Harm Reduction and Liberation for Black Trans Drug Users in Brazil

February 28, 2022

More transgender people are murdered in Brazil than any other country in the world. Though the government criminalized queer- and transphobia three years ago, violent attacks within the country have continued to rise. 2021 was Brazil’s deadliest year on record, with the country representing one-third of the world’s reported murders of gender variant people.

Under President Jair Bolsonaro, the government has sought to crush harm reduction work. Police carry out state-sanctioned massacres in neighborhoods it vilifies for use of crack cocaine. Even medical marijuana has barely broken free of prohibition.

Matuzza Sankofa grew up in the southeastern city of Itabira. Her mother did not accept her gender identity, expelling her from their home when she was 14. Sankofa lived in shelters until she turned 18, when she had no option but to live on the streets.

Eventually, at a house rented by queer and gender variant people, she found both lodging and an introduction to justice movements. When she was offered a job in the larger city of Belo Horizonte, providing harm reduction services to trans women, particularly those unhoused and engaged in sex work, she finally found a place to call home.

In 2019, Bolsonaro cut harm reduction from the national drug policy and reinstated involuntary commitment, and Sankofa found herself unemployed. She decided to move to São Paulo City, where she now coordinates the Centre of Harm Reduction Practices at É de Lei. She is also the director of Casa Chama, which offers social and legal supports for trans people in São Paulo.

Over Zoom, Filter spoke with Sankofa about the fight for harm reduction, housing and abolition in Brazil. The interview has been translated from Portuguese, and edited for length and clarity.


Felipe Neis Araujo: President Bolsonaro explicitly promotes transphobia. How can harm reduction policies for trans people be advanced under these conditions? Does the government do anything to support their safety and wellbeing?

Matuzza Sankofa: Hate against trans bodies was one of the elements of the current president’s electoral campaign. Nonetheless, the last general elections also saw record numbers of trans people running for office, who have been elected all across Brazil. Establishment politicians are not interested in or even capable of understanding our rights, needs and demands. They are not familiar with our experiences. That’s why we need to occupy these spaces: so that we have a say in the design and implementation of public policy.       

The current policy is to only take care of us when we are sick and dying. This is a political choice. There is no effective health care policy for trans people in Brazil. And this includes mental health care; there is not even effective mental health care for cis people.

At Casa Chama we have two very successful health care programs. One is an integral program through which our patients can access hormone therapy and all the other services they might need. The other program offers individual and collective psychological support. We reach people all across Brazil, in places that the Brazilian state cannot or will not reach. We prove that it’s possible, with the small resources we have. So the state must recognize the work of civil society organizations, and fund them to do this.

“A trans body committed to a religious institution that condemns gender non-conformity and preaches abstinence from drugs will be colonized again.”

In your experience working with trans people who use drugs, how is the current abstinence-only approach failing?

Sankofa: Under the current government, harm reduction initiatives have been systematically attacked and demolished. Meanwhile, the federal government has invested massively in therapeutic communities, operated by religious institutions. And a trans body committed to a religious institution that condemns gender non-conformity and preaches abstinence as the only healthy relationship with drugs will be colonized again. They will be told again that there is a proper way to live life, which is not the way that this trans body is living. This is violence.

In my point of view, the legalization of every drug is an urgent matter. We’ll never prevent everybody from using drugs, so we need to build policies based on reality and evidence, not conservative moral principles. We need a drug policy that caters to people who want to quit drugs, and to those who would like to quit but cannot do it on their own and also to those who don’t want to quit. The current policy only supports the first two.

We need to offer harm reduction to people who want to keep using drugs, and not criminalize them. The prisons are packed with Black and poor people who were caught with an insignificant amount of drugs and prosecuted for dealing. So we need to tackle these two issues: the legalization of every substance and the abolition of prisons.    

“Housing comes first. Every strategy of care comes after decent housing.”

Can we say, then, that Brazil’s drug policy is causing much greater harm than the drugs themselves?

Sankofa: Drug use in Brazil is not approached through the lens of public health. It is weaponized for social and political purposes. People violated and incarcerated for the possession of drugs are genderized and racialized. Many of them are homeless. We need to transform this and come up with a politics of care for people who use drugs.

The first thing one needs to take care of themselves or someone else is adequate housing. This should be very clear by now with the global pandemic. Housing comes first, and every strategy of care comes after decent housing.

Women, trans, Black, poor and homeless people are targeted for the possession of absurdly small amounts of banned substances every day in this country. If you go to Cracolândia, where I have a team working with the homeless population, you’ll see that they are Black, poor, trans. This so-called war on drugs is an excuse for committing genocide against certain bodies.



Image of Matuzza Sankofa courtesy of Imaginários by Condô Cultural

Felipe Neis Araujo

Felipe is a Brazilian anthropologist. He's a criminology lecturer at the University of Manchester, where he researches drug policy, state violence, structural racism and reparations for historical inequalities. He lives in London.

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