Note to the reader ยกHola! How are you, sunshine? If you are reading this is because you are a passionate advocate for LGTBIQ health and rights. May 17th is regarded as the International Day against Homophobia, Transphobia and Biphobia and it was created in 2004 to draw the attention of policymakers, opinion leaders, social movements, the public and the media to the violence and discrimination experienced by LGBTIQ people internationally. Me and a merry group of NORAS, LORAS and LORPS from the Americas have created this little but powerful magazine because we wish for you to see what occurs in our region regarding the LGTBIQ community and how discrimination and stigma are still major obstacles we tackle as a region. We encourage you to fight for what is right, for the ones who are jaded, for the ones struggling, for the ones who lost their lives. Remember you are very special and never give up: things ALWAYS get better.
Scora Regional Assistant for the Americas
The LGTBIQ Community and the Sustainable Development Goals In 2015 the 2030 Agenda for sustainable development was presented as a plan action for human kind to ensure prosperity for our planet and its habitants in all means. It was created for every human being regardless of age, sex, disability, race, ethnicity, origin, religion or economic or other status, etc. to achieve their full potential in a dignified and equal way. For this concept only is where the LGTBIQ community, like any other community, must be included in the development initiatives to truly ensure the “leave no one behind” commitment. I believe that two sustainable development goals are inextricably linked with the inclusion and care of the LGTIBQ community which are SDG 3: Good Health and Well Being and SDG 10: Reduced Inequalities. These sustainable development goals must be tailored to their specific needs, oriented to diminish the disparities and to promote their rights. First, let us address SDG 3. It has several targets that serve to analyze the advance on health and well-being of this group. Those targets are the following: HIV & AIDS, Mental Health & Well-Being, Drug &Alcohol Use, Sexual & Reproductive Health, Training of the Health Workforce, Access to Affordable Medicines, Universal Health Coverage. Why are they the most relevant? Because of the high prevalence of HIV among gay, bisexual and transwomen which has consequences on poor mental health, higher alcohol abuse, lack of access to healthcare services and no trained healthcare providers to attend their needs. For all these targets it is critical to separate data according to sexual orientation and identity to ensure an effective monitoring of progress for the LGTBIQ community by the creation of effective policies that will serve to protect the community. Regarding HIV & AIDS it is vital to assess the stigma and discrimination that occurs within the healthcare settings so new measures can be established to fight it. For mental health, tools to efficiently diagnose depression and anxiety are needed so preventive measures and treatment can be designed; this, to prevent suicidal rates from increasing. This target is very much in relation to alcohol and substance abuse in which the desired number of centers that fully and adequately assess addiction in LGTBIQ patients are scarce. When addressing the sexual and reproductive health of this group what is desired to achieve is to collect data of the institutions that offer this service in an integral way, especially taking in consideration if these institutions offer this service based on comprehensive sexuality education, inclusiveness and in a non – discriminatory way. This relates to the training of providers. It is very important to have information on the health workers that have a training on addressing the special needs of the LGTBIQ community and to know the skills and tools the possess to do so. Regarding access to affordable medicines, insurance must cover anti-retroviral medicines used prophylactically, and hormone therapy medicines as essential medicines. Finally, when addressing Universal Health Coverage what needs to be done is to Include gender affirmation and sex reassignment services as essential services as well as providing alternative assisted reproductive technologies for LGBTIQ people with parenting intentions. Also, it is crucial to assess the stigma and discrimination that might be experienced when accessing these services. The Sustainable development goal 10 tackles inequalities. Moreover, it guarantees the equality of opportunities and to reduce inequalities of outcome which includes the elimination of discriminatory laws, policies and practices while promoting appropriate legislation, policies and action in this regard. Therefore, if we do not include and assure the protection and promotion of LGTBIQ people’s rights, especially the right to health. We will be failing to achieve this SDG and false data of progress will be generated. What is needed is to safeguard their health rights in human rights that protect the autonomy and dignity of the community. Especially by eradicating laws and policies that criminalizes them or prevents them from fulfilling their rights. As a conclusion, the 2030 Agenda must ensure the inclusion of the LGBTBIQ community with its special considerations if true progress and equality are desired to be achieved. Each of us must work together to produce accurate data on LGBTI health and well-being in development programming, it is our duty as future health care providers to successfully the “leave no one behind” commitment.
Gabriela Cipriano Scora Regional Assistant Americas 17-18
Violence against LGBTQAP+ community and its consequences In Latin America even in the XXI century, we continue seeing violence against gay, lesbian, bisexual, trans people because they do not fit in the traditional binary model of heterosexual men or women. Organizations such as the International Lesbian, Gay, Bisexual, Trans and Intersex Association for Latin America and the Caribbean (ILGA-LAC) and international organizations such as the United Nations and the Inter-American Commission on Human Rights (IACHR) periodically alert on how LGBTIQAP+ people continue to be subject to systematic violence by groups outside the law, or state collectives and social groups or principles against sexual and gender diversity The main reasons why violence is exercised against people who identify or are perceived as LGBT are related to the need to control socially the way people live their sexuality and build their identity, according to parameters established by traditions and, in many cases, cases, ruled by machismo and the influence of some religions. In many cases it is difficult to determine what is the exact reason for a gay, lesbian, bisexual or transgender person to be murdered, raped or with signs of torture. However, what is known as "hate crime" and, to be more specific, as a "crime for prejudice", has managed to show that in many cases the level of cruelty in this crimes is directly related with the victims being perceived or identified as LGBT. Various civil society organizations and international organizations have called attention to the growing cruelty with which violence against LGBT people is exercised. The facts range from harassment and street violence, to impalement, dismemberment, torture, stoning or stabbing and beatings with blunt objects such as machetes or hammers. In the case of lesbian and bisexual women, the practice of "corrective violations" is quite widespread and refers to the idea that these "defective" orientations exist because these women need to have sexual relations with "real" men. People that are vulnerable because of other factors such as poverty, ethnic origin, lack of access to education or disability suffer the most types of violence in addition to identifying themselves as LGBTIQAP+. Violence occurs in a variety of settings: on the street, public parks, workplaces, schools, private homes, prisons and police detention cells. It can be spontaneous or organized, perpetrated by unknown individuals or by extremist groups. An important feature of many hate crimes against LGBTIQAP+ people is their brutality, because murder victims usually appear mutilated, severely burned, castrated and sexually abused. Torture and mistreatment of LGQBTIQAP+ people have been widely documented. The torture occurs frequently in places of detention, where LGBTIQAP+ people can be victimized by agents of police, prison guards or other detainees. Some forms of involuntary medical treatment can also constitute torture, like anal exams of gay men to “prove” his homosexuality, unwanted sterilization of transgender people and the application of forced electroshock therapy to “change” a person’s sexual orientation. All abuse is about power and control. LGBTIQAP+ people face physical and emotional violence. Transgendered survivors may encounter the following types of abuse: • Using offensive pronouns such as "it" to refer to the transgender partner • Ridiculing the transgender partner's body and / or appearance • Telling the transgender partner that he or she is not a real man or woman • Denying the transgender partner's access to medical treatment or hormones or coercing him or her to not pursue medical treatment Consequences of violence against LGBTIQAP+ people Violence against LGBTIQAP+ people brings many psychological problems, especially in minors and adolescents. • It can limit the development of bonds such as intimacy with other people • It can limit the communication with the family • Adolescents can diminish their capacity for expression since they are locked in rigid roles • It leads to expressing a wrong sexuality to “show” that they are not homosexual • It prevents the richness of diversity • During adolescence there may be rejection • It leads to self-limitation and self-exclusion as discriminatory and violent environments are prevented • LGBTIQAP+ people due to pressure can become aggressive or even present a psychosomatic disorder. They may also suffer from social anxiety, depression or even panic. Despite the perception that society is becoming more open and welcoming of LGBTQ+ persons, victimization disparities have not improved since the 1990s, when they were first measured. Some forms of victimization, particularly those affecting youth, appear to be worsening. This has serious, lifelong impacts on the physical and psychological health of LGBTQ+ youth and adults. In addition to feeling self-blame, shame, fear, anger, and depression, LGBTIQAP+ survivors may also be led to question their sexuality and if their abuse was a result of their sexuality. LGBT survivors may feel as if they are being punished for their sexual orientation and/or gender identity. When talking to others about their attack or abuse, LGBTIQAP+ survivors may feel as if their sexual orientation or gender identity is being focused on more than the actual abuse. LGBT survivors may be reluctant to tell family and friends who do not approve of their sexual orientation and/or gender identity because they may fear that their abuse will only reinforce negative stereotypes about the LGBT community. In addition, the LGBT community may not want to admit that domestic violence or sexual assault occurs in their community for the same reason and therefore may not support the survivor. In conclusion, the decrease in violence against LGBTIQAP + people will be achieved when there is more education to the community on this issue, since most of the hate crimes and discrimination is because people do not they understand what sexual diversity is, and therefore they classify it as abnormal since it does not fit into the binary model of gender identity and heterosexual orientation. It is necessary to understand that sexuality is fluid, that it covers a broad spectrum and therefore a classification system is not what best suits reality. References: • Violencia contra personas LGBTI: Informe Temático de la CIDH. (n.d.). Retrieved from http://oas.org/es/cidh/multimedia/2015/violencia-lgbti/violencia-lgbti.html • Violencia contra personas LGBT en Latinoamérica. (n.d.). Retrieved from https:// www.goethe.de/ins/cl/es/kul/mag/20816437.html • E. (2017, December 04). LGBT. Retrieved from https://everipedia.org/wiki/LGBT/ • Ohio University. (n.d.). Retrieved from https://www.ohio.edu/survivor/lgbt.cfm • What Do We Know, and What Do We Need to Know? - RTI. (n.d.)
María Paz Lasso Cisneros NORA AEMPPI-Ecuador
Where same sex sexual activity is illegal for men but legal for women Jamaica is often described as one of the most homophobic countries in the world as it is well known for directing violence and hatred towards homosexuality. Even with the growing acceptance of homosexuality today, Jamaica still has yet to improve it’s relationship and treatment towards members of the LGBT community. Growing up as a citizen of Jamaica, I have observed the stigma associated with being in same sex relationships and how difficult it is to “come out” as lesbian, gay or bisexual. However, some may say that there is more acceptance directed towards female same sex relationships than male same sex relationships. From the laws of the country to the popular genre of music originating from the country, Dancehall music, it is evident that there is more hatred directed towards gay men than there is towards women. In Jamaica, the laws do not criminalize being LGBT but they outlaw the acts. According to the Offences Against the Person Act (OAPA) Section 79. states the “Outrages on decency. Any male person who, in public or private, commits, or is a party to the commission of, or procures or attempts to procure the commission by any male person of, any act of gross indecency with another male person, shall be guilty of a misdemeanour, and being convicted thereof shall be liable at the discretion of the court to be imprisoned for a term not exceeding two years, with or without hard labour.” Also Section 77. states the “Attempt. Whosoever shall attempt to commit the said abominable crime, or shall be guilty of any assault with intent to commit the same, or of any indecent assault upon any male person, shall be guilty of a misdemeanour, and being convicted thereof, shall be liable to be imprisoned for a term not exceeding seven years, with or without hard labour.” These laws along with the popular “Buggery” law specifically targets males and ignores female same sex relations thereby leaving the same-sex sexual activity legal status as illegal for men and legal for women. “Their gigs have been cancelled all over the world and their names withdrawn from awards. But Jamaica's dancehall stars refuse to apologise for- or even stop singing - songs that encourage the murder of gay people” says Alexis Petridis after traveling to the Caribbean and discovering a country filled with so much hatred towards homosexuals. He believes that the country’s homophobic culture stems largely from a combination of “swaggering machismo” and religion. Jamaicans go as far as to profess their hatred towards the LGBT community through their popular music genre called Dancehall that began in the 1970s. The hate speech is typically targeted to gay men more than any other member of the LGBT community. For example the popular Jamaican artists Buju Banton has a well known song entitiled “Boom bye bye” dedicated to discussing how he will shoot gay men when he sees them as he sings “Boom bye bye Inna batty bwoy head.” Many Jamaican artists refer to gay men as “batty boys” and threaten them through their music. Whether it be in the form of one line or an entire song, Jamaican artists never fail to mention how much they dislike gay men in their music. Buju Banton performing at Ilosaarirock, Joensuu in July 2006 The lyrics of these songs are dangerous for the nation as it continues to promote violence against the LGBT community and in particular, against gay men. Now, members of the Jamaican LGBT community are no strangers to being disowned by their families and having to end up homeless but this homelessness puts many homosexual men especially in vulnerable positions. According to Mail Online News LGBTQ youths have to go as far as living in city storm drains to escape persecution such as the relatively well known group called The Gully Queens of Jamaica do. Mail Online News goes on to say that this community is threatened with bottles, bones and stones gushing into their beds at night along with the risk of being raped, assaulted or even murdered because they choose to be open about their sexuality. One of the Gully Queens, Khloe, was friends with Dwayne Jones, a transgender teen who was murdered in July 2013. Dwayne was brutally teased in high school for being effeminate until he finally dropped out. His father and his neighbours rejected him at the age of 14 and he was forced to leave the Jamaican slum where he grew up. By the age of 16, the teenager was dead after being beaten, stabbed, shot and run over by a car. The homophobic culture in Jamaica remains quite dominant but one can only hope that the generation coming forward will make a change.
Asha Boxill NORA JAMSA
Sexual Violence Against LGBTIQ People in the Americas “Every person has the right that his or her physical, psychical and moral integrity is respected” “Every person has the right to personal freedom and security” • Article 5 and 7, American Convention of Human Rights LGBTIQ people are most likely to be vulnerable to sexual violence. One of the reasons of this phenomenon emerges from the challenge of the non-traditional sex, sexuality and gender notions that surrounds the diversification in sexual orientations and gender identity. LGBT people are often victims of discrimination multiple when, in addition to their diverse sexual orientation and gender identity, they own other physical, age, cultural, social, ethnic or economic characteristics, among others. The impact of sexual aggressions against LGBT+ people may turn into a struggle because they are at a high risk to experiment denegation of medical treatment or to be revictimized in their search for medical attention after have been sexually attacked. According to a pilot stud carried in 2013 by the International Labor Office, working LGBT people are affected by workplace harassment and discrimination. Violence against children and teenagers UNESCO has joined the list of UN agencies that advocate for the gay, lesbian, bisexual and transgender agenda in October 28, 2016. In that publication they manifest they’re seeking to promote rights for LGBT+ children. UNICEF shows that according to a national survey held in schools of United States (National School Climate Survey, 2011), 2 in every 3 LGBT students manifested being victims of some way of sexual harassment, non-consented touching or inappropriate comments with sexual content. In 2012, 1 in every 5 expressed those situations happened more often. This lack of respect for the rights of LGBT children manifests itself in several ways. This includes, among others, bullying and intimidation; physical and sexual violence and even "reparative" violations.The effects of discrimination, exclusion and violence can extend throughout childhood, reach adulthood and trigger consequences for a lifetime, for example, being more likely to committing or thinking about suicide. Violence against minorities At the other side of the multicultural citizenship spectrum we could locate the sexual violence issue, as a way to eliminate the possibility itself of women’s autonomy realization. Jelke Boesten (2008) shows this problematic in his work "Narratives From sex, violence and availability: Race, Gender and hierarchies from the violation in Peru". His case-study type refers to violation against indigenous women, taken and socially accepted as legitimate victims of sexual violence. Boesten analyzes the normative framework of gender and race conceptions which turns sexual violence against certain categories of people, mostly in time of war and emergency, into a legitimate act. According to a 2013 Report by the UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, sixteen gay and trans persons in the United States were subjected to solitary confinement, torture and ill treatment, including sexual assault, while in detention in immigration instances. Experts in charge of the elaboration of Yogyakarta Principles pointed that sexual minorities were victims of torture and discrimination. They are also under the struggle of sexual violence like violations and sexual aggressions with the objective of punish them for not following the dominating gender roles and sexual patrons in the society. Violence by State Security Organisms: During the last years, the IACHR has constantly received information about acts of violence against LGBT+ people which are held by State’s security forces including tortures, inhuman and degrading treaty, excessive use of the force, arbitrary detention and other forms of abuse. Several cases of police violence have been documented across America. According to information received by the Commission, violence occurs in all stages of police custody. Among the different ways of abuse more commonly declared are demand for sexual favors; cases in which trans women are obligated to get completely naked in public and are threatened so that they usually don’t present future charges fearing to revenges against them, like in Mexico. Other hatred actions may include imputing charges unfairly to LGBT+ people, for example, having sex in public. Other reports indicate that grave instances of police abuse against LGBT persons, particularly trans women, are still frequent in various Argentinean provinces. Violence in prison According to the Bureau of Justice Statistics of the United States Department of Justice, LGBT inmates in US detention facilities are among those with the highest rates of sexual victimization. Among LGBT+ prisoners, 12.2% reported being sexually victimized by another inmate and 5. 4% reported being victimized by prison staff. In Mexico at least 60% of LGBT persons deprived of their liberty have been struggled by different kinds of abuse. Corrective Violence In Ecuador, it was reported the existence of 361 unhomosexualization between 2005 and 2014, reporting inhuman treaty, torture and abominable therapies for correcting their “deviation”. The IACHR has received information about violations and non-consulted medical procedures against intersex people with the objective of curing their bodies. Also, lesbian and bisexual women are very vulnerable to experiment corrective violations so that they get purified and disciplined. Sexual Violence in all its kinds has been and is still a struggle for LGBT+ people across America and Caribbean. Countries should make bigger efforts to create a safer environment and to educate the population so we all can fight ignorance and hate. Whereas many injustices are committed, our governments must seek for better structured and supportive policies looking for protection of LGBT+ people and other minorities. References: 1.
Viveros M. La sexualización de la raza y la racialización de la sexualidad en el contexto latinoamericano actual [Internet]. Bivipas.unal.edu.co. 2010 [cited 13 May 2018]. Available from: http://www.bivipas.unal.edu.co/bitstream/10720/663/1/256-Ponencia_MARA_VIVEROS.pdf
LGBT Jamaicans 'targets of violence' [Internet]. BBC News. 2014 [cited 12 May 2018]. Available from: http://www.bbc.com/news/world-latin-america29714586
Orlandi M. UNESCO promueve “derechos LGBT” para niños - C-Fam [Internet]. C-Fam. 2016 [cited 15 May 2018]. Available from: https://c-fam.org/ friday_fax/unesco-promueve-derechos-lgbt-para-ninos/
Oficina Internacional del Trabajo. Discriminación en el trabajo por motivos de orientación sexual e identidad de género: resultados del estudio piloto. GB.319/LILS/INF/1. 16 a 31 de octubre de 2013. [Internet] Ilo.org. 2013 [cited 15 May 2018]. Available from: http://www.ilo.org/wcmsp5/groups/ public/---ed_norm/---relconf/documents/meetingdocument/wcms_221738.pdf .
Comité de Violencia Sexual de la Comisión Ejecutiva de Atención a Víctimas. Investigación sobre la atención de personas LGBT en México [Internet]. Ceav.gob.mx. 2015 [cited 15 May 2018]. Available from: http://www.ceav.gob.mx/wp-content/uploads/2016/06/Investigaci%C3%83%C2% B3n-LGBT-Documento-Completo.pdf Inter-American Commission on Human Rights. Violence against lesbian, gay, bisexual, trans and intersex persons in the Americas. [Internet]. Oas.org. 2015 [cited 14 May 2018]. Available from: http://www.oas.org/en/iachr/reports/pdfs/violencelgbtipersons.pdf
Joritzel Quijano NORA IFMSA PANAMÁ
LGTBIQ reality in Bolivia: Indigenous and not indigenous approach We cannot begin to describe Bolivian reality without speaking of our ancestral background. Bolivia, just as many others Latin-American countries, is a multicultural place, where indigenous traditions and European traditions live together as a whole. People might think that this would separate our country into two; those with European lineage and therefore; European traditions only, and those with indigenous lineage who live attached to their own culture, or associations to those primary thoughts. Truth be told, most of us share both sides. Actually over 67% of Bolivian population is catholic, religion, which we know, was brought to America in the early XV century and mainly in the XVI century when arriving European conquerors. On the other side, there is a big number of Andean traditions that we all respect very deeply, for example; PACHAMAMA, deity who we all pay respect every early time of the year, asking her to provide health, food, and progress by a ceremony known as “Challa”. The explanation of these aspects matter, because that´s what defines our behavior as a society and as individuals. Based on those antecedents, we can begin to understand a Bolivian mind. From my point of view, we have so much and so different information recollected and stored in our collective consciousness, that a number of social, cultural, religious, historical, yet economic reasons will, always define the way we will behave and mainly, the cause of our behavior. We are traditional yet progressive, which leads to a misunderstanding of concepts, rights and respect. Some believe in a dual world; believe in a man and woman as a couple, man and woman as the center of a family to come, quoting words written centuries ago in the Holy Bible. This dualist concept was not necessary brought by European influence, in fact, it is known that the Andean cosmovision was and is also based on those factors, as Aymara people used to call “Chachawarmi”, the union of two in marriage; man and woman in a total complementation and reciprocity. Both these thoughts, leave absolute no place for different sort of love and different sorts of relationships among other. So, would that be the cause of our lack of understanding? The fact that, we´re not prepared to leave the complementary concept that we´re so attached to? Homosexuality, bisexuality, transsexuality, intersexuality, or any kind of sexuality that shows itself slightly different causes real commotion in Bolivian people, it´s a very sad thing to establish, but, even though, every day we see more and more progress and acceptation worldwide, there are places in the world where that simply does not happen as quickly. Bolivian LGBTI sector reality is extremely raw; they go through discrimination not only in their social environment, but also, in their own homes, with their families. In most cases, we have seen that they are not allowed to give an opinion, they are thought to be sick, and they are neglected, they are forced to live a life they do now cherish and forced to change who they truly want to be. The fact that´s even more astonishing is that when they finally overcome these, discrimination keeps going, but now inside the LGBTI sector. Aymara LGBTI sector has not been fully studied, but what we do now is that, traditional aymara families are the toughest to overcome. They are even more aggressive, they tend to rape, assault, and mistreat lesbian women, until they “heal” or to teach them “how to be women”, and tend to hit and even kill gay men if the community finds out of their sexual preference, which leads them to leave the community, move to a bigger city and create a new life against their will. All of these, only to suffer the same aggression and hatred, but only on a different scale. Despite this difficult situation, there has been people who have gotten past the awful scenery they were forced to play in. I´d like to take this opportunity to bring up one name; Antonella Navia; an amazing Bolivian woman, from aymara upbringing, who was the first female transsexual to become a physician in Bolivia, and has had to go through unbelievable obstacles to become who she is, and until this very day, plays a role model for generations to come.
Gabriela Emily Jimenez Cuba NORA IFMSA BOLIVIA
Being part of the LGBTQ community in a continent homophobic. We were born in the most wonderful continent, diverse and multicultural of the world, but also in a traditional earth, conservative and governed by an ideology of the gender a bit out of place and of time, based in the machismo; in where the man, by the simple fact to be man, has can and superiority against the woman. With this same machismo, trasmitido with our idiosyncrasy of generation in generation, also come an enormous quantity of beliefs and sentences that condition our freedom and our purer essence and deep, beliefs and sentences that sometimes are arrinconan in closets dark, full of suffering and pain and that in shape of protection, we same commission us to ensure with heavy and hard chains, so that anybody do us more damage. Who has not heard phrases related to masculinity or femininity or the lack of them? For example, if you are a man, you'll no doubt have heard from small phrases like; don't view of pink or don't play with dolls, that is for girls; or the typical phrase of men don't cry or be it man, not scream even though it hurts, if you're not going to seem “maricón”, “hueco”, “culero”, “joto”, “puto”, etc. eye not only men are victims of these typical phrases of our cultures, women also have won the our, as for example; it is a girl, don't play with cars, is not going to be playing around the male, or the typical ponte makeup, usa skirt and heels, so you see more women, or don't view as well, seem “marimacha”, “torta o tortillera”, “boyera”, etc., as well as we are diverse in culture, we also have a huge variety of words and phrases, to define someone who is not heterosexual and those that I have just mentioned, are all that exist. But, what I really want to expose in this writing, is not the large vocabulary that has the American continent, to define a person who belongs to the LGBTQ community; what I really want is to expose the harsh reality that everyday thousands of people, they have to deal with LGBTIQ in Latin America, a continent dominated by machismo and violence. In an interview published by the newspaper the Americas in Miami, in the year 2017, mentioned that, the NGO Transgender Europe placed in absolute numbers to Brazil first among 33 countries with murders of LGBTIQ people registered in 2016, with 123 cases, followed by Mexico that recorded at least 52. However, this same study, mentions that in relation to the number of inhabitants, there are small countries which are worse. "Honduras, for example, has a rate of 10.77 reports of killings of transgender people per million inhabitants," say the statistics of the organization since 2008. The rate for this period is 6.02 in Belize, of 4.49 2.21 in Brazil and in Mexico. Since January, up to the date of publication of this article, at least seven people were killed in El Salvador. According to another report published by the newspaper trade in Peru, in the year 2014; it is mentioned that at least 40 per cent of the homosexuals and the 65% of the transsexuals in Latin America have suffered homophobic violence in the school environment, according to the information provided by Mary Delaney, regional advisor on Health Education of Unesco. Up until about 10 years ago, Nicaragua and Panama penalized even homosexual relationships. In contrast to this, more or less eight years, Argentina became the first country in Latin America to approve marriage equality. This little difference in dates, reflects how LGBTIQ people in Latin America live between two extremes: on the one hand, some nations are moving toward equality, but on the other hand other and I would venture to say that the vast majority, still suffer directly the inequality and injustice. It is necessary to say, that while in Latin America the LGBTI community has achieved legal, social and political rights, for the recognition of their rights and freedoms, the hatred toward sexual diversity continues to claim victims on a daily basis, in many places, go out on the street as homosexual means to be exposed to serious threats, insults, beatings or even death. According to the report of 2015, the Inter-American Commission on Human Rights of the OAS, an institution that monitors and protects human rights in America, almost 600 people died throughout Latin America by the violence against LGBT people between January 2013 and March 2014, this same report indicates that the region, show that violence against LGBT people is increasingly extreme and common. Victims are often stoned, tortured and raped before being killed, and the crimes often go unpunished. But not everything is disappointing in Latin America for the LGBTIQ population , there is also good news; for example, Argentina in 2010, was the first Latin American country to approve same-sex marriage; In 2013 Uruguay became the second country in the region to legalize these connections, when the nation's congress adopted the law of equal marriage; Uruguay also became the first country to allow the adoption of children by same-sex couples. In Brazil and Colombia, is enabled thanks to the National Council of Justice and the Constitutional Court, respectively, were approved connections egalitarian. To an intermediate point have come Chile and Ecuador with equal civil unions, and Mexico the federal government submitted in May of 2017, a proposal for constitutional reform to recognize same-sex marriage throughout the territory. There is still a long struggle to ensure the rights and freedoms of LGBTIQ populations in America; but the struggle for change and acceptance has started, hopefully sooner rather than later, we are all seen as equal.
Fatima Andrea Rodriguez. NORA IFMSA GUATEMALA
Being trans on Latin America: a death sentence March 4 of 2018. 20:23 PM. Lights are shining as bright as the sun, the enclosure is full of the most prestigious people of our era, men and women on their dresses and suites, all from international brands. In the outside they all seem confident but on the inside they’re probably sweating. The music fades, dramatic drum roll on each one’s head, here’s the moment many people from different countries are waiting for, mostly a Chilean group of people with a fantastic woman between them. th
August 2017. Locarno. Same scene, different place and different audience. There are fewer people this time, and it isn’t on at least one channel per country. But here, a Latin-American project from Colombia is participating, and is willing to win a price. At home, Miss Maria, with his long skirt and her prayers to God, is waiting for news. The transgender/transsexual community topic seems to finally be reaching the light, because, even though is true that the whole LGBTTTQA+ community is now getting to the spotlight on many areas that it has never before, it looks like the T’s have been forgotten. And now that are coming out movies about them, is time to make a call, to see why it is important to start talking about it, to be published as books, to be shown on TV shows, to be present on the News. The most of the news I have watched related to trans people on my entire life (excluding the ones from LGBT focused news portals) are related to the first two paragraphs of this text, entertainment. It would be amazing if the only important thing to show to the world about them were their achievements, how they have won an Oscar and a Zonta Club Locarno, but the problem is they’re not, and let me tell you about it as a story. Alex was born with a genitalia that automatically conferred Alex a specific gender, and because of that, was treated a certain way. When Alex went to school Alex was bullied and of course felt uncomfortable, because for Alex it wasn’t a safe space, so Alex dropped out school. Alex decided to change Alex’s look, because Alex didn’t feel it represented who Alex was. Alex’s family didn’t agree, so they mistreated Alex and left Alex homeless. Alex tried to find a job, but the only jobs that seemed to fit for Alex according to the people, were hairdryer and prostitute. Alex wanted to become a med. Alex tried to find a place to live, but the law says the lessees have the right to choose who they rent to, and because of Alex appearance, nobody wanted to, and the ones who did want, took advantage of Alex, letting Alex stay at the worst and most antigenic places and asking for sex as payment. Alex never had access to Sexual and Reproductive Health Rights education, nor to contraceptive methods. Alex was found on a ditch, without clothes, stabbed several times and without vital signs. Alex was 22 years old when that happened. Alex never had a choice, everyone seemed to be choosing for Alex. Alex never understood why being who Alex wanted to be, was his death sentence. This is the story of someone in my country, with another name but with the same end, and I’m pretty sure is the story of many more in the world. According to statistics from the LGBT education Iberoamerican red on 2016, 65% of trans people on Latin-America have suffered transphobic violence on schools. Also, according to statistics from TvT (Trans Respect Versus Transphobia), between 2008 and 2017, 2609 trans people murders were registered, 2048 just on central and south America, besides 187 on north America. And those are just the numbers we can actually get, because probably there are many more not reported, or if reported, not clarifying the person was trans . This is why we have to start talking, because being part of the trans community seems to be a risk factor for not having life quality, or life at all, and that’s something we, as medical students, can start changing, just by educating us about simple things as definitions, by sensitizing us about this as a public health issue, by learning and giving trans people support and the knowledge about their body and their SRHR. We have more power than we think, and a bigger voice than they all could have together, so let’s use it, let’s start talking, let’s help to visualize it, so their lives and deaths, aren’t TRANSparent anymore.´
María Camila Zapata NORA ASCEMCOL
Social and laboral limitations in the trans community “Transgender people are those who have a gender identity or gender expression that differs from their assigned (biological) sex”  Over the years, the LGTBIQ community has gone through different problems related to social inclusion given the existing discrimination and the lack of support from people with power. Although there are movements and campaigns to improve inclusion, this continues to be a very serious problem, and even more so for the Trans community. People who identify as a different sex to the assigned at birth tends to be recognized as “freaks” or “monsters” by society, due to strict gender stereotypes that exist towards male/female roles. This makes Trans life very difficult, they suffer high levels of violence, harassment and rejection from different social groups, including family and friends, and ends up being isolated by heterosexual peers and even many become homeless. At the same time, there’s no legal protection for transgender in a workplace, society has prompt them to a life of poverty and higher rates of unemployment than the rest of the LGTBIQ community. “Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement”.  All of this makes sex work a suitable option for Trans people to participate in, and get the money they need to succeed in life. According to data from National Transgender Discrimination Survey roughly 13 percent of transgender reports having participated in the sex industry, being transgender women twice as likely to participate in the sex trade. There are many reasons why transgender choose to participate in sex work, some of them have it as a last option, others use it as a side job to have more income, and in some instances it’s because of coercions, such due to domestic violence in their childhood. Working in the sex industry comes with multiples risks, being violence one of the most important. “According to self-reported surveys from sex workers in the US most unwanted hatred or negative attitudes comes from the clients”.  All of this are almost never reported to the police, because of fear of discrimination or mistrust with the law enforcement. From all LGBTIQ communities, the trans community is a particularly discriminated group, probably because they show us how dynamic and non-binary sexuality and gender are. This makes it hard for them to appropriately fit into the society and limits their laboral opportunities. Lately, the high rates of violence towards transgender groups has been a popular topic, and it’s no surprise, specially because the principally affected people suffering from this situation are trans sexual workers. References: 1. Terry altilio, shirley otis-green (2011) Oxford textbook of palliative social work 2. Stotzer, rebecca l (2009) Violence against transgender people: a review of united states data. 3. Vivek Divan, Clifton Cortez, Marina Smelyanskaya, JoAnne Keatley (2003) Transgender social inclusion and equality: a pivotal path to development
Laura Hernández (NORA) and José Orozco ODEM
MUXES: THE THIRD MEXICAN GENDER Today, I came to talk to you, yes, to you! To you who surely saw at some point in your life the typical movie of those that are very common (let s not talk about brands), that film about the typical perfect couple, where the man goes to work and the woman stays at home, doing her chores, because we live in a society (or at least in Mexico I do) where that is the "normal" or the "common", however, I will tell you a story ... Once upon a time in a land far far away (well, not so far, only in the south of the country of Mexico) in the Zapotec region of the Isthmus of Tehuantepec, there was a society where all these roles did not make sense, because this is the place of the Muxes. If you asked me to define this gender, I would find myself with the limits of the gender/sex binary system, where it always teaches us that a woman must be feminine and a man must be masculine, however, with the muxes everything is different, they are masculine sex with a gender that, without being women, enters on what society calls feminine. The muxes are an identity that has been strongly constituted for many years, they fulfill traditional roles different from those of a woman of another culture, we can find them in activities such as cleaning, food procurement, caring for the husband and the children where their integration is impeccable, but also, in spaces that are normally occupied by men like bars, taverns or even just having fun. They are also immersed in fashion, as they wear beautiful and colorful costumes and award important social events such as dances, artisanal food preparation, design and embroidery of their beautiful regional costumes, floral hair ornaments and dresses. I could write hundreds of pages related to this beautiful culture, without a doubt, they are an example to follow, it is a culture where respect and diversity go hand in hand and coexist on a daily basis, something that we lack at all the country. It is a place where every year people from all over the world come together to celebrate this beautiful and rich culture and make us open our eyes to the whole world that does not need to fit within the rules of what society or the world has established as "Common" to be proud of who we are.
Estefan Arispuro NORA AMMEF
MUXES: breaking the heteronormative customs of a macho country Throughout the world, millions of people face the violence and discrimination of being themselves, of being different, of belonging to a minority classified as an LGTBIQ + community. In Mexico as in many countries, homophobia continues to be a controversial issue, from the big Cosmopolitan cities to the most recondite indigenous groups; despite living in the 21st century where inclusion and the struggle for minorities are themes of popularity and fashion, we can translocate ourselves in different parts of our continent where inclusion, tolerance, respect and the freedom to express our sexuality is different, from kissing in public, to other physical manifestations of affection, without arousing disgust for others. Mexico is a macho country by nature, but, just as there is discrimination, there is inclusion, with the younger population having this attribute. There is in our country a community of Zapotec origin, in the isthmus of Tehuantepec, in the municipality of Juchitan, Oaxaca, which has inhabitants called "Muxes", a word attributable to the genre that describes a person with male genital sex and female roles in the fields social, sexual and / or personal. The etymology of the word muxe comes from the Spanish word mujer, which in the sixteenth-century Spanish language was muller, hence deriving the word muxe. Within this community, the identity with the genre breaks the traditional, because this group is considered in a different section to the male and female, pigeonholed in a third gender. Within this community, the identity with the genre breaks the traditional, because this group is considered in a different section to the male and female, pigeonholed in a third gender. We can understand this third gender as a homosexual man with a social role adapted to the customs of a community that is based on matriarchy, therefore, they are attributed the roles of a woman such as housekeeping, cleaning, acquire, prepare food, and take care of children. The muxe have a great acceptance within the community, because besides contributing in the economic part for the maintenance of the home, they assume the role of caregivers of the parents during their old age, and the illnesses since the sons and women will form in some point of his life another family nucleus, in many cases when the mother or grandmother dies they inherit their authority becoming unifiers of their family. They are famous for the manufacture of Tehuana costumes typical of the region, which they wear proudly as part of their daily dress, although the older muxes choose not to resort to transvestism, which is within the behavioral standards of their society. In the sexual sphere, homosexual relationships are normal, although they do not usually have stable partners because their main commitment is to their family, it is even said that they are the initiators of the sexual life of young people in their region, since it is not well seen that women initiate sexual practices before marriage, but this is a fact that only the indigenous people of this town can confirm or deny since they do not share many attributes of their culture to people who do not belong to it. Being gay is very, very different from being muxe, according to them it is more than a mere sexual preference, they are considered a THIRD SEX, it is a great cultural burden that makes them proud, as well as families that have a born child with this "condition". They are the pride of an entire community, which recognizes them as one more sex, respects and values them. They do not recognize themselves as gay, trans, or transvestite, they do not call themselves women, because they know they are not. The dignity and preservation of sexual diversity muxe inclusive is represented by the association "The Truthful Intrepid Seekers of Danger", created by Oscar Cazorla in 1970 and for 47 years this community comes out with their dresses in the traditional festival of Juchitan "the candle of the intrepid "and proudly are the only community of sexual diversity to which the Catholic Church officiates a mass every November with an envoy from the diocese of Tehuantepec who heads the religious ceremony with which" the candle of the intrepid "is inaugurated. It is interesting how there can be a community with an acceptance of this kind since time immemorial to sexual diversity and how it has become part of their culture unlike the big cities where we boast of being modern, where we have more studies and understanding of the themes of "fashion" in which the acceptance of others is included as they are, but there is always a taboo. This community is worthy of admiration and respect because in spite of the limitations they may have for being part of an indigenous community in the mountains of Oaxaca, they promote and make part of their lives the acceptance and inclusion towards members of the LGTBIQ + community. , especially in the indigenous communities where machismo is much more pronounced than in the big cities, without a doubt it is a lesson that we must learn, and I wonder why a level of acceptance of sexual diversity in our country is not possible and the rest of the world, why not accept the differences of others as this community in my country does. Thus we can live in a society where there is no generic or sexual discrimination, contributing to a world where we are free and equal.
Javier Enrique Espinosa Rivadeneyra Rodolfo Emmanuel Pasos Rosado AMMEF
I am a transsexual The initials of my name are SD, i have 22 years, with much pride i can say that i am a trans man. 7 months ago start a treatment of hormone replacement therapy, this process is a complicated but at the same time very satisfactory. The feeling of not being identified with my gender was my from very small, because of the ideologies of the Guatemalan society, where you impose what you must do a "girl", is overshadowed those feelings, and I learned to live as a girl in this society as closed and square. In the year 2015 I wanted to make a good work, i wanted to donate my hair to people with cancer so i decided to cut my hair, when they finished and I saw myself in the mirror I saw someone completely different, I saw reflected a convenience that at the same time became many doubts, concerns and questions. At that time, I decided to open a closet that i closed with many locks since I was little, I started to look for information if that was a problem, disease and in society thought so, but surprise I found otherwise, several people telling of his experience and how happy they were after having taken this decision. In Guatemala there is a support group called "collective transformation." I saw a video that they were speaking of transsexualism, at that time find the necessary contacts in order to learn more about the topic and inform me about living in Guatemala. I was able to have contact with a transsexual person, to whom he could direct all my doubts, questions and concerns. Days later, full of nerves, I met with, from that moment I made my decision, my doubts became motivations, but after that came the fear of return to come out of the closet, no longer as a lesbian woman but face to society and my family saying I am a transsexual. The first person to find out was that my girlfriend to date is a woman who has supported me all the time, then to my mother, who has been a difficult path but the day-to-day is advanced, their greatest fear is how such a closed society, governed by religion i go to treat. The person more difficult to assimilate the situation is my father, with whom I have had a good relationship with for a long time, it is a closed and conservative person, but this has not been an impediment to find my happiness. How do you live in society? The most difficult thing is when you are in the "limbo" when the hormones have not yet been created changes in you physically, when it is a dilemma if you are a woman or a man?, your attitude is male, but your voice is high. Because in the places you are seeing, there are many looks on you, at the beginning this came to bother, but I learned to live with it and today I can walk in the streets with his head held high, knowing that the people i can criticize, but it really does not matter to me because I can say I am a happy person as I am. I feel comfortable with what I have created, this has been a change in my personality completely, a person who is not afraid of what you think of the security, in itself, doesn't care about the criticism. We are at a point where the society is still in diapers on the subject, unknown, avoid it, it is a taboo. With this, it can be concluded that even if people don't know about the subject we are non-existent, we are human beings with feelings, strengths, needs, and goals, with a future. Guatemala has men and transgender women and every time we are more.
The reception of the LGBT community in Ecuador and what they have overcome so far Ecuador has a conservative culture, however, the LGBTQ+ community (Gay, Lesbian, Bisexual, Transgender and Queer + people) has presented an evolution in the last 30 years that of which has not been an easy road. However, it has made great strides− despite the obstacles in the way− from the point of view that sexual activity between two people of the same sex was considered a crime in section 516 of the penal code. Penalties for Homosexual activity ranged from 4 to 8 years of deprivation of liberty (which was abolished since 1997) and by the hand of human rights abuse and violence to the community, gave an impulse to create organizations that with hard work. In 1997 Ecuador became the first country in the Americas −and the third in the world− to include sexual orientation as one of the categories protected against discrimination. This led to the development of the first LGBTQ+ pride march (which took place in Quito), this has been reflected in the newest constitution of 2008, article 66, ninth section, where it expressly states that people are recognized and guaranteed the right to make free, informed, voluntary and responsible decisions about their sexuality, life and sexual orientation. The state will promote access to the necessary means for these decisions to be made in safe conditions. In the same way, in articles 67 and 68 has included the union of people of the same sex, with complete social and legal protections available to married heterosexual couples, except for joint adoption. The first union that was ever done, occurred in August 2009. With this support, on August 5th, 2013, LGBTQ+ groups started a national campaign under the name of equal civil marriage, but the petition was rejected by public entities. Not giving up, results achieved later at the meeting held on August 18, 2014, with the LGBTQ+ Collectives; the President of Ecuador Rafael Correa announced in citizen link number 387 the registration of de facto unions of persons of the same sex as marital status, even though him being against this issue on more than one occasion, thus being a victory for the community. On September 15, 2014, LGBTQ+ activist Diane Rodríguez stars in the first facto union of a transgender couple in Ecuador. The achievement of the de facto unión, which was included as a civil status, was followed by protests by fundamentalist groups. However, the fight for the recognition of sexual rights and diversity did not stop, as a result, it promoted the organized work of several activists (LGBTQ+, women's organizations and young people) in November 2011. It started a petition on Change.org to ask the minister to close more than 200 "dehomosexualization" clinics (Gay conversion clinics). The group said that these clinics tortured and abused patients in an effort to "cure" them, these centers focused mainly on lesbians and operated under the pretense of drug rehabilitation centers, unfortunately only 27 were closed, while more than 200 were still working regularly. In January 2012, the health minister Carina Vance Mafla (LGBTQ+ activist) and former director of the Causana Foundation, continued with the closure of the workshops and released dozens of women. Today, in may 2018, the fight continues by the hand of Diane Rodriguez who helped to créate the Committee against torture, harassment and rape by the Church in Ecuador " in order to follow up on allegations of sexual abuse and harassment that’s been happening a lot lately in Ecuador, being this a very controversial subject. There is no doubt that the community has gone through extremely difficult and unjust situations, but every day new and important victories are being acquired in recognition of their rights. Although the celebration for the conquests for civil rights can not be complete until anyone can freely live their sexuality in any corner of the planet, without the fear of being persecuted or executed, and most importantly, when there has been an advance in social common thinking, so it would be seen as something completely normal to belong or not to the LGBTQ + community and not existing rejection from some people as there is currently. Nowadays, having sexual relations with people of the same sex is illegal in 78 countries, so there is still a long way to go, realizing that in this way they would be against the rights to privacy and non-discrimination. Despite the adversities, the community has managed to get ahead and open the way without losing the strength and passion that drives it, with the dream of achieving recognition and respect to the LGBTQ + community rights.
Jonnathan Esteban Suarez Quito Adrian Nicolas Alvarez Urgiles AEMPPI ECUADOR
The endless fight for the LGBTIQ+ rights in Perú I wish someday Perú becomes known not only for its delicious food but for its undeniable respect towards people. Our reality is far from that dream. Machismo has influenced are society in every single context of our life’s, ranging from subtle comments, such as “no seas marica” (don’t be a fag) in our everyday life, to hate crimes that take the life mainly from gay men, transgender women who are sex workers and lesbian girls and women that are sexually abused to “discipline them”. Who are the criminals? Many of them are young men that were part of what we call the authority meant to protect our life: the police and the army. Sometimes, violence is also seen as the lack of support from the family and the whole people around a LGBTIQ+ person. This becomes a severe threat to their mental health, many times ending in suicide, such as the case of a 12-year-old boy that told his stepfather he was gay. This man shaved the hair of the little boy, rejecting his sexual orientation. This boy was bullied in his school, in the Amazon of Perú. This boy took his beautiful and innocent life away because of his stepfather reaction. Other scenarios are the retaliation of the police towards the love expressions of the LGBTIQ+ community. Many gay and lesbian people would kiss with their couples in public, challenging the homophobia present in our Peruvian society. What did they received? Policemen insulting and beating them. They would touch the breasts and hams of the lesbian women. The Prosecutor’s Office doesn’t consider the policemen’s actions as a crime. Violation to LGBTIQ+ rights don’t end up there. In the media, there are well-known characters from the radio that would freely express their homophobic comments to all the city of Lima. “I would kick them if they kiss in front of my kids’ school”. To show some numbers about the violence towards the LGBTIQ+ community in Perú, in the year 2016 over 18 murders occurred, where 8 were gay men, 7 trans women and 3 lesbian women. There were 109 scenarios of physical violence that didn’t end in death, as well as 2 suicides. These numbers may be underestimated, meaning the problem is bigger than we think, so advocating for harder laws towards hate crimes is urging. So, how has the fight started? Back in the 1980’s, the Movimiento Homosexual de Lima (MHOL) and the Grupo de Autoconciencia Lésbica Feminista (GALF) were founded, being the first Peruvian LGBTIQ+ formed. In the 1990’s, an economist was fired because of his homosexuality. This was the first time that institutionalized homophobia was acknowledged in the dictatorship of Alberto Fujimori. Other 117 diplomats were fired because of their sexual orientation. In 1995, the first manifestation for the Gay Pride took place, with only 15 people present. Nowadays, this march is massive. In the start of the new democratic era, in 2002, a Constitutional Reform took place to include the prohibition of discrimination for sexual orientation in the Constitution to recognize the equality between the heterosexual and the nonheterosexual population. Sadly, the commission in charge of this reform decided not to include the prohibition for discrimination due to sexual orientation. Recently, there has been efforts at the congress to reject discrimination based on both sexual orientation and gender identity. Nevertheless, these measures have not gone far and this is still not a reality. We have several movements, feminist groups and young leaders willing to create a safe space in our country for the LGBTIQ+ community. Part of our efforts on advocating for LGBTIQ+ rights should focus on the government’s laws and work closely with decision takers to ensure laws that would comprehensively protect LGBTIQ+ people from hate crimes and finally end with homophobia, biphobia and transphobia. References: Centro de Promoción y Defensa de los Derechos Sexuales y Reproductivos (PROMSEX). Informe temático LGBT 2018. Derecho a la Igualdad de las personas LGBT en Perú: Perspectivas jurídicas y políticas. Pp: 13, 25-27. Movimiento Homosexual de Lima (MHOL). Informe Anual 2011. Pp: 125-129
Alicia Maldonado IFMSA-Perú
Being part of the LGTBIQ+ community in Peru Since the beginning of our culture, the LGTBIQ+ community has existed. We have the most important example in the Moche culture (100 - 700 AD), where the sexuality was developed in a freeway, being portrayed throw-out their pottery. Nevertheless, the beginning of the Inca Empire (1438 - 1572) marked a change, since it was one of the first cultures to punish male homosexuality (hualmishcu), especially in the Peruvian Andean region, while, in the Coast, people were more tolerant, especially with feminine homosexual population. With the arrival of the Conquerors to America (1532), every sexual practice considered “unnatural” was censored and condemned. Even if Peru was one of the pathfinders in South America in the depenalization of homosexuality (1924), the politic of equal rights that protected this community was left behind. Passing through the years, locating us in the 80s, our country lived in an era of terrorism in which crimes of hate were perpetuated. One example is the case of Luis Alberto Pinchi Vasquez, who was one of the first travesties in the location of Tarapoto that was famous in the world of beauty and was riddled as part of the “social cleansing”. Along with the political and economic crisis, an epidemic of HIV that affected mostly men that had sex with other men arise. This generated an impulse of organized masses that were asking for a better service in health for the community. From the 90s until now, there have been presented many legislative proposals that were looking to protect homosexual population’s rights, many of them focused on the civil union. Regrettably, all of them failed, until 2014, when the “Law proposing the Solidarity Society Regime” was approved. This law consists on the voluntary agreement between two people with 18 years or more, who live together in order to assist, support and originate property rights. Although this didn’t alter the civil status of the person, nor modify the family relationship of both participants, but at least, it allowed protection of the heritage of couples belonging to the LGTBIQ+ community. Another victory was the abolition of transsexuality as a pathology allowing these people their rights to gender identity. However, in 2017, the Peruvian Congress partially repealed Legislative Decree 1323, which hardened sentences for hate crimes that were committed due to intolerance or discrimination related to origin, sex, sexual orientation, gender identity, between others. Having talked a little bit about the evolution of the context of the population LGTBIQ+ and different events that affected it in a positive but also in a negative way, we can now analyze different factors that have an impact in this community.
Karla Aguirre and Juan José Flores IFMSA-Perú
The first approach from the Peruvian state to the LGBTIQ community: a virtual survey In Peru in 2008, the annual report about LGTBIQ community human rights was created and its aim was to analyze the reality of this population. It was developed by various non-governmental institutions like the LGBT Peruvian net and Promesex. By 2014 - 2015, was reported sundry cases of discriminatory acts like mockeries and abasements, even suicides and murders that are defined as discriminatory acts of hate in the Peruvian penal Code, nevertheless the Peruvian state did n o t r e c o g n i z e t h o s e a s a c t s a g a i n s t t h e l a w . The “Instituto Nacional de Estadística e Informática (INEI)” is a governmental institution in charge to hold the updated register of the Peruvian population. In that way, in the end of 2016, members from the Peruvian state, NGOs and other institutions focused on the topic and elaborated a request to INEI to do the first virtual survey for the LGBT community. The main aim was getting the first register of this population’s characteristics and to start policies, actions and strategies that guarantee their acknowledgment and protection into the public and private milieu. The main topics covered on the survey were education, health, employment, dwelling, ethnicity and incapacity,also, they focused in problems of violence and discrimination that affect them. At the end of 2017, the results were published as a technical report of free access on the INEI web page and diffused by some written communication media. (https://www.inei.gob.pe/). In the results, they highlighted that more than a half of registered people live actually in Lima region, capital of the country; it indicates that the other left amount represents the other 23 regions from Peru. In that way, we are facing an inequality of information, resulting on a under registration of the Peruvian reality. On the other hand, the majority of surveyed people belong to the age group of 18-29 years old. Therefore, is important to outstand that although the following results based on the answers of mentioned people would not be extrapolated to the total population, they are regarded a first inclusion action for this community. In the health sector, the 68% count with a health ensure and just the 25,4% of them, it comes from the Peruvian state. About the diseases that affect them, the mental disorders are on the first place; one fifth of them get any infectious disease and it could be in many cases because bad information about preventive methods for STI/HIV that still is present in a third of them and the other reason could be because they do not use any method. In the social section, they report that a 62,7% have gotten any kind of discrimination and/or violence from their daily surroundings and almost 80% do not admit their sexual orientation because the afraid to be discriminated. The main fear to feel free to admit their orientation is the established Peruvian perception about sexuality based just in two options, men and women.
Source: Primer Encuesta virtual para personas LGBTI, 2017.
Source: Primer Encuesta virtual para personas LGBTI, 2017
To conclude, this information is the first one about LGBT population but is not enough and is not possible carry out the aim of this survey. Firstly, the information about the 23 other regions is irrelevant, is nothing making a comparison with Lima and the same happens with the numbers of participants that most of them are just in one group of age. It was not registered the reasons why there was a few participants from the 23 other regions and from another groups of age but about the last one it could be triggered to a high access to the net by the group of age 18-29 years old. Therefore, in the future, a new exploratory study with enough information from each one of the 24 Peruvian regions and including different groups of age could reflect the real situation of the Peruvian LGBT community and start legislation to recognize and protect them from any act of discrimination or violence.
Karen Rojas Gonzales & Yelicsa Altamirano Lazo. IFMSA Perú
Disadvantages of living in a third world country and belonging to the LGTBIQ community In the last decade the LGBTIQ community has presented an increase in suicide rate compared to their heterosexual peers, building up to four times the percentage of these by rejection of society and doubling this figure if you have also family rejection. Although homosexuality is not illegal in our country, in the Dominican Republic there is a marked discrimination against the members of this community. While the former President of the United States Barack Obama was exercising his mandate, he decreed James Brewster as Ambassador of the United States to the Dominican Republic, generating a polemic among the many religious groups that are in the country. In the developed or first world countries, which are those that have the highest education index, belonging to the LGTBIQ community is irrelevant.
On the other hand, the simple fact of belonging to this community in underdeveloped countries means having an open door to prejudice and exclusion, where one is judged by the sexual orientation instead of being judged by the capacity that one has as a person as it would be in advanced countries. We currently live in a world governed by patriarchy with some advances in first world countries, obtaining in very few equality and in others; Respect. However, third world countries are still fervently governed by patriarchy and the Orthodox Church, thus preventing the necessary progress and acceptance of what they do not understand. Underdeveloped countries have a “balance” of “advantages and disadvantages” but this one is lost at some point when it comes to the collective LGBTIQ being this only a receiver of grievances, having a totality of 72 countries which consider illegal the Homosexuality and 8 other countries punish it with death penalty.
Disadvantages of living in a third world country and belonging to the LGTBIQ community According to ILGA (International Lesbian and Gay Association) - (May 2017), 13 countries have the legal capacity to condemn to death the defendants who maintain relations with same-sex persons, of which only 8 nations apply it. We think we need programs and activities that help seek to educate and raise awareness among Dominican citizens about the importance of eradicating discrimination faced by people with sexual orientation and diverse gender and, at the same time, to encourage the creation of safe spaces Discussion and dialogue on issues relevant to the LGBT Dominican community.
You don’t have to belong to the LGTBIQ community to know that every day and anywhere in the world, members will always have disadvantages and challenges. The reason I said “you don’t have to belong” Is because I'm sure that at least, the person reading these words, knows one person that belongs to that community, and although sometimes you just want to focus on your own problems, and the problems that are commonly mentioned, it is important to remember, it’s crucial we always show respect, respect for all beliefs beyond our own. The LGBTIQ community basically only wants to celebrate with pride who they are. As governor James Brewster said: "God created each one in a unique way, and that is what is celebrated, diversity" - (2017).
References: 1. Mapa mundial de los derechos LGBT: penas de muerte en 8 países y prisión en 72 de: https:// www.20minutos.es/noticia/3071159/0/mapa-mundialderechos-lgbt-penas-muerte-prision/ 2. Homo. fobia (Datos Mundiales en cifras) de: https:// www.telesurtv.net/pages/Especiales/HOMOFOBIA/ i n d e x . j s p 3. James Brewster: celebren la diversidad en este día del orgullo de: https://www.listindiario.com/la republica/2017/07/03/472474/james-brewster-celebrenla-diversidad-en-este-dia-del-orgullo 4. Carlos Rodríguez presenta situación LGBTIQ dominicana en Harvard de: https://acento.com.do/2018/ sociales/8564025-artista-activista-carlos-rodriguez-presentasituacion-lgbtiq-dominicana-harvard/ 5. Todavía 72 países criminalizan a los homosexuales de: http://www.publico.es/sociedad/homofobia-todavia-72p a i s e s - p e r s i g u e n . h t m l 6. Mapas: Legislación sobre la orientación sexual https:// ilga.org/es/mapas-legislacion-sobre-orientacion-sexual
Access to Health Services by the LGBT Community in Brazil The right to health is considered universal, but the reality is that many countries are marked by exclusion and violation of fundamental human rights, especially for minority social groups such as Lesbians, Gays, Bisexuals, and Transgenders (LGBT). That phenomenon is reflected in the lack of access to health services by that population. In Brazil, access to health services is recognized as a citizenâ€™s right. In the country, the Unified Health System (SUS) was established in 1988 and offers free, universal coverage for every citizen, and according to the latest data , 80% of the Brazilian population utilizes the system. 1
It has been revealed by studies that members of the LGBT group are more susceptible to health problems, such as abuse of alcohol, tobacco and illicit drugs, unprotected sex, mental disorders, Sexually Transmitted Diseases (STDs) as HIV/AIDS, and bullying. Although those conditions are the result of a multifactorial scenario, it is aggravated by the lack of access to health care, accurate information, as well as discriminatory practices of health professionals towards patients in this group. The difficulty of accessing health services by this group is noted and the main causes of exclusion of the LGBT population is due to homophobia, discrimination, and institutional heteronormativity. Transgender people continue to be the main victims of LGBT violence and the most targeted to serious violence, homicides, and bodily injuries. Considering that transgender people usually require differentiated care, they face extraordinary adversities when trying to access health. It is important to emphasize that equity in health is justified as the right that all people have to fair opportunities to achieve their full health potential. This leads to a reflection about equity as something that surpasses a principle of social justice, understanding that health inequities go beyond a merely economic hierarchy. Social vulnerability is characterized by the condition of groups of individuals that are marginalized by society â€“ that is, people or families that are in the process of social exclusion. Therefore, the difficulty of effective access to various services and denial of basic human rights classifies the LGBT population as vulnerable. Considering that scenario, in 2004, the ministry of health of Brazil, using their institutional capacity to promote equity policies, envisioned health programs that introduced differentials in LGBT health care, as a part of a series of programs directed to vulnerable populations. Those programs aim at reorienting health policies with the purpose of increasing access to health actions and services of quality for these groups. For these initiatives to be maintained and improved, continuous reformulation is essential, seeking constant improvements of the policies, as institutional and structural weaknesses jeopardize the continuity of these actions. Although an advance in the health policy directed to the LGBT population has been seen in the past few years, those were not implemented to their best capacities. Considering that Brazil is a country with continental dimensions, the effective training of all health professionals to better serve the LGBT population is still an issue. Another problem around that subject is that there is still a very conservative posture of the general population in accepting these changes towards a more inclusive approach for this group. That said, Brazil is still known as a leader in LGBT healthcare in result to progress on LGBT legislation. It has reached many achievements to help its LGBT citizens, by legalizing same-sex marriage, including access to gender reassignment surgery and hormone therapy for transgender people in the public health system, raising awareness to and fighting homophobia and leading international discussions on sexual orientation, gender identity, and human rights. The reduction in attendance and the subsequent search for assistance by the LGBT population is a result of the exclusion and marginalization in health services of this group, which reduces the chance of developing educational and preventive health work for them. It is clear the importance of the training and awareness of the health professionals in the care of the specific vulnerabilities of this group and the need to combat the institutional prejudice often suffered by this population. Reference: 1 - Unified health system (SUS), 2017. Available: <http://healthmarketinnovations.org>. Access: 10 May 2018.
DĂĄfny Cristina Ubriaco LORA IFMSA Brazil
The impact of discussing Medical Care of Trans People among Medical Students The current scenario of LGBTQ people in Brazil is considered controversial: despite tremendous achievements of rights and visibility in the last decade, the country is facing alarming data regarding violence and discrimination against this community . In other words, although the country has been praised as a progressive world leader in the conquering of LGBTQ rights, having the biggest Parade of the world, it is also recognized as the world leader in murdering of trans people, being responsible for 42% of trans murdering in the world. Regarding recent data released investigating more about the condition of trans people in Brazil, the scenario is presented as a critical situation: trans people are vulnerable in every social aspect recently studied in the country. Brazil is the leader country in harassment, hate crimes, and murdering. In contradiction to this, a study from UCLA Law School showed Brazil as the country where people are more familiar with trans persons, suggesting again this contradiction. In order to give proper care and support for this vulnerable population in Brazil, medical professionals must be well prepared and informed about trans health, avoiding alarming situations that are being studied around the world pointing the lack of knowledge by physicians of basic terms of gender identity, and demonstrating that 28% of physicians in Europe already denied care for this patients. Aiming to better prepare the Brazilian physicians of the future, it is necessary to introduce Trans Health to the medical education and curriculum, promoting inclusion and support for them. Thinking about that, the IFMSA Brazil UnP (Universidade Potiguar) and the IFMSA Brazil UFRN (Federal University of Rio Grande do Norte) promoted a night of discussion about the social scenario of trans people in the country, analysing its history, rights, healthcare and support from different dimensions. In the event, there was 51 students and 2 professors, a trans phycologist - the first trans person to graduate at Federal University of Rio Grande do Norte and to legally change her social name -, and an endocrinologist with expertise in the caring of trans people. The event started with a brief explanation of the Brazilian scenario in the context of trans vulnerability, and after it was performed the Step by Step group dynamic, in which 6 people, including 2 trans people, were invited to form a line in the front of the room. They were instructed to read situations projected in the slide and, in case of already experienced them in life, take a step forward. The dynamic was used to create a “live chart” of discrimination and lack of rights of trans people. Afterwards, the endocrinologist was invited to talk about healthcare of trans people, giving knowledge about simple concepts as gender identity, and later explaining about how to first receive a trans patient, hormonal therapy, and surgery. In the final moment of the event, the psychologist and trans activist invited started to explain a broader view of trans history in Brazil, talking about the major fights in the conquering of rights, the psychological aspects involved, and ending the presentation with a emotional report about personal experiences. Then, it was given to all students a survey containing statements to evaluate the impact of the discussion. Each statement was followed by a grading scale from 0-10, being 0 completely disagree, and 10 strongly agree with the statement. According to the survey, 88% of the students has strongly agreed that the discussion helped in the understanding of gender identity/biological sex differences; 78% of them strongly agreed that the discussion helped in the understanding of hormonal therapy; 86% strongly agreed the discussion was fundamental to perceive a specialized care for trans people; 90% strongly agreed that the event presented a broader view of trans vulnerability; 67% strongly agreed the discussion helped in knowing how to conduct a consult with a trans patient; and 80% strongly agreed the event helped in realising about transphobia in health policy and clinical care. The survey demonstrates the fundamental importance of this event in the medical curriculum, giving the critical situation of vulnerability of trans people in Brazil and the lack of knowledge faced by medical professionals and students. By promoting discussions in medical faculties across Brazil, it is possible to change this reality heading towards a country with zero discrimination and full inclusion. 1
CARRARA, S.; VIANNA, A.R.B. (2006) “Tá lá o corpo estendido no chão...”: A violência letal contra Travestis no Município do Rio de Janeiro. Revista de Saúde
2. 3. 4.
Trans Murder Monitoring (TMM), Transgender Europe, 2015. FLORES, A.S. (2015) Attitudes toward Transgender Rights: Perceived Knowledge and Secondary Interpersonal Contact. Politics, Groups, and Identities, 398-416; GOMEZ, M. M. (2008) Violência por Prejuicio, Sexualidades Diversas en la Jurisprudencia Latinoamericana. Bogotá: Siglo del Hombre Editores, American
Canadian National Diversity Council (2000) A provider's handbook on culturally competent care: lesbian, gay, bisexual and transgender population. Oakland, CA:
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University Washington College of Law, Center for Reproductive Rights; Kaiser Permanente.
6. CAROLAN, F. and REDMOND, S. (2003) Shout: research into the needs of young people in Northern Ireland who identify as lesbian, gay, bisexual and/or transgender. Belfast: YouthNet.
Letícia Sousa Oliveira , Flávia Helena Soares de Oliveira and Bárbara da Câmara Santos Marinho. IFMSA Brazil
LIFE EXPECTANCY OF TRANSEXUALS AND TRANSVESTITES IN BRAZIL Autora: Liliane Martins da Silva Sessão da Revista: IDAHOT Key words: life expectancy, transexuals, transvestites, violence. 1
INTRODUCTION Brasil, in absolut numbers, has the highest register of transsexuals and travestites killed, acordding to a study made by the ONG Transgender Europe . In this context is notable the vulnerability that these groups are submitted, which give them a life expectency of 35 years, aproximetely, according to the National Association of Transsexuals and Tranvestites from Brazil (Antra)- Comercy Jornal, which is reduce to less than half comparing to the rest of the brazilian population, by the IBGE data (Geography and Statistic Brazilian Institution) . .Historically speaking, can be noticed that Brazil has a sexist culture coming from the colonial era, besides a historical context shapped in high levels of violence (slavery, colonialism, dictatorship) and this heritage coming of the past corroborates to a country with high levels of transphobia. In addiction according to the homophobic violence relatory from Brazil published by the Human Rights Secretary of Republic Presidency (SDH), about 90% of the trans people see themselves forced to prostutite as a survival because of the lack social support and the obstacles faced in the job market. And because of the necessity of these tipe of job, it is notable a increase the number or violence cases. Thus, based on statistical information, the objective is to discuss the possible causes of reduced life expectancy of transvestites and transsexuals in Brazil, in addition to addressing their respective difficulties in living in a country characterized as transphobic. Therefore, based on the alarming data of violence and intolerance to this population, it is necessary to discuss human rights and equality inserted in this context. 1
2 METHODOLOGY This is a literature review, with articles available in the electronic addresses "PubMed" and "Scielo" with a primary focus on the causes that lead to the decrease in the life expectancy of transsexuals and transvestites with data from the last 10 years. 3
DISCUSSION According to the Brazilian´s Federal Constitution (art.196), health is a right of every citizen, with universal and igalitarian access, however, gays, lesbian, bissexual, transgender, transvestite, intersx and queer (GLBTIQ) population is marginalized in the right of health compared to the rest of brazilians population. In case of the transgender and transverstite, can be notice a lack of accessibility in the service of modification in primary and secondary caracteristcs, this prevents a safe bodily readjustment to this population that depends of risk aesthetic procedures. The indiscriminate use of hormones and “bombadeiras”- term used to the unauthorized people that apply injectable silicone in this population -are an example of demands of the trans population that are not offered in a practical way in the public health system. Thus, psychological disorders and suicide attempts are observed because of this lack of accessibility, that is incoherent to the “Conceito Ampliado de Saúde” described by “Lei orgânica de Saúde” n°8.080/90, that recognized health a result of certain conditions, such as: “alimentation, housing, education, income, environment, labor, leisure, freedom, access to and land tenure, and acces to health services” . On being to violence, it´s realized that the group composed by transexual and transvestite is a target to hate crimes, because of the social deprotection . It´s observed that a significant number of News programs, that address violence against this vulnerable population, is due to a diversity of factors, ranging from the issue of gender to socioeconomic status. Following this direction, the vunerability, caused mainly by prostitution, is the first reason of death in this population, since 55% of murders are observed in the streets . Besides that, is notice a negligence and a lack of state support regarding to security of this group, above all if has evidence of participation in these activities of prostitution (which represents the economic activity of 90% of this population) , in addition to drug trafficking, factors that reflect th social marginalization. In this context, a Brazil leads the world ranking of murders of transvetites and transexual (percentage of 52%)9. According to the graph and the data from International Transgender Europe ONG (TGEU)1, which monitors transvestites and transexual murders around the world, between the beganning of october 2016 and end of september 2017, 171 trans people were murdered in Brazil. 4
Source: Map of Transsexual and Transsexual Murders in Brazil in 2017.
Thus, it is noted that the issue of reduced life expectancy of transvestites and transsexuals in Brazil is broader than a simple issue related to violence. Even though death is a daily and universal occurrence, death experiences are mediated by the intersections of body, culture, society, and state .Therefore, the death of the body ceases to be a natural phenomenon and becomes social, temporal and spatially constructed. 9
4 RESULTS According to the literary review, it is observed that between January 2008 and September 2017, a total of 2609 transgender and gendered people were killed in 71 countries, with Brazil leading the world homicide ranking . It can be said that in Brazil, such an index of violence results from a sexist culture historically inherited. In addition, it is perceived that the trans population is not included in the guarantee of universal rights, which ends up hurting their right to come and go. Thus, it was possible to arrive at an estimate that every 48 hours a trans person is murdered in Brazil and that the average age of the victims is 27.7 years , a frightening reality since 10% of the national population is considered LGBTIQ+. transsexuals and transvestites the majority of this population . 1
5 CONCLUSION We conclude that the transvestite and transsexual population is the target of great prejudice and intolerance in Brazil, called transphobia. There is a lack of fundamental rights, structural exclusion and various types of violence, which are characterized by aggression, threats and killings, resulting in a shorter life expectancy. Thus, based on the alarming data of violence and intolerance to this population, it is necessary to discuss human rights and equality inserted in this context. 6
1. TRANSGENDER EUROPE’S TRANS MURDER MONITORING. Reported deaths of 816 murdered trans persons from january 2008 until december 2011 [Online, 2012a]. Disponível em http://www.transrespect-transphobia.org/uploads/downloads/TMM/TvT-TMMTables2008-2011-en.pdf. Acesso em 13 de maio de 2018 2. BENEVIDES, Bruna. A LUTA POR SOBREVIVÊNCIA NO PAÍS QUE MAIS MATA TRAVESTIS E TRANSEXUAIS DO MUNDO. Site Global Sustentável, [S.l.], 31 jul. 2017. Mapa dos assassinatos de Travestis e Transexuais no Brasil em 2017, p. 3. Disponível em: <https:// antrabrasil.files.wordpress.com/2018/02/relatc3b3rio-mapa-dos-assassinatos-2017-antra.pdf>. Acesso em: 13 maio 2018. 3. SECRETARIA ESPECIAL DE DIREITOS HUMANOS DO MINISTÉRIO DAS MULHERES, DA IGUALDADE RACIAL E DOS DIREITOS HUMANNOS. Relatório de Violência Homofóbica no Brasil: ano 2013. Brasília, 2016 4. BRASIL. Constituição Federal (1988). CONSTITUIÇÃO DA REPÚBLICA FEDERATIVA DO BRASIL. Diário Oficial da União: [s.n.], 1988. 498 p. Disponível em: <https://www2.senado.leg.br/bdsf/bitstream/handle/id/518231/CF88_Livro_EC91_2016.pdf>. Acesso em: 13 maio 2018 5. CARDOSO, Michelle Rodrigues; FERRO, Luís Felipe. Saúde e População LGBT: Demandas e Especificidades em Questão. PSICOLOGIA: CIÊNCIA E PROFISSÃO: [s.n.], 2012. 12 p. Disponível em: <http://www.scielo.br/pdf/pcp/v32n3/v32n3a03.pdf>. Acesso em: 13 maio 2018 6. Brasil. Presidência da República. (1990).Lei nº 8.080, de 19 de setembro de 1990. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Acesso: 13 de maio de 2018 Disponível em http://www.planalto.gov.br/ccivil_03/Leis/L8080.htm
7. STOTZER, Rebecca L. Comparison of hate crime rates across protected and unprotected groups. Los Angeles: University of California, School of Law, 2007. Disponível em http://williamsinstitute.law.ucla.edu/wp-content/uploads/Stotzer-Comparison-Hate-CrimeJune-2007.pdf. Acesso em 13 de maio de 2018. 8. BENEVIDES, Bruna. MAPA DOS ASSASSINATOS DE TRAVESTIS E TRANSEXUAIS NO BRASIL EM 2017. Associação Nacional de Travestis e Transexuais - Antra Brasil: [s.n.], 2017. 121 p. Disponível em: <https://antrabrasil.files.wordpress.com/2018/02/relatc3b3rio-mapa-dos-assassinatos-2017antra.pdf>. Acesso em: 13 maio 2018. 9. Maddrell, Avril and Sidaway, James D. 2010. Deathscapes: spaces for death, dying, mourning and remembrance. Farnham: Ashgate Publishing Limited Acesso: 14 de maio de 2018.
Liliane Martins da Silva IFMSA Brazil
Small but powerful effort to show the world the reality of the LGTBIQ community in this beautiful region