This blog post reviews some common support needs of transgender and gender non-conforming (TGNC) newcomers and discusses how you can be an affirming provider. It addresses client needs related to health, welcoming, and social services, and provides detailed information on legal concerns. This blog was informed by the experiences and contributions of Ari M. K. Jones, Esq., from Oasis Legal Services; Abby Davies and Jamie Sgarro from InReach; Max Niedzwiecki of the Episcopal Migration Ministries’ Rainbow Initiative; Anita Fábos of Clark University; and Craig Mortley of the University of Connecticut School of Social Work.
Transgender and gender non-conforming (TGNC) newcomers face unique challenges at the intersection of gender identity and immigration status. They must navigate complex systems to affirm their gender while dealing with immigration barriers, often experiencing discrimination, violence, and mental health issues due to transphobia and societal norms. This dual marginalization necessitates specialized services for TGNC newcomers beyond those typically offered to newcomers in general.
Accessing affirming, culturally competent, and trauma-informed services is often difficult for TGNC newcomers, who may also face isolation from other newcomer communities. Many experience gender dysphoria—a sense of distress due to a mismatch between their gender identity and their sex assigned at birth. Mismatches between their gender expression and gender markers on their official documents can expose them to potential harm.
Support Needs
The needs of TGNC newcomers can vary significantly and are influenced by diverse factors such as country of origin, languages spoken, socioeconomic status, and gender identity. TGNC people, including newcomers, often have to also navigate hostile and dangerous environments that impact their health and ability to successfully integrate into their communities. They are significantly more likely to be victims of violent crime than are cisgender people, and in 2024 alone have been targeted by at least 624 bills intended to limit their rights in 43 states.
Transition-Related Care
Transition-related care refers to the process that transgender and gender non-conforming individuals go through to align their physical appearance, social roles, and identity with their gender. This can include medical treatments such as hormone therapy or surgeries, as well as non-medical changes like choosing a new name, pronouns, and appearance. It’s important to note that transition-related care is highly individual, ranging from medical interventions to social changes, and evolving over time.
TGNC individuals who are newcomers face unique challenges in accessing this care, including:
- Navigating health care systems that are often unfamiliar with non-Western gender concepts and TGNC people
- Overcoming cultural and language barriers
- Understanding the full range of possibilities available in the U.S., as well as informed consent related to gender-affirming treatment
- Needing to provide documentation that they may not have access to, such as a photo ID, proof of income, or insurance
- Experiencing discrimination and stigma, whether from within health care systems or their own cultural communities
- Managing mental health challenges, including the stress of navigating a new country combined with the unique pressures of being TGNC
Consequently, in addition to navigating the complex U.S. immigration system, many TGNC newcomers face restricted access to gender-affirming care, denial of bathroom and facility use consistent with their gender identity, and opposition from people in positions of authority whose anti-TGNC stances are officially sanctioned, not to mention disproportionate threats to their physical safety.
For all these reasons, it is important for resettlement agencies to direct attention to the distinctive needs of TGNC clients.
Enhancing Resettlement Agency Support for TGNC Newcomers
Resettlement agency staff may not be aware that they are serving TGNC clients. Intake forms should offer opportunities, but not requirements, for clients to specify their sexual orientation and gender identity beyond the male/female binary designations, including a custom write-in option. It is helpful to avoid making assumptions about clients’ gender identities based on how they present (e.g., clothing, haircut, name, etc.).
Due to safety, privacy, or cultural concerns, some newcomers may not immediately feel comfortable sharing their gender identity or sexual orientation. Communicating about gender identity and expression across languages and cultures is complex. Stay up to date with affirming language: for example, use “sexual orientation” instead of “sexual preference” and “gender-affirming surgery” instead of “gender reassignment surgery.” It is equally important to use appropriate terminology in languages other than English. Glossaries of LGBTQ+ terms in multiple languages are published by organizations such as GLAAD, the Human Rights Campaign (HRC), the National Immigrant Justice Center, Center of Excellence on LGBTQ+ Behavioral Health Equity, and RUSA LGBTQ+.
Confidentiality is essential for TGNC clients. Do not share someone’s identity unless they give you explicit permission. Never assume that other newcomers are a safe haven or resource for every TGNC client, including those who they are traveling with and their own family.
When connecting clients to local service providers, make sure to send TGNC newcomers to trans-affirming services in their area. You can find information on establishing partnerships in this recent blog post.
Connecting TGNC Newcomers with Specialized Mental Health Resources
Affirming mental health care is crucial for many TGNC newcomers, who often arrive in the U.S. after experiencing social isolation, imprisonment, violence, torture, and death threats. Mental health providers who work with TGNC newcomers must be not only trans affirming, but also culturally competent, trauma-informed, and (when possible) proficient in relevant languages.
Alongside private therapy and counseling, support groups can be beneficial. While options specifically for TGNC/LGBTQ+ newcomers may vary in availability across states and regions, newcomers can also explore groups focused on shared identities such as their trans identity (e.g., for trans masculine folks), race/ethnicity, or language. In addition, online support groups such as those accessible through Trans Lifeline and some LGBTQ+ community centers can be extremely helpful. Be aware, however, that not all LGBTQ+ organizations will have sufficient expertise with newcomers or with TGNC populations; many focus more on sexual orientation than gender identity and on working with people who are U.S.-born.
Social Services and Referrals for TGNC Newcomers
In addition to mental health support, TGNC newcomers require access to the full range of services that are available to other clients. These services often need to be tailored to address the unique challenges and systemic barriers TGNC newcomers face. It’s also important to recognize that many TGNC newcomers continue to face discrimination, including from service providers. Accessing safe housing remains particularly challenging, despite the existence of some helpful programs as well as resources available through the U.S. Department of Housing and Urban Development.
InReach (formerly known as AsylumConnect) aims to connect TGNC and other queer people, including newcomers, to appropriate services. Launched in 2016, InReach is the world’s first open-source platform matching LGBTQ+ people facing persecution or discrimination with safe, independently verified resources through its free platform.
Diverse Legal Needs of TGNC Newcomers
TGNC newcomers face a wide variety of legal issues, including increased exposure to discrimination and violence, over-policing due to profiling, and violence when incarcerated. For more information about responding to the diverse legal needs of TGNC newcomers, please refer to our blog post Safeguarding Identity and Addressing the Legal Needs of LGBTQ+ Newcomers.
Name and Gender Marker Changes
For many TGNC newcomers, updating their legal name and/or gender marker is a priority. Using identity documents that display a name or gender marker that doesn’t affirm their gender identity or feels like it doesn’t fit who they are can contribute to someone’s gender dysphoria.
However, not all TGNC newcomers will prioritize a legal name or gender marker change, so avoid pressuring them to follow a specific course of action or timeline. Some TGNC people want to use the name they were assigned at birth. Some may not want to update their gender marker. As a provider, what’s most important is giving clients choices, empowering them, and following their lead while providing trauma-informed care.
For TGNC newcomers navigating the process of updating identity documents, it’s common to encounter mismatches between U.S. and foreign country documents. Carrying legal evidence, such as a court order, can help address this. Additionally, TGNC refugees or asylees should consult a legal professional before seeking document changes from their consulate to avoid jeopardizing their refugee status. More detailed information on U.S. Citizenship and Immigration Services (USCIS) policies and considerations when updating name or gender markers can be found in our blog post Safeguarding Identity and Addressing the Legal Needs of LGBTQ+ Newcomers.
Additional Resources
For further training and resources on supporting TGNC and other LGBTQ+ newcomers, check out these resources in the Switchboard library:
- Archived Webinar: Understanding and Serving LGBTQ+ Refugee and Newcomer Clients (2024)
- Archived Webinar: Creating Inclusive Spaces for the LGBTQ+ Community in Newcomer Services (2024)
- Archived Webinar: LGBTQ+ Responsive URM Programs and Services (2024)
- Blog Post: Proud to Welcome All: Community Education about LGBTQ+ Newcomers at Pride and World Refugee Day Events (2024)
- Blog Post: Welcoming LGBTQ+ Newcomers: Practical Tools and Tips (2024)
- Blog Post: Link when ready: Safeguarding Identity and Addressing the Legal Needs of LGBTQ+ Newcomers (2024)
- Podcast: Serving LGBTQ+ Newcomers (2023)
You can also access resources from the organizations that contributed to this blog post, as well as other Switchboard resources related to serving the LGTBQ+ community:
