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Background.-Transgender women (TW) in Puerto Rico (PR) face social stigmatization. Physicians' transgender stigma can have detrimental consequences for TW's health. Purpose.-The objective of this study was to document physicians' knowledge, competencies, and attitudes towards TW in PR and study their associations with stigma towards TW. Methods.-We implemented an exploratory sequential mixed-methods study. We used in-depth interviews (n=30) and self-administered questionnaire (n=255). Results.-Qualitative results illustrated lack of recognition of the needs of TW; they also evidenced the impact of stigmatizing attitudes on clinical decisions. Quantitative results showed that more willingness and knowledge to provide health services to TW were negatively associated with stigma. Participants who reported history of training in working with TW presented significantly less stigma than participants who had not received such training. Conclusion.-In order to provide stigma-free services for TW in PR, specialized training regarding the particular needs of this population is needed.

A sample of 302 Puerto Rican gay males living in Puerto Rico and New York participated in this study with the objective of assessing the prevalence of domestic violence. A self-administered questionnaire was developed addressing issues of intergenerational violence, addictive behaviors, and domestic violence in three dimensions: emotional, physical, and sexual violence. The results concluded that close to half of the participants had experienced some sort of violence in their intimate relationships, have a history of being witness to domestic violence in their family of origin, and had identified in themselves and their families, addictive behaviors. Other variables measured are HIV and sexual coercion, drug and alcohol abuse, and levels of acculturation among participants living in the United States. The main objective of this work is to describe the development of the instrument used in the study. Based on the results of this study we describe the psychometric characteristics and content of the final questionnaire. Final recommendations are made for other researchers interested in doing domestic violence studies with Latino gay men and men who have sex with men.

Transgender or trans people are deeply affected by social stigma in a wide range of forms and contexts including family, school, neighbourhood, work and clinical settings. Studies have rarely focused on how stigmatisation affects trans individuals’ experiences of travel and tourism. This research sought to critically explore the constraints that prevent trans people from engaging in tourism in Mexico. We conducted in-depth interviews with 15 trans participants. Experiences related to intrapersonal, interpersonal and structural constraints on tourism were explored during interviews. The findings include that trans men and women do not experience tourism constraints equally, and interpersonal constraints are closely related to social stigma that in turn influence these individuals’ fear of being discriminated against, abused or killed while travelling or engaging in leisure activities. The results are discussed in light of leisure and tourism constraints theory. Managerial implications include ways that the tourism industry can contribute to reducing constraints for trans travellers.

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Latin America is one of the deadliest regions for trans communities. Scientific research generated in the region has reported that trans people live through a complicated panorama shaped by multiple forms of oppression, extreme violence, and micro-aggressions. Although necropolitics, as a theoretical approach, has been useful to understand how State policies negatively affect trans individuals, it does not fully account for informal dynamics within groups and among individuals that are potentially lethal for this population in Latin America. To account for this gap, the author proposes two novel concepts: necropraxis (a pattern that manifest itself in everyday social interactions, through which gradual small doses of death are delivered to eliminate, symbolically and/or literally, trans people); and necroresistance (the ways in which trans people defy the threats imposed by necropraxis through “ordinary” acts manifested in their everyday life). The main objective of this article is to put forth definitions for these two concepts and identify how they apply in the context of trans communities in three countries of the region: Guatemala, Argentina, and Chile. To achieve the latter, the author relies on her ethnographic work in these contexts. Data were gathered through parcipant observation, in-depth interviews with trans persons ( N = 11) and informal conversations with individuals during the site visits. A deductive qualitative analysis was conducted. Results evidence how the manifestation of necropraxis and necroresistance were highly influenced by the historical, political, economic and sociocultural context of each country. This study provides valuable information to help both policymakers and other stakeholders understand the problem’s magnitude in the region and the ways necropraxis is experienced in everyday relations between trans individuals and others. Similarly, through the understanding of what constitutes necroresistance and its value, the proposed framework could help them outline prevention and management strategies to strengthen trans communities in different countries.

This article establishes heterosexual relationships as spaces out of control and, from Foucault’s view of power, positions them as answer to the discourses generated by society to control sexuality. This qualitative study included 20 Puerto Rican couples (11 seroconcordant and 9 serodiscordant) with the objective of identifying variables related to relationship satisfaction with sexual intimacy among women living with HIV/AIDS. Results evidence how in many instances sexual relations are, in fact, moments where passion precedes reason. By involving in high risk behavior, they ignore the preventive enterprise, distance themselves from reason and imposing passion. We come to conclusions about social sciences, specially psychology, and the contribution it can bring to redefine sexuality, substituting the regulating role for a new constructive one.

In this article, we explore the use of the image as a strategy to understand how natural disasters and coloniality impact the health of marginalized communities. We focus on the aftermath of Hurricane María in Puerto Rico and aim to describe how local people used the image as a strategy to challenge the invisibility fostered by coloniality and advocate for a more humane, equitable and effective public health response. We implemented a mixed methods research design including: (1) ethnographic observations, (2) qualitative in-depth interviews with 67 representatives of the health care system, (3) photographs they had taken as part of their experiences during and after the hurricane and (4) images from local newspapers and social media. In light of the findings we argue that Puerto Ricans engaged in decolonial visual resistance to manage the aftermath of the hurricane. Thus, while surviving the natural disaster, they challenged the traditional use of the image in public health endeavours.