Men at risk: correlates of verbal, physical and sexual violence against men who have sex with men across selected cities in India

Abstract

Background

Five distinct forms of violence - Physical, Verbal, Sexual, Cyber, and Relational - persistently afflict sexual minorities worldwide. The presence of feminine attributes in Men who have Sex with Men is inherently linked to a heightened susceptibility to various manifestations of violence, thereby exerting detrimental repercussions on both the physical and mental well-being of these individuals. This correlation stands as a principal contributor to the alarmingly elevated rates of suicide attempts among Men who have Sex with Men, particularly during their early years.

Data and Methods

This cross-sectional study investigates the risk factors for violence against Men who have Sex with Men in six metropolitan cities across India. Quantitative data were gathered from 300 self-identified Men who have Sex with Men, with 240 providing only quantitative data, while both quantitative and qualitative data were collected from a subset of 60 respondents, ranging in age from 18 to 70 years. Quantitative analysis was conducted using descriptive statistics, chi-square tests, and binary logistic regression to explore the likelihood of different types of violence. Qualitative data collected through in-depth interviews, were analyzed thematically to provide contextual depth and validate the quantitative findings, focusing on specific incidents and key themes associated with violence among Men who have Sex with Men.

Results

More than 60 per cent of the respondents encountered at least one type of violence due to their sexuality. More than half of the respondents who engaged in the receptive role during sexual activity reported experiencing sexual violence. The likelihood of encountering verbal violence was found to be nearly six times higher among respondents who were receptive than penetrative sexual partners. Respondents of Muslim religion exhibited a 2.6-fold increase in the likelihood of experiencing sexual violence compared to their Hindu counterparts.

Conclusion

Violence against Men who have Sex with Men is a pervasive issue in the six metropolitan cities studied in India, particularly affecting individuals with lower education and low income. These findings resonate with global research, which identifies similar risk factors for violence against sexual minorities, especially in regions with deep-rooted homophobia and socio-economic inequalities. Insights from this study underscore the urgent need for targeted policies and interventions to create a safer, more inclusive environment for this population in India and other parts of the Global South.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-024-20493-x.

Introduction

The Human Rights Council of the United Nations General Assembly has adopted a resolution of protection against violence and discrimination based on sexual orientation and gender identity [1]. Violence against sexual minorities is a perennial phenomenon worldwide [2]. Researchers have identified five types of violence (Verbal, Physical, Sexual, Cyber, and Relational) against sexual minorities [3–5]. There is a positive relationship between violence and feminine characteristics among Men who have Sex with Men (MSM, i.e., men who engage in sexual activity with other men) [6, 7]. Feminine and masculine traits are socially constructed, representing gender norms based on societal messages, rather than being inherent or factual [8]. Kothis (effeminate MSM), who identify themselves as a subgroup of the LGBT + community in India, are particularly vulnerable to physical violence due to their feminine gestures [9]. Non-masculine traits of Kothis lead them to face various forms of discrimination and violence by family members, neighbours, healthcare professionals and even the police [10]. Violence against these individuals is a repercussion of various variables, including homophobia [11]. Parrott et al. [12] found a correlation between homophobia and misogynistic attitudes. Homophobia has been found to be associated with violence toward men who are seen as feminine and women [13]. The root cause of homophobia that induces violence against MSM in India is the twin process of the HIV epidemic and the globalization of queer politics [14]. Violence against male sexual minorities is also linked to the judicial context in India. The colonial law of Sect. 377 of the IPC that made homosexuality illegal has caused considerable homophobia in Indian society [15].

Meyer has indicated an association of violence with stigma while discussing the minority stress theory [16]. This positive association between stigma and violence is evident in the case of India because Indian society considers homosexuality taboo [17]. Social stigma is high among Indian MSM. This stigma is more prevalent among Kothis because of their gender-nonconforming activities [18]. Both verbal and non-verbal violence act as barriers while availing healthcare facilities for MSM [19]. The physical and mental well-being of these individuals is negatively correlated with violence against them [20, 21]. The majority of sexual minorities do not disclose their sexual identity to outsiders, and this constant effort to hide their sexuality results in stress and anxiety [22, 23]. A high level of suicidal thinking and depressive symptoms among young adults is linked with school-time violence, which is positively associated with mental and physical health deterioration, including the risk of HIV and STIs [24–27]. The updated Stigma Index 2.0 by Friedland et al. [28] emphasizes the need for empirical evidence to address the intersecting stigmas faced by key populations, suggesting that similar methodologies could help understand the dynamics of violence against MSM in India.

Verbal violence against MSM

Homophobia leads to virulent verbal abuse of MSM individuals, and they are addressed by different words instead of their real names [29–31]. The portrayal of Hijra (transgender) and other members of the LGBT + community as funny characters in Indian cinema and using phrases like ‘Gay love angle’, ‘terror of Hijras’, ‘Gay murder’, ‘Gay gang’, ‘Gay crime’, ‘Gay thieves’ etc. in Indian media has strengthened the prejudice already prevalent in society [32–35]. Homophobic comments made under the garb of ‘humour’ and ‘friendly bullying’ on social media platforms also establish a stereotype and lead to verbal and non-verbal violence against MSM individuals [36].

Physical violence against MSM

Sexual minorities face considerable physical violence in the form of moral policing because of the lack of legal protection and social acceptance in India [37]. Physical violence faced by these individuals is mostly related to homophobia, which can be examined through the comments of the perpetrator [6, 11, 38]. This kind of physical violence often results in life-threatening situations [39]. Coming out (disclosing sexuality) to the family leads to negative social representation, and some ethnoreligious group members are involved in physical violence to save the ‘izzat’ (prestige) of the family and religion [40]. Men engaged in sex work often experience physical violence when caught working in public [41].

Sexual violence against MSM

Sexual violence is as common as verbal and physical violence against MSM individuals when they are caught engaging in sexual activity in ‘gay cruising sites’ [31, 41]. The intensity of sexual violence is greater for transgender individuals and may include extreme forms of violence such as gang rape [42]. Some transgender people reported receiving inhumane and disrespectful treatment from the police (including railway and traffic officers) and healthcare professionals [43, 44]. Sexual violence has been found to have psychosocial and sexual ramifications for MSM [45, 46]. Stigma related to homosexuality is a factor in sexual violence against MSM [47]. Many incidents of sexual violence against MSM are never reported due to fear of judgement, male rape myths, stigma, etc [48].

Impact of violence against MSM

Violence against MSM significantly impacts individuals, families, and communities in a multifaceted way. One of the studies indicates that MSM experience disproportionately high rates of anti-gay violence, showing that 89 per cent of MSM reported lifetime experiences of such violence, which includes verbal, physical, and sexual abuse [5]. The consequences of this violence extend beyond immediate physical harm, leading to long-term psychological issues such as depression and anxiety among MSM [27, 49]. Violence against LGBT + individuals is a significant public health issue, contributing to broader societal problems such as increased healthcare costs [50]. The failure to safeguard the human rights of individuals identifying as LGBT+, as well as to shield them from abuses such as violence and discriminatory laws and practices, constitute significant breaches of international human rights law and exerts extensive repercussions on society, exacerbating susceptibility to adverse health outcomes, including HIV infection, fostering social and economic marginalization, imposing burdens on families and communities, and adversely affecting economic development, equitable employment opportunities, and the overall progress towards the achievement of the forthcoming Sustainable Development Goals [51].

Prevention of violence against MSM

The social and structural factors contributing to violence against MSM, including discrimination and societal stigma, highlight the need for targeted prevention strategies. Emerging evidence suggests that well-executed violence prevention efforts can effectively change the attitudes that contribute to physical and sexual violence against men [52]. Effective interventions should incorporate anti-oppression training and comprehensive sexual education tailored to the unique experiences of sexual orientation and gender-diverse communities [53]. States are also urged to protect LGBT + individuals from violence and discrimination by investigating and prosecuting acts of abuse, recognizing homophobia and transphobia as aggravating factors in hate crimes, and repealing laws that criminalize same-sex conduct and gender expression. Effective violence prevention also involves promoting legal recognition, combating prejudice through public education, and ensuring the participation of LGBT + individuals in shaping policies that affect them [51]. Finally, national programs, like the one in Kenya, demonstrate that government-led initiatives can successfully increase response rates to violence against key populations, including MSM [54]. Thus, a comprehensive strategy that combines healthcare access, education, and supportive policies is essential for reducing violence against MSM.

Despite growing recognition of the challenges related to preventing violence against MSM, there is limited research focusing on the demographic and socioeconomic factors contributing to violence against MSM in India. Understanding these factors is crucial for developing targeted interventions and policies. In this realm, the present study investigates the demographic and socioeconomic patterns of violence among MSM in selected cities across India. It also explores how these patterns correlate with the experience of violence within the MSM population. By incorporating qualitative data through in-depth interviews, this research aims to contextualize and deepen the understanding of violence experienced by MSM. This evidence is essential for informing effective strategies to address violence and support the well-being of MSM, highlighting the need for comprehensive and nuanced approaches to tackle this pervasive issue.

Rationale of the study

Violence in any form acts as a barrier to the overall development of the affected individual or community. MSM is one of the vulnerable communities in India, which is facing perennial violence because of its distinct sexual behaviour. Yet segments of people with alternative sexuality find it difficult to report the sexual violence they face because they are either not considered sexual victims or they fear harassment by the system. The majority of such crimes are underreported due to fear of exposure, and cases of violence are often limited to the atrocities in police custody. Studies reveal how Sect. 377 of the IPC was used as a tool by police for physical and mental harassment and extortion of money from MSM individuals [37, 55, 56]. The alien law imposed during British rule in India against homosexuals worked as a catalyst to demean the position of sexual minorities in the country, making them vulnerable to violence. McGoldrick investigated that 1491 people, including 207 minors, were arrested across all Indian states and Union Territories in 2015 under Sect. 377 of the IPC [57].

Many studies showed that the percentage of men who identify as MSM or engage in same-sex relationships ranges between 4 per cent and 15 per cent [58–60]. The prevalence of violence against MSM in India is not only a critical social justice issue but also a pressing public health concern due to its far-reaching implications on physical, mental, and social well-being. Violence against MSM, often driven by homophobia and societal stigma, has severe psychological and physical consequences. The fear of exposure and legal repercussions prevents many MSM from seeking medical help or reporting incidents of violence, including sexual assault [61]. This underreporting leaves victims without support and results in inadequate public health data, limiting the effectiveness of health interventions.

The Indian MSM community has historically faced societal negativity, neglect from policymakers, and limited academic attention until recent years. This issue is not unique to India; similar challenges have been observed globally, as evidenced by research in various contexts. For instance, a case study from Kenya highlights how key populations, including MSM, experience significant violence and face substantial barriers to accessing necessary services and support [54]. Kenya’s approach underscores the importance of government-led interventions to enhance violence prevention and response among marginalized groups. In light of these global insights, the current study aims to explore ongoing violence against MSM in India. By understanding the specific challenges MSM faces, the study seeks to inform stakeholders how to better uphold their rights to equality, dignity, privacy, and freedom of expression. This is crucial even after legal advancements, such as the decriminalization of homosexuality following the Supreme Court of India’s decision on Sect. 377 of the IPC. The study will analyze the likelihood of verbal, physical, and sexual violence against MSM in selected Indian cities, using demographic and socioeconomic data. While there are broader studies on the LGBT + community in India and some focused research on specific subgroups like Hijra and Kothi, this study specifically addresses the MSM population.

Data and methods

Study area and sample size

This cross-sectional study focused on six major Indian cities: Delhi, Mumbai, Kolkata, Bengaluru, Ahmedabad, and Lucknow. These cities were chosen for their convenience, as metropolitan areas generally had a higher number of dating app users [62]. Each city represented India’s socio-cultural and economic diversity, spanning various states and geographic regions. The decision to conduct an exploratory study with 300 respondents was based on several factors, including (a) the expected non-response rate, (b) the use of a comprehensive semi-structured schedule covering diverse dimensions of MSM, (c) limited time for data collection, and (d) constrained financial resources available for the doctoral dissertation. Therefore, it was determined that each metro city would have 50 respondents. This method aligned with a previously published study [63].

Sampling design and selection of the respondents

The sampling design and respondent selection, as outlined by Pal et al. [63], were implemented in this study. The study employed a non-probability community venue sampling technique to enlist participants, chosen for its practicality in reaching self-identified MSM individuals using dating apps [64]. This method established a sampling design, that was purposive, lending an exploratory nature to the study. To qualify for participation, individuals needed to meet the following criteria: (a) being 18 years or older, and (b) self-identifying MSM. Participants were enrolled using ‘Grindr,’ a widely used location-based online dating and social networking application for LGBT + individuals. The app functioned as a means of identifying potential respondents. At first, a profile was made after downloading the application from the Google Play Store. The purpose behind joining the platform was expressly articulated in the bio/description section: ‘This account is exclusively established for research purposes on MSM issues.’ The initial screening for selecting respondents hinged on details like descriptions related to sexual orientation, sexual position preferences, etc., provided on the user’s account. Respondents using the Grindr app near bus stands, railway stations, universities, markets, and analogous locales were reached out to via text and audio messages. The response rate of dating app users participating in the survey was approximately 30 per cent during virtual contact. After establishing virtual connectivity, they were invited to meet in person and participate in the study. The response rate for participation increased to around 99 per cent during face-to-face meetings. All respondents identified themselves as gay or bisexual, depending on their engagement in sex with only men or with both men and women. Given this distinct classification of MSM sexual orientation, 25 gay and 25 bisexual individuals were selected from each city.

Data collection

A pilot study was conducted in Delhi to assess the efficacy and robustness of the data collection instrument. Following this, a semi-structured schedule was employed to gather data from June 2019 to February 2020. The semi-structured schedule comprised objective and subjective questions, aiming to explore various dimensions of the lives of MSM. All survey questions were administered in either Hindi or English. Quantitative data were collected from a total of 300 study respondents. This included 300 participants from whom quantitative data were collected, focusing on gathering broad, generalizable information on the experiences of MSM across six cities. Furthermore, a subgroup of 60 participants (10 from each city) out of the total study sampled population participated in a more in-depth phase, where detailed qualitative data were collected simultaneously, allowing for richer, context-specific insights. The rationale for this mixed-method approach was to capture the statistical trends and the nuanced, personal narratives that could explain the reasons behind the quantitative patterns. The interviews for the quantitative data collection lasted approximately 35 min. When qualitative data were also collected, these sessions extended to around 85 min, allowing for a deeper exploration of respondents’ experiences. Qualitative methods were specifically chosen for instances involving extreme or sensitive experiences—such as failed suicide attempts, engagement in sexual encounters with over 100 partners in the last 12 months, or experiences of rape or abduction by other MSM individuals. These cases required qualitative methods to fully understand the complex emotions, motivations, and social contexts that quantitative data alone could not adequately capture.

Participation in the study was entirely voluntary, with no monetary compensation provided to respondents. Before participation, all respondents provided informed consent after being thoroughly briefed on the research objectives, the content of the survey instruments, and any potential risks involved. The consent process emphasized the participants’ right to decline participation or withdraw at any time without any consequences. Anonymity and confidentiality were rigorously maintained throughout the study; no personal identifiers were collected, and all data were anonymized to protect the privacy of the respondents. Participants were also informed about the confidentiality of their responses, ensuring that their information would not be shared beyond the research team. The experience of mental distress was self-reported by respondents, as indicated by the survey tool or semi-structured questionnaire. This tool included specific questions designed to inquire about mental distress, such as feelings of isolation, negativity, anxiety, or thoughts of suicide. Respondents who reported experiencing mental distress without receiving professional help were advised to seek medical services promptly. Additionally, individuals engaged in risky sexual behaviours were encouraged to undergo testing for HIV and STIs, with appropriate references provided to government hospitals and NGOs for support. This section adhered to a methodology similar to a previously published study [63].

Outcome variables

Violence experienced by MSM was taken as an outcome variable for this paper. Three broad dimensions of violence against MSM were used in this study. These dimensions were verbal violence, physical violence, and sexual violence. The variables concerning questions related to violence faced by MSM were defined as follows:

Verbal Violence: It included verbal attacks on MSM. The respondents were asked, “Have you ever been threatened with being murdered for being MSM?”. If the participants answered ‘no’, then this dependent variable was coded as ‘0’. If they answered ‘yes’, then the variable was coded as ‘1’.

Physical Violence: It included physical attacks on MSM. The respondents were asked, “Have you ever been beaten up for being MSM?”. If the participants answered ‘no’, then this dependent variable was coded as ‘0’. If they answered ‘yes’, then this variable was coded as ‘1’.

Sexual Violence: It included sexual attacks on MSM. The respondents were asked, “Have you ever been raped/sexually molested for being MSM?”. If the participants answered ‘no’, then this dependent variable was coded as ‘0’. If they answered ‘yes’, then this variable was coded as ‘1’.

Any Violence: It included ‘Verbal Violence’, ‘Physical Violence’, and ‘Sexual Violence’ faced by MSM. If all variables were coded as ‘0’ then this dependent variable was coded as ‘0’. If any of these variables were coded as ‘1’, then this variable was coded as ‘1’.

Predictor variables

Sexual position

This was the key determinant variable for this study. Literature indicated that violence was significantly associated with the sexual positions of MSM. Here, coding was done into (a) ‘Penetrative partner’ for participants who reported taking the insertive role during anal sex with other men. (b) ‘Receptive partner’ for participants who reported taking the receptive role during anal sex with other men. (c) ‘Versatile’ for participants who reported engaging in both insertive and receptive roles during anal sex with other men. and (d) ‘Side’ for participants who reported that they did not engage in anal sex with other men.

Sexual orientation

This variable was intended to provide a macroscopic view of variation in violence among subgroups of the LGBT + community. The degree of violence might have differed based on one’s sexual orientation. Participants who reported that “they were sexually attracted to men only” were coded as ‘Gay’ and those who reported “they were sexually attracted to both men and women” were coded as ‘Bisexual’.

Disclosure

of Sexuality: This variable was defined by the disclosure status of an individual about his sexuality in public. The variable was coded as ‘1’ if the participants responded ‘Yes’ to the question “Are you out about your sexuality” and coded as ‘0’ if they responded ‘No’ to the question.

Sociodemographic variables

The age of the respondents was originally captured as a continuous variable through self-reporting. For analysis purposes, this data was subsequently categorized into the following age groups: ‘18–24’, ‘25–34’, and ‘35 & above’. The marital status of the respondents was classified as ‘Never Married’, ‘Separated/Widowed/Divorced’, and ‘Currently Married’. The educational level of the participants was divided into ‘Primary’, ‘Secondary/Higher Secondary’, and ‘Graduation and above’. The religion of the respondents was shown as ‘Hindu’, ‘Muslim’, and ‘Others’. The caste category of the respondents was classified as ‘General’, ‘Other Backward Class’ and ‘Scheduled Caste/Scheduled Tribe’. The other backward classes comprised those socially and educationally backward sections of the population including Christians and Muslims, other than the scheduled castes and scheduled tribes [65]. The occupation of the respondents was categorized as ‘Not Working’ (including respondents who were students, not working/unemployed individuals), ‘White’ (including respondents who were salaried professionals), ‘Blue’ (including respondents who were engaged in manual labour or paid on an hourly basis for the work), and ‘Pink’ (including respondents who were employed in care-oriented sectors). The annual income of the participants was shown in INR and divided into three groups, ‘Low Income’ (below 300,000 INR), ‘Middle Income’ (300,000-599,999 INR) and ‘High Income’ (600,000 INR and above). The living arrangement of the respondents was categorized depending on whom they lived with, therefore the categories were ‘With Parents’, ‘With Wife/Children’ and ‘Alone/With Male Partner’. The type of family was divided into ‘Nuclear’ and ‘Joint’. Social connectedness of the respondents was classified as ‘No’ (for respondents who did not attend any of the events like Gay parties, NGOs, Workshops or Pride Parades) and ‘Yes’ (for respondents who attended at least one of the events like Gay parties, NGOs, Workshops or Pride Parades). Support of the family related to the sexuality of respondents was divided into ‘No’ and ‘Yes’. The respective city of the respondent was marked as ‘Ahmedabad’, ‘Bengaluru’, ‘Delhi’, ‘Kolkata’, ‘Lucknow’ and ‘Mumbai’.

Qualitative and quantitative analysis

Qualitative analysis was conducted using thematic analysis, as outlined by Braun and Clarke [66]. This approach involved a systematic process of coding the data gathered from in-depth interviews, which were aimed at validating the quantitative data and providing deeper insights into the experiences of violence among MSM in India. The analysis followed a step-by-step process, starting with familiarization with the data through repeated reading of the transcripts, followed by the generation of initial codes that highlighted specific issues, incidents, key phrases, and particular words associated with violence. These codes were then organized into broader themes that reflected recurring patterns in the data. Throughout the process, particular attention was given to ensuring that the themes accurately captured the depth and complexity of the respondents’ experiences. The final themes were reviewed and refined to ensure they provided a coherent narrative that both supported and extended the findings from the quantitative analysis. This method was chosen because it allowed for the identification of both explicit and implicit meanings within the data, offering a nuanced understanding of the phenomena under study. In line with best practices in qualitative research, the analysis was conducted with careful consideration of the ethical principles of confidentiality and anonymity. All personal identifiers were removed during transcription, and participants were assured that their responses would be reported in a manner that protected their privacy. The thematic analysis process was informed by existing literature on qualitative research methodology [67] and was aimed at providing a robust, detailed account of the violence faced by MSM in India.

This paper employed univariate, bivariate, and binary logistic regression for quantitative analysis. A logistic model was performed on the outcome variables: ‘verbal violence’, ‘physical violence’, ‘sexual violence’, and ‘any violence’ against MSM. Violence against MSM was a binary outcome (violence not faced by respondents was coded as ‘0’ and violence faced by respondents was coded as ‘1’). The result of the binary regression model was presented in the form of odds ratios with a 95 per cent confidence interval. To explore the multidimensional nature of risk factors associated with different types of violence among the MSM population, we analyzed the interaction effects of household, socioeconomic, and demographic characteristics. These interaction effects were examined to understand how various socioeconomic factors, in combination, influenced the likelihood of experiencing violence. We employed the margins and marginsplot commands following the methodologies outlined by Buis [68] and Williams [69]. The margins command was used to estimate predictive odds ratios for experiences of violence among MSM, specifically focusing on how these odds varied based on the interaction between different socioeconomic positions. This approach allowed us to capture the compounded impact of multiple socioeconomic factors, thereby providing a nuanced understanding of the vulnerabilities within this population. The analysis was carried out using STATA 14.1.

Results

Qualitative result

The following segments endeavour to contextualize the narratives within the expansive spectrum of violence experienced by MSM participants in this study. By highlighting the intricate interplay of verbal, physical, and sexual violence, these narratives shed light on the multifaceted dimensions of adversity encountered by MSM individuals within familial and professional spheres. Through this lens, we aim to delve deeper into the complex realities and pervasive challenges this marginalized community faces, ultimately contributing to a more comprehensive understanding of their lived experiences.

Verbal violence

Qualitative data revealed that verbal violence against MSM individuals is a distressing reality, often originating from familial disapproval and societal stigma. The narratives offer poignant glimpses into the verbal abuse and intimidation encountered by individuals within their own families and communities, highlighting the pervasive discrimination and lack of acceptance prevalent in Indian society.

The narrative of a 38-year-old painter from Bengaluru unveiled a troubling encounter with their paternal uncle, whose hostile reaction upon learning about their sexual orientation included explicit threats of violence. The uncle’s aggressive response, underscored by the chilling statement “Had I been his son, he would have killed me by now,” highlights the deep-seated societal prejudices and the looming spectre of violence faced by MSM individuals within their kin. The narration in his words is as follows:

I can recall the day I revealed to my family that I was gay. Initially, my parents were unfamiliar with the concept and didn’t address it. However, they later discussed it with my paternal uncle. When he visited, he bluntly urged me to suppress my feelings for the sake of our family’s reputation. I explained that I couldn’t change my sexuality, but his response was harsh; he even went so far as to declare in front of everyone that if I were his son, he would have killed me. His anger was palpable, and we haven’t spoken since.

The experience of a 21-year-old tailor from Lucknow echoed the deep nature of verbal violence perpetuated by the neighbourhood individuals. Despite attempts to conceal his sexuality, he fell victim to harassment and blackmail, resulting in financial losses and ongoing threats of physical harm. This narrative underscores the vulnerability of MSM individuals to verbal abuse and extortion in their everyday interactions within their immediate surroundings. His experience is quoted below:

I never intended to disclose my sexuality publicly, but some acquaintances with whom I’ve been intimate in the past shared this information within our locality, effectively outing me. Although I haven’t officially announced it, there’s nothing left to hide. Unfortunately, the boys in my area seem to perceive my femininity, and many of them who frequent my shop subject me to verbal harassment. I’ve even experienced financial losses because they’ve blackmailed me over my sexuality, refusing to pay the full amount for the tailoring work I do. While I’ve attempted to stand up to them, they’ve threatened violence and asked me to shut up!

Physical violence

Respondents indicated that physical violence against MSM individuals often arises from entrenched homophobia, gender nonconformity, and power imbalances. These narratives vividly portray the stark realities of physical assault and intimidation endured by individuals within institutional settings and professional environments, perpetuating a culture of fear and oppression.

The following account of a 22-year-old cook from Ahmedabad revealed the brutal physical assault he suffered at the hands of a hostel mate, driven by mockery and disdain for his feminine gestures. The unprovoked attack, accompanied by derogatory comments, highlights the intersecting layers of violence experienced by MSM individuals, stemming from both their sexual orientation and gender expression. He recalled:

I used to be very introverted in the hostel, always avoiding confrontation despite being mocked for my feminine attributes. One of my hostel mates would occasionally borrow things from me. One day, when he came to ask for something again, he unexpectedly attacked me as soon as I opened the door. I was unable to comprehend what was happening and lost consciousness after a while. I remember him making derogatory comments about my feminine traits. When I regained consciousness after about 10 min, I was too afraid to confront him about why he had assaulted me.

The incidence faced by a 26-year-old dancer from Mumbai, within a professional context emphasizes the vulnerability of MSM individuals to workplace harassment and abuse. Despite voicing discomfort with the perpetrator’s actions, he faced escalating threats and physical violence, culminating in a terrifying assault outside the dance academy. This narrative underscores the impunity with which perpetrators of violence operate, perpetuating a climate of fear and mistrust among MSM individuals in their pursuit of livelihoods and careers. The incidence is stated below:

I joined a dance academy as a teacher three years ago. Among the other teachers was someone who had physically assaulted me. Initially, he made some inappropriate comments, but over time, his behaviour escalated to repeatedly tapping my head. I expressed my discomfort, but he persisted. When I finally complained to the academy director, the perpetrator confronted me outside in the dark and attacked me, threatening to kill me if I ever reported him again. I was so terrified that I had no choice but to leave the academy.

Sexual violence

The following experiences indicate that sexual violence against MSM individuals often occurs within intimate or familial settings, fuelled by power differentials, coercion, and societal taboos surrounding non-heteronormative identities. These narratives shed light on the experiences of sexual assault and exploitation faced by individuals, emphasizing the urgent need for comprehensive support and protection.

The encounter of a 24-year-old hairdresser from Delhi with a predatory neighbour underscores the vulnerability of MSM individuals to sexual harassment and assault in their immediate surroundings. Despite attempts to ignore the perpetrator’s advances, he was subjected to a terrifying assault, underscoring the pervasive threat of sexual violence faced by individuals in public spaces. The narration is below:

I was frequently subjected to the unsettling gaze of a neighbour as I traversed my neighbourhood. It soon became evident that his intentions were not good, as he would often wink and make lewd gestures towards me. Though I attempted to disregard his behaviour, one fateful night, as I was returning home from work, he lay in wait in a shadowy corner of the area. Grabbing me upon my arrival, he instilled such fear in me that I was rendered speechless. Pressing me against a nearby wall, he proceeded to subject me to unwanted advances. Eventually finding the strength to resist, I pushed him away and hastily escaped. From that moment on, his prying eyes stopped to haunt me.

A 26-year-old beautician from Kolkata experienced sexual coercion within his rented accommodation exposing the violation perpetrated by a landlord’s son. The perpetrator’s callous response to his distress further compounds the trauma of the assault, highlighting the normalization of sexual violence against MSM individuals and the urgent need for legal and social safeguards. The incidence is quoted below:

Residing in a rented house within the city, my family and I remained unaware of the landlord’s son harbouring evil intentions. However, on one solitary occasion when my family was absent, I found myself alone in the confines of my room. It was the time, he made his unwelcome entrance, initiating a conversation that swiftly turned uncomfortable. Without warning, he forcefully imposed himself upon me, pressuring me into acts of a sexual nature. Overwhelmed with anguish, my tears failed to move him, as he callously remarked, “Isn’t it what people like you desire? Why are you shedding tears now?”

Quantitative result

Table 1 presents the prevalence of different types of violence among MSM respondents. Overall, 61.3 per cent of the respondents reported experiencing at least one form of violence due to their sexual orientation. The incidence of verbal violence (80 per cent, p < 0.001), physical violence (45.5 per cent, p < 0.001), sexual violence (37.3 per cent, p < 0.05) and any violence (81.8 per cent, p < 0.001) was highest among respondents of the age group 18–24. More than three-fourths (78.7 per cent, p < 0.001) of the respondents whose sexual orientation was gay, had faced any violence. Notably, over 90 per cent (p < 0.001) of respondents who engaged in receptive sexual activity reported experiencing any violence. For respondents who disclosed their sexual identity publicly, the rates of verbal and physical violence were 88 per cent (p < 0.001) and 54.2 per cent (p < 0.001), respectively. Those who had never married faced a 62 per cent (p < 0.001) incidence of verbal violence. The incidence of all types of violence was highest (verbal violence: 75 per cent, p < 0.001; physical violence: 68.8 per cent, p < 0.001; sexual violence: 50 per cent, p < 0.05) among respondents having primary education only. Muslim respondents reported a 44.4 per cent (p < 0.05) incidence of sexual violence, while those from other backward classes experienced high rates of verbal (77.8 per cent, p < 0.001), physical (58.7 per cent, p < 0.001), and sexual (49.2 per cent, p < 0.001) violence.

Table 1.

Sample characteristics and differentials in the burden of different forms of violence by demographic and socioeconomic characteristics among men having sex with men across selected Indian cities

Characteristics	Percent	Sample Size (N)	Verbal violence	P- value	Physical violence	P- value	Sexual violence	P- value	Any violence	P- value
Age (in completed years)
18–24	36.7	110	80.0	0.000	45.5	0.000	37.3	0.009	81.8	0.000
25–34	40.3	121	43.0		24.0		28.9		52.9
35 and above	23.0	69	40.6		23.2		15.9		43.5
Sexual Orientation
Gay	50.0	150	75.3	0.000	47.3	0.000	38.0	0.001	78.7	0.000
Bisexual	50.0	150	36.7		16.0		20.0		44.0
Sexual Position
Penetrative	34.0	102	29.4	0.000	10.8	0.000	16.7	0.000	37.3	0.000
Receptive	25.3	76	89.5		61.8		53.9		90.8
Versatile	34.7	104	57.7		29.8		23.1		64.4
Side	6.0	18	55.6		33.3		27.8		55.6
Disclosure of Sexuality
No	72.3	217	43.8	0.000	23.0	0.000	27.2	0.264	50.7	0.000
Yes	27.7	83	88.0		54.2		33.7		89.2
Marital Status
Never Married	76.3	229	62.0	0.000	34.9	0.072	33.6	0.006	68.1	0.000
Separated/Widowed/Divorced	6.0	18	44.4		27.8		11.1		44.4
Currently Married	17.7	53	34.0		18.9		15.1		37.7
Education level
Primary	5.3	16	75.0	0.000	68.8	0.000	50.0	0.023	81.3	0.000
Secondary/Higher Secondary	27.7	83	71.1		49.4		36.1		74.7
Graduation and above	67.0	201	48.3		21.4		24.4		54.2
Religion
Hindu	71.3	214	57.0	0.756	32.7	0.009	26.2	0.019	62.6	0.589
Muslim	18.0	54	55.6		40.7		44.4		61.1
Other	10.7	32	50.0		9.4		21.9		53.1
Caste Category
General	56.7	170	42.4	0.000	20.6	0.000	22.4	0.000	48.8	0.000
Other Backward Class	21.0	63	77.8		58.7		49.2		84.1
Scheduled Caste/Scheduled Tribe	22.3	67	70.2		34.3		26.9		71.6
Occupation
Not working	37.7	113	62.8	0.000	31.0	0.000	30.1	0.020	68.1	0.000
White collar	33.0	99	42.1		24.2		22.1		47.4
Blue collar	19.3	58	46.5		29.3		25.9		51.7
Pink collar	10.0	30	88.2		58.8		50.0		94.1
Income group of Family
Low Income	20.0	60	80.0	0.000	60.0	0.000	45.0	0.005	85.0	0.000
Middle Income	27.0	81	74.1		34.6		29.6		79.0
High Income	53.0	159	37.7		19.5		22.6		43.4
Living Arrangement
With Parents	71.3	214	61.2	0.092	33.6	0.078	30.8	0.010	67.8	0.000
With Wife/Children	18.7	56	33.9		19.6		14.3		37.5
Alone/With Male Partner	10.0	30	60.0		40.0		43.3		60.0
Type of Family
Nuclear	74.7	224	56.7	0.677	32.6	0.555	27.2	0.247	59.8	0.356
Joint	25.3	76	54.0		28.9		34.2		65.8
Social connectedness
No	44.7	134	49.3	0.034	26.1	0.063	26.1	0.323	55.2	0.051
Yes	55.3	166	61.5		36.1		31.3		66.3
Family support
No	17.7	53	77.4	0.000	56.6	0.000	47.2	0.001	79.3	0.003
Yes	82.3	247	51.4		26.3		25.1		57.5
Residential City
Ahmedabad	16.7	50	42.0	0.714	30.0	0.042	26.0	0.131	50.0	0.010
Bengaluru	16.7	50	54.0		22.0		24.0		56.0
Delhi	16.7	50	66.0		42.0		44.0		72.0
Kolkata	16.7	50	72.0		46.0		28.0		80.0
Lucknow	16.7	50	46.0		26.0		20.0		52.0
Mumbai	16.7	50	56.0		24.0		32.0		58.0
Total	100	300	56.0		31.7		29.0		61.3

Note: Chi-square tests were used to obtain P-value

Respondents in pink-collar jobs faced the highest levels of verbal (88.2 per cent, p < 0.001), physical (58.8 per cent, p < 0.001), and sexual (50 per cent, p < 0.05) violence. An inverse relationship was noted between annual family income and the incidence of violence, with the highest incidence of any violence reported among low-income respondents (85 per cent, p < 0.001) and the lowest among high-income respondents (43.4 per cent, p < 0.001). Among those living with parents, 67.8 per cent (p < 0.001) reported experiencing any violence. The incidence of any violence among respondents who lived in a nuclear and a joint family was 59.8 per cent and 65.8 per cent respectively. Additionally, 66.3 per cent of those attending gay parties, NGOs, workshops, or pride parades related to the LGBT + community experienced any violence. For respondents lacking family support, incidences of verbal, physical, and sexual violence were 77.4 per cent (p < 0.001), 56.6 per cent (p < 0.001), and 47.2 per cent (p < 0.05), respectively. Regionally, the highest rates of verbal (72 per cent) and physical (46 per cent) violence were reported in Kolkata, while the highest incidence of sexual violence was recorded in Delhi (44 per cent).

Data in Table 2 show that the respondents of the age group 25–34 were 78 per cent (OR:0.22; CI: 0.08–0.60) less likely to face any violence compared to respondents of the age group 18–24 and the difference was significant. The odds of experiencing verbal violence were approximately six times (OR: 6.63; CI: 1.85–23.68) higher among respondents who engaged in receptive sexual activity compared to those who engaged in penetrative sexual activity, and the difference was significant. Respondents who were out about their sexuality in public were five times (OR: 5.08; CI: 1.64–15.67) more likely to face any violence than respondents who were not out in public and the difference was significant. The odds of facing physical violence were 91 per cent (OR: 0.09; CI: 0.01–0.65) lower among respondents having education level graduation and above compared to respondents having primary education only and the difference was significant. Respondents, who were Muslim were 2.6 times (OR: 2.65; CI: 1.04–6.74) more likely to face sexual violence compared to respondents whose religion was Hindu and the difference was significant. The odds of facing physical violence were 3.9 times (OR: 3.90; CI: 1.47–10.36) higher among respondents belonging to other backward classes than respondents of the general category and the difference was significant. Respondents belonging to the high-income group were 83 per cent (OR: 0.17; CI: 0.04–0.69) less likely to face any violence in comparison to respondents belonging to the low-income group and the difference was significant. The odds of facing any violence were approximately six times (OR: 6.30; CI: 2.57–15.42) higher among respondents who lived in a joint family than respondents who lived in a nuclear family and the difference was significant. Respondents whose family was supportive were 51 per cent (OR: 0.49; CI: 0.18–1.34) less likely to face sexual violence compared to respondents whose family was not supportive. The odds of facing verbal violence were 4.5 times (OR: 4.47; CI: 1.31–15.15) higher among respondents residing in Delhi than respondents residing in Ahmedabad and the difference was significant.

Table 2.

Adjusted odds ratio predicting likelihood of experiencing different forms of violence among men having sex with men across selected Indian cities

Characteristics	Verbal Violence	Physical Violence	Sexual Violence	Any Violence
	Odds ratio (95%CI)	Odds ratio (95%CI)	Odds ratio (95%CI)	Odds ratio (95%CI)
Age (in completed years)
18–24®	1.00	1.00	1.00	1.00
25–34	0.12*** (0.04–0.32)	0.50 (0.21–1.22)	1.01 (0.46–2.20)	0.22*** (0.08–0.60)
35 and above	0.11*** (0.02–0.46)	0.72 (0.18–2.93)	0.53 (0.14–1.91)	0.17** (0.04–0.71)
Sexual Orientation
Gay®	1.00	1.00	1.00	1.00
Bisexual	0.43* (0.18–1.01)	0.41* (0.16–1.04)	0.76 (0.33–1.78)	0.44* (0.19–1.04)
Sexual Position
Penetrative®	1.00	1.00	1.00	1.00
Receptive	6.63*** (1.85–23.68)	6.88*** (2.01–23.46)	7.25*** (2.31–22.75)	5.29** (1.44–19.42)
Versatile	2.34** (1.01–5.41)	2.65* (0.97–7.21)	1.51 (0.64–3.55)	2.23* (0.96–5.13)
Side	2.63 (0.68–10.19)	6.48** (1.50-27.91)	2.22 (0.57–8.66)	1.24 (0.33–4.68)
Disclosure of Sexuality
No®	1.00	1.00	1.00	1.00
Yes	6.70*** (2.22–20.18)	1.66 (0.66–4.13)	0.33** (0.12–0.87)	5.08*** (1.64–15.67)
Marital Status
Never Married®	1.00	1.00	1.00	1.00
Separated/Widowed/Divorced	1.15 (0.16–8.05)	1.39 (0.20–9.71)	0.13* (0.01–1.11)	0.84 (0.12–5.52)
Currently Married	3.01 (0.08–113.10)	0.31 (0.01–10.16)	na	3.04 (0.07-117.89)
Education level
Primary®	1.00	1.00	1.00	1.00
Secondary/High Secondary	0.28** (0.03–2.36)	0.21* (0.03–1.33)	0.67 (0.11–4.01)	0.13* (0.01–1.12)
Graduation and above	0.68 (0.07–6.11)	0.09** (0.01–0.65)	0.58 (0.09–3.79)	0.34 (0.04–2.96)
Religion
Hindu®	1.00	1.00	1.00	1.00
Muslim	1.52 (0.49–4.68)	1.34 (0.47–3.83)	2.65**(1.04–6.74)	1.10 (0.36–3.32)
Other	0.61 (0.19–1.99)	0.17** (0.03–0.73)	0.88 (0.30–2.53)	0.75 (0.24–2.33)
Caste Category
General®	1.00	1.00	1.00	1.00
Other Backward Class	2.80* (0.97–8.07)	3.90*** (1.47–10.36)	1.78 (0.74–4.28)	3.00* (0.98–9.20)
Scheduled Caste/Scheduled Tribe	2.52 (0.95–6.66)	0.95 (0.03–0.73)	1.00 (0.41–2.44)	1.50 (0.58–3.89)
Occupation
Not working®	1.00	1.00	1.00	1.00
White collar	1.40 (0.52–3.79)	1.95 (0.68–5.56)	0.93 (0.37–2.34)	1.13 (0.42–3.04)
Blue collar	0.79 (0.24–2.55)	1.21 (0.35–4.13)	1.04 (0.35–3.07)	0.64 (0.19–2.08)
Pink collar	1.22 (0.22–6.49)	0.40 (0.11–1.45)	0.72 (0.23–2.23)	2.55 (0.33–19.27)
Income group of Family
Low Income ®	1.00	1.00	1.00	1.00
Middle Income	1.69 (0.46–6.20)	0.51 (0.18–1.46)	1.03 (0.38–2.77)	1.12 (0.28–4.51)
High Income	0.26** (0.07–0.99)	0.40 (0.13–1.20)	0.83 (0.29–2.37)	0.17** (0.04–0.69)
Living Arrangement
With Parents®	1.00	1.00	1.00	1.00
With Wife/Children	0.61 (0.02–19.14)	1.75 (0.06–44.31)	na	0.35 (0.01–11.35)
Alone/With Male Partner	0.94 (0.20–4.33)	0.56 (0.12–2.60)	3.16 (0.77–12.94)	0.66 (0.14–3.02)
Type of Family
Nuclear®	1.00	1.00	1.00	1.00
Joint	3.18*** (1.36–7.46)	1.25 (0.54–2.88)	1.47 (0.71–3.03)	6.30*** (2.57–15.42)
Social connectedness
No®	1.00	1.00	1.00	1.00
Yes	0.82 (0.37–1.81)	1.53 (0.69–3.37)	1.05 (0.52–2.10)	0.81 (0.37–1.79)
Family support
No®	1.00	1.00	1.00	1.00
Yes	0.43 (0.12–1.46)	0.58 (0.20–1.67)	0.49 (0.18–1.34)	0.58 (0.16–2.02)
Residential City
Ahmedabad®	1.00	1.00	1.00	1.00
Bengaluru	1.64 (0.51–5.27)	0.40 (0.12–1.30)	0.85 (0.30–2.40)	1.10 (0.35–3.44)
Delhi	4.47** (1.31–15.15)	1.34 (0.42–4.22)	2.01 (0.72–5.64)	3.24* (0.97–10.79)
Kolkata	1.95 (0.56–6.78)	0.89 (0.29–2.69)	1.09 (0.37–3.13)	2.88 (0.77–10.76)
Lucknow	0.86 (0.26–2.77)	0.39 (0.12–1.29)	0.42 (0.13–1.34)	0.68 (0.22–2.08)
Mumbai	2.31 (0.69–7.64)	0.54 (0.16–1.84)	1.26 (0.44–3.62)	1.75 (0.54–5.65)
Constant	4.63 (0.34–62.03)	4.66 (3.80-57.08)	0.68 (0.06–6.98)	16.75 (1.29-217.11)

Note: *** p < 0.001, ** p < 0.05, *p < 0.10; na- data not available

Based on the interaction effect of selected Indian cities and socio-demographic characteristics, we have predicted the probabilities of verbal violence, physical violence, sexual violence, and any violence against MSM. Figure 1 indicates that Delhi is the city where gay and highly educated MSM are most likely to face verbal violence. Respondents who belong to the other backward classes and who do not have the support of their family regarding their sexuality are likely to experience verbal violence mostly in Mumbai. Figure 2 shows that MSM who are younger, who are out regarding their sexuality, and who are less educated are likely to experience physical violence mostly in Delhi. MSM belonging to the other backward classes and who do not have the support of their family are likely to experience physical violence mostly in Kolkata and Mumbai, respectively. Figure 3 shows that MSM are most unsafe for sexual violence in Delhi. Figure 4 shows that Mumbai is the city where MSM are most vulnerable to any violence. We found that Indian cities exhibit a disproportionate risk of violence against MSM. However, the risk of particular violence (such as sexual violence) is disproportionately higher in Delhi than in other cities. A violence study [70] conducted by the Philadelphia Lesbian and Gay Task Force revealed that gay and lesbian people in a major city were at least four times more likely to be victims of violence than people in the general urban population (i.e., cities with population over one million).

Fig. 1.

Margins plot showing the interaction effect of selected Indian cities and socio-demographic characteristics with the predicted probabilities of verbal violence against men having sex with men. Interaction effect of city and a) age group on verbal violence, b) Coming out with sexual orientation on verbal violence, c) Sexual identity on verbal violence, d) education on verbal violence, e) caste on verbal violence, f) family support on verbal violence

Fig. 2.

Margins plot showing the interaction effect of selected Indian cities and socio-demographic characteristics with the predicated probabilities of physical violence against men having sex with men. Interaction effect of city and a) age group on physical violence, b) Coming out with sexual orientation on physical violence, c) Sexual identity on physical violence, d) education on physical violence, e) caste on physical violence, f) family support on physical violence

Fig. 3.

Margins plot showing the interaction effect of selected Indian cities and socio-demographic characteristics with the predicated probabilities of sexual violence against men having sex with men. Interaction effect of city and a) age group on sexual violence, b) Coming out with sexual orientation on sexual violence, c) Sexual identity on sexual violence, d) education on sexual violence, e) caste on sexual violence, f) family support on sexual violence

Fig. 4.

Margins plot showing the interaction effect of selected Indian cities and socio-demographic characteristics with the predicated probabilities of any violence against men having sex with men. Interaction effect of city and a) age group on any violence, b) Coming out with sexual orientation on any violence, c) Sexual identity on any violence, d) caste on any violence, e) family support on any violence

Discussion

The present study undertakes a pioneering approach to analyse the patterns of violence against MSM in selected cities of India, considering their socioeconomic, demographic, and geographical factors. The study reveals that the independent variables significantly influence the extent of violence experienced by MSM. Prior scientific studies have already indicated that the entire LGBT + community in India faces vulnerability due to societal stigmatization. Furthermore, the discriminatory nature of Sect. 377 of the IPC exacerbated the unfavourable conditions for this community, leading to harassment. Despite previous efforts by researchers to shed light on the ground reality of the LGBT + community, there has been a historical lack of specific and categorical investigation focusing on subsets of the community. In this context, the present study aims to analyse the violence experienced by a specific subgroup, namely MSM. Through this analysis, it aims to provide a more detailed understanding of the challenges and problems encountered by this particular section of the LGBT + community.

Data from the present study confirmed that younger MSM individuals are more susceptible to all kinds of violence than older ones. This finding of a greater prevalence of violence among younger respondents is in line with the findings of previous studies [9, 38, 71–73]. It appears that younger MSM individuals might be more visible in public spaces and on social media platforms, which could contribute to their increased vulnerability to verbal and physical violence. This visibility, combined with a potential lack of access to resources or support compared to their older counterparts, may exacerbate their risk of facing such challenges. Additionally, the portrayal of gay individuals in media—particularly the depiction of effeminate men as comic relief—has gained traction in recent years. This trend may have reinforced negative stereotypes, thereby normalizing verbal ridicule and possibly contributing to the escalation of both verbal and physical violence against younger MSM.

In the present study, gay respondents reported a higher incidence of violence than bisexual respondents. This pattern has also been observed in other studies [73, 74], such as the study by Parrott et al. [12, 75], which found that gay people are seen as a threat to masculinity and are therefore more likely to face violence due to their increased visibility. Similarly, respondents who identified as receptive partners were more likely to face violence than respondents who identified as penetrative partners. This may suggest that stereotypes associating receptive partners with femininity could contribute to perceptions of increased vulnerability to violence [6, 9, 10, 71]. Existing stereotypes within the MSM community, particularly the association of femininity with the receptive role, continue to reinforce negative perceptions. These stereotypes may contribute to the vulnerability of effeminate MSM, as their visibility makes them more susceptible to violence. On the other hand, the ability of non-effeminate MSM to conceal their sexual orientation could potentially reduce their risk of encountering such threats. This underscores the complex ways in which gender expression and perceived masculinity can influence the safety and experiences of MSM individuals. Disclosing one’s sexuality in public can have predictable consequences, such as facing violence due to homophobia. Supporting the findings of previous studies [38, 76, 77], data from the present study show that verbal and physical violence were more common among respondents whose sexual orientation was disclosed in public.

Our study found that education plays a protective role against violence towards MSM. Respondents with higher educational qualifications reported lower rates of violence than those with lower educational qualifications. This finding contradicts the findings of Pelullo et al. [74] but aligns with other studies [9, 72]. Education appears to play a significant role in how MSM individuals navigate and respond to violence. Those with higher levels of education may have a greater awareness of their rights and the ability to seek legal recourse when faced with violence. In contrast, MSM with less education may be more frequently exposed to environments where violence is more common and severe, potentially leading to more brutal experiences. This disparity highlights the importance of education in empowering individuals to protect themselves and access necessary resources. One study [73] found that sexual minorities who also belong to religious minority groups have a greater likelihood of encountering violence compared to non-religious sexual minority individuals. However, in our study, the incidence of violence was higher among Muslims but lower among respondents of other religious affiliations in comparison to Hindus, who constitute the majority in the nation.

The financial status of the respondents was strongly linked to the level of violence they experienced. Economically well-off MSM were less likely to be subjected to violence than poor respondents. This finding is consistent with the study of Bayrakdar et al. [73] but is somewhat different from the findings of other researchers [72, 78]. Income levels significantly impact the experience of violence among MSM individuals. Higher income may provide opportunities to enhance one’s social status and can contribute to a reduction in violence risk factors. For instance, affluent individuals often have access to safer neighbourhoods and better legal resources, which can mitigate the potential for violence. This underscores how socio-economic factors are intertwined with personal safety and access to support. Many MSM individuals grapple with issues related to family support throughout their lives, with some facing unique challenges linked to family distress. However, it is crucial to emphasize that familial support regarding a child’s sexuality not only positively influences the child’s mental and emotional well-being but is also associated with reduced odds of them experiencing sexual identity-based violence [77, 79]. In essence, family acceptance and understanding play pivotal roles in the overall health and safety of MSM individuals.

The present study has several limitations that must be acknowledged. First, the exploratory nature of the research, combined with a relatively small sample size, means that while the findings offer valuable insights into the risk factors for violence among MSM in selected urban centres in India, they may not be generalizable to the entire MSM population. The use of purposive sampling through the dating app Grindr introduces another layer of limitation, as the results may reflect the experiences of only a subset of MSM who use this platform, potentially excluding those who do not have access to digital devices or are not proficient in using such technology. Additionally, the study’s reliance on participants from urban areas excludes MSM individuals from rural settings, who may face different challenges and access to resources. The qualitative phase focused on individuals who reported high risks and aggravated experiences of trauma, such as sexual assault and abduction, rather than a representative subset of all respondents, which may introduce biases and limit generalizability. Furthermore, the findings are based solely on those who were willing to participate and respond to the survey, potentially excluding perspectives from those who chose not to engage or were unable to do so. Lastly, the diverse socio-economic and health service contexts across the six cities studied were not examined in detail, which could have provided additional insights into city-wide differences in experiences of violence. Collectively, these limitations suggest that while the study provides important preliminary findings, caution should be exercised when interpreting the results and considering their applicability to the broader MSM community.

Recommendations for future research

Future research on violence against MSM in India should take a multifaceted approach to enrich our understanding and address the complex challenges faced by this marginalized community. One crucial area for exploration is conducting longitudinal studies to track the experiences of MSM individuals over time. Such studies can shed light on how factors like age, socioeconomic status, and the disclosure of sexual orientation intersect with experiences of violence, providing valuable insights into the long-term impacts and effective interventions. Additionally, there is a persistent need to explore the intersectionality of identities within the MSM community. By examining how factors such as race, religion, caste, and gender identity intersect with experiences of violence, researchers can uncover the unique vulnerabilities and barriers faced by different subgroups within the MSM community. This nuanced understanding is essential for developing targeted interventions that address the diverse needs and challenges that MSM individuals face across various socio-cultural contexts.

Geospatial analysis offers another avenue for future research. By mapping the prevalence of violence against MSM and identifying geographical hotspots, researchers can uncover regional disparities and underlying socio-cultural factors contributing to such variations. This geospatial approach can be helpful in the development of context-specific interventions tailored to address the specific challenges that MSM individuals face in different regions of India. Qualitative research holds place for exploring the resilience strategies employed by MSM individuals in navigating and resisting violence. By amplifying the voices and experiences of MSM individuals, researchers can understand the protective factors and coping mechanisms that promote resilience in the face of adversity. This qualitative exploration can provide valuable insights for developing interventions that empower MSM individuals to assert their rights and navigate challenging environments.

Policy evaluation is crucial for advancing efforts to address violence against MSM in India. Researchers can identify gaps and barriers in current interventions by assessing the impact of existing policies and legal frameworks. Advocating for evidence-based policy reforms that protect the rights of sexual minorities and promote their safety and well-being is essential for driving meaningful change. Moreover, rigorous evaluation of existing interventions and support services is necessary to assess their effectiveness in addressing violence against MSM. By evaluating the outcomes of interventions such as counselling, legal aid, and community-based programs, researchers can identify best practices and areas for improvement. This evidence-based approach is vital for ensuring that interventions are modified to the specific needs of MSM individuals and achieve meaningful impact. Future researchers may also focus on examining the implications of exposure to violence on the likelihood of engaging in risky sexual behaviour, health-seeking behaviour, mental health outcomes, social isolation, and economic shocks among MSM.

In summary, further investigation into violence against MSM in India should embrace a thorough and multifaceted approach. This should include long-term studies, analyses that consider intersecting identities, mapping of geographic patterns, qualitative inquiries, evaluations of policies, and assessments of intervention effectiveness. Researchers can identify the underlying reasons and impacts of violence against MSM by utilizing these various methods. This will enable the development of strategies grounded in evidence to improve their health, safety, and overall welfare within Indian society.

Conclusion

This paper attempts to study the vulnerabilities to violence against MSM in selected cities of India. The findings of this study show that violence against MSM is a significant human rights issue and a pressing public health concern. More than half of MSM have faced any violence, and those who are young, gay, out about their sexuality, less educated, belong to the other backward class, have low family income, and do not have the support of their family members regarding their sexuality face the highest risk of violence. Encountering various types of violence greatly affects the lives of MSM individuals negatively. It can result in physical and psychological adversities, social alienation, and financial struggles. Additionally, it can pose challenges for MSM in accessing healthcare, education, and other vital services.

The decriminalization of homosexuality by the Honourable Supreme Court of India is a significant step forward, but it is not enough to end violence against MSM. The government and other stakeholders need to work on awareness programs to educate people about the rights, privacy, and dignity of the LGBT + community, and to help dissuade the rigid socio-religious stance on discrimination against sexual minorities. They also need to provide support services for MSM who have experienced violence, such as counselling, legal aid, and financial assistance. Collective actions by stakeholders within the community and society are crucial for addressing violence against MSM. Strengthening rights and implementing targeted interventions can significantly reduce violence and discrimination, allowing MSM to live with dignity and safety. Such efforts are essential for creating a society where MSM are free from violence and can contribute to building more inclusive and just communities.

Electronic supplementary material

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Abbreviations

CI

Confidence Interval

GPS

Global Positioning System

HIV

Human Immunodeficiency Virus

INR

Indian National Rupees

IPC

Indian Penal Code

LGBT+

Lesbian, Gay, Bisexual, Transgender etc

MSM

Men who have Sex with Men

NGOs

Non-Governmental Organization

OR

Odds Ratio

STIs

Sexually Transmitted Infections

Author contributions

SP, PKP, MR and NT were involved in the conceptualisation, design, methodology, analysis and drafting of the manuscript. All authors read and approve the final manuscript.

Funding

This study was self-funded.

Data availability

The datasets generated and/or analysed during the current study are not publicly available because of its anonymous nature and the privacy concerns of respondents but are available from the corresponding author upon reasonable request.

Declarations

Ethical approval and consent to participate

The ethical approval for the study is obtained from the Institutional Ethics Committee (Reference No: BRS/2019/110), Department of Geography, Delhi School of Economics, University of Delhi, New Delhi, India. Verbal informed consent was sought from the study respondents, and only those who consented were recruited for the study as per the approval from the ethics committee. Privacy and confidentially have been ensured for all study respondents. The study participants were apprised that the information sought from them would be used purely for research and publication. All methods were carried out following relevant guidelines and regulations [80].

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.