Healthcare Access and Utilization Among Sexual and Gender Minority Migrants to Europe: A Systematic Review.

The purpose of this systematic review was to examine healthcare access and utilization among sexual and gender minority (SGM) migrants in Europe. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, Web of Science, Scopus, CINAHL, and Ovid MEDLINE from database inception through October 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published in English; (2) conducted in European countries; (3) focused on sexual and gender minority (SGM) migrants; and (4) examined healthcare access, healthcare utilization, or care experiences, with health outcomes considered as a secondary criterion only when reported alongside one of these primary measures. Studies that failed to meet all criteria were excluded. The methodological quality of included articles was assessed using the Joanna Briggs Institute appraisal tools, and findings were synthesized narratively. Sixteen studies were included in the final synthesis (10 quantitative, 6 qualitative). Most were cross-sectional and focused on HIV and sexual health services, particularly among migrant men who have sex with men. Barriers to healthcare access varied by domain: qualitative studies of general healthcare access (4 of 16 studies) reported legal insecurity, discrimination, language barriers, and limited culturally responsive, migrant-sensitive, and linguistically accessible services, whereas quantitative studies of HIV and sexual health services identified more specific, study-varying barriers such as low perceived risk and uneven testing or PrEP uptake. Evidence on mental health, general healthcare, and gender-affirming care was limited, with transgender people, and lesbian and bisexual women, underrepresented and no identified study specifically addressing healthcare access or utilization among intersex migrants. Most studies were conducted in a small number of regions, limiting generalizability across Europe. SGM migrants in Europe face substantial and multifaceted barriers to accessing healthcare, with existing research concentrating on a narrow range of services and populations. Broader research is needed to understand diverse healthcare needs better and to support equitable and accessible healthcare systems for SGM migrants.