Transgender Women's Experiences with Stigma, Trauma, and Attempted Suicide in the Dominican Republic

Abstract

Studies on attempted suicide in transgender populations, particularly those in resource-limited settings, are scarce. We examined the relationships between stigma, trauma, and suicide attempts in a national sample of transgender women from the Dominican Republic. Bivariate analysis examined differences between suicide attempters and nonattempters (n = 298). Multivariate analysis reported odds ratios with attempted suicide as the outcome (n = 260). About a quarter of respondents (23.9%) experienced sexual abuse, 12.3% were tortured, and 20.3% experienced a murder attempt. More than a quarter reported using illegal drugs. Independent sample t tests found significant differences between suicide attempters and nonattempters. Attempters were more likely to have experienced sexual abuse, psychological abuse, torture, and a murder attempt (p < .001 for all). Respondents who experienced psychological abuse had over three times higher odds of attempting suicide, compared to respondents who had not (OR = 3.203, p < .01). Experience with torture and attempted murder were associated with higher odds of attempting suicide (OR = 2.967, p < .05 and OR = 2.894, p < .05, respectively). Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are often not consistently enforced. Eliminating stigmatizing policies may reduce rates of negative health outcomes and subsequently improving population health.

Transgender female sex workers’ HIV knowledge, experienced stigma, and condom use in the Dominican Republic

“…[ 44 ] Transgender people (and transgender female sex workers) continue to experience stigma that robs them of respect, economic opportunities, and dignity. [ 44 – 49 ] These experiences have detrimental effects on the health and wellbeing of transgender people. [ 44 – 49 ] Experienced stigma, discrimination and physical violence may reduce the likelihood of condom use, increase engagement in highly risky sexual behaviors, and in turn, increase rates of HIV and STIs in transgender populations.…”

“…[ 44 – 49 ] These experiences have detrimental effects on the health and wellbeing of transgender people. [ 44 – 49 ] Experienced stigma, discrimination and physical violence may reduce the likelihood of condom use, increase engagement in highly risky sexual behaviors, and in turn, increase rates of HIV and STIs in transgender populations. [ 21 , 44 – 45 , 48 – 49 ] The vulnerabilities experienced by transgender persons, especially transgender persons in resource-constrained settings such as in the Dominican Republic, could be partially addressed through understanding of impact of policies that indirectly promote or allow harm to transgender citizens and subsequently diminish the effectiveness of public health and education interventions that are funded both by domestic and global agencies that seek to contain the HIV epidemic.…”

“…[ 44 – 49 ] Experienced stigma, discrimination and physical violence may reduce the likelihood of condom use, increase engagement in highly risky sexual behaviors, and in turn, increase rates of HIV and STIs in transgender populations. [ 21 , 44 – 45 , 48 – 49 ] The vulnerabilities experienced by transgender persons, especially transgender persons in resource-constrained settings such as in the Dominican Republic, could be partially addressed through understanding of impact of policies that indirectly promote or allow harm to transgender citizens and subsequently diminish the effectiveness of public health and education interventions that are funded both by domestic and global agencies that seek to contain the HIV epidemic. [ 44 ] By taking these actions through the revocation of such laws and making these societally relevant commitments, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America.…”

Assessing an inclusive model to increase access to comprehensive gender-based violence response services and improve HIV outcomes in Puerto Plata, Dominican Republic

“…Sexual violence in the last six months was reported by 18% of female sex workers (Mendoza et al 2017), and 11% of men who have sex with men and transgender women reported being forced or coerced at first intercourse (Brito et al 2015). In a national sample of transgender women, 46% reported experiencing trauma since the age of 14, including psychological abuse (32%), torture (12%) and attempted murder (20%) (Budhwani, Hearld et al 2017). Studies have explicitly shown that the GBV and HIV epidemics are linked among key populations in the Dominican Republic.…”

Alcohol Use, High Risk Behaviors, and Experiences of Discrimination Among Transgender Women in the Dominican Republic

“…Although studies of transgender individuals increasingly elucidate the experiences and health needs of this population (Budhwani et al, 2017a;Budhwani et al, 2017b), notable scientific and practice gaps persist. In particular, there is insufficient research on transgender individuals in resource-constrained settings (Budhwani, Hearld, Hasbún, et al, 2017;Q.…”