Abstract
to analyze the representations of healthcare provided to trans people living on the streets. ten women (three trans) and three cisgender men participated in this action research. Popular health education groups, focus groups, seminars and interviews were held, the data of which were organized in the software Nvivo®, submitted to content analysis and interpreted in the light of intersectionality theory. healthcare was represented by the technical, relational, structural and citizenship dimensions. The relationship between gender and poverty determines the specific health needs of trans people living on the streets. the need to expand conceptions and practices on healthcare to meet the specific health needs of trans people living on the streets was evidenced. Nursing, with competence and cultural sensitivity, can contribute to positive health outcomes and, consequently, break with the logic of exclusion, illness and poverty.
Highlights
The absence of official data on the number of homeless people, including trans people in this situation, reinforces their invisibility and negatively impacts the proposition of specific public health policies for this group[1,2,3].Lack of knowledge about the sociocultural, demographic and epidemiological profile of the trans population results in precarious health conditions for these people, which may be more harmful to those who accumulate derogatory experiences, such as those living on the streets.The last census of the homeless population in the city of São Paulo estimated the existence of 386 trans people living in this situation, which corresponds to 1.6% of the total (24,344 people)
The homeless situation, in this case, sheds light on the importance of understanding the possibilities of combinations between gender, race, social class and other categories of analysis in determining their health-disease-care process. This process that articulates different mechanisms of oppression reflects worse health outcomes for trans people living on the streets, especially those related to the high prevalence of harmful use of psychoactive substances, situations of violence, sexually transmitted infections (STI), complications related to the clandestine use of hormones, mental health problems and vulnerabilities related to precarious sex work[5,6,7,8,9,10,11,12]
Other actions that emerged from the identification of health needs of the people involved in the research and ensured their participation throughout the research process were: a parade to claim rights related to trans identity; visit to photographic exhibitions on the theme of gender and social class; collective production of a book chapter with/about the participation of trans people living on the streets in the university’s extension project; basic training in first aid; integration of students from the technical nursing and podiatry course with the project for trans people living on the streets
Summary
The last census of the homeless population in the city of São Paulo estimated the existence of 386 trans people living in this situation, which corresponds to 1.6% of the total (24,344 people). This estimate included trans women (55.5%), transvestites (10.5%) and trans men (9.5%), with a predominance of black people (67%) and aged between 31 and 49 years[4]. Extreme poverty and other consequences of unemployment, which are more prevalent in the trans population compared to the general population[5], such as homelessness, restricted or absent employability and low income, are effects and causes of the several exclusions that determine precarious health conditions. The homeless situation, in this case, sheds light on the importance of understanding the possibilities of combinations between gender, race, social class and other categories of analysis in determining their health-disease-care process
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