Abstract
Objectives. To examine the associations between discrimination, violence, and suicidality among travestis and transgender women in Brazil. Methods. We analyzed baseline data from the Transcendendo cohort (2015-2023) in Rio de Janeiro, Brazil, which enrolled travestis 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. Results. Among 662 participants, lifetime discrimination (adjusted odds ratio [AOR] = 1.21; 95% confidence interval [CI] = 1.11, 1.32; P < .001) and lifetime sexual assault (AOR = 1.60; 95% CI = 1.17, 2.19; P = .003) were significantly associated with increased odds of suicidality. Participants with positive body self-satisfaction, HIV, and increasing age had lower odds of suicidality. Conclusions. Our findings highlight the need for antidiscriminatory policies and health services tailored to the needs of this community to mitigate suicidality risk among travestis and transgender women in Brazil. (Am J Public Health. 2026;116(2):261-269. https://doi.org/10.2105/AJPH.2025.308280).