to succeed on appeal when the critical medico-legal report has been provided. This extends the time decision-making takes from start to fnish, unnecessarily increasing the stress and diffculty for claimants, as well as the cost to the state. Moreover, the defnition of 'torture' used by some NGOs may not cover abuse at the hands of family members as often experienced by SOGI minorities (Freedom from Torture 2019).

There are also concerns that when they are commissioned, these reports are not recognised as authoritative in the way that they should be. Freedom from Torture is one organisation providing these services, and, as mentioned in Chap. 7, has highlighted strong concerns about the UK government's mishandling of medical evidence of torture. The organisation claims that the Home Offce Asylum Policy Instruction on how expert medical evidence should be treated is being ignored, that clinical expertise is questioned by untrained caseworkers, and that the wrong standard of proof is applied (Freedom from Torture 2016).

The services of organisations such as Freedom from Torture are not specifcally for SOGI minorities and the organisation does not monitor its clients on the basis of SOGI identity. Yet, another participant whose organisation provides medico-legal reports in cases of human rights abuse estimates that, of the organisation's clients, '[a]round 90% of females and more than 50% of males have been raped as part of what has happened to them, either during traffcking or in their home country' (Carl, doctor with an organisation providing medico-legal reports, UK). This is true regardless of SOGI. However, he also believes that a quarter of his and the organisation's clients are LGBTIQ+. While this is only one individual's estimate, it suggests that the problems that Freedom from Torture have identifed in relation to decisionmakers' misuse of medical evidence of torture have a strong signifcance for SOGI minorities seeking asylum, many of whom have experienced torture.

It is clear from our feldwork that SOGI minorities need both expert therapeutic care as torture survivors and medico-legal experts to provide evidence in their cases. While the above fndings from organisations providing medico-legal reports and

support to torture victims comes from the UK, the experiences of torture, violence and sexual violence were more widespread and came from participants and their supporters in all three countries (Chap. 5). This suggests that specialist support for LGBTIQ+ survivors of torture is a vital need. Yet, we found little such support in Germany or Italy, and in the UK demand outstrips supply, with one psychotherapist estimating that 'even when we were taking one new client [referring to general provision] every fortnight, we would be turning away eight others' (Ashley, psychotherapist). A similarly dire situation can be observed in relation to mental health, as we will now consider.

#### *9.2.4 Mental Health*

Asylum claimants, particularly those who have experienced sexual violence and torture, have a heightened risk of mental health problems such as PTSD, severe depression, isolation, and feelings such as shame and helplessness (Hopkinson et al. 2017; Longacre et al. 2012; Reading and Rubin 2011). For members of SOGI minorities, it has been suggested that the relationship between early victimisation and negative mental health outcomes may be more pronounced (Hopkinson et al. 2017, p. 1650).

The combination of persecution by family or community in their country of origin with alienation from diaspora communities in the host country means that SOGI claimants are likely to experience isolation, both voluntary and self-imposed isolation, as well as PTSD, depression and other mental health problems (Alessi and Kahn 2017; Hopkinson et al. 2017; Micro Rainbow International 2013, pp. 27–28; Shidlo and Ahola 2013; Tabak and Levitan 2013; UNHCR 2013). Sexual violence can cause feelings of self-blame and self-hatred (Women's Refugee Commission 2019). This research supports our fndings, where the most commonly recurring health needs in our study related to mental health. Mental and physical health problems relating to the persecution they had experienced or the process of claiming asylum were reported by 56% of the respondents in our claimants' survey. This is not surprising in the context of the experiences of some SOGI claimants: one anonymised medico-legal report we were given access to documented the physical evidence of torture experienced by a lesbian woman from an East African country. She had been raped at the age of 12, forced into marriage at 15, and she and her partner had had acid thrown at them alongside other attacks. The report documented evidence of PTSD, problems with 'intrusive memories and visual and tactile fashbacks to her adverse experiences, particularly the rape'. The report stated that '[s]he also displays evidence of depression and panic attacks, which are often found among survivors of torture and related abuses' (anonymised report from January 2019 provided by Carl, doctor with an organisation providing medico-legal reports, UK).

Such experiences of torture, violence and sexual abuse were connected to experiences of PTSD in the accounts we heard from asylum claimants and also from the NGOs and professionals working with or supporting them. Lutfor (UK) explained how having PTSD jeopardised his study plans, preventing him from going to college on the student visa that was how he originally entered the UK. Ximena (UK) also told us that:

I suffer about the post traumatic disorder, for all those things happening in my life. Sometime, when sometime I say when I remember all those things happening to me, I feel sad. Because I remember my friend, I would like they were here, but they pass away. They were killed just for being transgender woman. But I am trying to continue with my life.

Carl explained that '[p]atients [who have been tortured] often think they are going crazy. They need to be reassured that they are having a normal human reaction to an intolerable situation. That, for me, is what actually PTSD is'.

Many people described how they felt to us. For example, in Germany, Halim explained:

And it's not really visible, and people think that now because I'm traumatised I'm going to be sitting home crying all the time. I'm trying to function, however it really affects my ability, or has affected for me my ability to function for a long time. And when I think back about it, of course the frst year I was traumatised and it refected on my energy, my concentration in a lot of ways. Yeah, but people don't really understand this.

In Italy, we were told that '[a] lot of us have temporary madness, which can be treated, caused by the Sahara Desert [their route to Italy], temporary madness. It's not easy to watch your friends dying around, and they expect you to be normal' (Nice Guy, focus group no. 1, northern Italy).

Shame and guilt also featured in our participants' stories.  Shame is also the justifcation for the abuse she experienced. She told us of her father's violence towards her and her mother: 'and he told me "I don't want to have a son who will be a shame for me, for my last name.  He blamed Ximena's mother for raising a 'very feminine' son and asked Ximena to leave home when she was 14.

Most common were accounts of depression like Sandra's (Germany): 'I felt empty, defeated, lost, tired, very, very tired. I lost all the motivation and all the thinking that I had about life and what I wanted to achieve and everything'. Very often, people talked about their depression unprompted, for example when talking about being unable to work, which, according to one focus group participant makes you feel worthless 'and that messes with you mentally' (focus group no. 1, Hesse, Germany). Other people, like Christina, felt hopeless. They had suffered a great deal from depression since arriving in the UK. At one point, they said 'Iwas contemplating if I should go back home because they are going to send me home anyway and I might as well just do it and if I have to die, just die, I don't really care anymore, I was going through that whole depression'. We asked Christina if they had felt able to get support and they said:

To be honest, I am always the one who gives advice. I never get advice. So it was, for me it was really hard to open up to people and say: "Oh look, I am struggling mentally, I need help".

This shows how diffcult many people fnd it to be dependent, and to feel unable to control their own lives, a theme we analyse further in Chap. 10.

There were many accounts of the known symptoms of depression such as sleeplessness. Rosette (Germany) told us:

Most of the time I don't even sleep.  Why can't I enjoy my life (whispering, very upset).

Survey respondents reported similar experiences, such as this lesbian woman from Uganda who was appealing against her refusal in Germany:

I have developed a sickness mentally I think it's because of over thinking and I can no longer sleep. I have sleepless nights and am on drugs per now. If I don't take drugs I can't sleep (C44).

Sometimes, people were unable to sleep because of recurring fashbacks. Water, for example, was unable to fnd peace because 'if I am sleeping, I see the pictures of everything, you know' (focus group no. 4, northern Italy). Sometimes, sleeplessness was due to real and present fears.  He had developed agoraphobia and had panic attacks when he went out in public.

We heard many accounts of suicidal thoughts and behaviours from lawyers, NGO workers and claimants themselves (for example Ali, UK; Amber, UK; Sandra, Germany). This was often linked to the asylum process and was sparked by a refusal of the claim (Lutfor, UK; Sadia, UK). People who had been detained also talked about how these experiences contributed to suicidal feelings:

I remember when I was in detention like I felt like I am being targeted for no reason and like you know, my emotional state was so bad like and I wanted to like, you know, commit suicide and I said I wanted, I don't want to live anymore, I just want to like kill myself, and get away from it (Lubwa, focus group no. 1, Manchester, UK).

Avoiding public places and social engagement was another common symptom of depression for our participants, though often diffcult to separate from practical reasons for isolation such as the lack of accessible SOGI-friendly spaces (Chap. 8). Several people described staying in their rooms and doing nothing: 'Because I barely talk, I don't talk to people, I was just all alone. I could just sit in the room, all day long not coming out' (Just Me, focus group no. 3, northern Italy). Other examples were given by Halim (Germany), Sandra (Germany), Selim (UK), Meggs (focus group no. 1, Manchester, UK), and Joyce (focus group no. 5, Nottingham, UK).

The conditions in which people lived aggravated their mental health issues. Halim was in a reception camp in Germany:

I was having a very diffcult time of my life and I couldn't close the door and say I'm on my own now, I didn't have a chance to do that. So it was very hard, the system and the people treating you, it felt like part of a herd of people, so it just didn't feel… it was very bad for my mental health I was very depressed at the time.

Two further phenomena are important to note here. The frst is the impact of mental health and health factors on the asylum process. It is clear that the impact of suffering from PTSD or depression needs to be recognised by decision-makers. Research shows how trauma affects memory (Herlihy and Turner 2007). This was confrmed by our participants. While trying to secure documentation of mental health problems in advance of the asylum interview for people who are vulnerable, Chiara, an NGO worker in Italy, recognised that 'people can be in a confused state, they can be extremely, how can I say, inaccurate when you ask them questions about, say, particularly diffcult moments in life, so it is possible that there are contradictions'. As previous chapters have shown, it is diffcult for SOGI claimants to provide the evidence decision-makers require to be convinced they are 'genuine' – genuinely LGBTIQ+ and genuinely at risk of persecution (as discussed in Chap. 7). Being severely depressed or suffering from PTSD compounds the diffculty in presenting a convincing testimony:

You know, my mind was not working and I was, my mind was like pushing me to stand there and watch that thing. Nothing else I remember. But when we went for our interview, when I told them "look, I am not mentally fne, I know when we came here [UK], what happened to us, I can tell you, but few things I really don't remember". But they did not believe me (Mary, UK).

Mary's partner Zaro, jointly claiming with her, confrmed her account. In another case that illustrates insuffcient awareness of claimants' mental health issues, in one appeal hearing in the UK, the claimant's barrister told the judge of the claimant's longstanding depression and suicidal thoughts. The Home Offce presenting offcer acting for the Secretary of State subsequently said to the claimant: 'you said when [your representative] asked that you lived openly as gay man, in what ways?'. The claimant explained in his response that because of his depression he had found it diffcult to relate to people, and go to gay bars and fnd a boyfriend – and he also could not afford to do this (First Tier Tribunal observation, London, November 2018). The lack of resources and mental health problems combined for this man in a way that made it harder to prove his claim in the ways that the UK asylum system expects. However, in this instance the appeal was successful and he received refugee status.

A government offcial in the UK also confrmed the impact of mental health in interviews and explained that if somebody has PTSD, then 'you have got to take that into account that they may not remember stuff' (Olivia, UK). Yet, as we saw in Chaps. 6 and 7, inconsistency is a frequent basis for refusal based on lack of credibility. We were told by one NGO worker:

and then they [people whose claim is refused] will be told "your language was vague, you didn't specify your feelings". I think sometimes it is people's mental health that causes them not to be able to say much about their feelings, as well, you know, they are withdrawn (Debbie, NGO worker, UK).

In terms of treatment and support, the mental health of asylum claimants and refugees is recognised both as an area where specialist services and expertise are needed, and also as an area where needs are not being met and there is not enough evidence (Basedow and Doyle 2016; Mind 2009; Piwowarczyk et al. 2017; Slobodin and de Jong 2015). Other research suggests that SOGI asylum claimants are often likely to have experienced childhood persecution and are survivors of childhood trauma, meaning that particular forms of clinical treatment such as art and music therapy may be appropriate (Hopkinson et al. 2017, p. 1662).

The need for mental health support is recognised as being high among LGBTIQ+ populations and, similarly, there is a high demand for therapeutic work with people who have been tortured (Eleanor, NGO worker, UK). A further complication is that healthcare, even if it is available, is often not culturally appropriate. An NGO worker in Italy pointed out that the standardised [diagnostic] tests used by psychologists and psychiatrists are modelled on Italian or Western patients and cannot be used with foreign patients (Chiara, NGO worker, Italy). Compounding this, it was suggested that cultural factors sometimes make it harder for SOGI minority asylum claimants to ask for mental health support:

I have done some work with BAME [Black, Asian and minority ethnic] communities across Greater Manchester and the biggest barrier was the stigma around mental health. So you have that cultural stigma, as well as being LGBT, so people fnd it really diffcult to access services (Justina, NGO worker, UK).

However, some of the people we talked to had received counselling (Ibrahim A., UK; Meggs, UK), but far more common were references to being prescribed antidepressant medication:

My GP, bless him, at that time he was also very supportive, yes, and he give me a lot of advice and I am still on antidepressants, until today, so like that was a big, big part, because I went suicidal as well at that time (Selim, UK).

In the UK, in particular, people told us they were taking medication to combat depression. Lutfor was taking 'mirtazapine, zopiclone, paroxetine, or paroxetine something, and iron'. Ibrahim A. had been taking anti-depressants but stopped, because he did not like the changes they caused to his behaviour. Joyce and Selim gave us similar accounts of lives that consisted of staying in their rooms and taking their medication.

Non-medicinal support or talking therapies was not always provided through formal counselling. Melisa (NGO worker, UK) told us:

We have a group called "Sister Sister", which is a support group for women only, LBT women, and we also have a choir, and sometimes we have theatre groups, we do some theatre work. We believe in tackling all trauma through, we take a holistic approach in tackling the trauma of LGBT asylum seekers and refugees.

Similarly, SGW (focus group no. 4, London, UK) also found it uplifting to join a support group: 'But the thing for me what worked was like I found [a local lesbian support group], so I used to go to Manchester every month to look forward to being in a surrounding'.

A less positive phenomenon that emerged in the research is that many people are re-traumatised – rather than supported – by the process of claiming asylum. This corresponds to research showing that LGBTIQ+ refugees are exposed to trauma not only prior to leaving their country of origin, but throughout the entire transit and reception process (Alessi et al. 2018). In Germany, Leon described this as almost inevitable: 'And then it is mutually dependent. If you already have a trauma and you are in a hopeless situation, the trauma will be amplifed' (Leon, NGO worker, Germany). Similarly, a SOGI group volunteer in Italy told us:

let's not open the Pandora's box on how the system makes people sick. Because the system makes people sick. (…) The system brings out the post-traumatic disorders, the fact of continually reliving the negative element, continuously telling how I was beaten, the nonrecognition of what I claim to be. It has effects on asylum claimants. The continuous expectation, the need to be identifed by an external subject with respect to what I am, creates a disturbance to people (Giulio, LGBTIQ+ group volunteer, Italy).

Chiara (NGO worker, Italy) also explained that the Italian reception system 'creates pathologies'. While people bring with them trauma from their country of origin, she felt that this then becomes chronic or more acute as a result of the reception system. Likewise, a doctor confrmed that '[t]he Home Offce practice of disbelief on top of people's past experiences frequently causes re-traumatisation' (Carl, doctor with an organisation providing medico-legal reports, UK).

This suggests that there needs to be both more sensitivity within the asylum decision-making and reception system to trauma-related needs, and also greater specialist provision outside these systems for individuals, and provision that is tailored to their needs in terms of SOGI, country of origin, gender and other characteristics. As with health, there are SOGI-specifc aspects to employment, the subject of the next Section.

#### **9.3 Work**

#### *9.3.1 The Right to Work*

The right to work and to freely choose one's work is recognised as fundamental to human existence.3 Despite this, and despite the requirements of Article 15 of the Reception Directive mentioned above, all our three case study countries prevent – legally or in practice – asylum claimants from working for some or all of the period that they are waiting for a decision on their application. In Germany, claimants may not work for the frst three months of their application (§61(2) Asylum Act Germany), and those from 'safe countries' placed in reception centres are unable to work for the entire period that their claim is being decided. After three months, they can apply for work but many will not speak German to the level needed for

<sup>3</sup>Article 23(1), UDHR; Article 6 ICESCR.

employment. In Italy, asylum claimants can start work within 60 days of making an asylum application, but in practice they face problems securing the residence permit needed to work. Moreover, Decree Law no. 113/2018, abolished the provision of vocational training for asylum claimants that existed under the former SPRAR system (ECRE, AIDA & ASGI 2019, p. 102). In the UK, asylum claimants are prohibited from working, although they can apply for permission to work if their claim is outstanding after a year. However, even then, they can only apply for jobs where workers are in short supply and these are narrowly defned (for example, consultant in neuro-physiology) (ECRE, AIDA & Refugee Council 2019, p. 72). There is one exception: people in immigration detention are able to work for a fxed rate of £1 per hour for 'routine activities' (Home Offce 2019, p. 5), a policy seen as exploitative but that was unsuccessfully challenged in 2019.4 In the UK, research has found that asylum claimants are susceptible to forced labour and that payment below the national minimum wage is normal for asylum claimants and refugees, with or without permission to work (Lewis et al. 2013).

Those with refugee status should have equal access to the labour market but, in reality, asylum claimants and people with refugee status experience similar barriers to fnding a job in terms of language, negotiating the bureaucracy of the host country, employer prejudice, lack of recognised qualifcations, and lack of what may be called social capital or networks – the kinds of connections that often enable citizens and established residents to fnd out about and secure jobs. More than one respondent pointed out the importance of language in fnding work. For example, Moses (Italy) said 'you have to perfect the Italian language before they can probably employ you, and on the other hand, scouting for job here it is not really that easy'.

Location plays a role in employment prospects. No country under comparison had a comprehensive package of employment support for refugees. The UK's Refugee Integration and Employment Service (RIES) funding ended in 2011 (Hill 2011) and refugees' access to support in fnding a job is determined largely by dispersal location during asylum, or by where they go after recognition if they are able to move. If people are able to fnd work, it is often at a much lower level of pay and status than their occupation in their country of origin. Alphaeus (Germany), working as a care provider for older people, had been an engineer, owning his own construction company. Sandra (Germany) also talked about building a new life, but one that is 'way far from being the same level' as she was used to (Chap. 5).

The inability to work is a huge cause of frustration for all asylum claimants, as was well documented through our feldwork. In Germany, one participant said: 'Put me somewhere where I can even babysit a child, take care of an old person. You know? Clean somebody's house and get paid. It's still a job, you know?' They continued 'As a nail technician, I'm used to working long hours. I'm not used to being at home, looking at the ceiling every day' (focus group no. 1, Hesse, Germany).

<sup>4</sup>*Morita & Ors v The Secretary of State for the Home Department* (2019) EWHC 758 (Admin). Toufque Hossain, director of public law at the law frm Duncan Lewis, which brought the legal challenge on behalf of the fve former detainees, said: 'Being paid £1 an hour for essential work is obscene' (Taylor, 2019).

A claimant in Italy described the period when some people claiming asylum were housed in camps as a missed opportunity to provide people with training and education:

when you leave the camp, you can be able to be useful to yourself.

In the UK, a coalition has campaigned around the call for the government to 'lift the ban' on asylum claimants working.5 There is both a fnancial imperative to people's wish to work and a psychological one: being denied a fulflling occupation and the means to support oneself is demoralising, particularly over a long period. Silver put it very simply: 'I have to be autonomous. I have to pay for myself' (Silver, Italy).

A lack of work often continued after the grant of international protection. A report by the Refugee Council in the UK on the problems people experience in moving on with their lives on being granted status found that no participant managed to get a job within their 'move on' period of 28 days: 'participants voiced frustration at their experiences of searching for work and their interactions with staff at the Jobcentre and they felt were not giving them the support they needed' (Basedow and Doyle 2016, p. 20). However, both before and after a decision on their application, many individuals became involved in community organisations or other voluntary activities, as we consider in the next Section.

#### *9.3.2 Voluntary Work and Community Involvement*

Many of our participants chose to become involved in community engagement or voluntary work – either working with existing civil society organisations or helping to establish new ones. These unpaid contributions sometimes continued after the grant of international protection and provided the basis for or a stepping stone to paid employment. As this unpaid campaigning or support or advocacy work was often with LGBTIQ+ migrant groups, this was the basis for individuals from SOGI minorities moving into this area of work. This was the case with Jayne, in the UK, who experienced a lengthy legal battle for asylum, during which time she helped to establish a local branch of a larger African-led LGBTIQ+ asylum organisation. Jayne said:

maybe those are the kinds of things that help me to keep sane… Trying to occupy myself. Yes, because you need to have a purpose in life and this whole system that is, what it does, you live a purposeless life, so it takes, I didn't come here educated, but I have met midwives, teachers, who are just now reduced to nothing, go to foodbank and come back and that is it. Even to get to volunteer, it is diffcult because the documentation hinders doing a DBS [the government certifcation needed to work with vulnerable people in the UK] application, yes, so it is… it is diffcult, a lot of people will lose it [mental health] along the way.

<sup>5</sup> https://www.refugee-action.org.uk/lift-the-ban/

Other people's experiences led them to pursue volunteering and undertake training to enable them to help people through the diffculties they had experienced, or as Lubwa explained, 'to give back to society' after people had supported him when he needed it (focus group no. 1, Manchester, UK). Joyce (UK) did a course on mental health and wellbeing so she could help people who had gone through the same problems as she had, having realised how common depression is.

Voluntary work was seen as a way to get experience, engage with people and fll the time while waiting for a decision. For example, Angel (Germany) said: 'So I want to start volunteering my time, like now that I can't work, volunteer my time, so that when I can work, I will have the experience'. However, there were no opportunities to do this in the rural area where she was accommodated (Chap. 8). In the UK, Lutfor told us about four different charities he had volunteered with, including the Red Cross, over more than two years while waiting for his claim to be decided.

At the same time, some participants felt exploited by the expectation they carry out unpaid work – one person even said they felt forced to take on voluntary work (Nice Guy, focus group no. 1, northern Italy). Furthermore, Wendy, an NGO worker in the UK, reported confusion on the part of offcials as to whether asylum claimants barred from paid employment were also barred from volunteering – which they are not. Wendy had to have several 'robust conversations' with UKBA staff to inform them of people's rights to volunteer and claim expenses that do not constitute payment. Not surprisingly, the diffculties individuals experienced in joining the formal job market often led them to situations where they were exploited or at risk, as we go on to consider.

#### *9.3.3 Sexual Exploitation and Sex Work*

The UNHCR has recognised the 'specifc protection risks that LGBTI refugees may experience in the country of asylum', including '[r]eliance on survival sex work, exposing individuals to various physical dangers and health risks, including sexual and physical violence, and sexually transmitted diseases' (UNHCR 2013, p. 4).

This was confrmed by our research. A number of people we talked to – both people claiming asylum and people working with them – gave us accounts of sexual or other forms of exploitation and suggested that this might be a problem of particular concern for SOGI claimants, especially transgender claimants. Bringing this point home, Ibrahim (Germany), a benefciary of subsidiary protection entitled to work and was involved with an LGBTIQ+ organisation, said that, in 2015, he had been in contact with seven male-to-female transgender refugees, one of whom was in sex work in Berlin while the other six had returned to Turkey (the country through which they had travelled to reach Europe). He explained that, in Germany:

[t]hey don't have any working opportunities. But when they were working in prostitution, they had an income, they had money, they were able to satisfy themselves, to go out and do things. But when they come here, you know, a woman needs a lot of expensive, like, makeup and all this stuff. And with this small amount of money and the lack of knowledge in the language, and they are not allowed to work, they were in a lot of depression and so... imagine at some point, some people go "look how I was looking in Turkey. How I look here." Imagine. So that is why a lot of people went back (Ibrahim, Germany).

Jules, staff member at ILGA-Europe, pointed out that the costs of medical treatment were another reason why transgender claimants were more likely to resort to prostitution.

Unsurprisingly, accounts of sexual exploitation and sex work were more commonly given by NGO workers or lawyers, rather than by claimants themselves. An NGO worker in Germany talked about casual prostitution or 'sugar daddy' relationships involving local German White men (Noah, NGO social worker).  The boys tell me almost all of these things happen, then if they do it voluntarily and it's okay to take those €20, I will never judge them.

Some claimants did talk about this kind of exploitation. One of our participants said that after she broke up with her partner, she got involved in sex work to help her survive, describing it as 'one of the darkest time in my life, if I'm honest'.

Sometimes, as we saw in Chap. 5, sexual abuse or exploitation – sexual or other – was a factor in people's journey to and arrival in Europe. We heard of SOGI asylum claimants – usually women – who were traffcked to Europe and either claimed protection (initially) as victims of traffcking or escaped and claimed protection on a SOGI basis. One UK participant had been brought to the UK on the promise of work, but on arrival found that the 'job' was prostitution, which is when she ran away to claim asylum. Another, also in the UK, told a similar story:

I will cut it a bit short because it is a bit emotional (…) I came to this country very young, in my 20s and it was, I passed through a lot in Cameroon. I was forced to get married very young, age of 17/18 years, I had a lot of domestic violence… And then I came to England through someone who brought me into the country. After the man brought me here, I had a lot of, I mean was forced to prostitution which I mean, because I never wanted to go back to Cameroon…

 Ibrahim was working as an activist to empower refugees to prevent this kind of abuse. However, this kind of exploitation is widely recognised. Jules (staff member at ILGA-Europe) also told us of people offering help 'under the guise of being volunteers or supporters' and exchanging sexual favours for money or medication.

These kinds of accounts of sexual exploitation were common and based on inequalities in power and assets of those concerned:

Yeah, that power, that power relation... yeah, yeah. So I had cases too. But thank God not many. So a few cases were reported to me, where in fact older, White, gay men have approached very young refugees waiting for an asylum decision and have offered support, such as offering their fat. But not only out of pure kindness, they also wanted something in return. So they quite explicitly have also put their terms on the table. These are the better ones. Because then there are also those that package it as a kind-hearted offer, but where then actually something more is required, but that is not openly framed as "trade". Such cases happened, but fortunately they were not so many, not so often. Well, that happens (Kadir, NGO worker, Germany).

In the UK, we were also told about people becoming sex workers or providing sex services, either formally or informally through transactional relationships in which sex was exchanged for accommodation or some kind of assistance with 'strings attached' (Gary, NGO worker; we also heard this from Eleanor, NGO worker, and Joseph, NGO volunteer). Moreover, exploitation did not necessarily end with the asylum decision, even if it was a positive one.  And that was never, never the case before'.

Meggs (focus group no. 1, Manchester, UK) had been doing her own research on vulnerability in preparation for a feminist conference she was helping to organise and was shocked to fnd out what young women were going through: 'In this country. I am not talking about back home. In this country. I have been destitute since last year March when my accommodation… I was kicked out of because my case was fnished'. She compared her situation to other women claiming asylum:

so some of the girls, because there is no accommodation, they will spend most of the times in Piccadilly going up and round with their bags full of Home Offce fles thinking that "after 8 o'clock where am I going to sleep? Which door can I knock on so I can sleep?" (…) any men who is going to approach them, they will have to take you because it is the survival of the fttest. (…) And it is now happening in this country, where we are expecting to be safe.

Not surprisingly, NGOs working with SOGI asylum claimants identify the risk of sexual abuse as an important one to address. In our survey we heard from one respondent that there was sexual abuse within and outside 'their own community' and that there had been cases of sexual favours demanded in exchange for giving witness evidence (S122, UK). It is not surprising if people with no income sometimes resort to such means of making money. However, not all exploitation we heard about was sexual as considered in the Section that follows.

#### *9.3.4 Discrimination and Exploitation in Employment*

Exploitation is not always sexual, we encountered situations where people were given work but underpaid or supported on an 'in kind basis' – in both situations, on the basis that people claiming asylum had no alternative but to accept these conditions. Here it is impossible to identify whether SOGI is a reason why these individuals were targeted in this way. What is easier to say with confdence is that their status as both asylum claimants or people who had yet to claim asylum, in combination with their SOGI minority status deprived them of alternatives and sources of support.

Zena thought she was coming to the UK to study, but instead was made to work as an unpaid nanny and domestic servant by a couple who took away her passport and would not let her leave the house alone (Zena, First Tier Tribunal Appeal, London, 2018 decision paper). But abuse is not always this blatant. Melisa, an NGO worker in the UK, said:

in terms of women, we have seen a lot of domestic servitude, where LGBT women are looking after children, doing domestic chores, and just for a roof over their head. Sometimes they are given a little bit of money but sometimes they are not.

Melisa's organisation provided life coaching for SOGI female asylum claimants in this situation, helping them to move on, be proactive and fnd employability and educational support:

because if she has been in domestic servitude for a long time, you sometimes forget yourself. Forget your ambitions, you forget the things that you are able to do. So what life coaching does, it brings that out, you know, they will talk to you about what you want to do, your ambitions, and you can actually make a journey path with your coach…

In the case of Lutfor (UK), mentioned in the previous chapter, he left his home country to escape persecution, but was unaware that he could claim asylum on that basis in the UK.  He lived with them for two years, cleaning and cooking and only leaving the house to go to the shops, receiving food and accommodation in exchange. He felt fondly about his hosts:

They were really nice people. I mean, they helped me [in] the situation when no one else did, I didn't get any kind of support from my family, but they did as much as they can. Sometimes they gave me their old clothes to wear… there is an open market in [location x], I go buy some groceries, come home, that was my life. Like every two or three days later I go for shopping, because there are too many people, like nine, including me in this house, four bedroomed house, nine guys, living here, so even too many vegetables, fsh and meat, everything, and that is why I go out, otherwise I don't. I didn't go out of the house.

Lutfor was detained when he eventually claimed asylum and taken to Harmondsworth, where his mobile phone was taken away from him. When he was released and returned to the house, the people in the house had packed up his possessions, having replaced him: 'they said we already got another one'.

Some of our participants also worked informally while waiting for a decision. For example, Prince Emrah (Germany), a belly dancer, worked sometimes on a paid and sometimes on an unpaid basis, including by dancing at Soli parties ('solidarity' fundraising events), such as a fundraiser for someone to pay for breast construction surgery. Payment for informal work is likely to be below the national minimum wage and irregular, especially in Italy, where many claimants and refugees are exploited in the agriculture sector working without a contract: 'they pay me *giornata*' – by the day (Franco, Italy).

Exploitation could be at the hands of European nationals, but sometimes also by people from the same diaspora community and sometimes based on prejudice:

The second diffculty is in the world of work because the world of work, obviously in some contexts, can still be homophobic, especially if in that world of work you come... unfortunately they are very exposed to the phenomenon of the ethnic *capolarato* [illegal migrant labour or gangmaster system based on ethnic or national ties]. So when a Bengali young man is inserted in a context of Bengali young men, who is hosted by a fellow countryman, who is inserted into the world of work by a compatriot, revealing his sexuality to them could be strongly negative, precisely because they are his social and labour integration (Silvana, judge, Italy).

For those in a position to seek formal employment, there were two stages of discrimination: when looking for work and once they were in post. For some jobseekers, SOGI was clearly a reason why they could not fnd work. Sylvia, in Germany (focus group no. 5, Bavaria), described what happened with one potential employer:

the would-be boss said "I want to give you a chance to try and see if you could ft this job". When I went to this lady and said "OK, I'm here, I would want to try", she requested my Facebook account. She had appreciated my working skills, but when the lady realised on Facebook that I'm a lesbian, she called me on the phone and asked "Are you really a lesbian?" I am not scared to say that I am a lesbian. Indeed, I confrmed to her that I am one. And she lost interest in employing me. So we still have challenges. There are people who still don't understand us here.