“Not Ideal Uncles”: Unveiling Childhood Sexual Victimization and Hidden Identity Struggles of GBTQI+ Youth in Sex Work in Botswana

Abstract

Objective

Globally, growing attention has been directed toward the sexual health and developmental experiences of gay, bisexual, transgender, queer, and intersex (GBTQI+) youth. Existing literature links childhood sexual victimization, familial rejection, bullying, and gender nonconformity to adverse sexual health outcomes. Evidence further suggests that sexual and gender minority youth are often targeted for abuse before they self-identify based on perceived gender nonconformity; yet, despite these insights, little is known about these dynamics in Botswana. This study applies an intersectional and sexual health lens to examine how early victimization shapes later sexual vulnerability among GBTQI+ individuals involved in sex work.

Methods

This article draws on findings from a larger qualitative study on male sex work in Botswana. Data from 15 purposively sampled participants who self-identified as a gay person or bisexual were analyzed to explore childhood experiences, pathways into sex work, and subsequent sexual health risks and victimization.

Findings

Participants reported patterns of vulnerability across the life course, including childhood sexual abuse, bullying, and familial rejection, often occurring prior to conscious sexual identity formation, linked to gender nonconformity. These experiences contributed to increasing reliance on sex work as a survival strategy. Within sex work, however, participants experienced continued sexual and physical violence, limited power to negotiate safer sex, and heightened exposure to sexual health risks, all of which are reinforced by cultural norms that stigmatize nonconforming masculinities.

Conclusion

The findings demonstrate that sexual health vulnerabilities among GBTQI+ individuals in Botswana are cumulative and structurally produced, beginning in childhood and extending into adulthood through constrained pathways into sex work. Early victimization, identity disruption, and economic exclusion intersect to shape sexual risk and harm.

Policy implications

Sexual health interventions should adopt trauma-informed and rights-based approaches that address early childhood victimization, family- and school-based stigma, and access to sexual health services and justice for GBTQI+ individuals.

Introduction

In Botswana, as in many African contexts, adolescents and young adults identifying as GBTQI+ (gay, bisexual, transgender, queer, intersex, and other diverse sexual and gender identities) face pervasive homophobic stigmatization and marginalization, particularly in accessing sexual health services and the justice system (Mashumba, 2024). This marginalization is often compounded by prevailing cultural, religious, and legal norms that criminalize same-sex practices and nonconforming gender expressions (Msibi, 2013; Müller et al., 2021). Langarita et al. (2024) emphasize that GBTQ children across the globe frequently endure multiple crises and forms of violence, underscoring the urgent need for tailored interventions that promote their well-being. However, much of the existing research predominantly focuses on sexual abuse of female children, often overlooking the unique experiences and needs of GBTQI+ children, which has significant implications for policy and practice (Alao, 2018; Mashumba, 2022). Notably, in Botswana, research addressing child welfare seldom centers on gay and bisexually identifying youth, representing a critical knowledge gap in safeguarding vulnerable populations.

Globally, the literature examining GBTQI+ adolescents and young adults involved in sex work remains limited, albeit growing. Foundational studies by Browne et al. (1999), Kramer and Berg (2003), Russell (2002), Ryan et al. (2010), and Widom and Kuhns (1996) have documented risk factors leading some LGBT youth to engage in sex work, including family rejection, homelessness, and previous experiences of abuse. Moreover, Coleman et al. (2022) has highlighted the complex interplay of social stigma, mental health challenges, and economic marginalization that disproportionately affect sexual minority populations, calling for nuanced research that foregrounds their lived experiences within varying cultural contexts. In the African setting, studies such as those by Baral et al. (2015) have underscored the heightened vulnerability of MSM (men who have sex with men) sex workers to violence, discrimination, and HIV infection, yet comprehensive research focusing on Botswana remains scarce.

While this study primarily sought to understand male sex work in Botswana, this article foregrounds the intersectional experiences of participants pertinent to their sexual orientation and gender identities. Childhood victimization is conceptualized broadly, encompassing sexual, physical, and emotional abuse. Sexual victimization includes “a wide range of non-consensual sexual experiences such as unwanted sexual contact, coercion, attempted rape, or rape” (Hequembourg et al., 2011, p. 479). As Mathews and Collin-Vézina (2019) explain, since the late 1970s there has been increasing scholarly attention to the etiology, prevalence, and sequelae of child sexual victimization. They note the use of varied terminology, including child sexual abuse, child sexual assault, child sexual exploitation, adverse sexual experiences, and unwanted sexual experiences to describe this complex phenomenon.

Child sexual abuse has been identified as a major global public health concern, linked to depression, sexually transmitted infections, running away, and complex psychological outcomes (Mathews & Collin-Vézina, 2019). Reflecting this urgency, the United Nations Sustainable Development Goals, that is, the United Nations General Assembly’s 2015 targets 5.2 and target 16.2, specifically call for action against child sexual abuse, recognizing its prevalence, the severe harm it causes, and its universal moral condemnation. This study acknowledges the critical need for enhanced understanding of GBTQ+ youths’ childhood experiences in Botswana and their long-term implications. Such insight can inform culturally appropriate interventions and services that affirm sexual and gender diversity. GBTQI+ individuals in Botswana and across Africa endure substantial challenges arising from the intersection of their sexual orientation, gender identity, and engagement in sex work. This intersection produces a continuum of vulnerabilities and forms of victimization often inadequately addressed by existing social and legal frameworks (Melendez & Pinto, 2007; Scorgie et al., 2013). This article, hence, foregrounds the experiences of participants both as GBTQI+ children and now as GBTQI+ sex workers. Research of this nature illuminates rarely explored issues affecting marginalized sexual minorities and sex workers, providing crucial awareness that can inform protective policies for vulnerable children. As the first investigation of its kind in Botswana, the study holds particular significance in examining the influence of cultural norms, family dynamics, religion, and societal attitudes on sexuality, child sexual abuse, and gender diversity.

Literature review

Research examining the intersection of sexual orientation, gender identity, and sex work reveals layered and compounding vulnerabilities for GBTQI+ individuals; however, sustained scholarly attention to these populations remains limited, particularly in African contexts. Existing studies across the continent have predominantly focused on female child sexual abuse and heterosexual female sex work, leaving male, transgender, and sexual minority youth underexamined (Alao & Maithamako, 2008; Mashumba, 2024; Ryan, 2009). Even within the global literature, empirical work addressing the victimization trajectories of GBTQI+ adolescents and young adults remains fragmented, often treating experiences such as homelessness, substance use, sexual exploitation, and victimization as discrete phenomena rather than interconnected processes (Briere & Runtz, 1990; Browne et al., 1999; Kramer & Berg, 2003; Ryan et al., 2010). This conceptual limitation obscures the cumulative and mutually reinforcing nature of harms experienced by sexual minority youth.

In Botswana, scholarly engagement with GBTQI+ populations has been largely confined to public health perspectives, particularly HIV and AIDS interventions targeting key populations (Mashumba, 2019, 2021). While this work is important, its narrow biomedical focus has left significant gaps in understanding family dynamics, childhood sexual victimization, cultural gender norm enforcement, economic precarity, and structural pathways into sex work among gay, bisexual, and transgender adolescents and young adults. Consequently, this population has historically received limited scientific attention, minimal social recognition, and weak legal and institutional protection (Mashumba, 2024), underscoring the importance of the present study in addressing a critical empirical and conceptual gap.

Recent legal developments in Botswana, particularly the decriminalization of same-sex relations, further necessitate a nuanced understanding of the lived realities of GBTQI+ youth. International research consistently demonstrates disproportionately elevated levels of childhood sexual abuse, family rejection, and social exclusion among male and transgender sex workers (Green-Simms, 2016; Mashumba, 2021, 2024). Family rejection has been identified as a central source of trauma, manifesting through emotional neglect, physical violence, and expulsion from family homes (Easton & Kong, 2017; Hailes et al., 2019; Ryan et al., 2010). Ryan (2009) also found that lesbian, gay, and bisexual young adults who experienced elevated levels of family rejection during adolescence were significantly more likely to attempt suicide, experience depression, engage in substance use, and participate in high-risk sexual behaviors. Conversely, family acceptance functions as a critical protective factor associated with improved mental health outcomes, social support, and reduced engagement in risky coping behaviors (Ryan et al., 2010).

Childhood sexual abuse further compounds these vulnerabilities. Extensive evidence links childhood sexual victimization to long-term psychosocial, psychiatric, and physical health outcomes, including depression, anxiety disorders, borderline personality disorder, and somatic symptoms (Hailes et al., 2019). Male survivors, in particular, demonstrate persistent associations with depressive symptomatology, hostility, and altered self-identity across the life course (Easton & Kong, 2017). These experiences frequently disrupt normative developmental trajectories and shape later sexual decision-making, relationship patterns, and economic survival strategies, including entry into transactional or commercial sex (Kramer & Berg, 2003; Mashumba, 2024).

Importantly, these harms do not occur in isolation. The concept of syndemics, originally developed within sexual and public health research, offers a powerful lens for understanding how co-occurring social and health conditions interact synergistically to exacerbate vulnerability among marginalized populations. Syndemic theory emphasizes that structural factors such as poverty, homelessness, violence, stigma, and substance use cluster together and mutually reinforce negative outcomes, particularly among socially excluded groups (Fava & Fortenberry, 2021). For GBTQI+ youth, experiences of family rejection, housing insecurity, sexual victimization, food insecurity, substance use, and engagement in sex work frequently co-occur, producing compounded risks rather than additive harms.

Empirical support for this framing is evident in cross-national research linking structural deprivation to sexual risk and survival strategies. Smith et al. (2021), in a study spanning 53 countries, demonstrate that food insecurity with hunger is significantly associated with risky sexual behaviors among adolescents, highlighting how economic precarity directly shapes sexual decision-making. These findings are particularly salient for unhoused and rejected GBTQI+ youth, for whom transactional sex may function as a survival mechanism rather than a freely chosen activity. Similarly, changes in sexual behaviors observed during the COVID-19 pandemic illustrate how macro-level disruptions intensify existing vulnerabilities (Hensel et al., 2023). Hensel et al. (2023) show that social isolation, stress, and economic instability altered both solo and partnered sexual behaviors across diverse global contexts, underscoring the sensitivity of sexual practices to broader structural shocks, effects likely magnified among the already marginalized youth.

Within Botswana, child sexual abuse must be understood within entrenched gendered and age-based power hierarchies that position children as subordinate to adult authority (Mashumba, 2019; Mookodi et al., 2004). Available data indicate that abuse often occurs within domestic spaces, with male family members frequently identified as perpetrators (Mashumba, 2021, 2024). However, national research has historically emphasized female victimization, rendering male child sexual abuse underreported and insufficiently theorized (Alao, 2018). This silence is particularly consequential for GBTQI+ youth, whose experiences of abuse may be further obscured by stigma, fear of disclosure, and heteronormative assumptions about victimhood. Beyond the family, GBTQI+ youth are routinely exposed to bullying, harassment, and violence within schools and communities, resulting in diminished self-esteem, social withdrawal, and educational disengagement (Etherington & Baker, 2018). Religious stigmatization compounds these harms, as exclusion from faith communities often fosters internalized homophobia, shame, and moral distress. These intersecting harms align closely with a syndemic framework, wherein social exclusion, trauma, economic deprivation, and sexual risk reinforce one another across the life course (Fava & Fortenberry, 2021).

The intersectionality framework as articulated by Crenshaw (1991) also provides an essential analytical foundation for understanding these layered vulnerabilities. Intersectionality highlights how multiple marginalized identities, such as sexual orientation, gender identity, age, socioeconomic status, and involvement in sex work, interact to produce distinct forms of oppression that cannot be captured through single-axis analyses. African scholarship documents how stigma, sexual victimization, and homo- and transphobia are mutually constitutive, producing entrenched inequalities for GBTQI+ individuals and sex workers (Green-Simms, 2016; Mashumba, 2024). When combined with syndemic theory, the intersectionality framework allows for a more robust understanding of how structural victimization and social exclusion converge to shape health and social outcomes of abused children and victimized youth sex workers.

The socio-ecological framework by Bronfenbrenner (1979) further complements these perspectives by situating individual experiences within broader institutional and cultural systems. Family structures, schools, religious institutions, community norms, and national policies all play critical roles in either mitigating or amplifying vulnerability. In Botswana, conservative cultural norms, patriarchal gender expectations, and religious moral frameworks frequently reinforce family rejection and silence around sexual victimization, thereby intensifying syndemic conditions. Despite these dynamics, there remains a striking paucity of Botswana-specific research examining how these socio-ecological factors intersect to shape GBTQI+ youth pathways into sex work and associated health risks, as most existing studies are derived from Western contexts (Etherington & Baker, 2018).

Finally, emerging scholarship on trauma-informed and sex-positive approaches offers an important corrective to deficit-based narratives that portray marginalized sexualities solely through risk and pathology. Fava and Fortenberry (2021) argue that trauma-informed, sex-positive frameworks recognize pleasure, agency, and resilience, while remaining attentive to histories of violence and coercion. This perspective is particularly relevant for GBTQI+ individuals involved in sex work, whose sexual lives are often framed exclusively through exploitation or disease. Integrating such approaches into research and policy can help recenter dignity, autonomy, and healing, while addressing the structural conditions that sustain syndemic harm.

Methodology

This study adopted a qualitative methodology. Twenty male sex workers were interviewed face-to-face in Gaborone (the capital city) and Kasane (tourism hub) using semi-structured interviews questions. For this article, data from 1) out of 0 male sex workers originally interviewed is presented. The selected participants ranged in age from 19 to 36, a demographic which aligns with Botswana’s definition of youth. Participants were based in Gaborone (the capital city) and Kasane (a major tourism hub), providing a varied context for understanding sex work dynamics in different urban settings. Participants were recruited via purposive and snowball sampling, strategies well-suited for accessing hard-to-reach or stigmatized populations (Noy, 2008). The inclusion criteria required that participants be Botswana nationals, of legal age (18 years and above), who had engaged in sex work with tourists within the preceding two years. Exclusion criteria included being under the age of 18 or not meeting the nationality or occupation criteria. Recruitment was initiated through trusted community contacts and peer referrals. Data were collected through face-to-face, semi-structured interviews. An interview guide was developed to elicit in-depth responses regarding participants’ background, sexual orientation, entry into sex work, experiences of victimization (in both childhood and adulthood), and coping mechanisms. The semi-structured format allowed for probing and clarification to ensure rich, meaningful accounts (Kumar, 2014). Interviews were conducted in private, safe venues chosen collaboratively with participants, and lasted from 60 to 120 minutes each, accommodating both English and Setswana language preferences as needed.

Data analysis

Data analysis was conducted using descriptive thematic analysis, following Braun and Clarke’s (2006, 2021) six-phase framework: familiarization, initial coding, searching for themes, reviewing themes, defining/naming themes, and producing the report. This process was inductive, as themes were generated from the data itself rather than being imposed by a preexisting theory, though analysis remained informed by broader theoretical perspectives on intersectionality and marginalization. NVivo qualitative analysis software supported the organization, coding, and management of qualitative data (Woods et al., 2016). Following iterative coding and constant comparison, two major themes were identified, victimization during childhood and victimization in adulthood as a sex worker, each with several subthemes and representative quotations directly drawn from participants’ accounts.

Ethics

Ethical considerations were reviewed and approved by the University of Botswana Ethics Review Board. This included informed, verbal, and explicit consent, the use of pseudonyms, altering of locations and removal of potentially identifying information before analysis to promote anonymity and confidentiality. A counselor was also engaged and availed to respondents who felt distressed during or after interviews. A research permit was also sought with the Ministry of Environment, Wildlife and Tourism, Botswana.

Findings

Results indicated that the participants were of median age of 26 years, and all possessed some type of tertiary education qualification or were still enrolled at a tertiary institution. Thematic analysis of interviews with participants of the study revealed a complex landscape of victimization, coping, and identity formation through the following themes and quotes are used to illuminate the lived realities and actionable insights for both scholarship and interventions:

Typologies and contexts of abuse

Child sexual abuse and betrayal of trust

Participants described distinct and varied forms of sexual abuse in childhood, typically perpetrated by trusted adults, including family members and teachers. These early victimization experiences were not isolated events, but part of wider patterns of betrayal and silence. As Lovebite recalled:

I am not sure if I was born gay or if I was converted into being gay by my mother’s brother (uncle). It all started unexpectedly one night, I must have been 12 … I couldn’t scream coz he covered my mouth, and I remember my anal area being so sore the next day and it was so difficult to pass stools. This continued till I was 17 but I never reported it coz I didn’t know where to start. (Lovebite, participant 1).

This subtheme is further echoed participant 5, Montes, whose quotation goes further to demonstrate sexual abuse by authority figures in educational contexts,

I was raped by one of the male teachers in the library as I was the library monitor, and we were cataloging and shelving new books together one afternoon. He would do that from time to time and gave me money, and although day one was painful, I started to enjoy it. I didn’t know what it was called at the time, I found out in tertiary school that I must be gay or bisexual because I also like girls. (Montes, participant 5)

These quotations highlight child sexual abuse in the family home and trusted nurturers, like teachers in a school setting. The normalization of such abuse within these relationships underscores a disturbing reality where children are vulnerable to exploitation by those they should be able to trust.

Abuse across the life span: from home to sex work

Adult experiences of victimization often mirrored or extended earlier trauma, with participants commonly reporting sexual assaults, physical violence, and economic exploitation by clients. Participant Sissyboy shared:

I have had many experiences of physical abuse from clients. … I have been raped twice. … They tend to target me more compared to my mates … maybe because I look more girly, … Some include clients who are high on cocaine brutally beating me, other clients refusing to pay after using me, others name-calling and shaming me after using me and I’ve been raped twice. … They tend to target me more compared to my mates in this business, maybe it’s because I look more girly, I don’t know. (Sissyboy)

Participant 6, Lovebite, also shared his story as follows,

My scream was so loud guests on other rooms in the hotel came out to bang on our door and ask what was going on. Everything had happened so fast because I don’t know when he removed my plaster and switched on his cigarette lighter to burn it. They called the police, but I didn’t want to open the case and just left. It was really embarrassing. (Lovebite).

While these for some may be seen as part of “kinky indulgents,” it was not without a doubt extremely painful for Lovebite. Lovebite’s experience of being burned and Sissyboy’s accounts of beatings and rape illustrate a disturbing normalization of violence within the context of sex work. Clients’ violence was frequently compounded by substance use, nonconsensual condom removal (“stealthing”), and refusal to pay for services.

Internalization, meaning-making, and identity due to familial rejection, bullying in school, and religion

Many participants struggled with internalized blame, family rejection, and societal messages that equate victimization or sexual orientation with shame. Familial rejection emerged as a major factor leading to internalization of trauma, forced meaning making, and confused identities. Participant 15, Loverboy stated,

When I came out and told my family I was gay they stopped talking to me and my mother said I should leave her house. (Loverboy.

This quotation illustrates a painful disconnection after coming out, with the participant’s family ceasing communication and rejecting him outright. Similarly, Participant 4, Diva-666. described physical abuse and forced conversion therapy practices imposed by a father who could not accept his child’s identity. He shared,

I had a good childhood, but all changed when I was caught making out with my boyfriend in my room, I was 18. My father took his belt and beat me to a pulp and that was followed by long weeks of being dragged to churches and traditional healers for the “gay demon” to be taken out. I had to leave home because the abuse was too much. … In a way, the poor conditions I found myself due to my family’s abuse pushed me to do sex work and fend for myself. (Diva-666).

Many participants struggled with internalized blame and. There was also self-questioning emanating from familial rejection, internalized blame and societal messages that equate victimization or sexual orientation with shame, as with Lovebite stating:

I am not sure if I was born gay or if I was converted into being gay by my mother’s brother… (Lovebite)

Another participant described how social and religious pressures framed their sexuality as a curse or illness:

It is worse for people like me when you’re seen as a curse than a human needing protection. The law is silent, the church leaders fuel hate, families reject us and take us to church for curse removal, and you find you have no safe place to go. (Rainmaker).

Participant 2. Take-two detailed the severe bullying faced at school, including physical violence and verbal harassment, while also revealing the harsh treatment received from family members who enforced traditional gender norms. He noted,

I’ve always been different; everyone knew that I couldn’t fit in with the boys and always hung out with the girls. They called me names in school, I was spat on, beaten up for no reason and even teachers targeted me. At home it was even more difficult because my parents were in denial about who I was. They would randomly emphasize that I should think of being a good brother and an ‘ideal uncle’ to my older siblings’ kids. My father would come grab me by the balls as a reminder to act like a man when I forgot my mannerisms and acted like a girl. I was constantly monitored, beaten, and verbally abused. The words “What kind of uncle would I be? Would you negotiate your niece’s lobola walking and talking like that?” as my late father would usually shout, still ring in my head from time-to-time coz it was as if I could change my physique or make my voice deep, (Take-Two2)

Similarly, participant 8, Rainmaker, noted that,

I was bullied and teased everywhere growing up because my body and voice did not match my face. It is worse for people like me when you’re seen as a curse than a human needing protection. Then the law is silent, the church leaders fuel hate, families reject us, and you find you have no safe place to go. I didn’t understand why I was so different from other kids; I needed someone, I was just a child. Eventually I got tired of the abuse and as soon as I finished high school I left, I’ve never gone back home. Now that I do sex work, I get appreciated for how I make people like me feel, (Rainmaker)

Coping and surviving: strategies of resilience and the evolution of self-perception

Despite trauma, many narratives reflect journeys from internalized stigma to self-acceptance and resilience, often through embracing sex work as a source of agency and validation, leaving toxic environments, creating ties, and adopting risk reduction strategies and safety tactics, as participant Sexyboy explained:

At some point I got to enjoy it, I mean I could make money while at the same time living my true sexual identity … and so far, I have been happy doing it. (Sexyboy).

Another quotation states, I block out everything; I remind myself why I am a sex worker and I become okay. (Titanic)

This quotation demonstrates the embracing of sex work as a coping mechanism. Participants also took bold steps to reclaim safety, often by leaving abusive homes or unsympathetic communities as follows:

Eventually I got tired of the abuse and as soon as I finished high school I left, I have never gone back home. Now that I do sex work, I get appreciated for how I make people like me feel. (Rainmaker)

Others also narrated creating communities and seeking belonging or affirmation among other LGBTQ+ sex workers and forming informal support networks were also one of the ways to cope, survive and build good self-perception as follows:

We are a family now … You help me out if I am in trouble and I help you out if you need something like a place to sleep or when a client turns rough. Sometimes when I go to a hotel with a client my friend will be sipping some wine at the bar just to make sure, they are close by in case I need help. Some clients can be really rough. (Take-Two)

We share everything: tips, lubes, condoms, ideas, and we are always a phone call away if any of us need support. We are also each other’s counsellors. (Diva-666)

In our WhatsApp group we share memes, jokes, tips, stories about clients, and any upcoming events where we could make money. We are there for each other. (Lovebite)

We are each other’s keepers: we keep each other’s secrets, we share opportunities, we vet clients together, share locations for safety, we check on each other, it makes everything all easier coz there is no judgement, we are just free and living our lives. (Sissyboy)

Participants described adaptive strategies to reduce harm, from vetting new clients through trusted peers, to avoiding hotels with known risks and carrying safety tools. However, it is visible that ambient stigma and fear of disclosure limited access to formal safety nets.

Effects on mental, social, and economic well-being

Narratives revealed ongoing struggles with depression, anxiety, and trust issues. Lingering trauma from childhood and cumulative violence in sex work led to hypervigilance, substance use, and despair:

Those words still ring in my head … it’s as if I could change my physique or make my voice deep. (Take-Two)

As a transgender person have accepted people may never understand what it’s like to be me, gender dysphoria is real and the trauma of whispers and staring when you pass cannot be compared to anything. I had to make a conscious decision to take myself the NGO where I now feel I belong even though nothing with the society has changed. (Frenzy-chick)

I was in a dark hole. I could feel myself drifting away each day. I had endured my family’s beatings, verbal, and emotional abuse. It was too much. (Gold)

As a sex worker now, I am “woke,” I’m always alert. I am even more alert when I am high. I cannot ever let myself be used again. I have suffered abuse all my life, I know it is not going to get better but all I can do is protect myself and protect my friends. No one is coming to save us. (Lovebite) /

The narratives also highlight significant health risks associated with the violence and coercive practices of clients. Participant 3, Gold, shared having suffered from anal fistula, warts, and hemorrhoids after clients were rough with him. He said,

I had anal fistula, warts, and hemorrhoids which occur when clients are too rough or when its dry sex because sometimes you meet those clients who are forceful, and others don’t even know you have to use lubricants. Others even refuse to use a condom which has a bit of lubrication. I have also been beaten by a client who didn’t want to pay suffering multiple injuries. (Gold,)

In our line of work sexual violence is real, it can occur anytime, even from the most innocent looking client. (Titanic)

They can remove condoms during the act without asking for consent. It’s called stealthing. I have experienced it twice and so has many of my mates, and it’s usually done by clients who do not care about their own health when it comes to STDs or even HIV/AIDS. (Frenzy-chick)

Gold’s mention of anal fistula, warts, and hemorrhoids due to rough treatment points to the health and physical toll that such victimization can have on sex workers. Frenzy-chick’s experience with ‘”tealthing,” which he defines as the nonconsensual removal of condoms, further emphasizes the lack of regard for health and safety among some clients. This theme reveals a critical intersection between victimization, health risks, and the need for protective measures within sex work.

Barriers to reporting and help-seeking

,Reluctance to report abuse stemmed from fear of stigma, legal repercussions, and disbelief by authorities. Quotes from participants Sexyboy, Chrysanthemum, Frenzy-Chick, and Take-Two illustrate a pervasive fear of exposure and stigma associated with their identities as sex workers. For example,

How can I go and report? Going to the police is not even an option for us. (Sexyboy)

Another participant, Chrysanthemum, remarked,

I can never report to the police and risk people knowing. (Chrysanthemum)

Take-Two also note,

We always have to hide what we are doing so the community does not know. If you go to the police that would be like blowing up your own cover and we can’t risk it. (Take-Two)

These barriers compounded vulnerability, reinforcing cycles of silence and exclusion.

The above analysis demonstrates that violence and victimization among GBTQI+ sex workers in Botswana are not simply episodic events but are deeply embedded within, and reinforced by, intersecting social, familial, cultural, and institutional systems. Experiences of abuse are organized not just by time, but by the type, meaning, and context of violence experienced; the strategies developed for survival; and the cumulative impact on participants’ mental health, livelihoods, and identities. Most critically, participants’ narratives reveal resilience and agency even in the face of overwhelming adversity, as well as persistent barriers to protection, justice, and well-being.

Through organizing and interpreting the data through these analytical lenses above, the categorization and context of abuse, coping strategies, health and social consequences, meaning-making, support-seeking, and the intergenerational cycling of trauma provide a richer, more actionable understanding of the lived realities of GBTQ+ sex workers, which is essential for informing targeted interventions, advocacy, and policy reform that are responsive to the actual complexities of participants’ experiences.

Intersectionality and vulnerability

The experiences shared also indicate that those who present themselves as more feminine are particularly vulnerable to victimization. Sissyboy, for example, noted:

Because I’m soft and speak like a girl and dress girly sometimes some clients want me just so they can abuse me. (Sissyboy)

Frenzy-chick also noted,

I identify as a transgender woman and compared to anyone in my circle I am always targeted by “insecure” and “toxic” clients because they know I’m likely defenseless to fight for myself and they can do whatever they want with me. But of course, there are those who are gentle who would treat me like a princess. (Frenzy-chick, participant 10)

These quotations present the participants’ observations about being targeted more than their peers, suggesting that societal stereotypes regarding masculinity and femininity contribute to heightened risks for individuals who do not conform to traditional gender norms. This theme illustrates how intersecting identities, such as gender expression and sexual orientation, can compound vulnerability within the context of sex work.

Discussion

The narratives presented in this study demonstrate that the childhood experiences of the GBTQI+ participants in Botswana are frequently marked by profound and multifaceted trauma, including sexual abuse, familial rejection, bullying, and religious stigmatization. As adults engaged in sex work, these individuals continue to encounter intersecting forms of vulnerability, exploitation, and violence, revealing a clear continuity between early victimization and later-life adversity. These findings reinforce the proposition that trauma is not temporally bounded but instead traverses developmental stages, shaping identity, coping strategies, and survival pathways well into adulthood. This life-course continuity aligns with international research demonstrating that childhood trauma among GBTQI+ individuals is strongly associated with long-term mental health challenges, including posttraumatic stress disorder (PTSD), depression, anxiety, and impaired relational functioning (Etherington & Baker, 2018; Mashumba, 2024).

Importantly, the present findings extend existing scholarship by illuminating identity disruption as a central mechanism linking childhood neglect and adult sexual vulnerability. Bigras et al. (2020) argue that childhood neglect undermines core identity development, resulting in persistent difficulties in self-definition, emotional regulation, and recognition of personal needs. Within this study, participants’ narratives reflect similar struggles, with early rejection and abuse eroding stable self-concepts and contributing to maladaptive coping strategies, including engagement in high-risk or transactional sexual encounters. Identity confusion and diminished self-worth appear to heighten susceptibility to coercive sexual dynamics, reinforcing cycles of exploitation within sex work contexts. These findings underscore that sexual vulnerability is not merely behavioral but is deeply rooted in disrupted developmental processes originating in childhood neglect and trauma.

Familial rejection also emerged as a particularly salient and enduring source of trauma, encompassing emotional abandonment, physical abuse, and expulsion from the family home. From a socio-ecological perspective, these dynamics highlight the critical influence of microsystemic (family) and exosystemic (community and institutional) forces in shaping developmental trajectories. Empirical evidence across African and global contexts consistently documents patterns of rejection or mistreatment following the disclosure or discovery of nonnormative sexual orientations (D’Augelli et al., 2005; Francis & Reygan, 2016; Green-Simms, 2016; Mashumba, 2024). Etherington and Baker (2018) further contend that such rejection dismantles existing support systems, exacerbates social isolation, and intensifies psychological vulnerability, thereby increasing reliance on precarious survival strategies.

The sex role theory provides a critical interpretive lens for understanding these patterns by foregrounding the consequences of transgressing culturally prescribed gender norms. In patriarchal societies such as Botswana, deviations from hegemonic masculinity are frequently sanctioned through exclusion, violence, and moral condemnation (Humphreys, 2013; Mashumba, 2021). For many participants, entry into sex work was precipitated by familial rejection and the immediate necessity for economic survival following displacement from the household. These findings echo earlier scholarship documenting pathways into sex work driven by homelessness, poverty, and the absence of alternative livelihood options (Daly, 1994; Kramer & Berg, 2003; Miller, 1986). In the Botswana context, these pressures are further compounded by unemployment, debt, and obligations to financially support extended family networks, reinforcing economic vulnerability as a structural driver of transactional sex (Mashumba, 2025; Mmeso, 2015).

This economic precarity must also be understood within a broader syndemic framework, wherein poverty, food insecurity, stigma, and sexual risk mutually reinforce one another. Smith et al. (2021), in their cross-national study of adolescents from 53 countries, demonstrate a strong association between food insecurity with hunger and engagement in risky sexual behaviors. These findings are highly relevant to the present study, as participants’ narratives reveal that unmet basic needs, such as food, shelter, and financial stability, often shape sexual decision making and constrain agency. For displaced and rejected GBTQI+ youth, sex work may therefore represent not a choice grounded in preference but a survival response to structural deprivation. This convergence of economic hardship and sexual vulnerability exemplifies the syndemic conditions under which harm is amplified rather than isolated.

In addition, experiences of sexual violence, including stealthing, physical assault, and sexual abuse, remain pervasive within participants’ adult lives. Consistent with prior research, GBTQI+ sex workers face significant barriers to negotiating safer sex due to power imbalances, economic dependency, and pervasive stigma (Gupta et al., 1996; Javaid, 2016, 2018; Mashumba, 2021, 2024; Samudzi & Mannell, 2016). These constraints situate sexual risk within structural contexts rather than individual behaviors alone, reinforcing the need for interventions that address both material conditions and social power relations. Persistent exposure to violence further compounds earlier trauma, entrenching cycles of victimization that span childhood and adulthood.

Furthermore, bullying also emerged as a recurring and consequential theme, with well-documented psychological sequelae including diminished self-esteem, social withdrawal, and disrupted educational trajectories (Arnott & Crago, 2009; Etherington & Baker, 2018). Research consistently demonstrates that GBTQ children and adolescents are disproportionately subjected to bullying and abuse by peers, educators, family members, and community actors (D’Augelli & Hershberger, 1993; Ferfolja & Ullman, 2020; Remafedi et al., 1991; Schneider et al., 1989). These early experiences of social exclusion not only undermine academic attainment but also limit future employment opportunities, thereby reinforcing economic vulnerability and increasing reliance on informal or stigmatized labor sectors such as sex work.

Religious stigmatization also constituted an additional and deeply entrenched layer of trauma. Exclusion from faith communities often fosters internalized homophobia, moral distress, and feelings of spiritual abandonment (Mashumba, 2021; Zalcberg, 2017). Ryan (2009) similarly argue that religiously grounded homophobia perpetuates victimization beyond adolescence, sustaining shame and self-blame into adulthood. Although much of the existing literature relies on quantitative designs, findings consistently highlight the detrimental effects of unsupportive religious, social, and cultural environments in legitimizing hostility toward sexual minorities (Murphy et al., 1999; Waldo et al., 1998).

GBTQI+ sex workers in Botswana are also acutely vulnerable to abuse perpetrated by clients, law enforcement officials, and other institutional actors (Aidsfonds, 2024), mirroring the findings of this study. Underreporting of violence remains widespread, driven by fear of retaliation, anticipated discrimination, and profound mistrust of the criminal justice system (Aidsfonds, 2024; Arnott & Crago, 2009; Mashumba, 2021, 2024). As Stemple and Meyer (2014) argue, this systematic underreporting perpetuates both the invisibility of male sexual victimization and the marginalization of men and boys within victimological research and policy responses.

Finally, cultural expectations attached to male social roles such as uncle, brother, or heir are deeply embedded in Tswana society and reinforced through patriarchal traditions (Mashumba, 2021; Mookodi et al., 2004; Schapera, 1970). Quotations from participants such as “What kind of uncle would you be?” exemplify how masculinity is tightly bound to family honor, heterosexuality, and lineage continuity, particularly within practices such as lobola negotiations. Failure to conform to these ideals is perceived as a threat to cultural hegemony and Afrocentric patriarchy (Scott, 2007), often resulting in shaming, ritualized punishment, or symbolic “cleansing” practices (Mashumba, 2021). Taken together, the findings of this study illuminate how interlocking familial, economic, cultural, and institutional systems collectively produce and sustain the vulnerabilities experienced by GBTQI+ individuals in Botswana. Addressing these enduring harms requires multidimensional, trauma-informed, and structurally grounded interventions that operate across all socio-ecological levels. Such interventions must move beyond individual behaviors change to confront the structural inequalities, identity disruptions, and syndemic conditions that shape both childhood victimization and adult survival strategies.

Implications of the study

Findings of this study have several implications for policy and practice. The continuity of victimization from childhood into adulthood among GBTQI+ sex workers in Botswana highlights the persistent nature of trauma and the complex interplay of various forms of discrimination. Addressing these issues requires a multifaceted approach that includes legal reforms, mental health services, and community support programs tailored to the unique needs of this marginalized group. In addition, by understanding the intersectionality of identity and vulnerability, policymakers and service providers can develop more effective strategies to support and protect GBTQI+ sex workers in Botswana because it is evident that there is a pressing need for inclusive support systems that address the unique needs of GBTQI+ sex workers or systems sensitive to their intersectional identities (Aidsfonds, 2024; Arnott & Crago, 2009). This study also posits that to effectively prevent child sexual abuse, Botswana must acknowledge the deleterious effects associated with abusive experiences in both childhood and adulthood, and strengthen family and societal protection of children, which remains weak in Botswana despite the Convention on the Rights of the Child, Article 19, requiring that nations must take all appropriate legislative, administrative, social, and educational measures to protect children from sexual abuse.

Study limitations

This study is not without limitations. Its significant limitation is the fact that participants were recruited through three nongovernmental organizations advocating for sex workers in Botswana, which skewed the sample to only those who accessed the NGOs services. In addition, the study did not collect any data on the interplay between criminalization and structural factors predisposing people to sex work as well as health outcomes; however, this is an area recommended for future studies. Last, this study acknowledges that the GBTQI+ community in Botswana is not a homogeneous group, as they are from diverse ethnic backgrounds, different upbringings, and diverse gender and sexual identities. Hence, their experiences are not intended to be representative or generalizable but to be viewed as unique, thought-provoking, and a call to action.

Conclusion

In conclusion, the intersectionality of identity and vulnerability is a critical aspect of understanding the experiences of GBTQI+ children and GBTQI+ sex workers in Botswana. The study revealed that childhood experiences for GBTQI+ individuals are marked by significant trauma stemming from sexual abuse, familial rejection, bullying, religious stigmatization, and ultimately resilience. As adult sex workers, they face significant challenges related to sexual and physical abuse, health risks, barriers to reporting victimization, intersectionality, and the continuity of trauma from childhood into adulthood. These interconnected themes highlight the urgent need for societal change to foster acceptance and protect vulnerable youth from such pervasive victimization. The study also underscores the urgent need for systemic change, including public education, policy reform, and targeted health interventions to protect vulnerable populations such as GBTQ+ individuals and sex workers from ongoing violence and discrimination. The combination of sexual orientation, gender identity, and occupation clearly creates a unique set of vulnerabilities that are not easily addressed by existing social and legal frameworks.

Conflict of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.