BackgroundAsylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of ‘othering’. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting ‘minoritization’ processes and the ‘pathologization’ of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities.MethodsFor the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status.ResultsThe analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. DiscussionsMacro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-levellegislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how ‘minoritization processes,’ influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status.ConclusionsEquitable health care provision requires systemic change that incorporate understandings of marginalization, ‘othering’ processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status.

<p>Esse artigo teve como objetivo desenvolver uma análise crítica de discursos sobre imigração e a posição que alguns imigrantes ocupam no discurso social. O foco é dado nos processos de minorização de alguns grupos, destacando a questão de gênero sem deixar de considerar as intersecções entre sexualidade, raça e classe social, conforme a tradição dos estudos críticos feministas e pós-coloniais. Neste sentido, examinamos alguns fragmentos de casos de imigrantes recém-chegados em um grande centro urbano, São Paulo. A posição em relação ao imigrante, como representante da alteridade, nos permitiu levantar algumas considerações, tendo como operadores a teoria da psicanálise, de Foucault e de estudos feministas e antirracistas. Nos casos apresentados, nota-se que o próprio processo de imigração muitas vezes não é levado em consideração na relação com o imigrante, o que pode naturalizar as diferenças sociais como traços individuais patologizados quando não criminalizados. Diversas posições dentro do imaginário social são ressaltadas e vividas nas relações com imigrantes. Ainda que com suas especificidades, pode--se ressaltar que uma série de discursos sobre imigrantes são continuamente reiterados colocando-os muitas vezes nas posições de vítimas, ameaças ou seres exóticos. Partindo dessa reiteração discursiva, analisamos como o outro é constituído nesse discurso, muitas vezes aparecendo como um outro fetichizado. Essa análise visou promover pontos críticos para intervenções e políticas públicas.</p>

Purpose The purpose of this paper is to debate intersectionality as a key methodological aspect for critical research. While intersectionality is a consensus for critical studies, it is important to highlight the challenges that a perspective that consider power relations across social categories put forward. For this, I examine how these relations are seen in research, and highlight the risks of hierarchical views on social categories, or the invisibilization of those same categories. Design/methodology/approach These reflections will be primarily based on previous research on immigration in São Paulo and on older transsexual women in Brazil, studies that required a multi-faceted analysis. The studies were based on critical feminist, post-colonial studies and psychoanalysis to examine discourses and to unravel the social imaginaries on the immigrant and on transsexual women in Brazil. For this, I bring forth the notion of the other as a discursive space often placed on these groups, and how the discursive position also reflect views on gender, race, sexuality and class as structural discursive boundaries in Brazil. Findings Taking the border as a metaphor to read everyday encounters, the body becomes a mark of difference, where subjects are placed at specific discursive (and also geographical) positions – at the center or at the margins. Taking this into account, the paper highlights two main aspects: first, a debate on the importance of intersectionality for critical methodological frameworks, and second, how critical discourse analysis allow us to defy the taken-for-granted binary constructions of other-us, that are continuously re-evoked and reified in discourse. Originality/value This debate is important as there are innumerous ways of approaching intersectionality, hence a critical analysis into current debates and methodological standpoints become central.

Individuals excluded from 'the social contract' are subject to a certain irruption of the traumatic, understood as subjective disorganization resulting from the emergence of that which is outside sense and outside signification. Such subjects experience the loss of a discourse of belonging and of being afforded a place in society. The lack of narcissistic gratification, along with the exclusion from group ideals and values, foster a fragmentation of social ties and produce disruptive effects in subjectivity. This paper discusses the possibilities afforded by psychoanalytic listening to subjects who have experienced social exclusion as traumatic: those who suffer extreme poverty and social exclusion within neoliberal economic models. Examples are drawn from clinical work with young people who live on the outskirts of the city of São Paulo and who have had the experience of living in the streets. Rather than attuning to this sort of listening, it is not rare for those in some social agencies and in some forms of psychotherapy to mistake apathy, loneliness and muting for structural characteristics of the subject rather than as the effects of exclusion and the reproduction of a form of social violence. This misrecognition precludes the creation of a symbolic elaboration that could provide a symptomatic shape to that which is experienced as traumatic. This paper argues for the possibility of listening to subjects silenced by exclusion.

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ResumoEsse artigo traz algumas reflexões sobre travestilidade e envelhecimento, baseadas na pesquisa Travestilidade e Envelhecimento. O tema do envelhecimento da população travesti e transsexual é pouco investigado nas pesquisas brasileiras, e há aqui uma grande gama de aspectos que necessitam de visibilidade e debate. Considerando o contexto transfóbico em que se encontram, destaca-se aqui aspectos levantados na pesquisa relacionados à saúde da população travesti e das mulheres trans em relação às mudanças corporais; as imigrações das travestis e mulheres transsexuais; e a história contada por elas. Nesse sentido, é ressaltada a importância em dar voz às travestis e populações transgêneras, num contexto o qual aspectos relacionados aos efeitos da transfobia são continuamente ignorados e ofuscados, o que coloca em xeque por um lado a garantia dos direitos humanos das populações transsexuais e travestis e por outro, revela como esses grupos configuram na história.

Este artigo pretende trazer reflexões para a clínica com foco na relação com a alteridade a partir da experiência no trabalho com crianças imigrantes na cidade de São Paulo. Considerando que na contemporaneidade as crianças são interpeladas, cada vez mais, por discursos objetificantes, esse trabalho pretende refletir sobre como estes operam na intersecção com discursos sobre imigração e como estes afetam a prática clínica. Para tanto, esse estudo irá retomar a discussão da infância enquanto uma categoria histórica, social e política e analisará específicos discursos sobre a criança imigrante no contexto escolar e na saúde mental. Esta análise contribui ao debate sobre a escuta na clínica, na qual ressaltamos a reflexão sobre alteridade e a importância em considerar o contexto social do sujeito, assim como o ideal de infância que está em cena, na sua relação com as categorias de gênero, raça e classe e imigração.

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