As pessoas trans e o Sistema Único de Saúde (SUS): representações sociais, (in)visibilidade, vozes e silenciamentos frente ao direito de (re)existir

Abstract

The public system in our country has encountered a series of challenges regarding public policies for the LGTBQIA+ community (Lesbians, Gays, Bisexuals, Transvestites, Transsexuals, Transgenders, Queer, Intersexuals, Asexuals, and other fluid and non-binary genders), further reinforcing a culture of prejudice and denial of minimum rights and dignity to this population. The importance of this study is justified to know more deeply the perception of health professionals in relation to the care provided (or not) in health services to the trans population, thus allowing new models of policies to be based on this population and the SUS principles. The general objective of the research was to analyze the health care of trans people in the Unified Health System (SUS) in Chapecó-SC from the social representations of health professionals, intertwining their life, training and care itineraries in search of the Right to (re)exist. The research in question is qualitative and descriptive, using the Theory of Social Representations (RS) as a theoretical axis. The research study scenario was the city of Chapecó. Fifteen health professionals from the most diverse categories of the various health services of the SUS network were selected. Data collection took place through remote and face-to-face interviews. A guiding instrument divided into three parts was used: the first characterization of the participants; second, a Free Word Association Test (TALP); and third, from a script with guiding questions to deepen the theme. Data analysis was performed using the technique advocated by Laurence Bardin. The discussion of the results was divided into three themes, namely: Theme 1 - I treat everyone the same: knowledge and practices about gender identity, sexual orientation and trans people; Theme 2 - I neither heard nor tried to find out (about the National LGBT Comprehensive Health Policy): is there really a need for a specific Policy?; Theme 3 - I have no prejudice: (in)visibility and pilgrimage in the services of the SUS network (?) as challenges for trans people. It is noticed that the access of these people is still limited and that the users become invisible and wandering through the System. It was noted by the participants' speeches that an (in)visibility of trans people within the services is created, by the expressed ways of the professionals in relating the equal treatment for all, since the principle cherished by the SUS is that of equity, that is, treat each individual valuing their particularities and demands, thus violating the constitutional principle of equity and excluding the specificities that these individuals have. In addition, it was possible to identify flaws in the qualification of health professionals regarding the service to the entire LGBTQIA+ community, especially trans people. It reflects on the silencing that occurred within the community itself in relation to trans people and also in health services, since their demands are not met, seen and heard. It is suggested that new studies on the subject be developed, in order to disseminate the importance of implementing the LGBT PNSI in the SUS, complying with its principles of integrality, equity and universality.