The Group for the Advancement of Psychiatry (America’s mental health think tank) calls for an end to the use of Title 42 to expel asylum seekers at the southern border. This policy places LGBTIQ asylum seekers in particular danger.
Among us are psychiatrists who evaluate people fleeing persecution, including those who are lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ). We have heard their devastating stories, and we know the mental health consequences of the human rights abuses they have suffered.
“Marina” and her young daughter fled their Central American country after years of persecution based on her lesbian sexual orientation and gender-nonconforming behavior. Her daughter was born after a so-called “corrective rape” by a local gang leader. At the US southern border, the 2 were forced to remain in Mexico under Title 42 [see following] and the Migrant Protection Protocols. During months of forced waiting, they experienced robbery, kidnapping, extortion, and sexual molestation.
Title 42 is a Trump Administration policy continued by the Biden Administration that blocks entry of refugees into the United States at the US-Mexico border under the pretext of public health. Part of US health law, Title 42 prohibits entry into the United States when the director of the Centers for Disease Control and Prevention (CDC) believes “there is a serious danger to the introduction of a disease into the United States.”
Protecting the public from SARS-CoV-2 does not require sacrificing the human rights and well-being of legitimate asylum seekers seeking safe haven from torture and other human rights abuses in the United States. Even some of the CDC’s own physicians argued that halting the asylum process was not based on protecting public wellness and safety. Title 42 can be rescinded in a safe way that is not a risk to public health.
Yet for reasons that probably have more to do with politics than public health, the Biden Administration and the CDC have extended this policy indefinitely. While the United States has historically been a beacon of hope for refugees fleeing persecution, the plight of refugees has been increasingly caught up in electoral politics. The American Immigration Council reports that the Biden Administration has banned more than a half million immigrants from entering into the United States and has increased the number of expulsions over the previous administration by 67%.1
American law and international human rights treaties require that the United States and other countries offer the right to seek asylum. According to Karen Musalo, JD, professor and founding director of the Center for Gender and Refugee Studies at UC Hastings, “Until Title 42 is rescinded, the US will continue to be in blatant violation of its domestic and international legal obligations.”2
Refugees expelled to the areas of Mexico just south of the border face grave danger. Human Rights First has tracked at least 1500 public reports of rape, torture, murder, and other human rights abuses among refugees in Mexico.3 The Marshall Project reports that the migrant death rate has almost doubled under Title 42.4
This situation is disheartening for all who value international laws that protect the right of those who have suffered persecution to seek safety. It is life threatening to those expelled—vulnerable human beings, especially those who are LGBTIQ, those who are living with HIV, Black and African migrants, unaccompanied minors, and families with young children. Anti-LGBTIQ and racist violence are well documented at the border.
Marina and her daughter eventually found safety. An attorney investigating cases of asylum seekers expelled to Mexico identified them as especially vulnerable and took on Marina’s case. A volunteer psychiatrist also evaluated the mental health consequences of her trauma. Asylum was granted in US Immigration Court.
We implore President Biden, his administration, and the CDC to reverse a policy that puts LGBTIQ asylum seekers and other refugees in peril and does not keep COVID-19 and its variants out of the United States. The United States should continue its honorable tradition of offering safe haven to those fleeing persecution and continue to uphold international human rights treaties and conventions that it has long championed. Now is the time to make a comprehensive break with the cruel and harmful immigration policies of the previous administration.
For further reading, see “42 U.S. Code § 265 - Suspension of Entries and Imports From Designated Places to Prevent Spread of Communicable Diseases.”
Dr Ahola is medical director emeritus at the Weill Cornell Center for Human Rights and has a private practice in New York City. Dr Adelson is director of the Youth Equity Science/YES Project; a senior visiting fellow at Yale Law School; an assistant clinical professor at Columbia University College of Physicians & Surgeons; and a clinical assistant professor at Weill Cornell Medical College. Dr Ashley is an associate professor of clinical psychiatry at Icahn School of Medicine at Mount Sinai. Dr Barber is an Episcopal priest at St George’s Church in Newburgh and St Paul’s Church in Poughkeepsie. Dr Byne works with the Division of Gender, Sexuality and Health at Columbia University College of Physicians and Surgeons. Dr Casoy is a community and public psychiatrist in New York City. Dr Chavez is a psychiatrist, LGBTQ+ Specialty Team (Southern Colorado VA) LGBTQ+, and veteran care coordinator senior instructor at University of Colorado Denver. Dr Drescher is a clinical professor of psychiatry at Columbia University and an adjunct professor at New York University. Dr Erickson-Schroth is an assistant professor of psychiatry at Columbia University Medical Center and a consulting psychiatrist at the Hetrick-Martin Institute. Dr Ghazzawi is a public psychiatry fellow at Columbia University. Dr Goldenberg has a private practice in New York City. Dr Hung is a consultation/liaison telepsychiatry assistant professor of clinical psychiatry at Weill Cornell Medicine, and an adjunct assistant professor of clinical psychiatry at Columbia University. Dr Libby is an assistant clinical professor at the Yale Child Study Center. Dr Lothwell is a clinical assistant professor in the Department of Psychiatry at New York University’s Grossman School of Medicine, and has a private practice in New York City. Dr Mattson is a professor emeritus of clinical psychiatry at Weill Cornell Medical College. Dr McAfee is vice chair and residency training director at SUNY Downstate Medical Center. Dr McIntosh is an associate professor in the Department of Psychiatry at the University of Toronto. Dr Nowaskie is a psychiatry resident (PGY4) in the Department of Psychiatry at Indiana University School of Medicine, and founder and president of OutCare Health. Dr Schwartz is on the faculty and supervisor of psychotherapy at the William Alanson White Institute, and has a private practice in New York City. Dr Tompkins is director of the Division of Substance Abuse and Addiction Medicine, and an associate clinical professor of psychiatry at the University of California, San Francisco School of Medicine. Dr Yarbough has a private practice in New York City.
1. Loweree J; Reichlin-Melnick A. Tracking the Biden agenda on legal immigration in the first 100 days. American Immigration Council. April 29, 2021. Accessed December 1, 2021.
2. Flores A. Immigration 101: what is Title 42? America’s Voice. June 28, 2021. Accessed December 1, 2021.
3. Delivered to danger: U.S. Government sending asylum seekers and migrants to danger. Human Rights First. February 19, 2021. Accessed December 1, 2021.
4. Calderón AR; Dias I. Strict border enforcement policies put migrants in harm’s way. Title 42 is no exception.The Marshall Project. May 26, 2021. Accessed December 1, 2021.