The main areas examined in this section are:General Trends in the findings Examples
Right to Life Extrajudicial Executions Examples Killings Examples
Right to Personal Integrity Law Enforcement Examples Rape and sexual violence Examples Other non-lethal attacks Mob attacks Examples
Medical Violence against Intersex Persons Specific Violations Examples
Provision of health services Examples
Attempts to “change” Examples
Hate speech and the incitement to violence
Intersectionality Indigenous peoples Women Examples Human mobility Examples Children and Youth Examples Human Rights Defenders Examples Persons Deprived of Liberty Examples Afro-descendants Examples Poverty
General trends in the findings of the IACHR
1. Underreporting and lack of official data
The IACHR notes that the available data do not reflect the full dimension of the violence suffered by LGBTI persons in any given State.
2. Pervasiveness of Violence
The IACHR is of the view that violence against LGBTI persons is prevalent in all countries in the Americas. The IACHR found that there were at least 770 acts of violence committed against LGBT persons in a fifteen month period, between January 2013 and March 2014, across 25 OAS Member States.
3. Invisibility of everyday violence
The IACHR notes that underreporting also renders everyday violence against LGBT persons invisible, particularly as it relates to non-lethal attacks.
Non-lethal attacks are the most common type of violence suffered by LGBTI persons in all OAS Member States.
These acts of violence are reported to be so commonplace in some parts of the region that they may not be reported, because they are part of ‘everyday life’ for LGBT persons.
Killings are most prone to be reported by the media, leaving out ordinary and persistent forms of everyday violence, which have to be, nonetheless, fully exposed, identified and addressed by States.
4. Invisibility against certain groups:
Trans men and bisexual persons
Severe violence in the family, in the health sector, and school bullying, are among the most common types of violence suffered by trans men.
Violence against bisexual persons is often exerted because such persons are perceived as either gay or lesbian, or because such persons are witnessed expressing same-sex affection. This tendency in the data to categorize bisexual persons and bisexual expressions of affection as gay or lesbian renders violence based on prejudice towards bisexuality invisible for data collection purposes.
5. High levels of cruelty
Crimes against LGBT persons stand out for their brutality and cruelty. Killings due to sexual orientation and gender identity are characterized by levels of physical violence that
“in some cases exceed those present in other types of hate crimes.”Report of the Special Repporteur on violence against women, its causes and consecuences, A/HRC/20?16, 23 May 2012, para.71
In the Registry there are numerous examples of killings that are particularly heinous, including cases of stoning, decapitation, burning, or impalement. Many victims are repeatedly stabbed or beaten to death with hammers or blunt objects. Others are punched or kicked to death, have acid thrown at them, or are suffocated. Some victims in the Registry were repeatedly run over by cars, mutilated or set afire. In many cases, victims were killed after being subject to gruesome acts of torture, inhumane or degrading treatment, and multiple forms of extreme humiliation, debasement, torture and/or rape.
6. Violence in response to public displays of same-sex affection
The IACHR has received reports of same-sex couples who were attacked because they showed affection in public, such as holding hands, caressing, embracing or kissing.
Same-sex couples showing public displays of affection are also a frequent target of police abuse and arbitrary detention by state agents –often with excessive use of force or verbal abuse– because of what is considered “immoral behavior” in public spaces.
"Many cases of violence against LGBT persons are underreported; many persons are afraid of reprisals, reluctant to identify themselves as LGBT, or do not trust the police or the justice system." Furthermore, internalized stigma and prejudiced views held by LGBT persons themselves might also hinder recognition and acknowledgment of abuse.tweet this
A study carried out in the United States shows that bisexual persons "experience higher rates of sexual and intimate partner violence than gay, lesbian, and straight people."tweet this
“Ahumada and Angulo started to beat [Daniel Zamudio] continuously; they jumped on his head and nose. […] Then, Angulo rose and urinated on Zamudio’s mouth and chest; Ahumada did the same, he also urinated on him; then they kept beating him; Ahumada smashed a bottle […] on Zamudio’s head and Angulo grabbed the bottle neck and carved three swastikas on him, two on his stomach and one on his chest, and he stabbed him twice on the left side of his body. […] Ahumada and Angulo beat Daniel again, they grabbed his head […] and it bounced against the floor. […] Ahumada then smashed another bottle against Zamudio’s head and […] carves two other swastikas on his back. After that, they jumped on his head, beat him on the nose, eyes, genitals and they urinated again over Zamudio. Raúl Lopez then grabbed a rock, and smashed it against his leg, trying to break it. He then […] grabbed his leg, twisted it and broke it; they were all laughing and they said it sounded like a chicken bone.”tweet this
In February 2013, the body of a 20-year-old trans woman was found in a rural road in Puebla, Mexico. Her face had been disfigured with a club or bat, several of her teeth were found a few yards apart and one of her eyeballs was detached.tweet this
In 2013, the IACHR was informed of the case of Joel Molero, a 19 year-old Peruvian man who was brutally attacked and beheaded, with his genitals, fingers and toes mutilated. His body was then put on a mattress and set on fire.tweet this
1. Extrajudicial Executions
Extrajudicial executions or killings are understood as deprivations of the right to life unlawfully perpetrated by State agents.
According to one regional organization, which obtained its information from witness testimony, police officers have been directly involved in a “good number” of killings of trans women.Redlactrans, The Night is Another Country: Impunity and violence against transgender women human rights defenders in Latin America
Lesbian, gay, bisexual and trans persons are “especially vulnerable” to extrajudicial killingsReport of the Special Repporteur on extrajudicial, summary, or arbitrary executions. Addendum. Follow-up country recommendations: Colomia, A/HRC/20/22/Add.2, 15 May 2012, para. 5a.
The majority of cases of violence against LGBT persons recorded in the Registry of Violence covering the time period of January 2013 to March 2014, there is little or no data as to the perpetrators of the violence, particularly in the cases of killings.Read the report
It is reported that four military police officers, after having humiliated two trans sex workers in Salvador, Brazil, in August 1998, forced them to jump into the sea, where one of them drowned.
In Guatemala, "Paulina and Sulma –both transgender persons– were approached [...] by four persons riding motorbikes and wearing police uniforms[...] opened fire on them. Paulina died of her injuries in the hospital three hours later. Sulma was severely injured but survived. [...] The policemen guarding her at the hospital repeatedly told her that she should stop making statements about the incident to investigators and others, as she was putting her life at risk by doing so. Uncertain whether this was well-intended advice or veiled death threats, she moved to a secret location". The IACHR granted her precautionary measures.
In December 2008, Nohelia Flores Álvarez was stabbed seventeen times in the throat, back, stomach and arms by a male police officer in Honduras, after the officer held her at gunpoint demanding sex, to which she refused. The police officer was sentenced to ten years in prison on September 2009. In January 2010, the IACHR granted two precautionary measures, as well as that of three other persons who were being threatened in the context of the trial against the police officers, including two state agents, members of the Dirección Nacional de Investigación Criminal in Tegucigalpa, who were investigating the case.
A young gay couple, aged 17 and 22, in Mexico City were both expelled from a nightclub after a quarrel between both of them. A police patrol car and other cars arrived and police agents violently pushed them into a white vehicle that was escorting the patrol car. The bodies of the two men were found the following day with numerous signs of beatings in various parts of the body (some of which were so brutal they left bones uncovered), their hands and feet strongly tied with wire, their ears amputated, and with three gunshot wounds in the head of each man.
Notwithstanding this, during that period, the IACHR received information of alleged executions by state agents of a 15-year-old boy in Patu, Brazil, a 40-year-old trans woman in Mexico city, and the aforementioned two gay men aged 17 and 22 in Mexico City. The IACHR was also informed of the killing of Angelina Lucía Martínez Figueroa, a 19-year-trans woman in Cartagena, Colombia, due to shots fired into the air by a police agent in an effort to break up a street fight.
Gay men, or those perceived as such, were more likely to be killed by bladed weapons and in private spaces, such as the home of the victim.
Whereas trans women and trans persons who express themselves as female were more likely to be killed by firearms, and their bodies were more likely to be found in the streets or other public spaces, and sometimes in situations linked to sex work.
Organizations report that killings of LGBT persons are not found in police records, and where they are, they end in impunity.Organización de Apoyo a una Sexualidad Integral Frente al SIDA (OASIS), Crímenes de Odio en Guatemala: una Aproximación a los Retos y Desafíos para el Desarrollo de una Investigación sobre Crímenes en el País en contra de Gay, Bisexuales y Trans, abril de 2010, p. 35.
The IACHR was informed of numerous killings of trans women who were sex workers, most of the killings allegedly perpetrated by their clients. These included victims who were —among many other violent acts— smashed in the head with rocks, stoned to death while offering their services, beaten to death with a broken bottle, stabbed while waiting in their regular spots, repeatedly shot when approaching a car, and even shot following a disagreement over fees.
Entertainment and socialization spaces for gay persons, and their vicinities, are also common locations in which killings take place. Bars and dance clubs are reported to be frequent locations where perpetrators target their victims, a modus operandi colloquially referred to as “pick-up crime.”Read the report
Numbers of Killings in the Americas
Many cases of violence against LGBT persons are underreported
(2009-2013, Mexico)Comisión Ejecutiva de Atención a víctimas (CEAV)
(2009-2010, Guatemala)Fundación Myrna Mack et. al, Discriminación por orientación sexual e identidad de género y una aproximación a la interseccionalidad con otras formas de discriminación en Guatemala, 4 November 2012, p. 33.
(2008-2013, Honduras)Cattrachas, Informe Anual Sobre Muertes Violentas de la comunidad LGTTBI, 2013, p. 4. It is noteworthy that the State of Honduras referred to the reliability of statistics gathered by this organization. Response to the IACHR Questionnaire on Violence against LGBTI Persons in the Americas submitted by the State of Honduras, Note DC-179/2013 dated November 20, 2013, received by IACHR Executive Secretariat on November 20, 2013, p.3.
(2011-2013, Peru)PROMSEX, Annual Report on the Human Rights of Transgender, Lesbians, Gays and Bisexual persons in Peru 2013, May 2014, p. 34; PROMSEX, Annual Report on the Human Rights of Transgender, Lesbians, Gays and Bisexual persons in Peru 2012, May 2013, p. 61; PROMSEX, Annual Report on the Human Rights of Transgender, Lesbians, Gays and Bisexual persons in Peru 2011, May 2012, p. 52
(2009-2013, Venezuela)Response to the IACHR Questionnaire on Violence against LGBTI Persons in the Americas submitted by Acción Ciudadana Contra el SIDA (ACCSI), 25 November 2013, received 25 November 2013, p.1; Acción Ciudadana Contra el SIDA (ACCSI), Informe Venezuela 2013 Crímenes de odio por orientación sexual, identidad de género y expresión de género en la noticia de los medios de comunicación y organizaciones de la sociedad civil, p.20.
(2011-2013, Argentina)Fundación Myrna Mack et. al, Discriminación por orientación sexual e identidad de género y una aproximación a la interseccionalidad con otras formas de discriminación en Guatemala, 4 November 2012, p. 33.
(2010-2011, Colombia)Colombia Diversa, Impunidad Sin Fin: Informe de Derechos Humanos de Lesbianas, Gay, Bisexuales y Personas Trans en Colombia 2010-2011, 2013, p. 14.
In April 2014, in Brazil, a bisexual woman was viciously stabbed, disemboweled, and her body abandoned near a railroad track. The perpetrator cut out the victim’s vagina and inserted it in her mouth before leaving. Investigators stated that this action spoke to the motive of the crime and that a former boyfriend of the woman was among the suspects.
In January 2014, in Brazil, a 40-year-old gay man was found near death near a sugar cane plantation in João Pessoa, his body showing signs of having been brutally beaten and raped. He was hospitalized but died shortly after.
In May 2013, a 22-year-old gay man was verbally attacked with homophobic epithets on the street and then run down with a car three consecutive times in Rio de Janeiro. Although his friends took him to a hospital, he did not survive the wounds; his spinal cord was fractured in three places and his hip, ribs and lungs were also severely affected.
In 2006, a serial killer was known to be targeting gay men in Mexico City by seducing them at gay bars, kidnapping them, and demanding ransom from their families. At least four gay men were killed. The gruesome details of the cold-blooded confessions of the serial killer included different ways in which he tormented his victims during their captivity, such as engraving marks on their foreheads with bladed instruments. The killer declared that “he had done society a favor, because gay men corrupt children.”
In recent years, online dating sites and location-based phone dating applications have also been reported as tools used by perpetrators to find their victims. In November 2014 in Colombia, there was reportedly a criminal gang that would lure gay men through social media in order to rob, attack, or kill them.
In January 2013, a group of men in a car passed in front of a gay bar in Mexico City and started screaming slurs directed at two patrons who were hugging each other. When one of the gay men confronted the group, one of the men in the car pulled out a gun and shot him dead on the spot.
Violations of the Right to Personal Integrity
"Every person has the right to have his physical, mental, and moral integrity respected."
"Every person has the right to personal liberty and security."
1. Violations in the context of law enforcement:
Torture, cruel, inhuman and degrading treatment
Police involvement in discrimination and violence against LGBT persons leads others to believe that they can harm persons of non-conforming sexuality or gender with impunity.
Arbitrary detention is another major concern in the overall context of police abuse against LGBT persons.
“To the police, all transgenders are prostitutes.”Human Rights Watch, Sex Workers at Risk, Condoms as Evidence of Prostitution in Four US Cities, 2012, p. 20.
The violence occurs at all stages of police custody, including apprehension, transportation in police vehicles and, above all, in the premises of police stations and lock-up facilities
"States must refrain from arresting or detaining persons on discriminatory grounds, including sexual orientation and gender identity."UN High Commissioner for Human Rights, Discrimination and violence against individuals based on their sexual orientation and gender identity, A/HRC/29/23, 4 May 2015, para. 15.
In Argentina, civil society indicates that .ATTTA, Ley de Identidad de Genero y Acceso al cuidado de la salud de las personas trans en Argentina, Pages 12-13.
The IACHR has received reports from multiple organizations of cases in which police agents not only perpetrate violence, but also incite others to attack LGBT persons, or are indifferent toward violence perpetrated by third parties.
The defender explained: “
only some police are abusive, but the lack of response and impunity concerns the whole police force.”Testimony of a transgender woman human rights defender from Cali. Meeting of LGBTI persons with the President of the IACHR in Cali. September 30, 2014.
In 2011 in Belize, two police officers arrived at a bar. One of the police officers asked two trans women: “why are you dressing like that if you are men?” The officers proceeded to arrest the women and, when asked for a reason, the officers answered: “because you look suspicious, you confuse me.” In transit, the two trans women were subjected to mistreatment. The abuse continued at the lock up facility, with one police officer insinuating that they “should be murdered and dumped on a nearby highway.” The women suffered rape threats from other detainees and one of them was forced to strip naked. They were released the next morning, with no charges brought against them. They did not file charges out of fear of reprisals and further victimization.tweet this
“All my arrests always came from just walking on the street, coming out of a club, or just because a cop identified me as transgender. They would always look for condoms. They don’t care about you, they take your purse, throw it on their car, your stuff they throw it on the floor, they pat frisk you, they ask if you have fake boobs, take them off right there, if you have a wig, take it off. It’s humiliating. Right there in the street, they take your identity right there. When they find condoms, they say ‘what are these for… how many dicks did you suck today? How much money did you make today?”tweet this
In 2013, a group of men were dancing during carnival in Port-au-Prince, Haiti, when police officers started beating them, uttering slurs and making comments that “they did not like it that they were effeminate.”tweet this
In Mexico City, a young man was allegedly arrested by federal police officers while he was walking on the street late at night. When he asked why he was being arrested, the officers answered “because you are gay” and then asked him to perform oral sex on them.tweet this
In 2013, two men were talking at a park in Santo Domingo, Dominican Republic, two police agents pushed the two men into the police car while referring to them as women, and drove them to a police station. When they demanded an explanation for their arrest, a police officer answered: “If you need a reason, we will say that you both were having oral sex at Parque Duarte.” Another officer then said that the men should be put in cells where rough men would rape them to “make them men.” Police agents told them that being a “faggot” was worse than being a criminal. The next day they were released without any further explanation.tweet this
Police officers were involved in the attack of a gay man in Jamaica which ultimately led to a mob killing. The incident began with the police officers beating the victim with batons, after which they urged others to beat him. The victim was dismembered, stabbed and stoned to death.tweet this
A trans woman in Honduras explained that when a drunk and aggressive client stabbed her in the arms, neck, and leg in September 2011, she sought help from the police. She recalls: “the police didn’t ask me to make a statement, they laughed at me and asked me for sexual services even after I had told them that I was injured and needed help. They told me that I got what I deserved for being out in the street.”tweet this
When Argentinean human rights defender and activist Diana Sacayán was insulted and attacked at a bar in 2013, she sought the assistance of two gendarmerie agents who were nearby. The agents spoke to her attacker, allowed him to leave and went back to her saying, “you’d better start running.” They then hit her with a baton. When she arrived at the local police station to file a report, the chief officer on duty refused to take her report and had her taken to a nearby hospital. No record was made of her presence at the police station. She suffered a fractured nose and cheekbone.tweet this
A transgender activist en El Progreso, Honduras, recounted: “
[in] 2012, three policemen forced me into a patrol car telling me they were going to take me to the station, but they took me to an isolated place and kicked me and punched me in the stomach for over 15 minutes. They left me lying there and threatened to kill me if I talked.”
In Colombia, there were also reports that members of security forces beat many trans women, particularly those who are sex workers, in the places where they receive surgery, such as silicone implants, as if wishing to destroy valuable parts of their bodies.tweet this
In Peru, Luis Alberto Rojas Marín, a young gay man, allegedly was arrested by police agents and suffered severe physical violence while in detention, including torture. Petitioners allege that three police officers raped the alleged victim with a rubber baton, in a context in which he was sexually harassed and insulted because of his sexual orientation. The IACHR declared this case admissible.tweet this
2. Rape and sexual violence
Lesbian, gay, bisexual, trans, and intersex persons can be particularly vulnerable to sexual violence. One of the reasons for this vulnerability stems from the fact that diverse sexual orientations and identities challenge the core notions of heteronormative sex, sexuality, and gender.
Forcible introduction of objects into the anus appears to be a common way of inflicting excruciating pain on victims, and is usually a part of brutal acts of violence perpetrated against gay men and trans women.
LGBT and gender non-conforming persons are at high risk of being denied medical treatment or being further victimized when seeking health care following a sexual assault, it may be the case that the impact of sexual assaults on LGBT and gender non-conforming persons is higher than on gender-conforming and non-LGBT victims of assault.
“Corrective rape” has been defined as a “
hate crime in which an individual is raped because of their perceived sexual or gender orientation, with the intended consequence of the rape being to ‘correct’ the individual’s orientation or make them ‘act’ more like their gender.”Keren Lehavot and Tracy L. Simpson, Incorporating Lesbian and Bisexual Women into Women Veterans’ Health Priorities, 27 June 2013.
Behind this crime lies the perverse and erroneous belief that being penetrated by a male will render the woman “normal” again.
The very concept of “corrective rape” is incoherent and deplorable, since any attempt to “correct” a fundamental aspect of a human being’s life by violence is repugnant to human dignity and decency.
In Ecuador, “corrective” rape has been reported to take place as one of the heinous methods employed in the “clinics of de-homosexualization.” Fundación de Desarrollo Integral “Causana,” Clínicas de Deshomosexualización: ¿Delito Común o Violencia Estructural?, 20 February 2014, p. 3.
In the United States in 2010, a gang kidnapped and brutally raped two 17-year-old gay adolescents and a 30-year-old gay man, using a baseball bat and the wooden handle of a plunger. The victims were also tied and burned with cigarettes on their nipples and penises.tweet this
In 2013, the IACHR received information about a case in Brazil in which a former alderman was viciously stabbed 106 times and was anally penetrated with the handle of a sickle.tweet this
A trans woman in Barranquilla, Colombia who, after suffering many years of attacks and discrimination, was brutally raped by four men who introduced several ants into her anus. She committed suicide shortly after the episode.tweet this
A young afro-descendant woman who, after telling her father she was a lesbian at the age of 11, was allegedly subjected to rape during a 14-year period by her father’s friends, which resulted in five children. After she managed to escape, she was then raped several times at the hands of illegal armed groups, often in front of her partners, as a punishment for her sexual orientation, and has been consequently internally displaced several times.tweet this
In 2007, in Jamaica a 17-year-old lesbian was held captive by her own mother and her pastor for 18 days. During this time, different religious men raped her repeatedly, day after day, in an attempt “
to make her take men” and “
live as god instructed.”
In 2010, in Jamaica, a lesbian woman was gang-raped by four men from her community who had complained about her “
butch” or “
manly” attire. After she was raped, the rapists cut her with a knife “
so she could better take men.” A few days after that episode, a friend of the first woman was abducted in a car at knifepoint, brutally raped, and then dumped half-naked. The women refused to go to the police because of the perceived ineffectual nature of any police response.
In 2010, in Jamaica, a lesbian woman was gang-raped by four men from her community who had complained about her “
butch” or “
manly” attire. After she was raped, the rapists cut her with a knife “
so she could better take men.” A few days after that episode, a friend of the first woman was abducted in a car at knifepoint, brutally raped, and then dumped half-naked. The women refused to go to the police because of the perceived ineffectual nature of any police response.
In 2012, in Haiti, five police officers gang-raped two lesbians and during the attack they told them: “
You have never been with a man? You are not a real woman! We will make you one!”
3. Other non-lethal attacks
The IACHR has been informed that sometimes attacks are religiously motivated, particularly attacks targeting young gay men.
In Brazil, three men attacked a 19-year-old gay man. Two of the men punched the victim repeatedly while the third prayed for the victim to be saved from his “
sins.” One of the attackers then wrapped the victim’s arm in a cloth and set it on fire. The attackers allegedly abandoned the victim with a note in his pocket that read: “
the fire of purification was set upon he who declared his bestial lover.”O Tempo, “Homossexual é agredido em ritual de ‘purificação de gays’,” 20 September 2014; O Tempo, “Polícia investiga motivação religiosa em agressão a gay,” 26 September 2014. tweet this
In the United States, five members of an evangelical church were charged with the kidnapping and assault of a young gay man. According to available information, the victim stated that the attack “
was meant to rid him of homosexual demons.”Daily News, “Indictment for 5 members of North Carolina’s Word of Faith Fellowship for alleged 2013 attack on gay man,” 11 December 2014.tweet this
4. Mob attacks
"Large crowds barricading, throwing objects (such as stones and Molotov cocktails), or calling for lynching of gay men."IACHR, Press Release No. 79/13. IACHR Expresses concern about Mob attacks, police abuse and other forms of violence against LGBTI persons. October 24, 2013.
In particular, the Commission has received reports of mob attacks occurring with unsettling frequency in Jamaica. See IACHR, Annual Report 2014, Chapter V: Follow-up of Recommendations issued by the IACHR in its country or thematic reports, Report on the Situation of Human Rights in Jamaica, para. 173 and ff.Read the report
An alarming case took place in 2012 at the University of Technology, Jamaica, when a student was chased by a group of male and female students through the university campus. The victim was able to reach the security office, where the mob remained screaming outside. A video shows how at least two guards slapped, kicked and punched the student in front of the crowd, while members of the mob began entering through the security office windows.tweet this
In July 2013, Dwayne Jones, a 16-year-old transgender teen, was viciously stabbed and shot to death by a mob at a party in Jamaica. Jones was reported to have suffered relentless teasing in high school for being effeminate, until dropping out for good. Jones had also been expelled from her house at the age of 14 and had resorted to living on the street.tweet this
On August 1, 2013, the police had to be called to rescue two gay men from another irate crowd that claimed the men “
were engaging in an illegal activity in a house” in St. Catherine, Jamaica. Prior to the police arrival, an occupant of the house attacked one of the accused men.
A mob firebombed a house in which several gay men were living in Porto Bello, St James, Jamaica.tweet this
In Haiti, two men thought to be gay were beaten to death during an anti-gay march led by the Haitian Coalition of Religious and Moral Organizations (Coalition Haïtienne des organisations religieuses et morales). The march took place in July 2013, in Port-au-Prince, amidst a wave of violence against lesbian, gay, trans, bisexual, and intersex persons.tweet this
Medical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose, may constitute torture or ill-treatment when enforced or administered without the free and informed consent of the person concerned."
UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
Specific human rights violations
commonly suffered by intersex persons
The 41-year-old man sitting before you right now was once, a long time ago, a 14-year-old girl who, upon being told that she was born without a vagina or a uterus, was also told that it was necessary to cut part of her intestine in order to surgically ‘create a vagina’. The purpose of that surgery was to ensure that I would grow up to become a woman who could be penetrated by a man. The failure of this procedure is obvious and after two surgeries and six years of vaginal dilations with a piece of metal called a 'bougie,' what I can attest to as a consequence of that intervention is the transformation of the healthy teenager that I used to be into the man that I am—someone who survives every day the experience of having been raped repeatedly, while asleep on an operating table.”
Twenty six years ago a team of medical professionals discovered that I had 'XY' chromosomes and internal testes, more commonly referred to today as 'partial androgen insensitivity syndrome.' Immediately after that, a surgery was scheduled to remove those internal testes, I was one then. When I was three, another surgery was performed. This time, it was to reduce the size of my clitoris, which was judged to be 'half a centimeter too long.' Then, when I was eleven and entering puberty, I underwent a third surgery. This time was to construct a 'more acceptable' vagina via the method called 'vaginoplasty.' I was lied to and told that I had cancerous ovaries and that the doctors were saviors, and had saved me.”
Chilean organizations have reported that in 2003, a 20-year-old man discovered through a series of medical tests that just after his birth, the doctor who had been authorized by his parents to treat an inguinal hernia had in fact removed the child’s testicles and operated on his genitals.tweet this
In regards to Intersex persons, the IACHR notes that
The UN Special Rapporteur on the right to health recommended that health-care providers strive to postpone non-emergency invasive and irreversible interventions until the patient is sufficiently mature to provide informed consent.Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, A/64/272, 10 August 2009, para. 49.
Violence in the provision of health services
Mistreatment, harassment, and even physical violence are part of the experience of LGBT persons seeking medical attention.
in United States affirmed that they had experienced at least one of the following types of discrimination or aggression:Lambda Legal, When Health Care Isn’t Caring Lambda Legal’s: Survey on Discrimination Against LGBT People and People Living with HIV, 2010, p. 10.
- being refused needed care;
- being blamed for their health status;
- health care professionals refusing to touch them or using excessive precautions;
- health care professionals using harsh or abusive language; or
- health care professionals being physically rough or abusive.
One astounding example of denial of medical treatment was the case of Robert Eads, an American trans man who was diagnosed with ovarian cancer. It has been documented that at least twelve medical professionals refused to treat him because they feared that “
treating this case of gender variance would hurt the reputation of their medical practices.”
Violence related to attempts to “change” sexual orientation and gender identity
Young LGBT persons are subjected to harmful so-called ‘therapies’ intended to ‘modify’ their orientation or identity. Such therapies are unethical, unscientific and ineffective and may be tantamount to torture.Joint Statement on International Day against Homophobia, Biphobia and Transphobia “Discriminated and Made Vulnerable: Young LGBT and Intersex People Need Recognition and Protection of their Rights,” May 17, 2015.
The person under “treatment” is confined to a center, a boarding school or “clinic,” most times against their will or through deception, and subject to very strict regimes. These regimes usually include inhumane or degrading treatment and even sexual abuse as part of the “procedure” to attempt to change their sexual orientation or gender identity.
Family members often deceive or even kidnap the victim; there have been cases in which victims were allegedly handcuffed or drugged so that they would not resist.
"Clínicas de deshomosexualización" in Ecuador:
The IACHR recognizes the State’s efforts in this regard, and encourages it to adopt all measures necessary to prevent the existence of these centers and to investigate them, as well as to punish those responsible.
Survivors indicated that once interned, they were:
- exposed to systematic verbal abuse, yelling, humiliation, and rape threats;
- housed in overcrowded rooms;
- held in isolation for long periods of time;
- deprived of food for several days or forced to eat unsanitary food or drink water from wells infested with dead toads, cockroaches and other insects;
- forced to “dress and behave like prostitutes to learn feminine behavior”
- and have sexual relations with other male interns by order of their “therapists;”
- kept in handcuffs for more than three months or
- chained to toilets that were being used by other persons;
- awakened with cold water buckets or urine being thrown on them;
- subjected to electroshock therapy;
- and touched, molested and even raped by custodial personnel.
Victims are extremely reluctant officially report these brutal acts to the autorities, among other, because:
- family members were involved in the abductions,
- law enforcement officials were involved in the wrongdoing and victims feared reprisals,
- lack of protections for those who report these crimes and a pervasive perception of impunity,
- the perpetrators were able to obtain written “consent” from the victims, and the victims believed that the existence of these documents precluded their possibilities of seeking justice.
Clara was waiting to go home with her parents when three men approached her, grabbed her by her hands and told her that “
anything she said could be used against her.” Clara demanded to see an arrest warrant, but the men instead threw her into a car and tried to handcuff her. Clara’s mother approached the car and told the men not to handcuff her. During the ride, Clara realized she was being “arrested” by her own family. She was in the backseat held at gunpoint by two men, each holding one of her legs. Minutes later they arrived at the “Julio Endara” psychiatric hospital. Clara saw her father and one of the men talking to a hospital guard. She was taken to a room where a female doctor injected a sedative which made her feel numb and incapable of reacting. She was then taken to a “clinic” in Chone, in the Ecuadorian province of Manabí, where she was locked up.
Hate speech and the incitement to violence against LGBTI persons
Information indicates that violence against LGBTI persons in the region is often fueled by the dissemination of hate speech targeted at this community in different contexts, including the media and the Internet.
It is essential to recognize that hate speech and incitement to violence can endanger the lives and safety of LGBTI people.
The IACHR reiterates that the promotion and protection of the right to freedom of expression should coincide with efforts to combat intolerance, discrimination, hate speech and incitement to violence.Read the report
According to the standards established under the American Convention speech cannot be prohibited simply because it expresses an intolerant or offensive idea or opinion. Rather, it must specifically incite violence or other similar action before it rises to the level of an act that must be punishable by law. The offensiveness of speech in and of itself is not sufficient reason to prohibit it.
The formal rejection of hate speech by high-level public officials and the condemnation of hateful ideas expressed can work as a preventive measure to combat incitement to violence and discrimination.
Preventive mechanisms could include: education to promote understanding and combat negative stereotypes and discrimination against LGBTI persons, including programs aimed at schoolchildren and informational campaigns; training for law enforcement agents and those involved in the administration of justice on the prohibition of hate speech and incitement to violence; and data collection and analysis in relation to freedom of expression and hate speech.
Intersectionality of violence against LGBTI persons
When lesbian, gay, bisexual, trans and intersex persons are victims of violence, their actual experiences of such violence are very diverse.
This diversity is a result of differing personal circumstances and characteristics, and in particular, the existence of certain factors that make some LGBTI persons especially vulnerable to violence, or which worsen the consequences of such violence.
1. Indigenous peoples
The IACHR notes that such persons might not self-identify as LGBT, and instead might self-identify with another expression of diverse sexuality, for example two-spirited, or might not discuss their gender or sexual orientation in terms that easily translate to the concept of LGBT as used in this report and elsewhere.IACHR, Public Hearing on Situation of Human Rights of Lesbian, Gay, Transexual, Bisexual and Intersex Indigenous Persons in the Americas, 147 Period of Sessions, 16 March 2013.
During a public hearing held in March 2013, a group of petitioners presented information on the negative impact of colonization on the ancestral sexualities and spiritualties of indigenous peoples.
According to the information provided, colonization resulted in the suppression of non-heteronormative sexualities among indigenous peoples. This had devastating consequences, including loss of acceptance of people of non-heteronormative sexualities within their own societies, self-harm, and suicide.
Acts of violence against women, including lesbian, bisexual and trans women, are experienced by women as manifestations of the structural and historical sexism and inequality between men and women.
Lesbian women are at particular risk for violence because of misogyny and gender inequality in society, but there is significant underreporting of violence against lesbian women.
Lesbian women are “
victims of ‘corrective rape’ or rape targeted to punish them, in an effort to ‘change’ their sexual orientation; collective beatings for public display of affection; attacks with acid; and forcib[le] commit[ment] to centers that offer to ‘convert’ their sexual orientation.”IACHR Annex to the Press Release 153, An Overview of Violence against LGBTI Persons in the Americas: a Registry Documenting Acts of Violence between January 1, 2013 and March 31, 2014
According to data from the 2010 U.S. National Intimate Partner and Sexual Violence Survey (NISVS) the lifetime prevalence of rape, physical violence, and/or stalking by an intimate partner was: IACHR Annex to the Press Release 153, An Overview of Violence against LGBTI Persons in the Americas: a Registry Documenting Acts of Violence between January 1, 2013 and March 31, 2014
The IACHR emphasizes that States have the obligation to prevent, punish and eradicate all forms of violence against women, including lesbian, bisexual, trans, and intersex women, as per the Belém do Pará Convention.
Violence against trans persons, particularly trans women, is the result of a combination of factors: exclusion, discrimination and violence within the family, schools, and society at large; lack of recognition of their gender identity; involvement in occupations that puts them at a higher risk for violence; and high criminalization.
The IACHR has expressed concern about the young age of trans victims.
There are certain specific acts of violence present in many cases of attacks against trans women:
- beatings targeted at the breasts;
- the puncturing of silicone breast implants, which causes the implants to leak toxic substances into the body;
- and genital mutilation, including even post-mortem castration.
Following her telling her father at the age of 11 that she was a lesbian, the woman was allegedly subjected to rape by her father’s friends during a 14-year period, which resulted in five children. After she managed to escape, she was then raped several times at the hands of illegal armed groups, often in front of her partners as a punishment for her sexual orientation. She has been consequently internally displaced several times in Colombia.tweet this
In Ecuador, a man shot his wife in her back and neck, saying that he did this because he thought she was a lesbian. The woman survived but was left permanently disabled and in charge of her five children.tweet this
In Chile, a young lesbian woman was repeatedly physically attacked and stabbed by the male relatives of her ex-girlfriend.tweet this
In Peru, a woman tried to defend her girlfriend from an attack by her brother that was prompted by their same-sex relationship. As a result she suffered machete wounds on her face, head and neck.tweet this
In 2009 in Peru, a trans woman sex worker named Techi Paredes was shaved bald and told to jump like a frog while being beaten with clubs by members of neighborhood councils. It was reported that one of the neighbors leading the attack declared: “
[w]e are giving them exemplary punishment and we are determined to eradicate them.”
In 2009, a group of residents in a neighborhood of the City of Buenos Aires, Argentina, is reported to have distributed flyers advocating the “elimination” of trans women from the neighborhood. This group referred to themselves as “
an anonymous group who decided to go to war with these men dressed as women.” Trans women in the area have reported suffering attacks with eggs, stones and bottles.
3. Persons in the context of human mobility
The IACHR has affirmes that persons in the context of human mobility, such as migrants and their families, asylum seekers, refugees, stateless persons, victims of human trafficking, internally displaced persons, among others, are vulnerable to human rights violations. Within this group, LGBT persons are extremely vulnerable to violence and discrimination.
Refugee claims based on sexual orientation and/or gender identity are most commonly recognized under the grounds of “membership of a particular social group” under the five grounds for persecution established in the 1951 Refugee Convention.
LGBT refugees’ experiences “
have taught them that they need to hide to survive. Speaking openly with strangers about their lives can feel shameful and dangerous.”ORAM, Blind Alleys: The Unseen struggles of Lesbian, Gay, Bisexual, Transgender and Intersex Refugees in Mexico, Uganda and South Africa, February 2013, p. 11.
Recommendations for adjudicating the refugee status of LGBT applicants: do not rely on stereotypical assumptions of LGBT persons.
In several countries trans women are housed with the general male population in immigration detention centers. Decision on where to house trans persons should be done on a case by case basis, with due respect to their personal dignity, and to the extent possible, with prior consultation of the person concerned.
“After living in the U.S. for twelve years, Johanna was apprehended by ICE and placed in an all-male detention facility [where she] was beaten and sexually assaulted [...] Unable to bear the conditions of her detention, she elected to self-deport. Life in El Salvador quickly became too dangerous for her and she attempted to return to the U.S. She crossed the border illegally and was apprehended by the Border Patrol. [... She] was sent to an all-male federal prison and was held in solitary confinement for seven months before being deported back to El Salvador for a second time [where] she was kidnapped and gang-raped. [...] the police, they refused to help her and suggested that the men should have killed her. Soon after this, she fled to the U.S. for a third time and was once again arrested [...] and imprisoned...”tweet this
4. Children and Youth
Children who are lesbian, gay, bisexual, transgender, or intersex, or who are seen as such, face stigma, discrimination and violence because of their perceived or actual sexual orientation and gender identity, or because their bodies differ from typical definitions of female or male.
According to UNICEF, the range of this discrimination and violence includes:
- isolation from peers at school, at home, or in the community;
- marginalization and exclusion from essential services like education and health care;
- abandonment by family and community;
- bullying and intimidation;
- and physical and sexual violence, including “corrective” rape.
There are cases in which parents or other family members exert physical violence against children because they perceive them as gender non-conforming, lesbian, gay, or bisexual. The intent of this violence is to “correct” the children, a brutal method referred to as “
beating the gay out/away.”
The authority of the family does not entitle it to exercise arbitrary control over a child where such exercise of control could pose a threat to the minor’s health or development.
Violence that takes place in educational environments
“LGBT children are often bullied by classmates and teachers, resulting in some students dropping out. They may even be refused school admission or expelled on the basis of their actual or perceived sexual orientation or gender identity.”Joint statement marking the 2015 International Day against Homophobia, Transphobia and Biphobia, the IACHR, the Committee on the Rights of the Child, UN human rights experts and other regional experts.
Students reported having being physically harassed or assaulted because of their real or perceived sexual orientation or gender identity:Eagle Canada Human Rights Trust, Every Class in Every School: Final Report on the First National Climate Survey on Homophobia, Biphobia and Transphobia in Canadian Schools.
Bullying based on sexual orientation and gender identity involve:
- relentless teasing, name-calling, and verbal abuse which escalated to more severe attacks, including: repeated molestation or touching of the victim’s genitals while the perpetrators hurled derogatory epithets;
- dragging the victim behind a pickup truck with a lasso around the victim’s neck;
- punching, kicking, and throwing the victim into a urinal;
- spraying water and dumping hot melted cheese on the victim’s head;
- urination and mock rape;
- throwing bottles and pushing the victim down the stairs;
- continuously shoving the victim into lockers and spiting on the victim;
- and continuous harassment culminating in a sexual assault in the school locker-room;
- among others.
For instance, the State of Argentina informed the IACHR that a local survey estimated that thans women had been unable to finish:Response to the IACHR Questionnaire on Violence against LGBTI Persons in the Americas submitted by the State of Argentina, Note 96357/2013, dated 29 November 2013, received by IACHR Executive Secretariat on 13December 2013, p. 16.
If bullying is tolerated, a strong social message is sent to LGBT persons that the open expression of their orientations or identities is not accepted.
Extreme examples include: a mother torturing and murdering her 4-year-old son because she perceived him to be gay; a father brutally attacking and humiliating his 16-year-old son, tying the child’s feet to a pickup truck and threatening to drag him down the street because of his sexual orientation; a sister continuously humiliating and attacking her 15 year old brother, including throwing urine on him, because he was gay (aggressions which eventually lead to the boys’ suicide); a father setting his son on fire because he discovered he was gay and HIV positive; and a brother brutally attacking his brother and threatening to kill him because he was gay.tweet this
In Haiti, a young man who, when he came out to his family, was attacked with a machete and beaten by his brother. When he went to the police, they told him that his brother was right to beat him if he was gay. Allegedly the police then declined to record his complaint and investigate.tweet this
In Guyana a civil society organization was contacted when a father threw his gay 13-year old boy out of his home and threatened to kill him. The Child Care and Protection Agency (CCPA) intervened and placed the child with his grandmother. The father was able to continue the abuse and harassment; there was no effective legal intervention in this case.tweet this
In 2014, an U.S.-based organization announced that it was proving legal aid to a conversion therapy survivor who alleges that “
shortly after coming out in 1996, his parents turned to the local church, which ran a school it promised could “cure” him and “stop him from being gay.” According to the victim, a teacher began subjecting him to weekly “counseling” sessions in which he regularly raped the teenager to convince him that being gay was more painful than suppressing his sexual orientation.”
In a case reported in Peru, the headmaster of the school publicly announced that he would “
initiate an investigation” to find out if two male students were in a relationship, in order to have them expelled from the institution to “
preserve the school’s prestige and reputation.”
5. Human Rights Defenders
The IACHR reiterates that the work of human rights defenders is fundamental for the universal implementation of human rights, and for the full existence of democracy and the rule of law. Human rights defenders are an essential pillar for the strengthening and consolidation of democracy.
UN Special Procedures have noted that LGBTI human rights defenders may face greater risks because their work “
challenges social structures, traditional practices and interpretation of religious precepts that may have been used over long periods of time to condone and justify violation of the human rights of members of such groups”.Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, A/56/156, 3 July 2001, para. 25; Report of the Special Representative of the Secretary-General on human rights defenders, E/CN.4/2001/94, 26 January 2001, para. 89(g).
LGBT human rights defenders suffer such violence as a consequence of their situation of triple vulnerability:
- persons who identify as LGBT are already vulnerable because of their sexuality, sexual orientation and/or gender identity
- because of their role as human rights defenders and
- because of the specific causes that they champion.
Among the most vulnerable to this severe violence are trans women who are human rights defenders and who also engage in sex work.
The IACHR has received troubling information concerning opposition groups and church groups that are constantly waging campaigns to discredit organizations that defend the rights of LGBTI persons.
to protect defenders of LGBTI persons in Belize, Honduras, Jamaica, Mexico, and Guatemala.
in Honduras between 2006 and 2013 Response to the IACHR Questionnaire on Violence against LGBTI Persons in the Americas submitted by Cattrachas, (Honduras), received by the IACHR Executive Secretariat on 1 December 2013, p. 26.
Public officials must refrain from making statements that stigmatize human rights defenders or that suggest that human rights organizations act improperly or illegally, merely because they engage in the work of promoting and protecting human rights.
In 2004, Brian Williamson, co-founder of the organization Jamaican Forum for Lesbians, All-sexuals and Gays (J-Flag), was found murdered in his home. He was stabbed 70 times and his body was mutilated. Within an hour after the discovery of his body, a Human Rights Watch researcher witnessed a crowd gather outside his home, some of the members of which were reportedly chanting, “
that’s what you get for sin,” and “
let’s kill all of them.”
On February 14, 2007, in Kingston, a group of gay men including gay-rights activist Gareth Williams were stoned by a mob of over 2,000 people when they were shopping in a mall. The police failed to arrest anyone for the attack and instead took the gay men into custody and subsequently abused them even as they sought to secure them from the mob.tweet this
6. Persons Deprived of Liberty
According to the UN Special Rapporteur, LGBT persons are at the bottom of the informal hierarchy in detention facilities, which results in double or triple discrimination, and they are disproportionately subjected to torture and other forms of ill treatment.Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, A/HRC/22/53, 1 February 2013, para. 79.
LGBT persons who are deprived of their liberty are at a heightened risk for sexual violence and other acts of violence and discrimination at the hands of custodial staff or other persons deprived of liberty.
Female prisoners whom guards viewed as “
masculine” in appearance have reportedly been subjected to harassment, physical abuse, and “
Additionally, gay men or trans women deprived of their liberty may be forced into servitude by other inmates, required to do menial tasks on their behalf, and provide sexual services to them.
Several NGOs report that LGBT persons often decide to remain in their cells as much as possible in order to avoid being attacked by other inmates.
Trans women are at heightened risk of sexual violence because of their routine imprisonment in male facilities, without regard to the specificities of the person or the case. The IACHR has affirmed that the decision on where to house trans persons should be done on a case by case basis, and to the extent possible, with prior consultation of the person concerned.
On the other hand, according to the available information, several prison compounds in Argentina, Brazil, Colombia, El Salvador, Guatemala, Honduras, Jamaica, Paraguay, the United States, and Uruguay, have separate pavilions or cells in male prisons to specifically house trans women and gay men.
Among LGBT prisoners:
in MéxicoUS Department of Justice - Bureau of Justice Statistics, PREA Data Collection Activities 2013, June 2013, NCJ 242114, p.2.
The IACHR calls on OAS Member States to adopt urgent and effective measures to guarantee the life, personal security, and integrity of LGBT persons, or those perceived as such, in the region’s places of detention, including prisons and immigration detention centers.
The IACHR calls on OAS Member States to restrict the indiscriminate and prolonged use of solitary confinement of LGBT persons in places of detention, including immigration detention centers and prisons.
Ashley Diamond, a 33-year-old trans afro-descendant woman deprived of liberty in Georgia, United States, had been raped at least seven times since being detained in 2012, and that her access to hormone therapy had been withheld. According to a news report, she had been mocked by prison officials as a “
he-she thing” and thrown into solitary confinement for “
pretending to be a woman.” Diamond has undergone drastic physical changes after being denied access to hormones and, in desperation, has tried to castrate herself and kill herself several times. In an interview, Diamond said, “
every day I struggle with trying to stay alive and not wanting to die. Sometimes I think being a martyr would be better than having to live with all this.”
On November 26th 2013, Ayelén, a trans woman, was arrested by local police in the city of San Miguel de Tucumán in Argentina. She was allegedly taken to the police station where five police officers raped her. She was then taken to a cell shared with other prisoners, where she was raped again by several of them. The following day she was forced to clean the police station. She managed to escape, and she went to a local hospital and filed a report. While the physical examinations were being performed at the hospital, police agents showed up and persuaded her to drop the charges. She was even forced to sign a document in which she declared that what she had previously stated was untrue.tweet this
Verõnica Bolina, an afro-Brazilian trans woman deprived of liberty in São Paulo, Brazil. According to the information received, she had been severely beaten, tortured, and subjected to degrading treatment at the hands of police after she bit off half the ear of a prison warden.tweet this
I was detained 18 times because I was a sex worker… they took me from the street and told me I was disrupting public order (escándalo en la vía pública) so they would lock me up. At the beginning I was in sector 10, which was only for gay and trans persons, but that (disappeared)… the last time I was housed with men… I was raped, abused… you have to give the “chiefs” sex in order to survive. These acts are not denounced out of fear… when I entered a prison, I was treated as a man and I was insulted… having a trans identity is very challenging… some trans women prefer to cut their hair short because they rather pass as gay and not as trans women, because we are victimized the most.”
7. Persons of African Descent
The IACHR has received troubling information concerning the high levels of discrimination and violence against lesbian, gay, bisexual, and trans (LGBT) persons of African descent in the Americas.
LGBTQ persons of color are more likely to experience violence perpetrated by their intimate partners, and are more likely to experience intimate partner violence that occurs in public.
When compared to white cisgender persons, trans persons of color are six times more likely to experience physical violence at the hands of the police. National Coalition of Anti-Violence Programs, A Report of Lesbian, Gay, Transgender, Queer, and HIV-Affected Hate Violence in 2013, 2014, p. 10.
Out of the killing of LGBTQ persons in 2014:
In 2011, self-identification of the LGBT victims of violence in Brazil:
(pretos and pardos)
The Commission was informed of the case of “Alias el Oso,” a member of a Colombian paramilitary group, who ordered the torture of gay men, especially those who were “effeminate”, and of Afro-descendants. The torture was to be carried out in the homes of the victims, and was intended to terrorize the population. The victims were subsequently forced to leave their communities.tweet this
8. Persons Living in Poverty
LGBT persons often face poverty, social exclusion, and high rates of homelessness. LGBT persons are expelled from their families and schools and in some instances cannot even obtain jobs paying minimum wage. This pushes them into the informal economy or into criminal activity.Spade, Dean. Interview by Laura Flanders, The Laura Flanders Show, GRITTV, 2015.
In Latin America, discrimination and structural exclusion in the labor market, based on sexual orientation, gender identity, and gender expression, is one of the triggers that “sets into motion an endless cycle of continued poverty.”Cabral, Mauro and Hoffman, Johanna. International Gay and Lesbian Humans Rights Commission, They Asked Me How I Was Living/Surviving, I said, surviving: Latin America Trans Women Living in Extreme Poverty, 2009, p. 6.
Some LGBT persons in such situations engage in sex work, or in survival sex, which is the exchange of sex for money, food, shelter, or other material goods needed for survival.
Regardless of socio-economic origins, a large number of trans women who are thrown out of their family homes at an early age end up among the high number of trans women who are severely impoverished most of their lives.”Cabral, Mauro and Hoffman, Johanna. International Gay and Lesbian Humans Rights Commission, They Asked Me How I Was Living/Surviving, I said, surviving: Latin America Trans Women Living in Extreme Poverty, 2009, p. 5.
It is reported that homelessness among LGBT persons “
is almost always the result of discrimination or violence.” LGBT persons are displaced from their homes, families, communities, and sometimes their country, by their families, landlords, and neighbors.J-FLAG, (re)Presenting and Redressing LGBT Homelessness in Jamaica: Towards a Multifaceted Approach to Addressing Anti-Gay Related Displacement, 2014, p. 2.
When intersex persons are born into impoverished families or to parents lacking access to formal education, the power imbalance that is normally present in the doctor-patient relationship tends to be exacerbated, with a consequent negative impact on intersex persons’ right to informed consent. Alcántara Z., Eva. Pobreza y Condición Intersexual en México: Reflexiones y Preguntas en Torno al Dispositivo Médico, Córdoba, Mejico: Anarres Editorial, 2009, p 16-30.
The prevalence in Latin America of informal and risky sex reassignment procedures causes a high number of (preventable) deaths of trans women. Cabral, Mauro and Hoffman, Johanna. International Gay and Lesbian Humans Rights Commission, They Asked Me How I Was Living/Surviving, I said, surviving: Latin America Trans Women Living in Extreme Poverty, 2009, p. 5.
One study conducted in Bogotá, Colombia showed in relation to reassigment procedures: Pachón, N. E. and Cruz, K. J. Uso De Modelantes Estéticos, Como Proceso De La Trasformación Corporal De Mujeres Transgeneristas, Bogotá, 2013. Obtenido de Tábula Rasa: Revista de Humanidades.