Health among sexual and gender minority people affected by armed conflict and forced displacement: Call for a biocultural and minority stress framework

Sexual and gender minority (SGM) populations are vulnerable to the intersecting challenges of armed conflict and forced displacement (ACFD), yet their unique health needs remain largely overlooked. We synthesize current scholarship on SGM populations affected by ACFD, with a focus on structural, psychosocial, and biological mechanisms that may impact SGM health. SGM populations face compounded risks during ACFD, including social exclusion, targeted violence, and limited access to humanitarian aid. These psychosocial stressors—heightened by social isolation and identity concealment—may be exacerbated by structural inequities, such as exclusion from shelters, healthcare, and legal protections. Chronic exposure to these conditions activates pathways of systemic inflammation, dysregulated immune responses, and metabolic disruption, which may enhance risks for a range of physical and mental health outcomes, including cardiovascular disease, PTSD, and accelerated biological aging. Our narrative review and conceptual synthesis demonstrates a paucity of empirical evidence regarding SGM populations affected by ACFD, for complex reasons which are discussed. Additionally, our review underscores that there is multi-sectoral awareness that further research and research-to-policy initiatives are needed to improve health and access. Drawing from Minority Stress Theory (MST) and biocultural anthropology, we advocate for an integrative conceptual approach that researchers can adopt to examine how structural violence, resource insecurity, and stigma may become biologically embedded, leading to adverse health outcomes in the context of ACFD. This review underscores the need to develop integrated, holistic approaches to study the experiences of SGM populations and promote health equity in and beyond crisis settings.