Violência na perspectiva de gênero e orientação sexual: relação entre as notificações e as declarações de óbito no município do Rio de Janeiro (2015 – 2019)

Abstract

Introduction - Violence is a current phenomenon, which relates to different factors and reveals the behavior / culture of a group or society, a serious public health problem. Regarding sexual orientation and gender identity, information is even more scarce and neglected, which reveals a conservative discourse that contributes to the maintenance of the privilege of some, excluding women, blacks, the poor and the LGBT population. Objective - To analyze sexual orientation and gender identity as factors associated with mortality from violent causes in the set of notifications for the “interpersonal / self-harm” problem of the Notifiable Diseases Information System (SINAN). Methods and Procedures - This is a non-concurrent cohort study, with passive follow-up through a database relationship using a probabilistic linkage technique between the occurrence of some form of violence reported in the Notifiable Diseases Information System and deaths due to causes in the Mortality Information System of residents in the city of Rio de Janeiro, from 2015 to 2019. Finally, survival analysis to determine the risk of dying from violent causes due to sexual orientation, as outlined in the study. Results - 487 true pairs were found, of these 89 with the desired outcome (violence death).The Coefficient of Mortality from violent causes showed statistical significance for males (p-value <0.001), transgender people (p-value <0.016), yellow and black / brown people (p-value <0.032), and no information on schooling, with less than 8 years of study (p-value <0.011) and self-harm (p <0.001). Survival analysis, especially Hazard's estimate using the Nelson-Aalen Curve, revealed that the risk of death from violent causes increases with time, becoming more pronounced after 4 years for the selected group. The Kaplan-Meier curves, survival estimates for mortality from violent causes observed a lower risk of survival as a function of time for groups of sexual minorities - Lesbians, Gays and Bisexuals (X2: 37.16; p-value <0.001) and of trans people - transvestites, trans women and trans men (X2: 34.98; p-value <0.001). The testing of the interaction observed that gender identity modifies the effect of the variable sexual orientation, being the heterosexual classification and other identities protective against violent deaths, while the presence of sexual minorities (LGB) and trans-producing identities at risk for deaths. Conclusion - The present study is unprecedented and reinforces the need for investment in the notification of qualified violence, especially considering sexual orientation and gender identity, so that, from then on, information can guide management spaces and the formulation of public policies for minority LGBT and expand strategies for action and empowerment of the LGBT movement.