Colombian Cities Research Articles

Trading baguettes for arepas: How hardcore French hip‐hop artists are using Medellin and Colombia to imitate/emulate the violent hypermasculine tropes of Pablo Escobar in order to exude toughness in rap videos

AbstractFew places on Earth have seen a more remarkable turnaround than the Colombian city of Medellin. Once dangerous, Medellin is now innovative. Yet, stereotypes remain. Thanks to films and online streaming series, Colombia struggles to remove imagery of its violent past. In recent years, hardcore rap artists from France have increasingly chosen Medellin to film videos despite having no links to Colombia. This association helps these rappers construct a violent narrative that is unavailable to them in France. This paper analyzes how French hip‐hop artists imitate Pablo Escobar by using Colombia as a visual tool to augment street cred.

Linguistic differences in the political communication of winning mayors in Colombia’s local elections between 2019 and 2023 / Diferencias lingüísticas en la comunicación política de gobernantes ganadores en las elecciones locales 2019–23 en Colombia

The use of language reflects different sociocognitive processes which are crucial in political psychology. In political communication in elections and governance, the manipulation of language to mobilize actions may be imperceptible by citizens, especially in the vast volumes of news posted on digital platforms like Twitter (now X). For this reason, we set out to analyse the differences in the linguistic style and content of the messages of 18 mayors of large cities in Colombia during the electoral campaign and the start of the period of governance through a two-stage design. We found that the politicians’ language during the electoral campaign had a persuasive function focused on promoting inclusive identities and generating empathy using prosocial topics. In contrast, the linguistic style during the term of office was more formal and complex, highlighting the legitimacy of the acts of governance. Differences were also found in the candidates on the left and right related to how they discuss economic issues during the electoral campaign. These findings show the need to take a multidisciplinary approach to address the effects of language and technology on the understanding and explanation of the psycho-political processes involved in elections and governance.

Between and within-city variations of PM2.5 oxidative potential in five cities in Colombia

AbstractFine particulate matter (PM2.5) has been shown to cause oxidative stress, which has negative health consequences. The oxidative potential (OP) of PM2.5, a promising health exposure metric, was assessed in five Colombian cities using the synthetic respiratory tract lining fluid assay that tracks the depletions of glutathione and ascorbate. For this, a set of 91 integrated 2-week ambient PM2.5 samples were collected using Ultrasonic Personal Aerosol Samplers (UPAS) at background (5), traffic (37), industrial (12) and residential (37) sites. Across all site types, mean PM2.5 mass concentration was 20.20 ± 9.36 µg m− 3. The oxidative potential (OPAA for ascorbate and OPGSH for glutathione) varied widely across cities with an average of 2.67 ± 1.27 for AA and 2.93 ± 1.22 % depletion m− 3 for GSH. OP metrics among cities were not correlated with PM2.5 mass concentrations. Overall, industrial sites showed higher PM2.5 mass concentrations and OPAA. In contrast, OPGSH was not found to differ among industrial, traffic, or residential sites, but was lower for background sites. Our findings provide substantial evidence of variations in PM2.5 OP between cities and within the cities. Further research is needed to assess the association between OP and adverse health effects, as well as to attribute the sources that cause such variations.

[Artículo traducido] Características clínicas y sociodemográficas de la alopecia areata en 5 ciudades colombianas: un análisis del RENAAC

BackgroundAlopecia areata (AA) is an autoimmune disease characterized by non-scaring hair loss and preservation of hair follicles. The information available on disease course, and clinical features of AA is scarce worldwide, and almost nonexistent in Colombia. ObjectiveTo determine the clinical and sociodemographic characteristics of patients diagnosed with AA who presented to a dermatology consultation in five Colombian cities. Material and methodsThis was a retrospective and multicenter study on data from an ongoing National Registry of Alopecia Areata in Colombia (RENAAC) collected in Bogota, Cali, Cartagena, Barranquilla, and Medellin, Colombia from March 2022 through April 2023. Data was recorded in a standardized form by trained physicians. The variables were expressed as measures of central tendency and dispersion, and absolute and relative frequencies. ResultsA total of 562 patients were included, 59.4% of whom were women, aged between 15 and 49 years (63.9%) with a mean disease course of 1.7 years. The most common finding was multiple plaque (53.2%), the predominant AA subtype was patchy (71.4%), and 29.5% of the patients had a past dermatological history, 18.3% had a past endocrinological history, and 8.9% had a past psychiatric history. The treatments most widely used were steroid injections (76.4%), 5% topical minoxidil (46.4%), followed by high-potency corticosteroids (42.5%). Study limitations and conclusionsAA was slightly predominant in women. As seen in other populations, this disease had an earlier onset in men vs women. Presentation in pediatric age was uncommon. The previous history of other dermatological diseases was checked in almost one third of the patients. Analysis of the co-presentation of AA with other autoimmune diseases is biased due to excluding patients with systemic erythematous lupus from the study.

Improving spatial accessibility to health care services in Cali, Colombia: stakeholder assessment of an innovative platform.

To (i) ascertain stakeholders' perceptions of the contextual factors and resources necessary to successfully implement the AMORE platform, a tool that provides accessibility assessments for health care services, considering factors such travel time and traffic conditions, and (ii) identify potential barriers to and facilitators for enhancing spatial accessibility to health care services within the Colombian urban context. In this qualitative study, semi-structured interviews were conducted with a purposive sample of seven key stakeholders. The sample was drawn from individuals involved in development of policies in Colombia, service providers, and users, among others, who had expertise in the field. Interviews were conducted until saturation was reached. The participants had positive views on the appearance of the AMORE platform, highlighting its user-friendly visualization. Suggestions were made about the variables used in the dashboard, the implementation of the platform, potential usage areas, and barriers and facilitators to implementation and use. Barriers included economic, political, and personnel challenges, while facilitators included creating a minimum viable product at a low cost and building interinstitutional and international cooperation. Innovations such as the AMORE platform have the potential to support decision-making processes across various sectors, including public policies and internal processes within private organizations, academia, and the community. However, implementing such a tool has financial, contextual and environmental challenges. The study identified key factors that were considered prerequisites for successfully implementing the AMORE platform in Colombian cities.

Long-term effects of air pollution on health in the five largest cities in Colombia

Long-term effects of air pollution on health in the five largest cities in Colombia

Real-world effectiveness of the CoronaVac vaccine in a retrospective population-based cohort in four Colombian cities (2021-2022)

ObjectivesThe National Vaccination Plan against SARS-CoV-2/COVID-19 was launched by the Ministry of Health and Social Protection on 14 February 2021. The main objective of this study was to evaluate the effectiveness of the CoronaVac in preventing the three clinical outcomes of infection, hospitalisation, or death, in a real-world scenario. DesignThis was a population-based retrospective dynamic cohort study using a multivariate Cox model to calculate hazard ratios to estimate vaccine effectiveness from 17 February 2021 to 30 June 2022. The data were collected from surveillance systems for 12 months for each individual. Four cities were selected on the basis of the reliability of their data bases. ResultsThe rates of CoronaVac effectiveness were 32% (95% confidence interval [CI] 31-33) for preventing infection, 55% (95% CI 54-56) for hospitalisation, and 90% (95% CI 89-90) for death, at the end of follow-up. These findings were more consistent during the first 4 months. Compared with the unvaccinated group, homologous booster doses appeared to increase effectiveness in preventing hospitalisation, whereas heterologous booster doses increased protection for both hospitalisation and death. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac, even when they received heterologous boosters. ConclusionsCoronaVac demonstrated effectiveness in preventing death and hospitalisation during the first year of follow-up, but its effectiveness in preventing infection was lower, decreasing rapidly after the first 4 months of follow-up. The effectiveness was higher among children aged between 3 and 12 years, and among adults aged ≥60 years. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac.

Assessing and monitoring air quality in cities and urban areas with a portable, modular and low-cost sensor station: calibration challenges

ABSTRACT Air pollution affects not only the air in cities but also extends to all indoor environments (homes, offices, schools, public places, transportation, etc.), where we spend between 80% and 90% of our time. Both indoor and outdoor air quality have emerged as significant health concerns and are integral to national strategies implemented by health and environmental institutes in each country. Recently, complaints regarding outdoor air quality have risen in cities, primarily due to automobile traffic and industrial activities in urban areas, and also indoors within homes, offices, and schools. The following paper presents a methodology for the calibration of low-cost monitoring stations based on measurements in a couple of cities in Colombia as part of the development of a project to reduce the environmental awareness gap in urban areas for the estimation of the air quality through low-cost, flexible, modular, and mobile air quality monitoring station design that could be used to assess air pollution in different indoor and outdoor environments. With the implementation of the low-cost stations, we have calibrated and evaluated the performance of the stations using usual linear regression methods, but we have also explored the use of unsupervised estimation with the help of machine learning algorithms, specifically with Random Forest estimators. We have found a significant improvement with using Random Forest for station calibration compared with those found using simple linear regressions for calibration effects. We have found that all the models offer a significant improvement in terms of RMSE. The regression model improves RMSE by up to 70%, while the multiple regression model does so by up to 73%. However, it is the Random Forest that shows the most remarkable improvement, with a reduction in RMSE of up to 86%.

Education for peace in a peace-friendly context: testing a virtual learning tool to improve teachers’ competencies for conflict transformation in Colombia

ABSTRACT Colombian society has been exposed to decades of sociopolitical violence with apparent effects on its social infrastructure that may inadvertently lead to more structural, cultural, and interpersonal forms of violence. Peacebuilding efforts are required, and education for peace plays a key role. This requires building conflict sensitivity within the school system and improving teachers’ competence-based knowledge in several domains. To achieve this aim, we developed and tested the ‘Eco-GesTE Virtual Learning Environment.’ Nine teachers (male and female) from a public school in Ibagué (an intermediate city in Colombia) completed 10 Interactive Virtual Learning Scenarios (IVLS) to improve emotional, social reasoning, integrative, and conflict transformation competencies over three months. They completed two conflict management style measures, before and after the intervention, besides a qualitative survey after the intervention. Non-parametric, paired samples Wilcoxon tests suggest marginally significant individual changes whereby teachers reported using fewer conflict-avoidant styles after completing the intervention. Qualitatively, participants also reported learning emotion regulation and listening skills, as well as feeling better equipped to handle situations with domain congruency. They also reported using more perspective-taking during conflicts. Findings suggest potential for competence-based knowledge online interventions to strengthen conflict transformation competencies among teachers and contribute to violence-free educational environments.

Birth Outcomes Related to Prenatal Zika, Dengue, and Other Flavivirus Infections in the Zika en Embarazadas y Niños Prospective Cohort Study in Colombia.

Zika virus (ZIKV) infection in pregnancy is associated with severe abnormalities of the brain and eye and other adverse outcomes. Zika en Embarazadas y Niños was a prospective cohort study conducted in multiple Colombian cities that enrolled pregnant women in their first trimester. Specimens collected from pregnant women (n = 1,519) during February 2017-September 2018 and their infants (n = 1,080) during June 2017-March 2019 were tested for prenatal ZIKV infection by nucleic acid amplification tests or IgM antibody testing. Zika virus infection in pregnancy was present in 3.2% of pregnant women (incidence rate [IR] per 1,000 person-months = 5.9, 95% CI: 4.3-7.8). Presumptive ZIKV infection was present in 0.8% of infants (IR = 1.6, 95% CI: 0.7-2.9). Five percent of infants with prenatal ZIKV exposure or infection presented with Zika-associated abnormalities; 4.7% were small for gestational age. Understanding the risk of ZIKV infection during pregnancy and associated adverse outcomes can help inform counseling efforts.

Mechanism of azole resistance in Candida vulturna, an emerging multidrug resistant pathogen related with Candida haeumulonii and Candida auris.

Candida vulturna is an emerging pathogen belonging to the Metshnikowiaceae family together with Candida auris and Candida haemulonii species complex. Some strains of this species were reported to be resistant to several antifungal agents. This study aims to address identification difficulties, evaluate antiungal susceptibilities and explore the molecular mechanisms of azole resistance of Candida vulturna. We studied five C. vulturna clinical strains isolated in three Colombian cities. Identification was performed by phenotypical, proteomic and molecular methods. Antifungal susceptibility testing was performed following CLSI protocol. Its ERG11 genes were sequenced and a substitution was encountered in azole resistant isolates. To confirm the role of this substitution in the resistance phenotype, Saccharomyces cerevisiae strains with a chimeric ERG11 gene were created. Discrepancies in identification methods are highlighted. Sequencing confirmed the identification as C. vulturna. Antifungal susceptibility varied among strains, with four strains exhibiting reduced susceptibility to azoles and amphotericin B. ERG11 sequencing showed a point mutation (producing a P135S substitution) that was associated with the azole-resistant phenotype. This study contributes to the understanding of C. vulturna's identification challenges, its susceptibility patterns, and sheds light on its molecular mechanisms of azole resistance.

A Rough Guide to the Oil Archive

The omnipresence of petroleum makes it an essential part of a history of the modern world. However, this ubiquity also presents a challenge as to which archival materials historians should use to tell this story. By using material gathered during fieldwork in the Colombian oil city of Barrancabermeja, this article aims to investigate the nature of the oil archive. Situated within the broader field of literature on the history of petroleum and archives, the investigation touches upon records in diverse archives, the urban fabric, and repositories of oil’s history to be found underground. By pinpointing such materials across Barrancabermeja, the article argues that the oil archive is not just found in historical documents but embedded in the landscape, in social practices, in human bodies, and even in the geology of the earth. To understand the deep-seated influence of oil, the article argues for the establishment of an interdisciplinary working group of the oil archive. Faced with the impending challenge of climate change and the long-lasting legacy of the fossil fuel age, such a group could provide evidence for how humanity got to this stage, point to different imaginaries of past and future, and clarify issues surrounding climate justice and responsibility.

Mental health index of the elderly population in Medellín (Colombia)-2021: a factorial analysis.

There are several risk factors associated with developing mental disorders among people over 60 years of age. Mental health encompasses multiple domains or capacities, which can comprise the psychological wellbeing of older people. Therefore, resilient coping, self-compassion, self-esteem, hopelessness, quality of life, and depression are considered the characteristics and adaptive mechanisms that bring together the main risk and protective factors for imbalance in mental wellbeing. This study aimed to establish the demographic, social, and family factors, as well as the clinical characteristics and lifestyle habits that influence the mental health of the elderly people in the city of Medellín, in the year 2021, to build a mental health index. This study adopts a quantitative approach, employs retrospective temporality, and utilizes secondary sources. A cross-sectional survey was carried out with the SABAM Project (health and mental wellbeing of older adults from five cities in Colombia in 2021 by its Spanish acronym) database (secondary source), which is part of the research group "Public Health Observatory" of CES University (Medellín, Colombia). The database comprised 500 records of people aged over 60 years from the city of Medellín in 2021. While constructing the index, a principal component analysis was used, along with the Varimax method for factor analysis rotation. The median age of the general population was 67 years (IQR 63-72); for men, the median age was 66 years (IQR 63-71) and for women, the median age was 67 years (IQR 63-72). An association was found between low socioeconomic levels, alcohol consumption, and the level of higher education (university-postgraduate) with low levels of the Mental Health Index in people over 60 years of age in Medellín during the year 2021. A quantitative model was developed to predict either a positive or negative prognosis in the mental wellbeing of the population over 60 years of age in the city of Medellín. The model was also used for the development of a sociodemographic profile highlighting the impact on mental health among people over 60 years of age with limited economic resources.

Spatial segregation patterns and association with built environment features in Colombian cities

Spatial segregation is a pressing issue in Latin American cities due to high urbanization, population density, and inequalities. This study examines segregation patterns in 84 middle to large cities in Colombia and their relationship with the spatial configuration of cities using satellite data. The analysis focuses on evenness and isolation metrics of segregation for ethnicity, education level, and employment status. The findings reveal higher segregation in education level and race/ethnicity in terms of evenness dimension, and in education level and employment status in terms of isolation dimension. The study also identifies associations between segregation and built environment metrics. Negative associations are observed between education level and race/ethnicity segregation and fragmentation, as well as between employment status and patches of isolation. Positive associations exist between education level and fragmentation, race/ethnicity and patches of isolation, and a negative association between employment status and street density. These results have implications for public urban policies, particularly in small and medium cities, where there is limited understanding of segregation dynamics. The study highlights the need to consider factors beyond income, such as ethnicity, in addressing spatial segregation in urban planning and policy-making.

IgE-Mediated Sensitization to Blo t 21 and Blo t 5 Is Associated With Asthma in the Tropics: A Case-Control Study.

Sensitization to Blomia tropicalis is associated with asthma in various tropical and subtropical countries; however, information about the specific molecular components associated with this disease is scarce. Using molecular diagnosis, we sought to identify B tropicalis allergens associated with asthma in Colombia. Specific IgE (sIgE) to 8 B tropicalis recombinant allergens (Blo t 2, 5, 7, 8, 10, 12, 13, and 21) was determined using an in-house ELISA system in asthma patients (n=272) and controls (n=298) recruited in a national prevalence study performed in several Colombian cities (Barranquilla, Bogotá, Medellín, Cali, and San Andrés). The study sample included children and adults (mean [SD] age, 28 [17] years). Cross-reactivity between Blo t 5 and Blo t 21 was evaluated using ELISA-inhibition. Specific IgE (sIgE) to 8 B tropicalis recombinant allergens (Blo t 2, 5, 7, 8, 10, 12, 13, and 21) was determined using an in-house ELISA system in asthma patients (n=272) and controls (n=298) recruited in a national prevalence study performed in several Colombian cities (Barranquilla, Bogotá, Medellín, Cali, and San Andrés). The study sample included children and adults (mean [SD] age, 28 [17] years). Cross-reactivity between Blo t 5 and Blo t 21 was evaluated using ELISA-inhibition. Although Blo t 5 and Blo t 21 are considered common sensitizers, this is the first report of their association with asthma. Both components should be included in molecular panels for diagnosis of allergy in the tropics.

Epidemiological and microbiological characteristics of S. aureus pediatric infections in Colombia 2018-2021, a national multicenter study (Staphylored Colombia).

Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.

The Venezuelan Migrant Population’s Right to Health in the Bucaramanga Metropolitan Area

Colombia has received the largest influx of Venezuelan refugees and migrants. Since 2015, more than 3 million Venezuelan migrants have entered the country. Those arriving in Cúcuta have several options for entering Colombian territory. One of the main routes involves a difficult and dangerous journey of nearly 200 km to the Metropolitan Area of Bucaramanga, which serves as a key territory for accessing various destinations. Because of its geographical location, this area serves as an important transit city, facilitating travel to other major cities in Colombia, such as Bogotá, Medellín, and Cali; it is also a residence destination for Venezuelan migrants. Among the specific reasons why immigrants choose Bucaramanga over other cities are factors like climate, the existence of various cooperation organizations that provide assistance, and the considerable number of migrant individuals previously settled in this area; thus, many new migrants have family or friendship connections there. Furthermore, for many, it is the safest option or the only place they can go to when the weather turns cold. In this study, we analyze the institutional response and identify barriers that limit the protection of Venezuelan migrants’ right to access to healthcare in this location where Venezuelan citizens have faced economic, legal, bureaucratic, and social barriers. This has profound consequences for migrants’ health and poses a risk to their lives. The article is primarily based on interviews and fieldwork conducted with migrant populations between 2022 and 2023 to identify the barriers and supporting elements they experienced in terms of health care services. Likewise, this study makes a significant contribution by directly examining the experiences of Venezuelan migrants in relation to the right to health in this area. This provides a useful understanding of the social phenomenon at both the academic and institutional levels.

The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities

AimsTo assess the association between sociodemographic and clinical factors with body mass index (BMI) in a population at risk of type 2 diabetes (T2D) in Bogotá and Barranquilla, Colombia. MethodsThis cross-sectional study used data from the PREDICOL Study. Participants with a FINDRISC ≥ 12 who underwent an Oral Glucose Tolerance Test (OGTT) were included in the study (n=1166). The final analytical sample size was 1101 participants. Those with missing data were excluded from the analysis (n=65). The main outcome was body mass index (BMI), which was categorized as normal, overweight, and obese. We utilized unadjusted and adjusted ordinal logistic regression analysis to calculate odds ratios (OR) and 95 % confidence intervals (CI). ResultsThe prevalence of overweight and obesity was 41 % (n=449) and 47 % (n=517), respectively. Participants with a 2-hour glucose ≥139 mg/dl had 1.71 times higher odds of being overweight or obese (regarding normal weight) than participants with normal 2-hour glucose values. In addition, being a woman, waist circumference altered, and blood pressure >120/80 mmHg were statistically significantly associated with a higher BMI. ConclusionStrategies to control glycemia, blood pressure, and central adiposity are needed in people at risk of T2D. Future studies should be considered with a territorial and gender focus, considering behavioral, and sociocultural patterns.

Disaster-induced disruption of policies for informal urban settlements

The rapid growth of informal urban settlements (IUS) presents a significant challenge to cities worldwide, particularly regarding disaster vulnerability. Many of their inhabitants are also victims of disaster-induced displacements due to complete loss or government-led relocation programs. The disaster or land-use management policies do not usually tackle the associated vulnerabilities of these informal settlers. Therefore, this research investigates the use case of a disaster-prone city in Colombia, where the policies and their implications at different levels (national to local) are analysed for IUS. To do so, we study the relationship between land use and disaster management policies in the case study of Mocoa in Colombia, examining its 2017 disaster as a disruptor event. The dissection of existing policies and their effectiveness revealed a lack of community engagement in the planning process and in addressing the issues associated with the vulnerabilities of IUS. Conclusions and recommendations are proposed to target community engagement in the planning process after comparing the policies and their challenges before and after the disaster.

Health care: life stories by trans women in Colombia

BackgroundIn Colombia, health care for people with trans life experiences is characterised by countless barriers to health services and care. Commonly, trans people have experienced stigma and discrimination among health professionals, a lack of services and professionals specialized to guarantee affirmative processes from non-hegemonic gender perspectives, and there exists a marked pathologization and medicalization of services. Therefore, it is necessary to provide affirmative health services to improve health and well-being from the recognition of their needs and experiences. The article describes life narratives about health care for the gender transitions of trans women in Colombia.MethodsA qualitative narrative study was conducted with 139 trans women in seven cities in Colombia. In-depth interviews and discussion groups were conducted between June 2019 and March 2020. Data were analyzed using thematic analysis and the Atlas Ti cloud program. National and international ethical guidelines were followed in the development of the research.ResultsThis research provided an overview of the health experiences of Colombian trans women. They reported their experiences of pathologizing approaches to transgender healthcare, stigma, discrimination, and barriers to accessing preventive, specialized, and regular healthcare services. For this reason, they opted for self-medicated gender transition processes and self-management of health care. An important aspect to consider within healthcare is that not all women want binary gender transition processes.ConclusionParticipants felt that in Colombia there is a lack of affirmative health care for transgender women and that there are many limitations to care related to the gender transition processes. This exposes them to more situations that violate their rights and influences their lack of confidence and their search for professional health care. In Colombia, it is important to develop strategies for education, information, and communication, as well as a handbook for health workers on specialized healthcare for trans women.