ABSTRACT

Objective

To identify social vulnerability profiles of transgender people who have experienced intimate partner violence in Brazil and to assess the association with recurrent violence and referrals to support services.

Methods

This was a cross-sectional study of reported cases of violence against transgender people in Brazil (2015-2021) utilizing data from SINAN/DATASUS. Sociodemographic profiles were defined using two-step cluster analysis and associations estimated by means of binary logistic regression, with odds ratios (OR) and confidence intervals (CI).

Results

A total of 3,384 cases were reported, identifying five profiles. Recurrent violence was more frequent in the South region (71.1%), among individuals with elementary education (64.9%) and those with disabilities (74.0%) (p<0.001). Fewer referrals were observed in the North region (76.6%), among Asian and Indigenous people (74.5%) and among lesbians (81.6%) (p<0.05). No significant differences were found between the profiles (p>0.05).

Conclusion

Social disparities influence intimate partner violence, but no significant differences were observed between the identified profiles.

Palabras clave
Minorías de Género; Violencia por Parejas Íntimas; Vulnerabilidad Social; Interseccionalidad; Estudio Observacional

Study contributions

Main results

Recurrent violence was observed in the South region, among individuals with elementary education and with physical disabilities or mental disorders. A lower frequency of referrals was found in the North region, among Indigenous people or people of Asian race /skin color, and lesbians.

Implications for services

There is a need to strengthen strategies that promote equity in access to services, professional training and foster the development of culturally sensitive services, alongside raising awareness of the different forms of violence.

Perspectives

Further research, considering elements not covered in this study, such as social support and systemic discrimination, may help elucidate additional factors related to patterns of recurrent violence.

Palabras clave
Minorías de Género; Violencia por Parejas Íntimas; Vulnerabilidad Social; Interseccionalidad; Estudio Observacional

RESUMEN

Objetivo

Identificar perfiles de vulnerabilidad social de personas transgénero víctimas de violencia por parte de parejas íntimas en Brasil; verificar la asociación con la repetición de violencia y derivación a servicios de atención.

Métodos

Estudio transversal de casos denunciados de violencia contra personas trans en Brasil, utilizando datos del SINAN/DATASUS. Los perfiles sociodemográficos se delinearon mediante análisis de conglomerados en dos etapas; las asociaciones se estimaron mediante regresión logística binaria utilizando odds ratios (OR) e intervalos de confianza (IC).

Resultados

Se reportaron 3.384 casos, delineándose cinco perfiles. La repetición de violencia fue más acentuada en el Sur (71,1%), entre personas con educación primaria (64,9%) y con discapacidad (74,0%) (p<0,001). Menos derivaciones en el Norte (76,6%), entre mujeres asiáticas e indígenas (74,5%), lesbianas (81,6%) (p<0,05).

Conclusión

Disparidades sociales influyen en la violencia de pareja, pero no hay diferencias significativas entre los perfiles identificados.

Palabras clave
Minorías de Género; Violencia por Parejas Íntimas; Vulnerabilidad Social; Interseccionalidad; Estudio Observacional

INTRODUCTION

Violence perpetrated against transgender people, particularly, is a complex and multifactorial phenomenon that encompasses events of various types and natures. ¹1 Peixoto VB. Violência contra LGBTs no Brasil: premissas históricas da violação no Brasil. PERI [Internet]. 2018 [citado 15 fev. 2024]; vol. 1, n. 10, p. 7-23. Disponível em: https://periodicos.ufba.br/index.php/revistaperiodicus/article/view/28014
https://periodicos.ufba.br/index.php/rev...

2 Prado AJ, de Sousa MF. Políticas Públicas e a Saúde da População LGBT: Uma revisão integrativa. Tempus Actas de Saúde Coletiva [Internet]. 2017; vol. 11, n. 1, p. 69-80. Disponível em: https://www.tempus.unb.br/index.php/tempus/article/view/1895
https://www.tempus.unb.br/index.php/temp...

3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB...

4 Miskolci R, Signorelli MC, Canavese D, Teixeira F do B, Polidoro M, Moretti-Pires RO, de Souza MHT, Pereira PPG. Desafios da saúde da população LGBTI+ no Brasil: uma análise do cenário por triangulação de métodos. Cien Saude Colet. 2022; vol. 27, n. 10, p. 3815-3824. Disponível em: https://doi.org/10.1590/1413-812320222710.06602022
https://doi.org/10.1590/1413-81232022271...

5 Sena AGN, Souto KMB. Avanços e desafios na implementação da Política Nacional de Saúde Integral LGBT. TEMPUS [Internet]. 2017; vol. 11, n. 1, p. 09-28. Disponível em: https://www.tempusactas.unb.br/index.php/tempus/article/view/1923
https://www.tempusactas.unb.br/index.php... -⁶6 Brasil, Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Política Nacional de Redução da Morbimortalidade por Acidentes e Violências, Portaria MS/GM n. 737 de 16 de maio de 2001, Ed. 2, p. 1-63. In addition to risk factors, it is essential to analyze it based on socio-environmental and political determinants and conditions, which are strongly associated with social inequalities. ⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... ,⁸8 Marzulo EP, Heck MA, Filippi EE. Desigualdades socioeconômicas no Brasil. DRd - Desenvolvimento Regional em debate [Internet]. 2020 [citado 22 fev. 2024]; vol. 10, p. 1377-1402. Disponível em: http://www.periodicos.unc.br/index.php/drd/article/view/3191
http://www.periodicos.unc.br/index.php/d... Violence must be understood within the framework of social structures and power relations, which are reflected in cultural and behavioral issues. Furthermore, violence should be examined in the context of gender, class, and race/skin color relations. ⁹9 Minayo MC de S. Violência e Saúde. SciELO Books. Editora FIOCRUZ; p. 1-134, Rio de Janeiro, 2006. Disponível em: https://static.scielo.org/scielobooks/y9sxc/pdf/minayo-9788575413807.pdf
https://static.scielo.org/scielobooks/y9... ,¹⁰10 Krug E, Dahlberg L, Mercy J, Zwi A, Lozano R. The world report on violence and health. World Health Organization, WHO, p.346, 2002.

Transgender people in Brazil experience violence on a daily basis. ¹¹11 Transrespect versus Transphobia Worldwide, Trans Murder Monitoring - TMM [Internet]. 2022 [citado 15 fev. de 2023]. Disponível em: https://transrespect.org/en/tmm-update-tdor-2022/
https://transrespect.org/en/tmm-update-t... ,¹²12 Cerqueira D, Bueno, S. Atlas da Violência 2023. Brasília. Instituto de Pesquisa Econômica Aplicada, IPEA. Fórum Brasileiro de Segurança Pública, FBSP; 2023. Disponível em: https://dx.doi.org/10.38116/riatlasdaviolencia2023
https://dx.doi.org/10.38116/riatlasdavio... Between October 2008 and September 2022, an alarming total of 1,741 transgender people and transvestites lost their lives due to violent acts. In the period from 2022 to 2023, Brazil recorded 96 transgender homicides, standing out as the country with the highest number of such violent cases. Europe, with 37 reported cases, and North America, with 26 cases, showed lower but still concerning figures.¹¹11 Transrespect versus Transphobia Worldwide, Trans Murder Monitoring - TMM [Internet]. 2022 [citado 15 fev. de 2023]. Disponível em: https://transrespect.org/en/tmm-update-tdor-2022/
https://transrespect.org/en/tmm-update-t... Between 2020 and 2021, physical violence against these people increased by 9.5%, while psychological violence rose by 20.4%. ¹²12 Cerqueira D, Bueno, S. Atlas da Violência 2023. Brasília. Instituto de Pesquisa Econômica Aplicada, IPEA. Fórum Brasileiro de Segurança Pública, FBSP; 2023. Disponível em: https://dx.doi.org/10.38116/riatlasdaviolencia2023
https://dx.doi.org/10.38116/riatlasdavio...

The relevance of socioeconomic and demographic characteristics in shaping the context of violence experienced by LGBTQIAPN+ people is well recognized in the literature. ¹1 Peixoto VB. Violência contra LGBTs no Brasil: premissas históricas da violação no Brasil. PERI [Internet]. 2018 [citado 15 fev. 2024]; vol. 1, n. 10, p. 7-23. Disponível em: https://periodicos.ufba.br/index.php/revistaperiodicus/article/view/28014
https://periodicos.ufba.br/index.php/rev... ,²2 Prado AJ, de Sousa MF. Políticas Públicas e a Saúde da População LGBT: Uma revisão integrativa. Tempus Actas de Saúde Coletiva [Internet]. 2017; vol. 11, n. 1, p. 69-80. Disponível em: https://www.tempus.unb.br/index.php/tempus/article/view/1895
https://www.tempus.unb.br/index.php/temp... A racial perspective adds complexity when analyzing data on interpersonal violence against transgender people. From 2020 to 2021, Black transgender women faced a disproportionate rate of violence, accounting for 58% of cases, compared to 35% for White transgender women. Black transgender men experienced 56% of violent incidents, while White transgender men represented 40%. As for transvestites, the situation is even more alarming: 65% of violent incidents involved Black transvestites, compared to 31% for White transvestites. These data show how transphobic violence is closely linked to racial discrimination, intensifying threats faced by Black transgender people. ¹²12 Cerqueira D, Bueno, S. Atlas da Violência 2023. Brasília. Instituto de Pesquisa Econômica Aplicada, IPEA. Fórum Brasileiro de Segurança Pública, FBSP; 2023. Disponível em: https://dx.doi.org/10.38116/riatlasdaviolencia2023
https://dx.doi.org/10.38116/riatlasdavio...

Regarding intimate partner violence directed at transgender people, a specific manifestation of violence occurs within relationships, where transphobia plays a significant role. This phenomenon encompasses various forms, including sexual, physical, verbal, psychological and financial violence. The severity of these aggressions is heightened among individuals with precarious socioeconomic conditions, substance abuse issues and those engaged in sex work, due to their greater exposure to historical processes that make them more vulnerable.³3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB... ,⁵5 Sena AGN, Souto KMB. Avanços e desafios na implementação da Política Nacional de Saúde Integral LGBT. TEMPUS [Internet]. 2017; vol. 11, n. 1, p. 09-28. Disponível em: https://www.tempusactas.unb.br/index.php/tempus/article/view/1923
https://www.tempusactas.unb.br/index.php... Victims face particular challenges in seeking support, which makes it difficult to break the cycle of violence.⁵5 Sena AGN, Souto KMB. Avanços e desafios na implementação da Política Nacional de Saúde Integral LGBT. TEMPUS [Internet]. 2017; vol. 11, n. 1, p. 09-28. Disponível em: https://www.tempusactas.unb.br/index.php/tempus/article/view/1923
https://www.tempusactas.unb.br/index.php... It is worth highlighting that the discussion about intimate partner violence often focus on heterosexual and cisgender couples (people whose gender identity aligns with their biological sex), neglecting the experiences of sexual and gender minorities who face similar challenges.³3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB...

Analyzing the context of interpersonal violence against transgender people, based on the theoretical frameworks of intersectionality and vulnerability, offers a valuable perspective. These tools help healthcare professionals understand differences between individuals regarding gender, race/skin color, class, and other factors.⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... This approach contributes to the analysis of public policies aimed at promoting equity, recognizing that needs may vary even within the transgender population. In clinical practice, intersectionality and vulnerability allow for the understanding that subjectivities differ based on prior experiences and social position. ³3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB...

4 Miskolci R, Signorelli MC, Canavese D, Teixeira F do B, Polidoro M, Moretti-Pires RO, de Souza MHT, Pereira PPG. Desafios da saúde da população LGBTI+ no Brasil: uma análise do cenário por triangulação de métodos. Cien Saude Colet. 2022; vol. 27, n. 10, p. 3815-3824. Disponível em: https://doi.org/10.1590/1413-812320222710.06602022
https://doi.org/10.1590/1413-81232022271... -⁵5 Sena AGN, Souto KMB. Avanços e desafios na implementação da Política Nacional de Saúde Integral LGBT. TEMPUS [Internet]. 2017; vol. 11, n. 1, p. 09-28. Disponível em: https://www.tempusactas.unb.br/index.php/tempus/article/view/1923
https://www.tempusactas.unb.br/index.php...

The objectives of this study were to identify social vulnerability profiles of transgender people who have experienced intimate partner violence in Brazil and to assess the association with recurrent violence and referrals to victim support services.

METHODS

Study design

This was a cross-sectional study using secondary data.

Setting

A quantitative approach was applied to the reported cases of intimate partner violence across all federative units in Brazil, taking into consideration records between 2015 and e 2021.

Participants

The study population consisted of transvestites, transgender women and transgender men ,aged 20 to 59 years, based on records from the Notifiable Health Conditions Information System (Sistema de Informações de Agravos de Notificação - SINAN) ,available on the website of the Brazilian National Health System Information Technology Department (Departamento de Informática do Sistema Único de Saúde - DATASUS).

Variables

The dependent variables of the study were recurrent violence and referrals to victim support services. The independent variables included age group, race/skin color, schooling, region of the country, physical disability or mental disorders, sexual orientation, and gender identity.

Data sources and measurement

Data were obtained from SINAN, which has included fields for sexual orientation and gender identity in its notification form since the second half of 2014.¹³13 Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde. VIVA, Instrutivo de Notificação de Violência Interpessoal e Autoprovocada [Internet]. Ed. 2, p. 1-94. Brasília, DF, 2016. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/viva_instrutivo_violencia_interpessoal_
http://bvsms.saude.gov.br/bvs/publicacoe...

Intimate partners were defined as individuals in an emotional intimate relationship with the victim, regardless of cohabitation, covering categories such as spouse, ex-spouse, boyfriend/girlfriend or ex-boyfriend/girlfriend. All forms of interpersonal violence described in the notification form were included, such as physical violence, psychological/moral violence, torture, sexual violence, financial/economic violence, etc.

The population was limited to transvestites, transgender women and transgender men because SINAN does not include other sexual orientations and identities.¹³13 Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde. VIVA, Instrutivo de Notificação de Violência Interpessoal e Autoprovocada [Internet]. Ed. 2, p. 1-94. Brasília, DF, 2016. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/viva_instrutivo_violencia_interpessoal_
http://bvsms.saude.gov.br/bvs/publicacoe...

Bias control

The completeness and consistency of the records, identifying missing data and temporal inconsistencies, were verified for data quality analysis. Critical variables, such as type of violence, sexual orientation and gender identity, were validated. Duplicate records were removed, and cases of self-inflicted violence were excluded.

Study size

The study size was determined by considering the total number records available for the period, ensuring sample representativeness. This approach avoided random sampling, as the data were secondary and covered a significant universe of the target population.

Statistical methods

Exploratory data analysis was performed using tests comparing the frequency of repeated episodes of intimate partners violence and cases referred to victim support services, which considered sociodemographic variables.

Social vulnerability profiles were identified through cluster analysis, which groups cases based on similarities, using sociodemographic variables to describe homogeneous clusters of transgender people. The following variables were used in the model: age group, race/skin color (grouping Black and mixed-race individuals as “Black”), schooling, region of the country, physical disability or mental disorders, sexual orientation and gender identity.

The two-step cluster method, available in SPSS ® 23.0 (Statistical Package for Social Science for Windows, Inc., USA), was used, as it is suitable for large databases with both continuous and categorical variables. This method performs agglomerative partitioning in two steps: first, pre-clusters are formed, and then they are regrouped to form final sub-profiles, with the optimal number of clusters determined by the Bayesian information criterion and distance measured by the log-likelihood, both standard options in the software.¹⁴14 Figueiredo Filho DB, Silva Júnior JA da, Rocha EC da. Classificando regimes políticos utilizando análise de conglomerados. Opin Publica, 2012; vol. 18, p. 109-28. Disponível em: https://doi.org/10.1590/S0104-62762012000100006.
https://doi.org/10.1590/S0104-6276201200...

15 Bacher J, Wenzig K, Vogler M. SPSS TwoStep Cluster-a first evaluation. Berlin: Lehrstuhl für Soziologie [Internet], 2004. Disponível em: https://nbn-resolving.org/urn:nbn:de:0168-ssoar-327153
https://nbn-resolving.org/urn:nbn:de:016... -¹⁶16 Chan Y. Biostatistics 304. Cluster Analysis. Singapore Med J, 2005; vol. 46, n. 4, p. 153-159.

Sociodemographic profiles were described and compared in relation to the variables “recurrent violence” and “referral” through analysis of difference in proportions using Pearson’s chi- square with Bonferroni correction, at a significance level of 0.05.

Binary logistic regression analysis was used to verify the strength of the association between variables “recurrent violence” and “referral”, and the identified profiles at a significance level of 0.05. The odds ratio (OR) was calculated to quantify the strength of associations, along with 95% confidence intervals (CI) in order to assess the precision of the estimates. Profile A was comprised of Black, transgender women, aged 20 to 29 years, with high school education, from the Southeast region and without disabilities or disorders. This profile was used as the reference for the regression analysis because it corresponds to the profile with the lowest number of social vulnerability markers for violence.

Ethical aspects

Ethical approval was not required as secondary data without participant identification were used.

RESULTS

Between 2015 and 2021, a total of 3,384 cases of intimate partner violence against transgender people were reported in Brazil, distributed as follows: 717 in 2015; 910 in 2016; 2,800 in 2017; 157 in 2018; 147 in 2019; 140 in 2020; and 543 in 2021. The frequency of violence, analyzing sociodemographic characteristics separately, was higher among transgender women (82.0%), residents of the Southeast region (52.9%), aged 20 to 29 years (38.8%), Black people (54.7%), with elementary education (34.1%) and heterosexuals (70.7%). Reports of cases involving people with physical disabilities or mental disorders accounted for 4.6% of the population studied (Table 1).

The exploratory analysis of Table 2 shows the results of the tests comparing the frequency of repeated episodes of intimate partner violence and the cases referred with the sociodemographic variables representing the social markers of difference. A higher frequency of recurrent cases was observed in the South region (p<0.001), individuals with elementary education (p<0.001) and with physical disabilities or mental disorders (p<0.001). There was no significant difference regarding age group (p=0.174), race/ skin color (p=0.048), sexual orientation (p=0.710) and gender identity (p=0.429).

A greater frequency of reported cases of intimate partner violence that were referred, compared to those not referred, was identified, for all social markers of difference evaluated. It could be seen that transgender people from the North region (p<0.001), Asian or Indigenous people (p=0.026) and lesbians (p<0.001) received fewer referrals. There was no significant difference regarding age group (p=0.869), physical disability or mental disorders (p=0.704), schooling (p=0.257) and gender identity (p=0.418) (Table 2).

With regard to the two-step cluster method, the most important variables in predicting the profiles were “gender identity” and “sexual orientation”, followed by “race/skin color”, “level of education” and “region of the country”. “Age group” and “disability/disorder” were less influential in the formation of the profiles, which were outlined in five categories presented in Table 3.

The study identified five distinct profiles of transgender people: (A) women, heterosexual, predominantly Black, aged 20 to 29 years, from the Southeast region, with high school education and without disabilities; (B) women, heterosexual, of White race/skin color, from the Southeast region, aged 30 to 39 years, with elementary education and without disabilities; (C) women, lesbian, of Black race/skin color, from the Southeast region, with elementary education, aged 20 to 29 years and without disabilities; (D) men, gay , of Black race/skin color, from the Southeast region, with elementary education, aged 20 to 39 years and without disabilities; and (E) women, heterosexual, of Black race/skin color, from the Northeast region, with elementary education, aged 20 to 39 years and without disabilities ( Table 3) .

Profiles A, B, C, D and E predominantly presented a higher number of episodes of recurrent violence, ranging from 61.6% to 69.2%. All profiles showed a predominance of redirection to other victim support services. Notably, profile C showed the highest recurrent intimate partner violence, and profile A received referral or guidance in approximately 100.0% of cases (Table 4).

No significant difference was found between the profiles regarding the frequency of recurrent violence (p=0.375) and referrals of reported cases (p=0.277) (Table 4). As for the likelihood recurrence of reported cases, the binary logistic regression analysis did not reveal statistically significant differences between the profiles when compared to profile A (Table 5).

DISCUSSION

The results of this study, based on the framework of intersectionality, align with the historical context of political and social rights, which were not guaranteed to transgender people at the time of their establishment.⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... ,¹⁷17 Couto MT, de Oliveira E, Separavich MAA, Luiz O do C. The feminist perspective of intersectionality in the field of public health: A narrative review of the theoretical-methodological literature. Salud Colect. 2019; vol, 15, n. 1, p. 3-14. Disponível em: https://scielosp.org/pdf/scol/2019.v15/e1994/en
https://scielosp.org/pdf/scol/2019.v15/e... Different sexual orientation and gender identity exacerbate the issues of violence and unequal access to social rights for transgender people, even today, when taking into consideration the historical power relations in Brazil. These individuals face a dynamic of inequality, segregation and marginalization within the social structure, which plays a significant role of the production and reproduction of their identities.¹⁸18 Nogueira FJ de S, Leitão ES de F, Silva ECS da. Interseccionalidades na Experiência de Pessoas Trans nos Serviços de Saúde. PSSA [Internet]. 2021 [citado 22 fev. 2024]; vol. 13, n. 3, p. 35-49. Disponível em: https://pssa.ucdb.br/pssa/article/view/1243/1283
https://pssa.ucdb.br/pssa/article/view/1...

19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent... -²⁰20 Shelton SA, Lester AOS. A narrative exploration of the importance of intersectionality in a Black trans woman’s mental health experiences. Int J Transgend Health [Internet]. 2020 [citado 22 fev. 2024]; vol. 23, n. 1-2, p. 108-121. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35403106/
https://pubmed.ncbi.nlm.nih.gov/35403106...

In this study, the absolute number of intimate partner violence cases against transgender people increased between 2015 and 2017, and sharply decreased in 2018, remained stable from 2018 to 2020, and increased again in 2021. The sharp drop in 2018 may have been influenced by several factors, such as changes in reporting policies, alterations in registration criteria, or variations in care practices. The implementation of more robust policies, such as the use of the Dial 100 (Disque 100), may have contributed to more systematic data collection on violence against the LGBTQIAPN+ population. It is worth highlighting that this reduction in the number of reported cases does not necessarily reflect an actual decrease in violence, and may be associated with underreporting, where many cases remain unreported due to fear of retaliations or lack of trust in authorities.

In 2020, COVID-19 control measures such as social distancing and lockdown may have affected both the reporting and incidence of violence. The pandemic led to increased stress, social isolation, and economic vulnerability, factors often associated with increased intimate partner violence. ²¹21 Evans ML, Lindauer M, Farrell ME. A Pandemic within a Pandemic, Intimate Partner Violence during Covid-19. New England Journal of Medicine [Internet]. 2020 [citado 22 fev. 2024]; vol. 383, n. 24, p. 2302-4. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMp2024046
https://www.nejm.org/doi/full/10.1056/NE...

22 Marques ALM, Sorentino I da S, Rodrigues JL, Machin R, Oliveira E de, Couto MT. O impacto da Covid-19 em grupos marginalizados: contribuições da interseccionalidade como perspectiva teórico-política. Interface - Comunicação, Saúde, Educação. 2021; vol. 25, suppl 1. Disponível em: https://doi.org/10.1590/Interface.200712
https://doi.org/10.1590/Interface.200712... -²³23 Braga LHR, Menezes CS, Martins IV, Da Silva JDP, Torres JL. Fatores associados à piora no estilo de vida durante a pandemia de Covid-19 na população brasileira de lésbicas, gays, bissexuais, transexuais, travestis e identidades relacionadas: estudo transversal. Epidemiologia e Serviços de Saúde [Internet]. 2022 [citado 22 fev. 2024]; vol. 31, n. 1, p. e2021752. Disponível em: https://www.scielo.br/j/ress/a/pb9FJP4DByzFkgSJVg5kdRv/?lang=pt
https://www.scielo.br/j/ress/a/pb9FJP4DB... Although restrictions on movement may have hindered access to support services and case notifications, the increase observed in 2021 may be linked to the relaxation of COVID-19 control measures, which allowed for greater visibility and case notifications. ²¹21 Evans ML, Lindauer M, Farrell ME. A Pandemic within a Pandemic, Intimate Partner Violence during Covid-19. New England Journal of Medicine [Internet]. 2020 [citado 22 fev. 2024]; vol. 383, n. 24, p. 2302-4. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMp2024046
https://www.nejm.org/doi/full/10.1056/NE...

22 Marques ALM, Sorentino I da S, Rodrigues JL, Machin R, Oliveira E de, Couto MT. O impacto da Covid-19 em grupos marginalizados: contribuições da interseccionalidade como perspectiva teórico-política. Interface - Comunicação, Saúde, Educação. 2021; vol. 25, suppl 1. Disponível em: https://doi.org/10.1590/Interface.200712
https://doi.org/10.1590/Interface.200712... -²³23 Braga LHR, Menezes CS, Martins IV, Da Silva JDP, Torres JL. Fatores associados à piora no estilo de vida durante a pandemia de Covid-19 na população brasileira de lésbicas, gays, bissexuais, transexuais, travestis e identidades relacionadas: estudo transversal. Epidemiologia e Serviços de Saúde [Internet]. 2022 [citado 22 fev. 2024]; vol. 31, n. 1, p. e2021752. Disponível em: https://www.scielo.br/j/ress/a/pb9FJP4DByzFkgSJVg5kdRv/?lang=pt
https://www.scielo.br/j/ress/a/pb9FJP4DB...

The Southeast region of Brazil, densely populated and urbanized, showed the highest number of intimate partner violence cases. Despite being the wealthiest region in the country, it faces high rates of notifications of intimate partner violence. This contrast reveals that economic wealth does not necessarily reduce violence. It also highlights that regional socioeconomic inequality can intensify the vulnerability of specific groups, increasing their exposure to violence. The highest frequency occurs among people aged 20 to 29, of Black race/skin color, those with elementary education, transgender women, and heterosexual women.⁸8 Marzulo EP, Heck MA, Filippi EE. Desigualdades socioeconômicas no Brasil. DRd - Desenvolvimento Regional em debate [Internet]. 2020 [citado 22 fev. 2024]; vol. 10, p. 1377-1402. Disponível em: http://www.periodicos.unc.br/index.php/drd/article/view/3191
http://www.periodicos.unc.br/index.php/d... ,²⁴24 De Albuquerque MV, Viana AL d’Ávila, De Lima LD, Ferreira MP, Fusaro ER, Iozzi FL. Regional health inequalities: changes observed in Brazil from 2000-2016. Cien Saude Colet [Internet]. 2017 [citado 22 fev. 2024]; vol. 22, n. 4, p. 1055-1064. Disponível em: https://www.scielo.br/j/csc/a/mnpHNBCXdptWTzt64rx5GSn/abstract/?lang=en
https://www.scielo.br/j/csc/a/mnpHNBCXdp... The social markers of difference associated with a higher incidence reflect systemic discrimination patterns, while entrenched cultural norms contribute to an environment conducive to violence. ⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... ,¹⁹19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent...

The high concentration of reported cases in certain regions may indicate greater visibility and efficiency in notification systems, which reflects increased awareness of the rights of transgender people and a greater willingness to report cases of violence. The Southeast region, for example, has a high number of reports, and may be more advanced in terms of recognizing and reporting cases of intimate partner violence. This situation highlights the need for specific and adapted strategies to address violence against transgender people, especially in regions with high notification rates.²⁵25 Minayo MCDS, De Souza ER, Da Silva MMA, De Assis SG. Institucionalização do tema da violência no SUS: avanços e desafios. Cien Saude Colet [Internet]. 2018 [citado 22 fev. 2024]; vol. 23, n. 6, p.2007-2016. Disponível em: https://www.scielo.br/j/csc/a/Q3kCPCWfBzqh8mzBnMhxmYj/?format=html
https://www.scielo.br/j/csc/a/Q3kCPCWfBz... ,²⁶26 De Oliveira APC, Gabriel M, Dal Poz MR, Dussault G. Challenges for ensuring availability and accessibility to health care services under Brazil’s Unified Health System (SUS). Cien Saude Colet [Internet]. 2017 [citado 22 fev. 2024]; vol. 22, n. 4, p. 1165-1180. Disponível em: https://www.scielo.br/j/csc/a/X7GmB9B7T3hbXmzqgCXZgKs/abstract/?lang=en
https://www.scielo.br/j/csc/a/X7GmB9B7T3...

When the markers were evaluated separately, a statistical difference was observed in the frequency of repeated episodes of intimate partner violence against transgender people. In the South region, a higher frequency of repeated cases stood out, especially among those with elementary education and people with physical disabilities or mental disorders. In addition, a disparity was observed among groups of people from the North region, Asian or Indigenous individuals and lesbians who were less referred to support services.

The concentration of cases in these two Brazilian regions suggests geographic peculiarities, which indicates possible variations in prevention policies and support networks. ⁸8 Marzulo EP, Heck MA, Filippi EE. Desigualdades socioeconômicas no Brasil. DRd - Desenvolvimento Regional em debate [Internet]. 2020 [citado 22 fev. 2024]; vol. 10, p. 1377-1402. Disponível em: http://www.periodicos.unc.br/index.php/drd/article/view/3191
http://www.periodicos.unc.br/index.php/d... ,²⁴24 De Albuquerque MV, Viana AL d’Ávila, De Lima LD, Ferreira MP, Fusaro ER, Iozzi FL. Regional health inequalities: changes observed in Brazil from 2000-2016. Cien Saude Colet [Internet]. 2017 [citado 22 fev. 2024]; vol. 22, n. 4, p. 1055-1064. Disponível em: https://www.scielo.br/j/csc/a/mnpHNBCXdptWTzt64rx5GSn/abstract/?lang=en
https://www.scielo.br/j/csc/a/mnpHNBCXdp... This shows limitations in the resources available in this area or geographic barriers that hinder access to support services. Furthermore, inequalities in access to support services and in the professionals’ perception of the severity of cases were observed. ²⁵25 Minayo MCDS, De Souza ER, Da Silva MMA, De Assis SG. Institucionalização do tema da violência no SUS: avanços e desafios. Cien Saude Colet [Internet]. 2018 [citado 22 fev. 2024]; vol. 23, n. 6, p.2007-2016. Disponível em: https://www.scielo.br/j/csc/a/Q3kCPCWfBzqh8mzBnMhxmYj/?format=html
https://www.scielo.br/j/csc/a/Q3kCPCWfBz...

26 De Oliveira APC, Gabriel M, Dal Poz MR, Dussault G. Challenges for ensuring availability and accessibility to health care services under Brazil’s Unified Health System (SUS). Cien Saude Colet [Internet]. 2017 [citado 22 fev. 2024]; vol. 22, n. 4, p. 1165-1180. Disponível em: https://www.scielo.br/j/csc/a/X7GmB9B7T3hbXmzqgCXZgKs/abstract/?lang=en
https://www.scielo.br/j/csc/a/X7GmB9B7T3... -²⁷27 Jesus MKMR de, Moré IAA, Querino RA, Oliveira VH de. Experiências de mulheres transexuais no sistema de saúde: visibilidade em direção à equidade. Interface - Comunicação, Saúde, Educação [Internet]. 2023 [citado 22 fev. 2024]; vol. 27, p. e220369. Disponível em: https://www.scielo.br/j/icse/a/FFLKPsJCkvKb3Hg9YbK9c5N/?lang=pt

The predominance of recurrent violence among people with elementary education underscores the specific challenges faced by individuals with lower education levels, such as reduced awareness of rights, difficulties in seeking help and prolonged exposure to environments conducive to violence.¹⁹19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent...

The lower frequency of referrals for Asian or Indigenous origin people may reflect cultural prejudice, a lack of understanding of the specific needs of these groups, or the absence of culturally sensitive services.¹⁹19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent... ,²⁷27 Jesus MKMR de, Moré IAA, Querino RA, Oliveira VH de. Experiências de mulheres transexuais no sistema de saúde: visibilidade em direção à equidade. Interface - Comunicação, Saúde, Educação [Internet]. 2023 [citado 22 fev. 2024]; vol. 27, p. e220369. Disponível em: https://www.scielo.br/j/icse/a/FFLKPsJCkvKb3Hg9YbK9c5N/?lang=pt

28 Vitral Pinto II, Suely de Araújo Andrade SI, Lofego Rodrigues III L, Aline Siqueira Santos MI, Melo Arruda Marinho MI, Andrade Benício LI, et al. Profile of notification of violence against Lesbian, Gay, Bisexual, Transvestite and Transsexual people recorded in the National Information System on Notifiable Diseases, Brazil, 2015-2017. Rev Bras Epidemiol. 2020; vol. 23, n. 1, p. 1-13.-²⁹29 Félix e Silva AL, Mendonça CCC, Viana BA, Souza IWC da S, Azevedo MN. Violência interpessoal contra adolescentes LGBT: Uma perspectiva ampliada sobre tendências, contextos regionais e desafios emergentes. Revista de Antropologia da UFSCar [Internet]. 2023; vol. 15, n. 1, p. 123-139. Disponível em: https://doi.org/10.14244/rau.v15i1.446
https://doi.org/10.14244/rau.v15i1.446... The reduced frequency of referrals for lesbians suggests potential gaps in identifying and addressing specific needs of this community. This indicates the need for increased awareness of the different forms of violence affecting them or the presence of discrimination based on sexual orientation.³⁰30 Santana ADS, Lima MS de, Moura JWS, Vanderley ICS, Araújo EC de. Dificuldades no acesso aos serviços de saúde por lésbicas, gays, bissexuais e transgêneros. Rev Enferm UFPE online. 2020; vol. 13, p. e243211. Disponível em: https://doi.org/10.5205/1981-8963.2020.243211
https://doi.org/10.5205/1981-8963.2020.2...

These patterns emphasize the urgency of strategies that promote equity in access to support services. This includes training professionals, implementing culturally sensitive services, and raising awareness of the different forms of violence experienced by these specific groups. ²⁵25 Minayo MCDS, De Souza ER, Da Silva MMA, De Assis SG. Institucionalização do tema da violência no SUS: avanços e desafios. Cien Saude Colet [Internet]. 2018 [citado 22 fev. 2024]; vol. 23, n. 6, p.2007-2016. Disponível em: https://www.scielo.br/j/csc/a/Q3kCPCWfBzqh8mzBnMhxmYj/?format=html
https://www.scielo.br/j/csc/a/Q3kCPCWfBz...

26 De Oliveira APC, Gabriel M, Dal Poz MR, Dussault G. Challenges for ensuring availability and accessibility to health care services under Brazil’s Unified Health System (SUS). Cien Saude Colet [Internet]. 2017 [citado 22 fev. 2024]; vol. 22, n. 4, p. 1165-1180. Disponível em: https://www.scielo.br/j/csc/a/X7GmB9B7T3hbXmzqgCXZgKs/abstract/?lang=en
https://www.scielo.br/j/csc/a/X7GmB9B7T3... -²⁷27 Jesus MKMR de, Moré IAA, Querino RA, Oliveira VH de. Experiências de mulheres transexuais no sistema de saúde: visibilidade em direção à equidade. Interface - Comunicação, Saúde, Educação [Internet]. 2023 [citado 22 fev. 2024]; vol. 27, p. e220369. Disponível em: https://www.scielo.br/j/icse/a/FFLKPsJCkvKb3Hg9YbK9c5N/?lang=pt Overcoming these barriers is essential to ensure that all individuals receive appropriate support when experiencing intimate partner violence.

In this study, five distinct profiles of transgender people were examined, each characterized by different sociodemographic aspects. It could be seen that all profiles showed more episodes of recurrent violence than non-recurrent violence, with profile C, which includes transgender women, from the Southeast region, of Black race/skin color, with elementary education and lesbians, standing out as the one with the highest number of recurrent violence episodes.

The analysis reveals variations in the relationship between individual characteristics and the experience of recurrent violence. The emphasis on profile C suggests that the intersectionality of oppressions plays a significant role .⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... ,¹⁸18 Nogueira FJ de S, Leitão ES de F, Silva ECS da. Interseccionalidades na Experiência de Pessoas Trans nos Serviços de Saúde. PSSA [Internet]. 2021 [citado 22 fev. 2024]; vol. 13, n. 3, p. 35-49. Disponível em: https://pssa.ucdb.br/pssa/article/view/1243/1283
https://pssa.ucdb.br/pssa/article/view/1...

19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent... -²⁰20 Shelton SA, Lester AOS. A narrative exploration of the importance of intersectionality in a Black trans woman’s mental health experiences. Int J Transgend Health [Internet]. 2020 [citado 22 fev. 2024]; vol. 23, n. 1-2, p. 108-121. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35403106/
https://pubmed.ncbi.nlm.nih.gov/35403106... This indicates that specific combinations of identities, such as being a transgender woman, from the Southeast region, of Black race/skin color, with elementary education, and lesbian, may be associated with greater vulnerability to recurrent violence. Experiences of discrimination and violence may be intensified when multiple social markers of difference intersect. This highlights the complexity of social dynamics and the need for more sensitive and inclusive approaches in interventions and policies aimed at combating violence.⁷7 Luiz O do C, Couto MT, Oliveira E de, Separavich MA. Inequality in health, social determinants, and intersectionality: a systematic review/Desigualdade em saúde, determinantes sociais, e interseccionalidade: uma revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2020; vol. 3, n. 5, p.11827-11841. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/16193O do C,
https://ojs.brazilianjournals.com.br/ojs... ,¹⁸18 Nogueira FJ de S, Leitão ES de F, Silva ECS da. Interseccionalidades na Experiência de Pessoas Trans nos Serviços de Saúde. PSSA [Internet]. 2021 [citado 22 fev. 2024]; vol. 13, n. 3, p. 35-49. Disponível em: https://pssa.ucdb.br/pssa/article/view/1243/1283
https://pssa.ucdb.br/pssa/article/view/1...

19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent... -²⁰20 Shelton SA, Lester AOS. A narrative exploration of the importance of intersectionality in a Black trans woman’s mental health experiences. Int J Transgend Health [Internet]. 2020 [citado 22 fev. 2024]; vol. 23, n. 1-2, p. 108-121. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35403106/
https://pubmed.ncbi.nlm.nih.gov/35403106...

It could be seen that all profiles were referred to other points within the victim support network. Profile A, consisting of a transgender woman, from the Southeast region, aged 20 to 29, of Black race skin color, with high school education, without physical disabilities or mental disorders and heterosexual, received the highest number referrals.

This finding indicates that profile A was more likely to be referred for support or guidance services. This may be attributed to a specific combination of factors, such as higher education, geographic characteristics, and the absence of physical disability or mental disorders, which may influence professionals’ perception of the need for referral.¹⁸18 Nogueira FJ de S, Leitão ES de F, Silva ECS da. Interseccionalidades na Experiência de Pessoas Trans nos Serviços de Saúde. PSSA [Internet]. 2021 [citado 22 fev. 2024]; vol. 13, n. 3, p. 35-49. Disponível em: https://pssa.ucdb.br/pssa/article/view/1243/1283
https://pssa.ucdb.br/pssa/article/view/1... ,¹⁹19 Goulart VP, Nardi HC. Vidas inimigas, necropolítica e interseccionalidade: da exclusão na educação ao suicídio/assassinato de pessoas trans. Revista Entreideias: Educação, Cultura e Sociedade [Internet]. 2022 [citado 22 fev. 2024]; vol. 11, n. 1. Disponível em: https://periodicos.ufba.br/index.php/entreideias/article/view/45614
https://periodicos.ufba.br/index.php/ent... Understanding these specificities is crucial for developing more effective referral and support strategies, ensuring that assistance is appropriate and sensitive to the specific needs of each transgender person profile.

The confirmation that there was no significant difference between the profiles regarding the frequency of recurrent violence and referrals of reported cases is a relevant result. The binary logistic regression analysis found no statistically significant differences in the probability of recurrence of reported cases. This result underscores the complexity of the phenomenon and indicates that factors associated with recurrent violence do not vary significantly among the different profiles analyzed.

This lack of significant differences suggests that the individual and contextual characteristics considered in the profiles are not isolated determinants of recurrent violence. This indicates the need for a holistic approach to understanding and addressing intimate partner violence against transgender people. ³3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB... ,²⁹29 Félix e Silva AL, Mendonça CCC, Viana BA, Souza IWC da S, Azevedo MN. Violência interpessoal contra adolescentes LGBT: Uma perspectiva ampliada sobre tendências, contextos regionais e desafios emergentes. Revista de Antropologia da UFSCar [Internet]. 2023; vol. 15, n. 1, p. 123-139. Disponível em: https://doi.org/10.14244/rau.v15i1.446
https://doi.org/10.14244/rau.v15i1.446...

The complexity of the phenomenon indicates that other factors, not addressed in the profiles, may have a crucial influence on recurrent violence. Elements such as social support, access to economic resources and systemic discrimination are mentioned as variables that play important roles. ²¹21 Evans ML, Lindauer M, Farrell ME. A Pandemic within a Pandemic, Intimate Partner Violence during Covid-19. New England Journal of Medicine [Internet]. 2020 [citado 22 fev. 2024]; vol. 383, n. 24, p. 2302-4. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMp2024046
https://www.nejm.org/doi/full/10.1056/NE... ,²⁹29 Félix e Silva AL, Mendonça CCC, Viana BA, Souza IWC da S, Azevedo MN. Violência interpessoal contra adolescentes LGBT: Uma perspectiva ampliada sobre tendências, contextos regionais e desafios emergentes. Revista de Antropologia da UFSCar [Internet]. 2023; vol. 15, n. 1, p. 123-139. Disponível em: https://doi.org/10.14244/rau.v15i1.446
https://doi.org/10.14244/rau.v15i1.446... Interpretating the results highlights the importance of considering a broader range of variables in understanding and preventing recurrent violence against transgender people. A holistic approach is essential for developing more effective strategies, which encompass both individual characteristics and various contextual factors that shape the dynamics of intimate partner violence.³3 da Silva ICB, de Araújo EC, Santana AD da S, Moura JW da S, Ramalho MN de A, de Abreu PD. A violência de gênero perpetrada contra mulheres trans. Rev.Bras Enferm [Internet]. 2022 [citado 22 fev. 2024]; vol. 75, Suppl 2, p. e20210173. Disponível em: https://www.scielo.br/j/reben/a/RnNr3PFBcwc9YhTx9VF8bLn/?lang=en
https://www.scielo.br/j/reben/a/RnNr3PFB...

This study, although limited by aggregate data and biases in administrative records, is one of the first to address intimate partner violence against transgender people during the COVID-19 pandemic. ²¹21 Evans ML, Lindauer M, Farrell ME. A Pandemic within a Pandemic, Intimate Partner Violence during Covid-19. New England Journal of Medicine [Internet]. 2020 [citado 22 fev. 2024]; vol. 383, n. 24, p. 2302-4. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMp2024046
https://www.nejm.org/doi/full/10.1056/NE... The political and social issues faced by LGBTQIAPN+ people remain challenging, with an increase and fluctuation in intimate partner violence cases over the years, influenced by notification policies and the pandemic. Regional disparities highlight the need for specific approaches, and the lack of significant differences between profiles in terms of recurrent violence and referrals points to the importance of a holistic approach that considers social support and systemic discrimination. The study contributes to the initial understanding of the phenomenon and reinforces the need for ongoing research and interventions that are sensitive to its complexities.

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