This article is adapted from an episode of our podcast, “Civic.” Click the audio player below to hear the full story.
Scores of LGBTQ refugees come to San Francisco to escape threats in Latin American countries that have weak protections for people vulnerable to hate crimes based on their sexual orientation and gender identity.
The San Francisco Asylum Project at the Center for Immigration Protection offers legal defense and housing for those who have been persecuted or fear persecution over their gender identity or sexual orientation. But there’s a glaring gap in one crucial service: support for substance use disorder recovery.
According to a number of studies, a high rate of LGBTQ Latin Americans turn to substance use to cope with stigma and discrimination, as well as their own sexual orientation or gender identity.
But according to David, an LGBTQ member of Alcoholics Anonymous from Colombia who asked that we use only his first name, recovery support is limited because other Latin Americans are sometimes hostile when discussions touch on LGBTQ themes — like the difficulty of transitioning or coming out.
This “Civic” episode includes the story of community members who started a substance use disorder recovery group for LGBTQ Latin American immigrants.
“There is no way for the trans community and for LGBT people, Spanish speaking, to go to a support group, because they’re filled with straight people,” David said.
Honey Mahogany, director of San Francisco’s Office of Transgender Initiatives, said she’s unaware of substance use disorder treatment programs specifically for LGBTQ immigrants.
A city ordinance requires that the Department of Public Health track certain health and demographic data for LGBTQ populations, but it does not record the prevalence of substance use disorders for these groups.
Instead, in its latest report, the Department of Public Health noted the proportion of substance use disorder patients who answered questions about their sexual orientation and gender identity, but not how many LGBTQ residents were enrolled in recovery programs.
Perilous future for trans population
Transgender people across the country are facing increasing hostility as 45 states consider more than 660 anti-trans bills to deny access to basic healthcare, legal recognition, education, bathrooms, athletics or the right to openly exist in public schools, while the incoming Trump administration promises to push Congress to pass a bill declaring that the federal government would recognize only male and female genders assigned at birth.
LGBTQ Latin Americans are facing added pressure from the incoming administration’s promise to deport millions of immigrants that it considers illegal — even those with protected status under U.S. law.
At a Trans Immigrants Day commemoration at City Hall on Nov. 18, Mahogany vowed to protect those seeking sanctuary.
“We are going to Trump-proof this state,” she said. “For those of you who are immigrants who have come here looking for a better life, escaping oppression at home, we have got your back.”
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Clashing values
Although San Francisco and California have some of the country’s most stringent protections against discrimination based on gender identity or sexual orientation, some Latinx immigrants still experience stigma.
Persistent anti-LGBTQ biases are prevalent in many Latin American communities due in large part to the influence of Catholic traditions, David said.
“The first thing that my father told me when I told him that I like guys was, ‘But do you know that that is one of the biggest abominations of the Catholic Church?’” he said.
Francisco Monserrat Mendoza Marquez, 56, had a troubled childhood in Mexico under his father’s harsh treatment. He kept his sexuality suppressed, internalizing a sense of moral failing while dabbling in drugs. Then in 2002, a divorce and his father’s death drove him into heavy substance use.
He moved to the United States in 2014 seeking a fresh start, but his addiction endured. While living in Los Angeles, Marquez hit rock bottom in 2023 when photos depicting him in a sexual encounter during a three-day blackout drug binge were posted on TikTok, leading to bullying and harassment.
Marquez fled to San Francisco. Unhoused and struggling with a severe substance use disorder, he sought help at St. Anthony Foundation, hoping that the Franciscan Catholic-based charity would align with his strong connection to faith and the Bible.
For more than seven decades, St. Anthony’s has been offering meals, clothing, healthcare and job training for poor and unhoused people in the Tenderloin District. And it’s one of the few local organizations offering substance use counseling for unhoused Spanish speakers.
Marquez said he was shamed when he shared his story with a member of St. Anthony’s peer program, which trains recovery treatment graduates to provide counseling.
“That program at St. Anthony’s, I just had a lot of regrets of having even gone,” Marquez said through an interpreter. “When I was telling him why I was looking for help, why I wanted to cure myself and why I wanted to look at these personal values and morals, I was found with a lot of disrespect, and I would see him laughing or mocking me.
“When you’re in a situation like this, those are things that don’t help you move forward. They actually pull you back.”
Laura Flannigan, St. Anthony’s chief operating officer since May, said she’s never heard complaints about intolerance toward LGBTQ people.
“St. Anthony’s has a really outstanding reputation, certainly in the neighborhood, of being a place that welcomes anyone who comes to our doors,” she said.
But clashing values have sometimes led to strained circumstances at St. Anthony’s. Nils Behnke, St. Anthony’s CEO from 2020 to 2023, talked about tensions during a June 2021 online conversation with San Francisco Archbishop Salvatore Cordileone that was hosted by the Benedict XVI Institute.
“You find yourself in a situation that can sometimes be described as mission drift,” Behnke said.
Behnke said his goal was “mission integration” — to get St. Anthony’s “back on the right path” by attracting young employees who were involved not merely in the social services aspect of the organization but also its religious education.
Cordileone, who once referred to same-sex marriage as “the ultimate attack of the Evil One,” was a central figure behind a successful 2008 state ballot measure to strip California’s same-sex couples of marriage equality. The measure, which added a new section to the state Constitution providing that “only marriage between a man and a woman is valid or recognized in California,” was overturned in 2010 by the 9th U.S. Circuit Court of Appeals. The U.S. Supreme Court upheld the district court’s decision in 2013.
In conversation with Behnke, Cordileone said the church had to “adapt to a culture to try to infuse it with the gospel.”
“We need to do a lot of preliminary pre-evangelization work,” he said. “The soil and the culture nowadays is very barren. So we need to need to cultivate that soil so it can be fertile when the seeds are planted. That’s what I see what St. Anthony’s Foundation is doing. It opens the mind when people encounter so much love.”
Flannigan said St. Anthony’s does not “technically report to the Catholic Diocese.”
Ancient cultures were inclusive
Anti-LGBTQ stigma was introduced into the area that would become Latin America during colonization, and truly took hold during the Spanish Inquisition, according to Luis Mott, a Brazilian anthropologist.
The region’s ancient cultures were accepting of same-sex relationships — certain tribes used non-binary social structures and did not have strict gender roles.
The colonial ideology valued conquest and led to macho behavior that was even more pronounced in Latin America than it was on the Iberian Peninsula at the time, according to Mott.
Debra Camarillo, CEO of the Latino Commission, the only residential treatment facility for San Francisco’s Latinx population, believes that the key to healing for Latinx LGBTQ people lies in their indigenous roots.
“I’m a queer myself,” Camarillo said. “Going through life battling with trying to fit in and contending with all the assumptions of what that is and what you’re supposed to be — you know, ‘It’s a sin and you’re going to go to hell.’ I believe part of my addiction was part of that.”
Camarillo said many indigenous cultures around the world view gender and sexuality on a spectrum, and ancient teachings maintained that “there’s nothing that you need to do to become sacred, you are sacred, the essence of you and your spirit.”
Camarillo said she has seen the profound effect of that message on people attending her lectures.
“I have been many places, and especially working with young transgenders, and they’ll come and embrace me, crying with tears, ‘I have never, ever heard that I’m sacred,’” Camarillo said.
New SF Latinx LGBTQ support group widely embraced
David said he was driven to create a safe online space where his community could connect after he met an El Salvadoran trans Latina who talked about the hostility she endured when her AA group discovered she was transgender.
“I was like, ‘Whoa.’ I really felt a call,” David said. “Like, ‘I need to do something about it.’”
Ambar Alfaro has been fighting for trans rights in El Salvador since 2008. She is part of the Latin American and Caribbean Network of Trans People and co-founder of the Permanent Table on LGTBI Population Human Rights in El Salvador, which provides information about the legal and social challenges faced by the country’s LGBTQIA citizens.
She has been invited several times to petition before the Inter-American Commission on Human Rights, part of the Organization of American States, which works to promote and protect human rights in 35 countries. Her activism had made her a target of attack.
“She got threatened with a firearm,” David said. “She’s getting persecution because of the crazy political situation in Salvador.”
Last year, she sought support for a substance use disorder, but she soon felt forced to leave.
“One person from one of those groups saw me speaking on a video very openly about being trans and the LGBTQ rights,” Alfaro said through an interpreter. “And after that the behavior from them against me was completely different and was very hostile. Morally and physically, I feel threatened.”
David, his husband, Eric, and Alfaro cofounded Recuperación Diversa — Diverse Recovery — an online group supporting recovery for all manner of unhealthy behavior, whether with substance use, food or emotional codependency. It’s also open to people who don’t necessarily feel that they’re struggling but want to learn more.
Alfaro said she wanted to help form a recovery support group to honor trans Latin Americans who were killed over their gender identity.
“We owe this to the people that are not with us anymore, for people to have the possibility of getting recovery from drugs and alcohol that is dignifying,” she said.
Since August, online membership has grown by word of mouth to include people from the U.S. East and West coasts, Mexico, El Salvador, Colombia, the Guianas, Argentina and Peru.
“It’s beautiful to see people that are coming in and they’re like, ‘I was waiting for this, and finally I have a place to be, and I finally have a place to talk,’” David said.
The group meets six days a week. Find out how to connect by emailing [email protected].
