Invisibilities: Exploring Identities & Stories of Trans Community Members & Leaders in Santo Domingo, Dominican Republic

As a public health professional and as a child of immigrants, I have always been drawn to diving into the diverse perspectives that shape different populations’ realities and, ultimately, their health outcomes. When the opportunity arose to embark on a project focused on interviewing and surveying HIV positive trans community in Santo Domingo, I knew it was a chance to engage in meaningful conversations and shed light on stories often overlooked – especially in the Latin American context. Now that I have finished my summer practicum with the Unidad de Vacuna e Investigación at the Instituto Dominicano de Dermatología y Cirugía de la Piel (IDCP), I have taken some time to reflect on the diversity and layered experiences shared with me by trans community members.

From the moment I stepped into this project, I was captivated by the resilience, strength, and diversity amongst the trans individuals I had the privilege of speaking with. Each person had a unique story to tell, shaped by their experiences, struggles, and triumphs. These stories painted a vivid picture of the challenges the trans community faces in a patriarchal society that often misconstrues, mistreats and marginalizes them. Machismo is rampant in Dominican culture, as is it is in all of Latin America, that is very much a remnant of the country’s colonization period. As one trans leader explained, that individuals – particularly men – who exhibit chauvinistic behavior are often called “Trujillista”. This term comes from the country’s brutal dictator that reigned between 1930 to 1961, Rafael Trujillo, referring to the belligerent behavior implemented by his armed forces at the time. It was fascinating to see how the country’s dark past informs the coinage of a term that oppresses such a marginalized community.

One of the most important aspects of this project, whether in qualitative interviews or administering surveys, was creating a safe and welcoming space for these vulnerable conversations – which often covered topics such as sexual/domestic abuse, drug use, and mental health. It was crucial to establish an environment where individuals felt comfortable sharing their thoughts, feelings, and experiences. We held the interviews and surveys in locations where participants felt secure, facilitated them through a consent process and assured them that their identities would not be tied to the information that would be shared with us. Many explained that their biggest fear was having their HIV status disclosed to other trans sex workers in the study, which could cause a domine effect that may trigger rival trans sex workers to tell potential clients and thus hindering their ability to secure customers.

The entire research team – including primary investigators, participant recruiters,
psychologists, and MPH Practicum students.

Throughout the conversations, all participants shared annecdotes reflecting the preconceived notions and misconceptions Dominican society have against the trans community, particularly those that are HIV positive. It was disheartening to hear about the discrimination, stigma, and lack of compassion the community faces, typically perpetrated by their own family members, employers and law enforcement. Nonetheless, it was also inspiring to witness many of their determination to challenge these misconceptions and advocate for their rights through grass roots efforts. What struck me the most was the sense of responsibility of older trans women to give back and carve a path for the younger generations of trans women. Several community leaders I spoke were all involved some form of capacity building – supporting local trans NGOs through health education, political advocacy, or vocational training efforts. All shared how there is a dire need to equip trans women, at a young age, with education as their main armor to be used against the patriarchy. Despite the hardships the community endures, there is overwhelming pride in the visibility of trans women that continues to grow due to the growing presence of trans-serving NGOs in the area such as TRANSSA and COTRAVETED. These organizations are committed to unifying the community, empowerment, and personal/professional development opportunities for LGBTQI+ individuals in the DR.

Leading a mock survey interview to test interview facilitation best practices.

The experiences and stories shared during my interviews and surveys underscored the urgent need for advocacy, education, and awareness. It is the responsibility of the Dominican government to give legitimacy and a platform to amplify the voices of trans women, challenge stereotypes, and work toward creating a more inclusive and accepting society. I am immensely grateful for the opportunity to have connected with the trans community in Santo Domingo. The Dominican Republic will always have a piece of my heart – from its kind people, delicious food, rhythmic music, balmy nights and the ice-cold Presidente beer shared with friends at the park during the sunset – it is truly a gem in the Caribbean. I can’t wait to go back and, not only see how the study has unfolded, but also to be enveloped by the lively feel of the country.  As I continue to process the insights gained from this experience, I am reminded why I chose to become a public health professional. By lending our ears, hearts, and actions to those who often go unheard, we can collectively build a world where everyone’s story is celebrated, valued, and ultimately, respected.

Stunning sunset from Las Terrenas beach in the northwestern region of the country.

-Tiffiany Portacio

Discovering the Beauty and Challenges of Language

Hello again! My name is Emily Benson, and I am a second-year MPH student in the global health concentration. I did my practicum this summer with Refugee Community Partnership (RCP), a non-profit organization in Carrboro, NC. RCP works alongside local refugee and immigrant communities to connect them to the resources and social connections they need to thrive and to mobilize organizations to eliminate barriers to accessing these resources.

I recently completed my practicum with RCP, and I have learned so much! I have been working with them on a research project that aims to identify the main barriers to health care among local refugee and immigrant communities. This practicum experience has not only deepened my passion for healthcare access and the social determinants of health but has also revealed a health barrier to me that is not often discussed in public health – language barriers.

Ler, another UNC Gillings intern at RCP, and I working in the RCP office.

The Importance (and Beauty!) of Language

The research project I was working on is a community-led research project that is analyzing language access in medical settings. This research consists of data from RCP’s Language Navigator Program (discussed in my previous blog post!) and community health forums. The research team is currently working to host community forums with six language communities: Arabic, Karen, Burmese, Pashto, Dari, and Spanish.

For my practicum, I have been working on two main tasks: (1) Analyzing the qualitative data from the language navigator program feedback surveys and (2) Working to organize the research data to effectively present the research findings to local healthcare institutions and professionals.

Through these tasks and working with individuals of various language communities, I have learned so much. I have particularly discovered a lot about my personal implicit biases around languages other than English. Working with RCP has opened my mind to the beauty and importance of different languages that are spoken here in the US and around the world. Enabling individuals to communicate in their own language is vitally important, as it has an enormous impact on many aspects of life – most prominently, an individual’s overall health. Specifically, lack of language access in medical settings has potentially detrimental effects including, but not limited to, critical information missed in a health appointment, miscommunication between the patient and provider, misdiagnosis of the patient, and/or incorrect or ineffective treatment.

Because of this internship, I can gratefully say that I will never take for granted language access again and have a new-found appreciation for all languages worldwide. I hope this research project will bring to light the health inequities that exist among refugee and immigrant communities in the US and pave a path to changes in medical institutions to reduce the impact of language barriers.

The Afghan Women’s Sewing Group

Over the course of my internship with RCP, I also had the opportunity to become involved with an Afghan Women’s Sewing Group. Being able to help with this pilot program has been very eye-opening for me. I have been able to meet, interact with, and get to know some amazingly brave and courageous women from Afghanistan and hear some of their stories.

It has been really cool to see them create community and share culture, experiences, and knowledge with each other through this group. Many of these women are incredibly talented when it comes to sewing and embroidery. Through this group, they have all made incredibly beautiful pieces!!

An embroidery piece made by a member of the sewing group

One of the biggest challenges that this experience presented to me was that I could not fully communicate directly with many of these women as we do not speak the same language. However, the most prominent thing I learned from this challenge is this:

A smile and acts of kindness are the same in every language.

I fully believe that these two things have the potential to be the bridge between all cultures and people around the world and can be the beginning of dismantling these language barriers. I have absolutely loved being able to connect with these women and experience a little bit of their beautiful culture and am grateful for all of the things I have learned along the way. I am very excited to see where this group goes in the future!

I want to end this blog with a quote that has changed my whole perspective on the importance and beauty of languages, and I hope it inspires each of you reading this blog as well.

“We dream in language, we sing in language, we think in language. It is tied to our lands, to our bodies, to our relationships, and to our knowledge. It is important that we feel respected as speakers—not just for what we have to say, but also how we say it.”  – Antena Aire

 Thanks for reading and following along as I completed my practicum!

– Emily