2SLGBTQ+ refers to individuals who identify as Two Spirit, Lesbian, Gay, Bisexual, Pansexual, Trans, Gender Independent and Queer. 2SLGBTQ+ newcomers have faced unique challenges that can challenge healthcare providers who are not equipped to provide inclusive and culturally competent care.

As such, many 2SLGBTQ+ newcomers have fled their home countries due to sexual and gender-based persecution and violence, and may have acute health needs. Homophobia and transphobia may also have prevented these patients from accessing care in their home countries, exacerbating chronic conditions. Special consideration should be given to lesbian, bisexual, queer and two-spirit women, who are more likely to be survivors of sexual violence, female genital mutilation and forced marriages. Gender nonconforming newcomers may also have faced heteronormative urological or gynaecological checkups in their home countries, and as such may not be up to date with many screening tests. Certain pediatric patients in this population, such as those with intersex traits, may have undergone hormonal or surgical treatments to forcibly change their appearance. Additionally, 2SLGBTQ+ newcomers are more likely to have symptoms of Post-Traumatic Stress Disorder and suicidal ideation due to histories of conflict and persecution, compounding familial rejection, homophobia and transphobia. Providers must be aware of these increased risks in order to provide trans-inclusive, unbiased care.