Violence Experiences in Childhood and Adolescence Among Gay Men and Transgender Women Living in Perú: A Qualitative Exploration

A Scoping Review of Anti-Bullying Interventions: Reducing Traumatic Effect of Bullying Among Adolescents

Bullying is a violent activity that causes significant harm to both victims and perpetrators. Anxiety, despair, low self-esteem, and suicidal ideation are signs of bullying's traumatic effect. The social environment's support proved critical in lessening the devastating experience of bullying on adolescents. The purpose of this study is to conduct a scoping Review of Anti-Bullying Interventions with the aim of reporting techniques to reduce traumatic effect of bullying among adolescents. A design scoping review was done in this investigation. The publications were discovered using the PRISMA Extension for Scoping Review method. Three databases were used to find this article: PubMed, CINAHL, and Scopus. The inclusion criteria for this study were that the sample included adolescent victims of bullying, that it was full text, that it was written in English, that it included anti-bullying therapies, that it used randomized control trials or quasi-experimental designs, and that it was published during the last ten years (2014-2023). The authors found 16 articles were obtained that explored Anti-bullying therapies to minimize symptoms of trauma in adolescent bullies. All of the studies found that the intervention significantly reduced the effects of bullying on victims (p<0.05). The sample sizes ranged from 31 to 5539 teenage respondents. This study discovered three types of anti-bullying interventions: social support, social skills, and school-based programs. Activities such as education, counseling, and training are used to prevent bullying behavior in schools. Adolescent intervention takes into account the participants' physical and psychological situations and focuses on completing the stages of adolescent development. Interventions to reduce the impact of trauma on bullying victims need to involve health providers, parents, and adolescents. This aims to form a mutually supportive system in overcoming the problem of bullying.

Intersectional stigma and the arc of intranational migration: experiences of transgender adolescents and women who migrate within Peru

BACKGROUND

Migration is recognized as a key determinant of health. Yet, limited research addresses the arc of intranational migration and, even less, the experiences of transgender (trans) adolescents and women migrants and the associated health vulnerabilities. Using intersectional stigma as a theoretical frame, this study seeks to better understand the sexual health vulnerabilities and needs of trans women migrants in Peru.

METHODS

Between October and November 2016, in-depth interviews (n = 14) and two focus groups (n = 20) were conducted in Spanish with trans women in three Peruvian cities. To explore pre- and during migration experiences, focus groups were conducted in Pucallpa and Iquitos, key cities in the Amazon where trajectories often originate. To assess during migration and post-migration experiences, we conducted interviews in Pucallpa, Iquitos, and Lima to better understand processes of relocation. Audio files were transcribed verbatim and analysed via an immersion crystallization approach, an inductive and iterative process, using Dedoose (v.6.1.18).

RESULTS

Participants described migration as an arc and, thus, results are presented in three phases: pre-migration; during migration; and post-migration. Intersectional stigma was identified as a transversal theme throughout the three stages of migration. The pre-migration stage was characterized by poverty, transphobia, and violence frequently motivating the decision to migrate to a larger city. Exploitation was also described as pervasive during migration and in relocation. Many participants spoke of their introduction to sex work during migration, as key to economic earning and associated violence (police, clients).

CONCLUSION

Findings advance understandings of intranational migration and forced displacement as key determinants of trans women's health. Dimensions of violence at the intersection of classism and cisgenderism render trans women highly vulnerable at every step of their migratory journeys. Experiences of intranational mobility and relocation were described as uniquely tied to age, intersectional transphobic stigma, engagement in sex work, and multiple forms of violence, which impact and can magnify sexual health vulnerabilities for transgender women in Peru who migrated intranationally.

Harassment disparities and risk profile within lesbian, gay, bisexual and transgender Spanish adult population: Comparisons by age, gender identity, sexual orientation, and perpetration context

Lesbian, Gay, Bisexual and Transgender (LGBT) harassment disparities have become a public health issue due to discrimination and the effects on these people's health and wellbeing. The purpose was to compare harassment disparities within the Spanish adult LGBT population according to age, gender identity, sexual orientation and the context of perpetration and to describe the harassment risk profile. A sample of 1,051 LGBT adults participated in a cross-sectional study. Frequencies, percentages and Chi-square tests of independence for stablishing significant differences (p < 0.05) were calculated. The corrected standardized residuals allowed to identify the categories in which significant differences emerged. Binomial logistic regression was used to define the probability of the main LGBT groups of suffering harassment. Results show that 54.4% of the participants had experienced harassment. Young adults presented a higher prevalence than the older group. There were significant harassment differences between transgender (67.2%) and cisgender (52.7%) groups, and also between the subgroup of trans women (75.8%) and the subgroups of cis men (60.2%) and cis women (42.9%). The main disparities according to sexual orientation emerged between lesbian trans and the other LGB groups. Most harassment occurred in educational contexts and public spaces. Trans-women and trans non-binary reported a higher rate of harassment than cis LGB persons in all contexts. Trans people with different orientations (especially lesbian and gay trans) differed in harassment from LGB cis in four of the six contexts analyzed. Harassment is likely to diminish between 2 and 3% each year as LGBTs get older in educational contexts and public spaces but increases 1.07 times in the workplace. Trans women, trans non-binary, lesbian cis and trans-men were more likely to suffer harassment than bisexual cis persons. Trans women present the highest risk of harassment in three contexts (workplace, family and public spaces) and trans non-binary in the other three contexts (education, health and sport). Harassment is a serious problem for LGBT adults in Spain, especially among trans people, which differ in characteristics from those of the sexual minorities mainstream. Programs and policies targeted for improving health should therefore consider the differences that came to light in this study.

Attitudes Towards School Violence: A Qualitative Study With Spanish Children

School violence is a social issue of particular interest both for intervention and research. Attitudes towards violence have been reported in the literature as relevant variables for evaluation, prevention, and intervention in this field. This study aims to examine in-depth attitudes toward school violence. The sample consists of 96 participants from Spanish Elementary Education and Compulsory Secondary Education schools. A qualitative study was conducted through focus groups and thematic analysis of the data. The results identify a habitual set of attitudes towards violence in children. These are related to violence as a way to feel better or increase self-esteem, as leisure or fun, perceived as legitimate, when violence is exercised against those who are different, when it has no consequences, to resolve conflicts, to socialize, and to attract the attention of peers. These results could serve as a basis for the creation of evaluation tools, as well as the design of prevention and intervention plans based on attitude modification.

Stigma Experienced by Transgender Women of Color in Their Dating and Romantic Relationships: Implications for Gender-based Violence Prevention Programs

Although transgender women of color, specifically Black and Latina experience gender-based violence in a variety of contexts, one of the most consistently reported is from a dating or romantic partner. This qualitative study sought to understand the manifestations and consequences of stigma experienced by transgender women of color in their dating or romantic relationships. Between January and February 2019, we purposively recruited 33 transgender women of color to participate in five focus group discussions and complete a brief survey. We employed both inductive and deductive approaches to coding and thematic analysis. We identified different forms of anti-transgender interpersonal stigma experienced by transgender women of color seeking romantic relationships and by those in romantic relationships. For those dating and seeking relationships, anti-transgender interpersonal stigma took the form of dehumanizing stereotypes and sexual objectification. While these manifestations of anti-transgender interpersonal stigma persisted for some within relationships, concealment behaviors from partners was the predominant type of anti-transgender interpersonal stigma. Each of these forms of anti-transgender interpersonal stigma had significant gender-based violence consequences, specifically encountering physical violence, experiencing psychological trauma, and engaging in survival strategies. In the current climate of COVID-19, which is exacerbating risks of gender-based violence, there is an urgent need to understand and address the nuanced manifestations of stigma in relationships and their consequences on the lives of transgender women of color. Culturally grounded gender-based violence prevention policies and programs with transgender women should address these forms of stigma and build on community strengths. Findings also highlight the importance of future research and gender-based violence prevention programming with cisgender men in/seeking partnerships with transgender women of color.

Context, Types, and Consequences of Violence Across the Life Course: A Qualitative Study of the Lived Experiences of Transgender Women Living With HIV

Violence is a known driver of HIV vulnerability among transgender (trans) women, who are disproportionately impacted by HIV globally. Violence is also a barrier to accessing HIV prevention, treatment, and support. Yet, little is known about the everyday experiences of violence faced by trans women living with HIV, who live at the intersection of a marginalized gender identity and physical health condition. To address this gap, this study draws on semi-structured, individual interviews conducted 2017-2018 with a purposive sample (selected based on diverse identities) of trans women living with HIV (n = 11) participating in a large, community-based cohort study in three Canadian provinces. Framework analysis was used to identify key themes, patterns within themes between participants, and patterns across themes among participants. Findings showed that trans women living with HIV experience specific contexts of violence shaped at the intersection of stigma based on gender identity, gender expression, and HIV status, among other identities/experiences. Violence experienced in childhood (e.g., familial rejection, bullying) increased trans women's likelihood of being exposed to a violent social context in young adulthood (e.g., state violence perpetuated by the police, interpersonal violence perpetuated by sexual partners, and community violence perpetuated by society-at-large/the general public), which increased trans women's HIV vulnerability; once living with HIV trans women were subjected to discursive violence from healthcare providers. These multiple forms of violence have serious consequences for trans women living with HIV's ongoing social, mental, and physical well-being. The findings suggest that interventions are urgently needed to reduce violence against trans women in childhood and young adulthood, in addition to reducing violence against trans women living with HIV perpetuated by healthcare providers in adulthood, to both proactively and responsively promote their safety, health, and well-being.

Attitudes toward School Violence against LGBTQIA+. A Qualitative Study

School climate is one of the main concerns in terms of research and intervention worldwide. Although it can be directed toward any student, some groups seem to be more vulnerable, as is the case of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer and intersex +) students, among others. Attitudes toward violence are a construct of particular importance for action plans focused on improving school coexistence. The aim of this study is to examine attitudes toward school violence against LGBTQIA+ students and their relationship with violent behaviors. For this purpose, 96 Spanish students of Spanish elementary education (PE) and compulsory secondary education (CSE) participated in this qualitative study through focus groups for its subsequent thematic analysis. The results identify four types of attitudes toward violence, such as the use of violence as a form of fun, to feel better, when it is perceived as legitimate, and as a way of relating to the LGBTQIA+ community. In addition, a greater number of negative attitudes and violent behaviors toward homosexual boys and transgender minors are observed.

Intimate Partner Violence Against Transgender Women: Prevalence and Correlates in Lima, Peru (2016-2018)

Limited data exists on intimate partner violence (IPV) among transgender women (TW), though global trends suggest IPV is associated with HIV risk in this population. We describe the prevalence of verbal, physical, and/or sexual violence as well as participant- and partner-level correlates of IPV among TW in Lima, Peru. Among 389 respondents, 15.2% reported IPV with one or more of their last three sexual partners: 9.2% verbal, 8.2% physical, and 2.3% sexual violence. Physical and verbal violence were more common with stable partners (aPR 3.46, 95% CI 1.17-10.25, aPR 2.46, 95% CI 1.14-5.28, respectively). Physical violence was associated with condomless receptive anal intercourse (cRAI) (aPR 2.22, 95% CI 1.19-4.13) and partner alcohol use (aPR 4.38, 95% CI 1.56-12.33) while verbal violence correlated with participant inebriation (aPR 4.86, 95% CI 1.63-14.46). Our results link IPV with stable partnerships, alcohol use, and cRAI, suggesting TW in Peru may benefit from multidimensional IPV prevention strategies to foster supportive relationships and reduce HIV transmission.

Combined effects of gender affirmation and economic hardship on vulnerability to HIV: a qualitative analysis among U.S. adult transgender women

Background

Transgender women (“trans women”), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition.

Methods

We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors and recent economic hardship related to employment/income, housing, or food security. Interviews were recorded, transcribed, and analyzed using thematic content analysis.

Results

The majority (74%) of trans women were racial/ethnic minorities with mean age of 26.3 years. Gender-affirming behaviors varied with 58% of trans women having legally changed their name and gender marker; 79% having initiated hormone therapy; and 11% having not initiated any medical or legal changes. None had undertaken surgical changes. Findings suggested that the process of gender transitioning resulted in both increasing and decreasing HIV risk. The high need for gender affirmation by male sex partners contributed to trans women’s exposure to sexual objectification, sexual risk behaviors, and conflicting interests in HIV prevention messaging. Loss of housing and employment due to transition along with the high costs of transition products and medical visits increased reliance on sex work and created new obstacles in accessing HIV services. Trans women experienced lower HIV risk as they acquired legal and medical transition services, reshaped interactions with sex partners, and received gender-affirming support by others, including health providers, employers, peers, and housing professionals. Sexual abstinence was viewed as a negative consequence of incomplete transition, although characterized as a period of low HIV risk.

Conclusions

Structural and policy initiatives that promote safe gender transition and economic stability in trans women may play a critical role in reducing HIV in this population. Addressing the harmful pressures for U.S. trans women to conform to perceived feminine stereotypes may also serve an important role.