Stigmatised gay, bisexual and transgender Syrian refugees who survived sexual violence in war are struggling to get medical or mental health care, human rights groups said on Wednesday. More than 40 LGBT+ survivors in Lebanon told Human Rights Watch that they were raped, sexually harassed and had their genitals burned by government forces and armed groups, including Islamic State, resulting in physical and psychological trauma. But existing services tend to focus on women and girls and survivors said they were reluctant to seek help for problems like depression and rectal bleeding because of shame. “There’s already so much stigma … so imagine in a conflict setting where violations are rife. The minute they even see you presenting as soft, they will take it as a sort of excuse to attack,” said Sara Kayyali, HRW Syria researcher. “When you’re gay in Syria and this happens to you, your own family – and we’ve documented cases of this – will tell you, ‘Get out, leave the country. I wish they killed you’,” she told the Thomson Reuters Foundation. Government officials in Syria and Lebanon – which hosts almost 1 million Syrian refugees according to the United Nations – did not immediately respond to requests for comment.