Today, 17 May in 1990 the World Health Organization decided homosexuality was not a mental disorder. Since 2004 the day has been celebrated to draw attention to the violence and discrimination experienced by Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) people internationally.

In Latin America, the life expectancy of transgender women is 35 years old, according to the Inter-American Commission on Human Rights. Across the Caribbean the lives of transgender women are affected by criminalizing laws, stigma, marginalization and terrifying violence by state and non-state actors.

In a 2014 report on police violence towards transgender sex workers in the Dominican Republic, TRANSSA, a Dominican transgender-led group, documented the unlawful detention of Ana. She was stripped by the police and detained in the back of an open wagon. The police then removed her wig, and paraded her around the streets naked. Later at the police station, when she was trying to sleep, they threw buckets of water on her. Police said if she said anything about the abuse, she would "disappear."

Like in Ana's case, most States in the Caribbean fail to protect transgender people from violence, and their gender identity and expression is rarely taken into account as grounds for hate crimes during murder investigations, resulting in impunity. TRANSSA estimates that 34 transgender people have been murdered in hate crimes over the past 10 years in the Dominican Republic and only 3 people have been convicted.

Guyana Trans United estimates 9 people have been killed due to their gender identity and expression since 2014 in the South American country. Of those cases, only one person has been charged, but there have been no convictions.

Violence and discrimination against transgender children and youth starts early. They are excluded from homes, schools and families because of their gender identity.

In Jamaica, transgender children and teens are often kicked out of their homes and some had at one time even sought refuge in storm drains in Kingston´s business district. JFLAG, Jamaica´s leading LGBTI group, has repeatedly called on the government to intervene in families to stop the exclusion of LGBTI children and to increase shelters for the homeless.

According to a study by the Caribbean Vulnerable Communities Coalition (CVC) in the Dominican Republic less than 35 percent of transgender women sex workers have completed secondary school. As they are pushed away from education, many become involved in transactional sex as early as 16. This early social exclusion leads to poverty and more violence. Transgender people are often pushed into criminalized work, such as sex work, which further exposes them to police abuse and arbitrary detentions. Eighty percent of Dominican transgender women involved in sex work have been arrested or detained at least once, and 36 percent had exchanged sex with police officers to avoid being arrested.

But extreme violence is not the only human rights abuse transgender women face. Many transgender women continue to die, not from lack of medical options, but due to intense stigma and discrimination that drives them away from health care services. Data reflecting HIV prevalence within the Caribbean transgender community is scarce, but according to a 2013 study published in the Lancet that reviewed HIV data in 10 low and middle income countries, almost 18 percent of transgender women live with HIV. In many Caribbean countries, transgender women often die instead of accessing stigmatizing healthcare services and treatment for HIV and AIDS.

With few exceptions, Caribbean political leaders are silent on transgender issues. When politicians do speak, their comments are often shameful and offensive. In May 2016, Bahamian media reported that a local Member of Parliament had publically advocated for transgender people to be exiled to an isolated island.

Despite this unacceptable reality, across the Caribbean, brave human rights defenders push for change.

Quincy McEwan, Director of Guyana Trans United, is a litigant in a constitutional challenge to colonial laws which criminalize cross-dressing. Her organization runs programs that help transgender women access healthcare services, support groups and activities to raise visibility of transgender women. Accessing public spaces is still a major challenge for transgender people in Guyana, and her organization recently protested a magistrate´s decision to bar a transgender woman from entering his courtroom whilst she was dressed in female clothing. Quincy says things "change very slowly" but believes it´s increasingly easier to approach Ministers of Parliament in Guyana and to engage people on transgender issues.

Cuba is the only country in the Caribbean where gender reassignment treatment is permitted, but there is little publicly available information on how accessible the treatment is. In Puerto Rico, the Governor issued instructions in August 2015 allowing for gender to be changed on driving licenses, but as in the rest of the Caribbean, there are no provisions for changing gender in other identity documents.

Yet in the neighboring Dominican Republic, Christian King, who leads TRANSSA, says his organization and others are bringing the issue of legal gender recognition to the national debate. Christian believes there is a need for a "legal tool" against entrenched discrimination. TRANSSA also runs programs for HIV positive transgender women, helping them to navigate the healthcare system and fight the stigma and discrimination transgender women experience in services.

Christian believes there have been many advances.

We have a public prosecutor's office trying to resolve some small cases, there are diverse social actors interested in the general situation of LGBTI people, and in the health system there is a specific strategy for key populations (those at higher risk for HIV). There are also many trans leaders, the result of voluntary community empowerment work, fighting to improve their own situation and that of their fellow trans. In ten years since TRANSSA was founded, we have seen many results.

Alexus D´Marco heads the Caribbean´s newest transgender organization, Bahamas Transgender Intersex United (BTIU), founded only in April 2016. Alexus says the group was formed as the government was saying there were no transgender people in the country; a huge irony Alexus says, because the same Bahamian government receives US funds to run programs for transgender people. Since its first press conference, Alexus says members of the group have received direct and indirect threats from members of the public and the Deputy Prime Minister has reportedly been critical of transgender people. Alexus says, "We need sensitivity and diversity training for members of government on what it is to be LGBTQI because they don´t know."

So the struggle for transgender rights in the Caribbean continues. Civil society are raising their voices and getting stronger because people want visibility. It´s already created backlash. But, at the very least, it's becoming harder for Caribbean governments to deny transgender people exist.