Abstract
Sexual and gender-diverse (SGD) survival migrants face unique challenges navigating multilevel stigma across migratory phases while seeking asylum in the United States. This analytic essay extends Ungar's social-ecological conceptualization of resilience to understand how SGD survival migrants strategically manage their identities within traumatogenic processes to progress from survival to flourishing. We examine 2 critical migration-related stressors: the social visibility dilemma and intersectional concealability. The social visibility dilemma emerges from US asylum requirements mandating visible SGD identity demonstration, creating paradoxical pressures for individuals conditioned to conceal their identities in high-stigma environments and avoid associated stigma for loved ones in their countries of origin. Intersectional concealability refers to how multiple stigmatized identities perceived by others may launch stigma cascades operating through mechanisms of contextual believability and perception-based cascades. Resilience among SGD survival migrants reflects atypical, culturally relative strategies that challenge Global Northern paradigms of identity coherence. Public health practitioners and policymakers must recognize that apparent inconsistency often represents sophisticated adaptation within constrained environments. Recommendations include trauma-informed mental health care, peer support networks, asylum process reforms protecting confidentiality, and validation of diverse identity expressions beyond Global Northern visibility norms. (Am J Public Health. 2026;116(2):222-228. https://doi.org/10.2105/AJPH.2025.308337).