Malta Monica, Gomes de Jesus Jaqueline, LeGrand Sara, Seixas Michele, Benevides Bruna, Silva Maria das Dores, Lana Jonas Soares, Huynh Hy V, Belden Charles M, Whetten Kathryn
Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, Canada.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
Glob Public Health. 2020 Oct;15(10):1463-1478. doi: 10.1080/17441692.2020.1767676. Epub 2020 May 21.
Worldwide, Brazil has the highest prevalence of violence and hate crimes against sexual and gender minorities (SGMs) among countries with available data. To explore the impact of this scenario, we conducted a qualitative study with 50 SGMs from Rio de Janeiro, Brazil. Among the participants, 66% screened positive for generalised anxiety disorder, 46% for major depressive disorder and 39% for PTSD. A third reported low self-esteem (32%) and one quarter low social support (26%). Experiences of interpersonal discrimination were highly prevalent (>60%), while institutional discrimination related to employment or healthcare was reported by 46% of participants. Verbal abuse is very common (80%), followed by physical assault (40%). Sexual violence is highly frequent among women. Focus groups analysis highlighted three major domains: (1) stigma and discrimination (family, friends and partners, in schools and health services, influencing social isolation); (2) violence (bullying, harassment, physical and sexual violence); and (3) mental suffering (alcohol and drug abuse, depression, suicidality, anxiety). Our findings suggest a close synergy between experiences of discrimination and violence with selected mental disorders. This complex synergy might be better addressed by longer-term individual and group-level interventions that could foster social solidarity among the different groups that comprise SGMs.
在有数据可查的国家中，巴西是全球针对性少数群体（SGM）的暴力和仇恨犯罪发生率最高的国家。为探究这种情况的影响，我们对来自巴西里约热内卢的50名性少数群体进行了一项定性研究。在参与者中，66%的人筛查出广泛性焦虑症呈阳性，46%的人患有重度抑郁症，39%的人患有创伤后应激障碍。三分之一的人报告自尊水平较低（32%），四分之一的人社会支持较低（26%）。人际歧视的经历非常普遍（>60%），而46%的参与者报告了与就业或医疗保健相关的机构歧视。言语虐待很常见（80%），其次是身体攻击（40%）。性暴力在女性中非常频繁。焦点小组分析突出了三个主要领域：（1）耻辱和歧视（在家庭、朋友和伴侣中，在学校和医疗服务中，影响社会孤立）；（2）暴力（欺凌、骚扰、身体和性暴力）；以及（3）精神痛苦（酗酒和药物滥用、抑郁、自杀倾向、焦虑）。我们的研究结果表明，歧视和暴力经历与某些精神障碍之间存在密切的协同作用。这种复杂的协同作用可能通过长期的个人和群体层面的干预措施得到更好的解决，这些措施可以促进构成性少数群体的不同群体之间的社会团结。
