Prevalence of Physical and Sexual Violence Among Transgender and Non-Binary People in the Baixada Santista Region, Brazil: A Cross-Sectional Study

This study aimed to estimate the lifetime prevalence of physical and sexual violence and to analyze associated sociodemographic and health-related factors among nonbinary persons, transgender men, and travestis /transgender women living in the Baixada Santista region, São Paulo, Brazil. Data were drawn from the Mapping of the Trans Population of Baixada Santista, conducted in 2023 in nine municipalities. The study included individuals aged 18 years or older who self-identified as nonbinary, transgender men, travestis , or transgender women. Outcomes were lifetime physical violence and lifetime sexual violence, assessed by self-report. Independent variables included sociodemographic characteristics, health conditions, and experiences of discrimination based on gender identity. Descriptive and bivariate analyses were performed using Pearson’s chi-squared test. Poisson regression was used to estimate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). A total of 234 participants were included. The lifetime prevalence of physical violence was 58.2%, and sexual violence was also reported by 58.2% of the sample. After adjustment, transgender men (Adj.PR 0.55; 95% CI [0.37, 0.82]) and travestis /transgender women (Adj.PR 0.70 [0.51, 0.98]) showed lower prevalence of sexual violence than nonbinary persons. Discrimination based on gender identity remained independently associated with sexual violence (Adj.PR 2.12 [1.07, 4.18]). For physical violence, living in shelters was the only factor independently associated with higher prevalence (Adj.PR 1.43 [1.05, 1.94]). Physical violence and sexual violence were highly prevalent among transgender and nonbinary populations, with distinct vulnerability patterns according to gender identity, discrimination, and housing conditions. Healthcare professionals need to be vigilant regarding this population, given the magnitude of the prevalence of violence and other health outcomes.