Addressing discrimination and violence against Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons from Brazil: a mobile health intervention.

BACKGROUND: Sexual and gender minorities (SGM) experience higher rates of discrimination and violence when compared to cis, heterosexual peers. However, violent crimes and other hate incidents against SGM persons are consistently not reported and prosecuted because of chronic distrust between the SGM community and police. Brazil is one of the most dangerous countries for SGM persons globally. Herein, we describe the development of a mobile health intervention to address the rampant violence against this population, the Rainbow Resistance-Dandarah app. METHODS: We conducted community-based participatory research (CBPR) between 2019 and 2020. The study started with in-depth interviews (IDIs) and focus group discussions (FGDs) with representatives of the SGM community from Brazil. Descriptive qualitative data analysis included the plotting of a 'word cloud', to visually represent word frequency, data coding and analysis of more frequent themes related to app acceptability, usability, and feasibility. A sub-sample of SGM tested the app and suggested improvements, and the final version was launched in December 2019. RESULTS: Since the app was launched in December 2019, the app recorded 4,114 active SGM users. Most participants are cisgender men (50.9%), self-identified as gay (43.5%), White (47.3%), and aged 29 or less (60.9%). FGDs and IDIs participants discussed the importance of the app in the context of widespread violence toward SGM persons. Study participants perceived this mHealth strategy as an important, effective, and accessible for SGM surviving violence. The CBPR design was highlighted as a key strategy that allowed SGM persons to collaborate in the design of this intervention actively. Some users reported how the panic button saved their lives during violent attacks. CONCLUSIONS: Rainbow Resistance-Dandarah app was endorsed as a powerful tool for enhancing reporting episodes of violence/discrimination against SGM persons and a key strategy to connect users with a safe network of supportive services. Results indicate that the app is an engaging, acceptable, and potentially effective mHealth intervention. Participants reported many advantages of using it, such as being able to report harassment and violence, connect with a safe network and receive immediate support.

Addressing Discrimination and Violence against Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons from Brazil: A mobile Health intervention.

Background: Sexual and gender minorities (SGM) experience higher rates of discrimination and violence when compared to cis, heterosexual peers. However, violent crimes and other hate incidents against SGM persons are consistently not reported and prosecuted because of chronic distrust between the SGM community and police. Brazil is one of the most dangerous countries for SGM persons in the world. Herein we describe the development of a mobile health intervention to address the rampant violence against this population, the Rainbow Resistance - Dandarah app. Methods: We conducted community-based participatory research (CBPR) between 2019-2020. The study started with in-depth interviews (IDIs) and focus group discussions (FGDs) with representatives of the SGM community from Brazil. Descriptive qualitative data analysis included the plotting of a 'word cloud', to visually represent word frequency, data coding and analysis of more frequent themes related to app acceptability, usability, and feasibility. A sub-sample of SGM tested the app and suggested improvements, and the final version was launched in December 2019. Results: Since the app was launched in December 2019, the app recorded 4,114 active SGM users. Most participants are cisgender men (50.9%), self-identified as gay (43.5%), White (47.3%), and aged 29 or less (60.9%). FGDs and IDIs participants discussed the importance of the app in the context of widespread violence toward SGM persons. Study participants perceived this mHealth strategy as an important, effective, and accessible strategy for SGM surviving violence. The CBPR design was highlighted as a key strategy that allowed SGM persons to collaborate in the design of this intervention actively. Some users reported how the panic button saved their lives during violent attacks. Conclusions: Rainbow Resistance - Dandarah app was endorsed as a powerful tool for enhancing reporting episodes of violence/discrimination against SGM persons and a key strategy to connect users with a safe network of supportive services. Results indicate that the app is an engaging, acceptable, and potentially effective mHealth intervention. Participants reported many advantages of using it, such as being able to report harassment and violence, connect with a safe network and receive immediate support.

'Our life is pointless ': Exploring discrimination, violence and mental health challenges among sexual and gender minorities from Brazil.

Worldwide, Brazil has the highest prevalence of violence and hate crimes against sexual and gender minorities (SGMs) among countries with available data. To explore the impact of this scenario, we conducted a qualitative study with 50 SGMs from Rio de Janeiro, Brazil. Among the participants, 66% screened positive for generalised anxiety disorder, 46% for major depressive disorder and 39% for PTSD. A third reported low self-esteem (32%) and one quarter low social support (26%). Experiences of interpersonal discrimination were highly prevalent (>60%), while institutional discrimination related to employment or healthcare was reported by 46% of participants. Verbal abuse is very common (80%), followed by physical assault (40%). Sexual violence is highly frequent among women. Focus groups analysis highlighted three major domains: (1) stigma and discrimination (family, friends and partners, in schools and health services, influencing social isolation); (2) violence (bullying, harassment, physical and sexual violence); and (3) mental suffering (alcohol and drug abuse, depression, suicidality, anxiety). Our findings suggest a close synergy between experiences of discrimination and violence with selected mental disorders. This complex synergy might be better addressed by longer-term individual and group-level interventions that could foster social solidarity among the different groups that comprise SGMs.

Sexual and gender minorities rights in Latin America and the Caribbean: a multi-country evaluation.

BACKGROUND: Although the extent of legal inequities experienced by sexual and gender minorities (SGM) has declined during recent decades, this population still enjoys fewer legal protections and benefits than the non-gender-variant, heterosexual population. Herein we analyze the current scenario of SGM rights in Latin America and the Caribbean (LAC). METHODS: Policy documents and governmental strategies addressing SGM rights were analyzed within a timeline framework by three major LAC sub-regions: the Caribbean, Mesoamerica and South America. RESULTS: Our search identified 88 eligible documents addressing the following categories: (1) legal protections towards same-sex couples (decriminalization of same-sex acts among consenting adults, legal recognition of same-sex unions, same-sex marriage, adoption by same-sex couples), and (2) anti-discrimination laws (SGM allowed to serve openly in the military and anti-discrimination laws related to sexual orientation, gender identity and/or expression). The majority of Caribbean countries prohibit same-sex acts between consenting adults, while in Mesoamerica same-sex couples do not have equal marriage rights and are not allowed to adopt as a couple. In the Caribbean and Mesoamerica transgender people lack proper legal protection. Legislation to protect SGM rights in South America is the most inclusive and progressive in LAC. Several countries recognize same-sex marriage and the right of transgender people to legally change their name and gender. The majority of South American countries have some kind of anti-discrimination law, but no effective mechanisms to enforce these laws. In spite of those progresses, the LAC region registers the highest rate of violence and hate crimes against SGM in the world. CONCLUSION: In the Caribbean and Mesoamerica the overall discriminatory legislation exacerbates violence against SGM within a social and cultural context of strong sexist, gender stereotypes and widespread violence. This scenario is driving hundreds of SGM to leave their home countries. In spite of progressive legislations, several South American countries are currently controlled either by highly conservative leaders (e.g. Brazil and Chile) or by repressive dictators (Venezuela). The near future of the LAC region is unknown, but if such trends continue, severe human rights problems, including setbacks in SGM legal protections, are likely.