Mathieu Seppey Université de Montréal

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Michaël Arnaud Égides (Alliance internationale francophone pour l'égalité et les diversités), Montréal

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Gabriel Girard SESSTIM (Sciences économiques et sociales de la santé & traitement de l’information médicale), ISSPAM (Institut des sciences de la santé publique), Aix Marseille Université; Inserm (Institut national de la santé et de la recherche médicale); IRD (Institut de recherche pour le développement)

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Christina Zarowsky Université de Montréal
Centre de recherche en santé publique

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Queering Humanitarian Practices through the Inclusion of SOGIESC Concepts

Diverse SOGIESC issues (sexual orientations, gender identities and expressions, and sex characteristics) are seldom discussed in humanitarian work but are emerging as an important gap to fill in both knowledge and practice. This review’s objective is to provide a clearer picture of how SOGIESC issues are included in humanitarian practices. A socio-ecological approach is used to identify the different settings in which these issues are present and should be addressed by the humanitarian sector. The review is based on a search of three databases covering peer-reviewed articles and grey literature that link SOGIESC issues and populations with humanitarian work. The fifty-one documents included in this review provide insights into its three main results. (1) SOGIESC concepts must be clarified in the humanitarian sector, which has been partially aware of these concepts and related issues. Two good governance principles should be prioritised and reviewed. (2) The inclusion of SOGIESC issues lacks clear ‘Direction’ (strategic planning) for the reduction of SOGIESC-based discrimination beyond short-term disaster management. (3) Diverse SOGIESC communities lack ‘legitimacy and voice’ to address their needs and participate in emergency responses. Transformative practices are identified to palliate those gaps but, most importantly, to connect humanitarian work to diverse SOGIESC peoples.

Introduction

The principle of ‘impartiality’ is at the core of humanitarian work. It has been commonly referenced by the International Committee of the Red Cross as one of the ‘Fundamental principles’ and represents three concepts: non-discrimination, impartiality (decisions based on needs over personal considerations or feelings) and proportionality (prioritisation of the most vulnerable) (IFRC, 2024). It has now been incorporated in numerous humanitarian standards and guidelines (e.g. Core Humanitarian Standard (CHS Alliance, 2024), Sphere Standards (Sphere Project, 2018), Red Cross Code of Conduct (IFRC, 1994), Principles and Good Practice of Humanitarian Donorship (GHD, 2018).

A first challenge arises, however: how to be impartial in contexts where one knows very little about the ‘Other’ or may even be unaware of the ‘Other’. The ‘Other’ can have many labels: ‘women’, ‘children’, ‘people with disabilities’, or ‘diverse SOGIESC peoples’1 (people with diverse sexual orientations, gender identities and expressions, and sex characteristics). While there is an increasing body of evidence on SOGIESC issues, SOGIESC diversity is seldom mentioned in humanitarian documents; in the Sphere Handbook, a core reference for standards in humanitarian response, it first appeared in the fourth edition in 2018 with around twenty mentions over 458 pages (Sphere Project, 2018). A second challenge is how to provide services impartially within a cis-heteronormative system. A queering process, challenging these norms has started within international human rights with the Yogyakarta Principles (Corrêa and Muntarbhorn, 2007) and its added ten principles (Cabral Grinspan et al., 2017: 10). These principles provide important interpretations of SOGIESC diversity within human rights; this work still must be done in humanitarian work.

This review aims to connect humanitarian actions with the ‘Other’, in this case diverse SOGIESC communities, through transformative practices. Its objective is to better understand how SOGIESC issues are included in humanitarian practices, to chart a more responsive way forward. To do so, diverse SOGIESC issues must be made explicit and analysed, to lay the foundation for reflection and change.

Methods

To respond to this question in a restricted timeframe to inform the reflections of Égides (an international francophone alliance for equality and diversities) we conducted a rapid review (Tricco et al., 2015) with a thematic synthesis (Thomas and Harden, 2008). A detailed report was then produced and is now available in French (Seppey et al., 2024a) and English (Seppey et al., 2024b). This report presents additional information in relation to different humanitarian sectors (e.g. WASH, shelters, food and non-food items distribution, health) and further specificities about SOGIESC.

The rapid review used the socio-ecological approach to analyse humanitarian practices and better understand how SOGIESC were included in those practices. This approach is based on five interacting dimensions in which humanitarian practices take place: individual, interpersonal, organisational, community and public policy (McLeroy et al., 1988). By understanding these practices and their socio-ecological dimensions, new levers of action can be identified to instil change (Cislaghi and Heise, 2019) and greater inclusion of SOGIESC concepts. This review follows a queer approach (Otto and Jones, 2023) by challenging cis-heteronormative practices that are taken for granted and by providing transformative insights to rethink relationships between SOGIESC communities and humanitarian practitioners.

A search strategy was developed in consultation with Égides and the co-authors and used in two databases for peer-reviewed articles (Web of Science and Global Health, accessed 24 May 2023) and in one database (Humanitarian Library, accessed 2 May 2023) for grey literature (Seppey et al., 2024b: Appendix 1: Research strategy). Diverse organisational websites were also investigated for further grey literature (e.g. UNHCR, Inter-Agency Standing Committee (IASC), Plan International, Oxfam, International Committee of the Red Cross, CARE International, UNICEF, UN Office for the Coordination of Humanitarian Affairs (OCHA)). Records were uploaded to the Covidence software for duplicate removal and screenings (title/abstract and full text). References were selected during the title and abstract screening following two criteria: (1) main subject is about SOGIESC populations and/or issues and (2) main subject is about humanitarian aid contexts. References were excluded during the full-text screening based on four criteria: (1) no substantive focus on diverse SOGIESC populations or issues, (2) no substantive focus on humanitarian aid contexts, (3) subject is about a domestically managed crisis and (4) not in French or English (Figure 1). Data was extracted via Excel tables and included bibliographic and interpretative information relating to the socio-ecological approach. Results were synthesised according to this approach (individual, interpersonal, organisational, community and public policy) and through harmful to transformative practices (Dwyer et al., 2021).

Figure 1:
Figure 1:

Flow diagram

Citation: Journal of Humanitarian Affairs 5, 3; 10.7227/JHA.116

Results

Our research strategy yielded a total of 1,234 records, with 51 documents finally included (more detailed in Table 1). The documents are predominantly authored by organisations from Global North countries (75%) and from countries in the Asia-Pacific region (29%). They were mostly developed with the participation of UN agencies (47%) (e.g. UNHCR, International Organization for Migration (IOM)), non-governmental organisations (NGOs) (33%) (e.g. Edge Effect in Australia is involved in 7 documents), international NGOs (INGOs) (22%) and universities (24%). The format of the documents (n=51) was as follows: 13 guidelines, 11 case studies, 9 reports, 7 reviews, 4 editorials, 3 trainings, 3 assessment tools and 1 action plan. The following results aim to illustrate contemporary discussions, through the documents’ key findings, recommendations and debates. Authors’ recommendations are presented in the reports (Seppey et al., 2024a (Fr.), 2024b (Eng.)).

Table 1:

List of included documents

Authors, year Organisations Formats SOGIESC specific Other target populations Main sector Other sectors addressed
(Asi et al., 2022)
  • Univ. of Central Florida

  • Georgetown Univ.

  • London School of Hygiene & Tropical Medicine

  • King’s College London

  • AISE Consulting

  • BRAC Univ.

  • Washington Univ.

  • Harvard Univ.

Review No
  • Women

  • Migrants

Health Partnerships
(Balgos, Gaillard and Sanz, 2012)
  • De La Salle Univ.

  • Univ. of Auckland

  • Durham Univ.

Case study Yes
  • N/A

Partnerships Rehabilitation and Shelter
(Chynoweth et al., 2020)
  • Women’s Refugee Commission

  • Univ. of New South Wales

Case study No
  • Men

  • Migrants

Gender-based violence (GBV) Health and Protection
(Devakula et al., 2018)
  • APCOM

  • APTN

  • ASEAN SOGIE Caucus

  • IPPF (International Planned Parenthood Federation)

  • Edge Effect

  • UN Women

Action plan Yes
  • N/A

N/A Partnerships
(Dolan, 2014)
  • Refugee Law Project

Editorial Yes
  • N/A

GBV Partnerships
(Dolan, 2016)
  • Refugee Law Project

Editorial No
  • Men

GBV Partnerships
(Dominey-Howes, Gorman-Murray and McKinnon, 2014)
  • Univ. of New South Wales

  • Univ. of Western Sydney

Review Yes
  • N/A

N/A N/A
(Dwyer and Woolf, 2018)
  • Edge Effect

  • Oxfam Australia

Case study Yes
  • N/A

N/A All but Education, Food and non-food items distribution, Health and Migration
(Dwyer et al., 2021)
  • Edge Effect

  • Swedish Cooperation

  • UN Women

  • Women for Climate-Resilient Societies

Report Yes
  • N/A

Partnerships N/A
(Dwyer, 2022)
  • Edge Effect

Report Yes
  • N/A

Partnerships N/A
(Gaillard, Gorman-Murray and Fordham, 2017a)
  • Univ. of Auckland

  • Northumbria Univ.

  • Western Sydney Univ.

Case study Yes
  • N/A

Partnerships N/A
(Gaillard et al., 2017b)
  • Univ. of Auckland

  • Univ. of the Philippines Diliman

  • Univ. of Western Sydney

  • Samoa Fa‘afafine Association

Case study Yes
  • N/A

Partnerships N/A
(Haneef and Laitila, 2018)
  • IFRC (International Federation of Red Cross and Red Crescent Societies)

Training No
  • Women

  • Youth

  • Persons with disabilities

N/A All but Education, Partnerships and Migration
(Heartland Alliance International, 2014)
  • Heartland Alliance International

Case study Yes
  • Migrants

Migration GBV, Health, Rehabilitation, Shelter and Partnerships
(House and Dwyer, 2019)
  • Edge Effect

Case study Yes
  • Youth

Partnerships N/A
(Humanitarian Advisory Group and VPride Foundation, 2018)
  • Humanitarian Advisory Group

Case study Yes
  • N/A

Partnerships N/A
(IASC, 2018)
  • IASC

Guidelines No
  • Youth

N/A All but GBV, Partnerships and Migration
(International Gay and Lesbian Human Rights Commission and SEROvie, 2011)
  • OutRight Action international

  • SEROvie

Case study Yes
  • N/A

N/A Food and non-food items distribution, Protection, Shelter and Partnerships
(IOM, 2020a)
  • IOM

Guidelines No
  • Women

  • Youth

  • Migrants

  • Persons with disabilities

Migration Health
(IOM, 2020b)
  • IOM

Guidelines Yes
  • Migrants

Migration N/A
(IPPF, 2019)
  • IPPF

Report Yes
  • N/A

Partnerships GBV and Health
(Kiss et al., 2020)
  • All Survivors Project

  • London School of Hygiene & Tropical Medicine

Review Yes
  • Men

GBV Health
(Madrigal-Borloz and UNHCR, 2021)
  • UNHCR

  • UN Independent Expert on Protection Against Violence and Discrimination Based on Sexual Orientation and Gender Identity

Report Yes
  • Migrants

Migration All but Education, Food and non-food items distribution and Partnerships
(Margalit, 2018)
  • N/A

Editorial No
  • Men

Protection Partnerships
(Nathwani and Piccot, 2015)
  • UNHCR

Report Yes
  • Men

Migration All but Education, Food and non-food items distribution and WASH
(OutRight, 2023)
  • OutRight Action International

Report Yes
  • N/A

Health Food and non-food items distribution, Rehabilitation, Shelter and Partnerships
(Plan International, 2020)
  • Plan International

  • Edge Effect

Guidelines Yes
  • Youth

Health All but Food and non-food items distribution and Migration
(Rengers et al., 2019)
  • Univ. of Groningen

Case study Yes
  • N/A

Partnerships N/A
Robertson, Arifin and Dwyer, 2021)
  • UN Women

  • Ede Effect

  • Swedish Cooperation

  • Empower

Assessment tool Yes
  • Women

  • Persons with disabilities

N/A Protection, Rehabilitation and Shelter
(Rosenberg et al., 2016)
  • Women’s Refugee Commission

Case study No
  • Women

  • Men

  • Youth

  • Migrants

  • Persons with disabilities

Migration GBV, Rehabilitation, Shelter and Partnerships
(Rumbach, 2017)
  • UNHCR

  • IOM

Training Yes
  • Migrants

Migration All but Food and non-food items distribution and Partnerships
(Rumbach, 2020a)
  • IOM

Assessment tool Yes
  • Migrants

Migration Education, Health, Rehabilitation and Shelter
(Rumbach, 2020b)
  • IOM

Guidelines Yes
  • Migrants

Migration N/A
(Rushton et al., 2019)
  • Massey Unvi.

  • Univ. of Tasmania

  • Univ. of Otago

  • DRR Dynamics

Review Yes
  • N/A

Partnerships N/A
(Simmonds et al., 2022)
  • MGH Institute of Health Professions

  • Reproductive Health Access Project

Review Yes
  • N/A

Health GBV
(Türk, 2013)
  • Forced Migration Review

Guidelines Yes
  • Migrants

Migration N/A
(Tusker-Haworth, 2022)
  • Univ. of Manchester

Report Yes
  • N/A

Partnerships N/A
(Tusker-Haworth, McKinnon and Eriksen, 2022)
  • Univ. of Sydney

  • Univ. of Manchester

  • Univ. of Wollongong

  • ETH Zurich

Review Yes
  • N/A

Partnersips N/A
(UNHCR, 2011a)
  • UNHCR

Guidelines Yes
  • Migrants

Migration GBV, Protection and Partnerships
(UNHCR, 2011b)
  • UNHCR

Guidelines Yes
  • Migrants

Migration Protection
(UNHCR, 2012)
  • UNHCR

Guidelines Yes
  • Migrants

Migration Protection
(UNHCR, 2013)
  • UNHCR

Assessment tool Yes
  • Migrants

Migration Protection and Shelter
(UNHCR, 2017)
  • UNHCR

Report Yes
  • Migrants

Migration Protection
(UNHCR, 2020)
  • UNHCR

Guidelines Yes
  • Migrants

Migration Health, Protection and Shelters
(UNHCR, 2021a)
  • UNHCR

Report No
  • Women

  • Youth

  • Migrants

Migration N/A
(UNHCR, 2021b)
  • UNHCR

Guidelines Yes
  • Youth

  • Migrants

Migration All but Education, Food and non-food items distribution and WASH
(UNHCR, 2024)
  • UNHCR

Guidelines Yes
  • Migrants

Migration Education, Health, Rehabilitation and Shelter
(UNHCR and IOM, 2021)
  • UNHCR

  • IOM

Training Yes
  • Migrants

Migration N/A
(UN Women, Asia and the Pacific Working Group, 2017)
  • APR GiHAWG (Asian and the Pacific Region Gender in Humanitarian Action Working Group)

Review Yes
  • N/A

Partnerships N/A
(Ward, 2016)
  • IASC

Editorial No
  • Women

GBV Partnerships
(Ward and Lafrenière, 2015)
  • IASC

Guidelines No
  • Youth

N/A All but Partnerships and Migration

Individual

Fear and adaptation

Humanitarian practices often take place in a setting of fear, where individuals have lived discrimination and abuse based on their SOGIESC (Devakula et al., 2018; IOM, 2020b; Margalit, 2018, Rosenberg et al., 2016; UNHCR, 2012). This fear predates emergencies and is linked to being exposed, or ‘outed’, which could lead to further discriminations (IOM, 2020a; Rengers et al., 2019; Rosenberg et al., 2016). By expressing non-conforming gender expression, trans* communities are most at risks of discrimination (e.g. verbal, sexual or physical abuse, detention, murder) (UNHCR, 2012). These fears are often caused by threats to life and dignity and are expressed through the adoption of more ‘discreet’ (IASC, 2018; Türk, 2013; UNHCR, 2012; UNHCR, 2013) or ‘secretive’ (IGLHRC and SEROvie, 2011; UNHCR, 2013) behaviours, which aim at hiding their SOGIESC. For example, gay men in Haiti were: ‘altering their voice, posture, and gait –“mettre des roches sur nos épaules” (“putting rocks on our shoulders”)’ to avoid further discrimination (IGLHRC and SEROvie, 2011). Diverse SOGIESC populations can therefore be difficult to identify and reach (IGLHRC and SEROvie, 2011; Rengers et al., 2019; Rosenberg et al., 2016; UNHCR, 2013; UNHCR, 2021b), especially if they avoid services (Chynoweth et al., 2020; Simmonds et al., 2022; UNHCR, 2011b).

Needs and access

The consequences of ‘discreet’ behaviours often lead to greater vulnerability due to unmet needs (e.g. in relation to psychosocial care, medico-legal procedures and access to livelihoods) (Chynoweth et al., 2020). Even when such needs are addressed, service providers may disregard or stigmatise diverse SOGIESC (UNHCR, 2021b), thus delegitimising their claims. A good example is the stigmatisation of male survivors of gender-based violence (GBV), who can be perceived as ‘traitors’ by other men and criminalised for having suffered sexual abuse (e.g. sodomy) (UNHCR, 2012). Knowledge about less visible communities’ specific needs can be highly limited, as is illustrated by the sole mention of menstrual and hygiene kits for transmen (Plan International, 2020; Rumbach, 2020b; UNHCR, 2021b). Similarly, capacities of diverse SOGIESC individuals are often hidden by stamping these populations as ‘vulnerable’ (Balgos et al., 2012; Dominey-Howes et al., 2014; Gaillard et al., 2017a, 2017b; Simmonds et al., 2022; Tusker-Haworth, 2022; Tusker-Haworth et al., 2022; UNHCR, 2024). This is often the case for lesbian, bisexual, or trans* women who are also conflated with sex workers (IGLHRC and SEROvie, 2011). While vulnerabilities need to be addressed to protect these populations’ rights, capacities must also be recognised as complements to avoid the disenfranchisement of those same populations (Balgos et al., 2012; Tusker-Haworth, 2022).

SOGIESC diversity and youth

Intersecting with SOGIESC diversity, younger age was found to bring higher risks of abuse (HAG and VPride Foundation, 2018; Plan International, 2020; UNHCR, 2021b; Ward and Lafrenière, 2015). Greater dependency on parents, families or schools can maintain diverse SOGIESC children in unsafe and abusive environments, where myths and stereotypes can be induced (e.g. homosexuality or transgenderism as a ‘sin’, ‘unnatural’, or a ‘western agenda’), thus leading to lower self-esteem, pressure to conform or suicidal ideas (House and Dwyer, 2019). Unaccompanied diverse SOGIESC children in migratory process are more vulnerable when placed in host families or institutionalised (UNHCR, 2021b). Again, diverse SOGIESC girls are most often muted and at risk of domestic abuse, neglect and child marriage (IASC, 2018; Ward and Lafrenière, 2015). Intersex children are often abused through unnecessary medical interventions at an early age (e.g. sterilisation, ‘corrective operations’) (UNHCR, 2021b). While other intersections with SOGIESC diversity can be hypothesised, few others were reported in the documents (e.g. socio-economic status (Dominey-Howes et al., 2014; IGLHRC and SEROvie, 2011, Rosenberg et al., 2016; Tusker-Haworth et al., 2022) or country of origin (Chynoweth et al., 2020; Dwyer and Woolf, 2018; HAI, 2014; Madrigal-Borloz and UNHCR, 2021; Rushton et al., 2019; UNHCR, 2021b).

Interpersonal

Service provision as homo/bi/transphobic interactions

Interactions with diverse SOGIESC individuals are often dependant on their decision to ‘stay in the closet’ or ‘come out’ (Rengers et al., 2019). That decision is often the result of weighing different issues such as safety, fear of being discriminated against and social support (Rengers et al., 2019; UNHCR, 2021b). This concerns both beneficiaries and service providers, such as humanitarian workers (Rengers et al., 2019). This decision is important since service providers can express homo/bi/transphobic behaviours, such as intrusive questioning, abusive language, or ‘correcting’ comments or acts (Türk, 2013). These behaviours are often ill-informed and are often based on anecdotal and stereotypical insights about SOGIESC diversity (e.g. gays are effeminate, trans* people are gays, lesbians are masculine) (Madrigal-Borloz and UNHCR, 2021; Türk, 2013; UNHCR, 2012; UNHCR, 2021b; UNHCR and IOM, 2021). This fear can also be due to a homo/bi/transphobic environment, where these issues are perceived as morally, politically, religiously or culturally unacceptable or contentious (House and Dwyer, 2019; Rengers et al., 2019). Service providers responsive to diverse SOGIESC populations can be perceived as disrupting social norms and face reprisals. This type of environment impedes them from having a more professional or human rights-based approach, while excluding diverse SOGIESC people (Dwyer et al., 2021; Plan International, 2020; Rosenberg et al., 2016).

‘Rationalising’ exclusion

Different misconceptions can be identified as biases in humanitarian interactions. One is to view resources as a zero-sum game, where allocating resources to diverse SOGIESC communities would reduce resources elsewhere (HAG and VPride Foundation, 2018), the reluctance to expand GBV services beyond ‘women’ towards gay/bisexual males and trans* communities is a good example. Resources are thought to be limited, services to be difficult to expand and the number of diverse SOGIESC individuals not sufficient; however, solutions can be found in simply adapting actual services by including SOGIESC issues in programme designs (Devakula et al., 2018; HAG and VPride Foundation, 2018). A second misconception is about the fear to do harm, which ultimately leads to a status quo where SOGIESC issues are not addressed (HAG and VPride Foundation, 2018; Plan International, 2020). This fear to do harm can be due to a lack of knowledge about SOGIESC issues; there is much confusion for service providers around concepts such as ‘sex’, ‘gender’, SO, GIE, or SC (Haneef and Laitila, 2018; Plan International, 2020; UNHCR, 2021b).

Organisational

Low representation within emergency planning

Few guidelines and plans of actions are made regarding SOGIESC diversity, due to lack of knowledge (Gaillard et al., 2017a; HAI, 2014), implementation capacities (Rosenberg et al., 2016) and willingness to act (Madrigal-Borloz and UNHCR, 2021; UNHCR, 2021b). For example, most national emergency response plans do not include diverse SOGIESC issues, especially those of local communities (e.g. Aravanis in India, Warias in Indonesia, Baklas in Philippines) not identifying with western ‘LGBTIQ+’ concepts (Gaillard et al., 2017a; IGLHRC and SEROvie, 2011; Tusker-Haworth et al., 2022). If included, SOGIESC diversity often fits into specific and less resourced sectors (e.g. GBV, protection, human rights) (Asi et al., 2022; Dwyer and Woolf, 2018; Dwyer et al., 2021). This low priority within organisations is also exemplified by unsystematic and sporadic activities (Nathwani and Piccot, 2015) that are often being championed by motivated individuals or small groups (Dwyer et al., 2021) while seldom in higher management (Balgos et al., 2012; Dwyer and Woolf, 2018, Tusker-Haworth et al., 2022), and to such issues being more easily linked to reputational damage (either in favour or disfavour of SOGIESC diversity) (UNHCR, 2020).

Inappropriate data collection

Data management in organisations can often confuse SOGIESC concepts, hindering the organisation from adapting and properly learning about SOGIESC issues. For example, databases are often based on binary indicators of ‘sex’, which is assigned at birth (female/male), instead of gender (Devakula et al., 2018; Dwyer et al., 2021; Simmonds et al., 2022; UNHCR, 2021b). In 2021, the UNHCR made mandatory the disaggregation of data by ‘age’ and ‘sex’ (not gender) for all its beneficiaries (Dwyer et al., 2021). The IASC’s evaluation tool ‘Gender with Age Marker’ (GAM) offers to report on ‘LGBTI’ populations, amalgamating all SOGIESC concepts together (Dwyer et al., 2021). Of all projects compiled in the GAM database, only 2 per cent of them touched ‘LGBTI’ populations, which are considered in parallel with other categories of fused sex/gender ‘Female/women and girls’ and ‘Male/men and boys’. Two documents (Devakula et al., 2018; Dwyer et al., 2021) identified the improvement of the GAM as an important opportunity to better understand SOGIESC issues. Also, less understood communities can be wrongly aggregated together, such as intersex and trans* communities (UNHCR, 2012): ‘Notwithstanding these limitations [not having intersex participants], our findings here apply to intersex refugees since they are present in all of the regions where we collected data and because it is well established that they face similar types of persecution and discrimination’ (Rosenberg et al., 2016: 71).

Reaching out vs exposing SOGIESC populations

Methods and tools for data collection can also be problematic by publicly exposing SOGIESC (e.g. street surveys, focus groups, lack of confidentiality during interviews), which can dissuade non-conforming communities from participating in the process (Tusker-Haworth et al., 2022). Gender roles restricting lesbian and bisexual women to domestic spaces hinders further their participation (Rosenberg et al., 2016; UNHCR, 2020). Lower participation and therefore under-representation in data may inaccurately lead to concluding that diverse SOGIESC communities are absent in a population. The assumption that ±5 per cent of a community are diverse SOGIESC individuals – based on Australian and British surveys – should address the argument of diverse SOGIESC presence in a community and help advocate for more adapted resources (Devakula et al., 2018; HAG and VPride Foundation, 2018). To further incentivise inclusion of SOGIESC issues in humanitarian practices, tracking funds was also identified as a means to document SOGIESC issues and a mechanism towards more accountability (Dwyer et al., 2021).

Adding ‘new’ notions to programming

Humanitarian programming is often based on cisgender and heterosexual notions of social units (e.g. partners, families), which de facto excludes non-conforming diverse SOGIESC social units (e.g. chosen families, same-sex couples, dependent children) (Dominey-Howes et al., 2014; Dwyer and Woolf, 2018; Dwyer et al., 2021; OutRight, 2023; Simmonds et al., 2022; UNHCR, 2012). Livelihood programmes can be mis-adapted and highly gendered, excluding trans* communities or people with non-conforming gender: ‘Transwomen in Beirut, Kampala, and the Ecuadorian border city of San Lorenzo, reported that realistically, there are only two livelihood options available to them: working in hair salons or sex work’ (Rosenberg et al., 2016). In addition, when integrating SOGIESC notions, international organisations often import western notions and narratives of ‘LGBTIQ+’ communities that do not correspond to local diverse SOGIESC communities’ realities (Gaillard et al., 2017b; Tusker-Haworth et al., 2022), for example the importance of dancing in the livelihood of Aravanis is India (Simmonds et al., 2022) or the dual feminine/masculine role of Fa‘afafines in Samoa (Dwyer and Woolf, 2018).

Partnerships towards specific programming

The attribution of human resources towards SOGIESC issues is also often limited, making it difficult to implement targeted programmes (House and Dwyer, 2019; Nathwani and Piccot, 2015; UNHCR, 2017). In response to these programming challenges, most of the documents identified partnerships with local organisations as a solution – even a panacea. However, diverse SOGIESC organisations also present their own challenges, such as their illegality or low resources (Devakula et al., 2018). Partnerships between humanitarian and diverse SOGIESC organisations quickly bring to the forefront questions of capacity building, unequal power relations, trust and safety issues, and lack of correspondence between either organisation’s objectives (Dwyer and Woolf, 2018; Madrigal-Borloz and UNHCR, 2021; Rumbach, 2017; UNHCR, 2021b): ‘In Kampala, the refugee-led Angels Support Group has created a makeshift shelter for LGBTI refugees who would otherwise be homeless. The Angels struggle to find funding to keep this shelter going, and upwards of 10 people are living in a space designed for two’ (Rosenberg et al., 2016).

Despite these caveats, inclusion of diverse SOGIESC communities in humanitarian programming is a consensus across all documents. Those communities, through hired staff, need to be included during all steps of emergency response (from risk mitigation to implementation and decision-making) (UNHCR, 2020). Organisations should therefore propose inclusive measures towards this aim and position themselves clearly for the protection of human rights, including those of diverse SOGIESC communities (Devakula et al., 2018; Madrigal-Borloz and UNHCR, 2021; Rosenberg et al., 2016; UNHCR, 2021b).

Learning about SOGIESC

‘Trainings and sensitisations’ about SOGIESC were the most cited solutions to respond to the challenges mentioned above. The two trainings from the IOM/UNHCR were the most complete (Rumbach, 2017; UNHCR and IOM, 2021). While focused on diverse SOGIESC migrants, these trainings address a variety of important issues: in one training, appropriate language, international laws, safe spaces, myths and realities, protection and reflexivity about SOGIESC diversity (UNHCR and IOM, 2021); in the other training, risk points and potential mitigation responses for participation and outreach, GBV, access to justice, shelter and sanitation, education and livelihood (Rumbach, 2017). Organisations from other humanitarian sectors do not possess such exhaustive trainings, which explains calls for more intersectional and feminist approaches in disaster risk reduction (DRR) (Devakula et al., 2018; Dwyer and Woolf, 2018; Gaillard et al., 2017a; Kiss et al., 2020; Madrigal-Borloz and UNHCR, 2021; Plan International, 2020; Tusker-Haworth et al., 2022; UNHCR, 2024). The staff needs identified in the documents were related to the identification of diverse SOGIESC peoples’ needs and capacity, an increased awareness of their biases and knowledge about SOGIESC and the professionalisation and usage of human rights (Madrigal-Borloz and UNHCR, 2021; UNHCR, 2021b, 2024).

Community

Social exclusion and abuse

Exclusion is often due to social myths about SOGIESC diversity being an immoral choice or a medical illness to be cured (HAI, 2014; UNHCR, 2012). ‘Corrective measures’ (e.g. murder, rape, conversion therapies, physical abuse) can therefore be used to enforce conformity of diverse SOGIESC communities, their allies, or people perceived as such (Margalit, 2018; UNHCR, 2012). Due to the intersection of sexism and homo/bi/transphobia, lesbian, bisexual and trans* women are most targeted by these measures (e.g. forced marriage, rape, honour killing) (IASC, 2018; IGLHRC and SEROvie, 2011; Margalit, 2018; Rosenberg et al., 2016; Türk, 2013; UNHCR, 2012; UNHCR, 2021b). Community exclusion can be expressed in more conservative religious or traditionalist groups, who can blame diverse SOGIESC people for disasters: the latter being a punishment for the former (Dwyer and Woolf, 2018; IGLHRC and SEROvie, 2011): ‘LGBTI communities were further marginalised as churches blamed them for ‘causing’ the earthquake [Haiti 2010]. Following accusatory sermons, some gay and bisexual men were assaulted’ (Dominey-Howes et al., 2014). Employers may avoid hiring diverse SOGIESC people to keep them from ‘hurting the image’ of their company (HAI, 2014). Diverse SOGIESC individuals can also be abused within their family (e.g. neglect, physical and sexual abuse), whether it be due to homo/bi/transphobia or social pressure to exclude them (Balgos et al., 2012; Dwyer and Woolf, 2018; HAI, 2014; UNHCR, 2020): ‘Traditional talanoa discussions [in Fiji] revealed that even if families are willing to accept one of their own as a member of a sexual and/or gender minority, they may feel community pressure to force that person out of the village’ (Dwyer and Woolf, 2018).

SOGIESC communities in disaster risk reduction

There are few examples of diverse SOGIESC communities which are involved in official DRR and humanitarian responses (Balgos et al., 2012; Devakula et al., 2018; Dwyer and Woolf, 2018; Gaillard et al., 2017b). ‘Map’, ‘identify’, ‘engage’ and ‘consult’ are the main courses of action to ‘ensure’ that such communities are represented in humanitarian practices. They experience the same emergencies as the rest of the population but participate in DRR and relief activities through their own informal networks. These networks (e.g. ‘chosen families’) function in parallel with humanitarian services, with the provision of safer spaces, psychosocial support, protection and information (Balgos et al., 2012; Dwyer and Woolf, 2018; UNHCR, 2020). However, these networks are more vulnerable during crises (e.g. loss of resources, need to move/hide) and are hidden from authorities, officials and perceived potential abusers (HAI, 2014; IGLHRC and SEROvie, 2011; IOM, 2020a). Much work must be done by humanitarian workers to reach out to these networks (UNHCR, 2021b).

Public Policy

International regulations

SOGIESC are still not explicit grounds for protection in international law. To this day, they must be interpreted as ‘sex’, ‘political or other opinion’, or ‘any other similar criteria’ (Margalit, 2018). However, monitoring committees for international conventions are providing more and more interpretations denouncing discrimination based on SOGIESC (Margalit, 2018; Türk, 2013; UNHCR and IOM, 2021). At the regional level, resolutions have been passed supporting the inclusion of SOGIESC as protected grounds for protection from discrimination. Decisions, comments and resolutions have been made principally in Europe and the Americas (e.g. by the European and Inter-American Courts of Human Rights). The African Commission on Human and Peoples’ Rights (ACHPR) has also adopted a resolution (ACHPR, 2014) calling explicitly for the end of discrimination and abuse based on SO and GI in Africa (Margalit, 2018).

Domestic regulations

Nationally, specific laws are made to regulate SOGIESC, especially sexual acts (e.g. sodomy between men). For examples, in 2023: same-sex sexual acts were still criminalised in 64 countries, 7 countries officially ordering death sentences; legal gender recognition was impossible in 72 countries, while some countries where it was legal requested surgeries and/or sterilisation; regulations about ‘conversion therapies’ are present in only 24 countries, while only 9 restrict medical interventions on intersex children (ILGA World, 2023). Non-specific laws can also disproportionately target diverse SOGIESC populations like trans* communities (e.g. accusations of impersonation, public debauchery, loitering) or gay men (e.g. anti-sodomy laws) (Rosenberg et al., 2016; UNHCR, 2012, 2021): ‘The police and government institutions are using that penal code to really fight the LGBT community… If [a man] reports sexual violence in a government health facility, they probably will not help [him].... In fact, you may be in much more trouble if you report’ (Chynoweth et al., 2020).

Examples of discriminatory policies based on SOGIESC

The following examples are those reported in the review documents and include domestic disaster management; however, they are illustrative of policies elsewhere. Financial compensations can be restricted to married couples (e.g. Japan and the United States) or ‘male/female’ partners (e.g. India and Nepal), which respectively excludes same-sex couples and trans* partners from receiving aid (Devakula et al., 2018; Gaillard et al., 2017b). Efforts centred on middle- and upper-class neighbourhoods (e.g. 2010 earthquakes in Haiti and Chile), or more expensive touristic areas, often delaying relief towards lower income populations, such as diverse SOGIESC communities (IGLHRC and SEROvie, 2011). Families can also be automatically understood as heterosexual families with biological children (e.g. United States), excluding same-sex partners with adopted children or chosen families (Dominey-Howes et al., 2014).

Omission of SOGIESC in policies

Specific information about SOGIESC may not be included in policies due to the invisibility of those communities. However, a hypothesis of ‘deliberate design’ may account for key disaster management frameworks completely erasing SOGIESC (e.g. the Millennium Development Goals and Sustainable Development Goals or the Hyogo and Sendai frameworks) (Dwyer and Woolf, 2018). Policy documents often put SOGIESC issues aside: ‘Mentions of “LGBTIQ+”, “SOGIESC”, “sexual orientation”, and “gender identity” … is almost exclusively: (a) as part of a list of other dimensions of inequality; (b) in a footnote; or (c) in the glossary’ (House and Dwyer, 2019). International and national policymakers need to be aware of SOGIESC issues to avoid further use of myths and stereotypes, stop tokenistic use of diverse SOGIESC and show inclusivity beyond the male/female binary, cis-heteronormativity and nuclear family (Dominey-Howes et al., 2014; Dwyer and Woolf 2018; Tusker-Haworth et al., 2022; Ward and Lafrenière, 2015).

Discussion

This review identified a variety of humanitarian practices related to SOGIESC according to different socio-ecological dimensions. These practices can then be categorised according to their level of inclusion (Table 2). According to this matrix, many humanitarian practices should be reviewed for being harmful to diverse SOGIESC communities or unaware of SOGIESC issues. Some inclusive and transformative practices are, however, already in place and should be recognised and expanded.

Table 2:

Humanitarian practices’ degree of inclusion (Dwyer et al., 2021) contextualised through socio-ecological dimensions (McLeroy et al., 1988)

Inclusion
Socio-ecological Framework Harmful Unaware Aware Inclusive Transformative
Individual

(knowledge, attitude, behaviour, aptitude, life story)
  • Reliance on ‘discretion’ to avoid services

  • Reliance on ‘secrecy’ to conceal clients’ SOGIESC

  • Uninformed about pre-existing discriminations based on SOGIESC

  • Unrecognised capacities and needs

  • Self-assessment of own bias

  • X

  • Tapping into diverse SOGIECS individuals’ capacities in response to emergencies

Interpersonal

(direct relationships

[e.g. service provider, property owner, friend])
  • Lack of confidentiality

  • Intrusive and abusive language

  • Delegitimising of needs

  • Zero-sum game thinking regarding service provision

  • Anti-SOGIESC rhetoric portraying nonconformity as being immoral, unnatural, or socially dangerous

  • Fear of association with diverse SOGIESC people

  • Inadequate language

  • Undue fear of harm

  • ‘Staying in the closet’

  • Use of stereotypes and myths in relation to SOGIESC diversity

  • Uninformed about what SOGIESC are

  • ‘Coming out’

  • X

  • X

Organisational

(organisations’ characteristics and regulations)
  • Gendered facilities exposing SOGIESC

  • Service provision based on cis-heteronormative criteria

  • Exclusion from databases

  • Inadequate data collection methods/tools

  • Low feedback mechanisms

  • Lack of funds tracking

  • Inappropriate livelihood training

  • Confusion between ‘Sex’ and ‘Gender’

  • Use of ‘LGBTIQ’ without knowledge of local SOGIESC diversity

  • Community-based services

  • Include SOGIESC in specific sectors already about gender or human rights (e.g. GBV, protection)

  • Prioritisation of SOGIESC issues only based on individuals or sporadic events

  • Aggregated SOGIESC data

  • Assume ±5% of population has diverse SOGIESC

  • Hiring diverse SOGIESC or SOGIESC-friendly staff

  • Elaboration of SOGIESC-specific guidelines

  • Clear position on human rights of SOGIESC communities

  • Mandate staff training and sensitisation on SOGIESC issues

  • Providing services based on needs and capacities as well as human rights

  • Revision of key standard operational procedures in partnership with diverse SOGIESC civil society organisations

  • A multi-sectoral approach to including SOGIESC issues

Community

(social structures [e.g. work environment, neighbourhood, healthcare system], relationships between organisations, resource distribution)
  • ‘Corrective’ measures for diverse SOGIESC communities and their allies

  • Use of diverse SOGIESC communities as scapegoats after disasters

  • Confinement of SOGIESC diversity to specific employment sectors

  • Reconstruction efforts targeting middle and upper social classes

  • Cis-heteronormative conceptions of social units (e.g. partners, families)

  • SOGIESC diversity’s dependence on vulnerable networks

  • Vague statements about diverse SOGIESC inclusion in humanitarian responses

  • Provide diverse SOGIESC-friendly referral pathways

  • Fund diverse SOGIESC organisations

  • Account for informal sectors during relief aid and reconstruction

  • Partner with diverse SOGIESC organisations at all stages of emergencies

  • Mainstreaming protection issues in all sectors

  • Sharing practices between diverse SOGIESC and humanitarian organisations

  • Placing inclusive processes to distribute resources first over their delivery as products

Public policy

(laws and policies)
  • Invisibility in official policies or planification

  • Criminalising laws (homosexuality, sex work, drug use, etc.)

  • Pathologizing non-conformal sexual orientations, genders and sex characteristics

  • Cis-heteronormative policies on families

  • Awareness of human rights

  • Tokenistic use of ‘LGBTIQ+’ acronyms or partnerships

  • Legal recognition of gender identities

  • Awareness of human rights related to SOGIESC

  • Anti-discrimination policies

  • Advocacy to remove discriminatory policies

  • Use judicial avenues to abrogate discriminatory laws and policies

Identifying Levers of Action

Understanding ‘SOGIESC’ vs ‘sexes’ vs ‘genders’

Confusions about ‘sex’, ‘gender’ and all SOGIESC-related notions can be identified as an important lever for action by being at the intersection of every socio-ecological dimension (Cislaghi and Heise, 2019). Heterosexual males fear that rape can ‘turn them gay’ (Chynoweth et al., 2020), transwomen are accused of not ‘getting a job like a man’ or referred to male facilities (e.g. housing) by service providers (Rosenberg et al., 2016), intersex people – the ‘I’ in the LGBTIQ acronym – are both ‘absent’ and ‘accounted for’ in organisations’ reports (Rosenberg et al., 2016), communities use ‘corrective measures’ (e.g. bullying, conversion therapies, rape, forced marriage, killing) to ‘transform/conform’ identities (UNHCR, 2012) and public policies conflate sexual activities (e.g. sodomy) with SO or GIE (Türk, 2013). These confusions often rely on a simplistic, historical and binary conception of ‘sex’ (‘male/female’) as equating to ‘gender’ (‘man/woman’) (Garofalo and Garvin, 2020). This conception has been proven scientifically to be much more complex and based on ambiguous observations. The humanitarian sector is not impermeable to this confusion, often using ‘Gender’ interchangeably with ‘Sex’ or synonymously with ‘Women’ (meaning ‘cis-women’) (Gupta et al., 2023).

Adding to these confusions, the humanitarian sector often imports culturally specific western nomenclatures (e.g. LGBTIQ+) and understandings, often hiding the realities of local diverse SOGIESC communities (e.g. Aravanis, Warias, Baklas) (Tusker-Haworth et al., 2022). Experiences of emergencies are highly specific to their contexts, which highlights the importance of the ‘localisation’ agenda in the humanitarian sector. This agenda aims at increasing local actors’ and populations’ participation in the humanitarian sector (Wall and Hedlund, 2016). However, this agenda remains to be better defined and operationalised (CHS Alliance, 2018; Wall and Hedlund, 2016). Regarding SOGIESC, many questions remain unresolved: How can foreign organisations involve diverse SOGIESC populations without being aware of them? How can they provide space for participation in contexts of criminalisation or social exclusion?

Changing the humanitarian culture towards better governance

Such questions can be difficult to answer, especially in a humanitarian system that can be still be characterised by patriarchy, machismo, paternalism and colonialism, urgency to act, and hierarchical ways of thinking (Gupta et al., 2023). Cultural changes are likely necessary to respond to these questions, including addressing the issue of governance. Governance can be described through different principles but, in relation to SOGIESC, the principles of ‘Legitimacy and Voice’ (e.g. participation) and ‘Direction’ (e.g. strategic vision) come to mind (Graham et al., 2003).

The principle of ‘Direction’ can be understood as the ability to foresee long-term objectives and the steps needed to attain them, all within complex historical, cultural and political settings (Graham et al., 2003). This principle seems contradictory to disaster management, which is based on the urgency to act, off-script actions and one-size-fits-all procedures (Gupta et al., 2023). The absence of ‘direction’ has many potential effects. For example, after the tsunami (2004) in Chennai, resettlement colonies were built to lodge survivors, such as the Semmanjeri neighbourhood. However, these colonies were built in highly vulnerable sites with high risks of flooding (Jain et al., 2017); the title of the article ‘In Semmanjeri: “We get a tsunami every year”’ summarises this contradiction well (Palani Kumar, 2020). Repeated disasters and humanitarian responses have created undesired and avoidable long-term effects among the most vulnerable populations: loss of dignity and agency, greater dependence on external assistance and mistrust of local institutions, distorted local economies (e.g. arrival of humanitarian workers and organisations, over-distribution of unsustainable boats leading to over-fishing) and costly, maladapted and unsustainable infrastructures (Jain et al., 2017). Lack of ‘direction’ has also led to undesired and avoidable effects in relation to SOGIESC issues (e.g. exile of diverse SOGIESC peoples from refugee camps, exclusion from food distribution) (Seppey et al., 2024b).

To see a new ‘direction’, one needs to legitimate and give a voice to the concerned people. Partnerships were a solution often mentioned in documents and were thought to be the way forward (Seppey et al., 2024b). Increased contacts, including partnerships, have been proven to change social attitudes towards SOGIESC diversity (Steffens and Preuß, 2020). Concrete measures were identified, such as hiring diverse SOGIESC individuals in organisations (Rosenberg et al., 2016) and creating external partnerships with local diverse SOGIESC organisations (Dwyer et al., 2021). However, to be transformative, these solutions must be supported by organisational structures, target decision-making and be accompanied by realism; diverse SOGIESC individuals or organisations cannot be the saviours or be solely responsible for their communities’ inclusion in humanitarian work (Gupta et al., 2023). These partnerships are opportunities for all participants to create expertise, whether in humanitarian practices or SOGIESC issues, and to reflect on one’s biases, whether against humanitarian work or SOGIESC diversity. Learnings from these partnerships should be translated into practical results, followed by thorough supervision from partners, to ensure accountability toward communities – another principle for good governance (Gupta et al., 2023).

Limitations

This type of review was chosen due to a limited timeframe and motivated by the need for rapid recommendations to inform strategic development in an organisation (Tricco et al., 2015). Therefore, its scope may not encompass all contexts and issues in the literature. Different gaps can be noted, such as the diversity in migratory crisis (e.g. in South America, North Africa or the West Balkans), armed conflicts (e.g. Syria, Colombia, Ukraine) and refugee camp management (e.g. Cox’s Bazar in Bangladesh, Kakuma in Kenya).

A critical appraisal was conducted (Seppey et al., 2024b: Appendix 2: Critical appraisal) using the AACODS checklist (Tyndall, 2010); no document was excluded due to its score. Through this appraisal, expert organisations and individuals have been identified in relation to the intersection between humanitarian work and SOGIESC issues: UNHCR, IOM, Edge Effect, E. Dwyer, J. Rumbach, J. C. Gaillard and A. Gorman-Murray. The quality and significance of certain documents are worth mentioning (Balgos et al., 2012; Devakula et al., 2018; Dwyer and Woolf, 2018; Dwyer et al., 2021; Rengers et al., 2019; Robertson et al., 2021; Rosenberg et al., 2016; Tusker-Haworth et al., 2022).

Conclusion

Queering humanitarian work and practices is on its way but there is much work to be done. Discrimination, in all socio-ecological dimensions, is a part of diverse SOGIESC peoples’ lived experience, from a personal to a public policy point of view: it is already present when emergencies occur, and then it becomes amplified. Misconceptions about SOGIESC communities, and governance aspects of humanitarian work, have been identified as key levers towards SOGIESC inclusion. Humanitarian work should do more than alleviate circumstantial vulnerabilities and take on higher principles to ensure ‘fairness’, ‘accountability’, ‘performance’, ‘legitimacy and voice’ and ‘direction’ (Graham et al., 2003) for diverse SOGIESC populations. It cannot fail diverse SOGIESC peoples, to whom it is morally bound. Changes must be made for the road to failure is paved with good intentions.

Acknowledgements

Thanks to Céline Füri, Coline Camier, Geneviève Némouthé and Patrice Charpentier for the preliminary discussions of this review and thanks to Matthew Rettino for the editing and final review.

Funding

This work has been funded by the Fonds de recherche du Québec – Bourse Tremplin 2023, Égides and the Centre de Recherche en Santé Publique.

Note

1

We use ‘diverse SOGIESC’ people/communities to refer to individuals/populations with SOGIESC different from heterosexual, cisgender and endosexual. We prefer this nomenclature to the LGBTIQ+ acronym and its derivatives since they often refer to western cultural notions and can be more politically charged.

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  • Margalit, A. (2018), ‘Still a Blind Spot: The Protection of LGBT Persons during Armed Conflict and Other Situations of Violence’, International Review of the Red Cross, 100(907–909), 23765, doi: 10.1017/S1816383119000201.

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