Association of Discrimination and Violence With Suicidality Among <i>Travestis</i> and Transgender Women in Rio de Janeiro, Brazil, 2015‒2023: A Cross-Sectional Study.

Abstract

<b>Objectives.</b> To examine the associations between discrimination, violence, and suicidality among <i>travestis</i> and transgender women in Brazil. <b>Methods.</b> We analyzed baseline data from the <i>Transcendendo</i> cohort (2015-2023) in Rio de Janeiro, Brazil, which enrolled <i>travestis</i> and transgender women aged 18 years and older. We assessed lifetime discrimination by using an 8-item scale reflecting transgender-related mistreatment experiences. We also measured physical and sexual violence, sociodemographics, and psychosocial factors. We categorized suicidality as no ideation, ideation only, and ideation with attempts, analyzed using a multivariable ordinal regression model. <b>Results.</b> Among 662 participants, lifetime discrimination (adjusted odds ratio [AOR] = 1.21; 95% confidence interval [CI] = 1.11, 1.32; <i>P</i> < .001) and lifetime sexual assault (AOR = 1.60; 95% CI = 1.17, 2.19; <i>P</i> = .003) were significantly associated with increased odds of suicidality. Participants with positive body self-satisfaction, HIV, and increasing age had lower odds of suicidality. <b>Conclusions.</b> Our findings highlight the need for antidiscriminatory policies and health services tailored to the needs of this community to mitigate suicidality risk among <i>travestis</i> and transgender women in Brazil. (<i>Am J Public Health</i>. 2026;116(2):261-269. https://doi.org/10.2105/AJPH.2025.308280).