Written by Hally Mahler, Project Director, FHI 360 LINKAGES and Rose Wilcher, Director, Research Utilization, FHI 360
Last year, a friend and colleague, Beyonce Karungi, wrote about what it is like to be a transgender woman in Uganda. She talked about being rejected by family members and about being beaten up and burned with cigarettes for being transgender. She described being harassed by police who wanted to make her a “proper man.” She recounted being raped at gunpoint by a client when she was a sex worker, because she insisted that he use a condom. Beyonce wrote that “… from the standpoint of a transgender woman like myself — our human rights and unique challenges are not addressed and not given the attention they deserve.”
Beyonce’s story is not uncommon. Experiences of violence are widespread among key populations: sex workers, men who have sex with men, transgender people and people who inject drugs. Here are just a few examples:
- A study of sex workers from seven cities in Cameroon found that 60 percent had experienced physical or sexual violence.
- A Global Gay Men’s Health and Rights Survey reported that 69 percent of respondents knew someone who had been physically assaulted because he was gay or had sex with men.
- A Ukraine survey found that 43 percent of women who injected drugs reported having been physically assaulted by police, and 13 percent reported having been forced by police to have sex.
- A study conducted in Lebanon reported that 68 percent of trans women had experienced physical violence because of their gender identity or expression.
This violence can often be traced back to homophobia, transphobia and other rigid beliefs about acceptable behavior for men and women. For example, perpetrators of violence against men who have sex with men often claim that they are attempting to “cure” men who are perceived to have rejected their masculinity. Likewise, transgender people experience violence from those who believe they have not fulfilled expectations associated with the sex they were assigned at birth.
Trans women are particularly vulnerable to violence from those who believe that experiencing violence is part of what it means to be a woman. Much of the violence that is directed at female sex workers and women who inject drugs is a manifestation of gender inequality and discrimination against women more broadly. But levels of violence against both are exacerbated by the belief that women who sell sexual services or inject drugs are immoral and have strayed from socially acceptable behaviors for women.
A broader understanding of gender-based violence
From November 25 through December 10, individuals and organizations around the world are participating in the 16 Days of Activism against Gender-based Violence campaign. Every year, this campaign brings attention to the urgent need to eliminate violence against women and girls. But, the campaign is also an opportunity to examine the root causes of gender-based violence and shed light on those who experience such violence but who are not traditionally recognized during the 16 days.
FHI 360’s LINKAGES project promotes an inclusive view of gender-based violence — one that acknowledges that it affects not only women and girls in the “general population,” but also men who have sex with men; transgender individuals; and highly marginalized groups of women, such as sex workers and women who inject drugs. These groups are often omitted from calls to end gender-based violence.
HIV and gender-based violence
Experiences of violence increase the risk of key populations acquiring HIV and deeply affect their desire and ability to obtain health care, get tested for HIV and adhere to HIV treatments. For example, epidemiologic modeling has shown that reducing violence against female sex workers would reduce new HIV infections among sex workers and adults in the general population by 25 percent and 6 percent, respectively.
We will not make sustainable gains against the HIV epidemic if we do not also address the violence that key populations experience at the hands of family, community members, health care providers and police. Here are five ways that everyone who works with key populations can address gender-based and other forms of violence:
- Uncover the root causes and gender dimensions of violence against key populations. By conducting gender analyses, as LINKAGES has done in Kenya and Cameroon, we can reveal how gender norms and beliefs underlie much of the violence faced by key populations and identify ways to challenge harmful beliefs and better address such violence.
- Support community-led solutions. Community-based organizations headed by members of key populations are taking the lead in delivering the HIV services that their community members want and need, including addressing violence. In addition, outreach workers and peer educators from key population communities can be trained to screen for violence and provide first-line response in line with global best practices.
- Work with police and other community power holders so that they become allies in responding to violence and building stronger crisis response systems. Programs must garner commitments from local attorneys, hospital staff, psychologists, peer educators, and police that they will offer client-centered, nonjudgmental services to all survivors of violence, and that they will facilitate key populations’ ability to report violence when it occurs.
- Advocate for legal and policy reforms that explicitly protect the human rights of key populations. Even in hostile legal environments, steps can be taken to prevent and respond to violence. For example, we can advocate for the explicit inclusion of sex workers, men who have sex with men and transgender people in any legislation that is created to protect women and girls from gender-based violence.
- Draw attention to the science and the stories on the causes, consequences and experiences of gender-based violence among key populations, as well as the evidence-based strategies for addressing such violence. Through the LINKAGES blog series, Key Population Heroes, and our project newsletter, The LINK, we amplify the voices of key population members who have bravely shared their experiences of stigma, discrimination and violence and called on us to join them in fighting for change.
Toward a more inclusive campaign against gender-based violence
Many people think of gender-based violence only in relation to women and girls. But, by developing a more inclusive view, we can help ensure that policies, preventive efforts and response systems benefit all those who experience such violence. Understanding and addressing the broader gender-based aspect of this problem will also allow us to strengthen the networks and combine the resources of the groups that are working to dismantle gender-based discrimination and advance the human rights of all women, girls, and sexual and gender minorities.
During the remainder of the 16 Days campaign, we will hear from colleagues representing key population communities about how they are affected by gender-based violence and what they are doing about it. We invite you to subscribe to the LINKAGES blog, contribute to the conversation on social media, and join us in advocating for the right of all people to live free from gender-based violence.