By Ernesto Picco, from Santiago del Estero. When Daniela Gutiérrez, a 49-year-old trans woman, finally made it into the Santiago del Estero Regional Hospital, she was already dead. It was the night of Monday, June 18. The following morning, the local press reported that she had arrived with signs of mechanical asphyxiation. Local representatives of AT.TTA (Association of Transvestites, Transsexuals, and Transgender People of Argentina) told Presentes that they intervened to support the family and follow the judicial investigation. The case took an unexpected turn when the autopsy confirmed, a few hours ago, that the cause of death was septicemia (a generalized infection) caused by severe peritonitis. Martín Silva, the prosecutor on duty, said that the autopsy ruled out death by mechanical asphyxiation, as some media outlets had reported. "On Monday, the family wanted the body released for the wake, but I ordered the autopsy and an on-site inspection of the house." "I wanted to make sure there hadn't been any fight or anything unusual, because she arrived at the hospital already dead. On Tuesday night, Dr. Ledesma, who performed the autopsy, confirmed to me that the death was due to her pre-existing condition, and that there were no signs of medicolegal interest. I don't know where the version about signs of mechanical asphyxiation came from," the prosecutor told Presentes.

"They didn't want to admit her to the hospital."

Daniela's family informed ATTTA that she had been trying to get medical attention at the Regional Hospital for weeks, but they refused to admit her. “She was a patient at the hospital, and they didn't want to admit her,” said Luisa Paz, a representative of ATTTA. “She had an enlarged, fatty heart, cirrhosis, and HIV. She was in and out of the hospital all the time. They didn't want to admit her.” She died as a result of institutional violence, of not being able to receive proper care. And after her death, she became a victim of media violence.Daniela was about to turn 50. She lived in the Primera Junta neighborhood of the capital of Santiago del Estero, she was married, a homemaker, she had a sister and several nephews. “Her family was very supportive,” says Rubí Gómez of ATTTA, “and when it came out in the newspaper that she might have been murdered, they couldn’t believe it. They desperately needed to know the autopsy results and what had happened.” The only recorded murder of a trans person in Santiago del Estero occurred in 2014 and shocked the public. Brian Salto, a former police officer, ran over 24-year-old Pamela Moreno with his truck.He was sentenced to 20 years in prison. Beyond the resonance of that case, institutional violence, as denounced by members of the transvestite and trans collective, is silent and persistent.

READ MORE: #NiUnaMenos: at least 4 transvesticides and dozens of trans deaths in 2018

Rejection of the health system

“We have recorded the deaths of our sisters who, faced with rejection from the healthcare system, never return,” explained Rubí Gómez. She added that “the three leading causes of death among the trans population are health-related. First, HIV, since due to poor care, many prefer to abandon treatment and die rather than continue facing discrimination. Another is hormone therapy without a prescription, which affects internal organs. And then there is the use of rudimentary, homemade silicone implants. The first two issues must be addressed by the State, and this is covered by the Gender Identity Law.” Although the The Gender Identity Law has been in effect for more than six years.Various trans and travesti organizations have been denouncing the fact that the healthcare system, among other sectors, is not complying with the Gender Identity Law. Even after her death, Daniela and her family continued to suffer from this non-compliance. Those close to her emphasized the need for greater awareness within both the healthcare and judicial systems. “At the morgue, they treated her as male, even though she has her ID and is protected by the Gender Identity Law, even though she is deceased,” explained a family member. “As an organization, we had to come forward to refute this, being there and speaking with the family,” explained Rubí Gómez, “and to highlight the negligence with which the trans population is treated in particular. On Monday morning, she went to the hospital because she felt unwell, and they told her to leave, that everything was fine. Then, in the afternoon, this happened.”

[READ ALSO: “Transvesticide, the final link in the chain of daily violence against transvestites and trans people”]

The urgency of an inclusive clinic

In December 2017, representatives from ATTA began a series of meetings at the Ministry of Health, with support from the Provincial Secretariat of Human Rights. They formally denounced the problems of access to public healthcare for the trans community in Santiago. The process began to open an inclusive clinic, which official sources announce will take place in the coming months. Patricia Gómez, a clinical sexologist, was appointed to head this clinic, which will operate within the Hospital Independencia. “We have two objectives,” the doctor explained: “to provide specific and general care to trans people through this clinic, and also to conduct workshops for all hospital staff to raise their awareness, because we will likely need to coordinate consultations with other services and ensure respectful treatment.”

Social transvesticide, the main cause of death

“We receive very poor treatment,” Luisa Paz emphasized, “but now we are hopeful because we have the possibility of this space to raise awareness among hospital staff and provide our fellow trans women with a real support network within the hospital and the healthcare system.” Meanwhile, activists from the trans and travesti community in other provinces, along with organizations like the Trans Memory Archive, denounce that In addition to the transvestites, there were at least 30 deaths of female colleagues who were victims of what is called "social transvesticide". “The most invisible numbers are those deaths, which are also crimes.The residue left by the State's lack of attention: due to prostitution, lack of access to healthcare. It's residual violence. All trans people experience residual violence. There's no awareness of this violence: from when they yell "faggot" at you to when they attack you in the street. Deaths from injectable industrial silicone are a topic that's not discussed. And in the healthcare system, there are no treatments for its removal, and it's a constant, self-inflicted danger due to societal mandates,” Lara Bertolini, a trans activist and employee of the Public Prosecutor's Office, told Presentes two weeks ago. Daniela's death adds to this long list.