O processo de transição de pessoas trans dentro do SUS: a busca pelo direito à saúde

Abstract

This study highlights the diversity of gender identities, focusing on the challenges faced by transgender individuals through the lens of public policies, particularly the Comprehensive LGBT Health Policy. It addresses the transgender process, health promotion, and gender recognition, revealing a discrepancy between the availability of these services and the persistent exclusion and violence faced by the transgender population. Therefore, the general objective of the study is to understand the transition process for transgender individuals within and outside the Unified Health System (SUS), in accordance with current public policies. The study utilizes a qualitative approach to analyze the gender transition process of transgender individuals, with a focus on the Chapecó region in Santa Catarina. The selected participants were over 18 years old, had completed higher education, resided in Chapecó, and were users of the SUS. Data was collected through interviews via Google Meet® and analyzed using the Bardin method. Three interviews were conducted, all of the participants had undergone social transition, one-third were in the process of hormonal transition, and none had undergone surgical procedures at the time. Regarding hormonal transition, one-third went through all stages through the SUS, onethird partially through the SUS or private initiative, and one-third exclusively through private initiative. One-third admitted to having used counterfeit/illegal hormones on their own, while two-thirds did not. Additionally, 32 studies were reviewed, of which 22 were used in the discussion. The results reflect the importance of social and hormonal transition for transgender individuals, aiming to achieve the desired social recognition and combat the subordination imposed by the binary gender structure. Access to transition procedures through the SUS in Brazil is challenging, with a low number of interventions being performed. In Chapecó, hormonal transition is carried out in Basic Health Units (UBS), while surgeries are performed in Florianópolis or other accredited hospitals. In private health services, there are additional requirements to undergo gender confirmation surgery. This reflects the slow and bureaucratic nature of the public healthcare system in Brazil, leading many individuals to rely on social media groups for information about transitioning. As appearance and the pursuit of "passing" are crucial in the transition process, some transgender individuals take health risks by selfadministering hormones due to the lack of adequate access. This lack of proper hormone access increases health risks for transgender individuals. The interviews revealed the unanimous desire to undergo breast surgeries, leading many to seek private healthcare due to long waiting periods in the public system. The importance of public policies in ensuring access to healthcare and gender recognition for transgender individuals is emphasized. However, significant improvements in the healthcare system are necessary to adequately meet the needs of this population. Actions such as healthcare professional training, streamlining bureaucratic procedures, and establishing specialized centers can contribute to comprehensive and respectful care. Promoting equity and combating exclusion and violence are fundamental to ensuring an inclusive society for all individuals, regardless of their sexual orientation or gender identity.