Help-Seeking and Challenges Faced by Transwomen Following Exposure to Gender- Based Violence; A Qualitative Study in the Greater Kampala Metropolitan Area, Uganda

BackgroundThe prevalence of gender-based violence (GBV) towards transwomen remains high andis both a human rights and public health concern. Nonetheless, there is limited evidence of the referral pathways used by transwomen once exposed to GBV. The current study, therefore, aimed to explore the referral pathways and the challenges faced by transwomen in seeking GBV support services in the Greater Kampala Metropolitan Area, Uganda.MethodsA qualitative study design was used. We conducted a total of 20 in-depth interviews, 6 focus group discussions, and 10 key informant interviews. Respondents were recruited using snowball sampling, and purposively selected for interviews. Data were transcribed verbatim and analysed following a thematic framework. NVivo software was used to organise data into themes and subthemes.ResultsThe gender-based violence referral pathways used by transwomen included key population-friendly healthcare facilities, key population-friendly civil society organizations, and friends and family. Key population-friendly healthcare facilities provided medical and psychosocial support services; key population civil society organizations provided shelter, nutritional support, and legal services, whereas friends and family provided emotional support. Lack of recognition of transgender identity; long distances to healthcare facilities; discrimination in some healthcare facilities, civil society organizations, and at the hands of police officers and prison inmates; and the lack of trans-competent healthcare providers and limited scope of GBV services and related equipment made it difficult for transwomen to access GBV support services.Conclusion There were no formal channels for transwomen to access GBV support services. Available avenues such as key population healthcare facilities, key population-friendly civil society organizations, and the police also perpetrated violence against transwomen in the Greater Kampala Metropolitan Area. Our findings suggest the need to formalize referral pathways for transwomen and to sensitize service providers at all points of care about the transgender identity. There is a need to break the structural barriers that limit access to and uptake of GBV support services among transwomen.