The National Policy for Comprehensive Health of Lesbians, Gays, Bisexuals and Transgender (LGBT) and access to the Sex Reassignment Process in the Brazilian Unified Health System (SUS): progress and challenges.

Gianna Schreiber Popadiuk,Daniel Canavese Oliveira,Marcos Claudio Signorelli

doi:10.1590/1413-81232017225.32782016

Gianna Schreiber Popadiuk, Daniel Canavese Oliveira + Show 1 more

Open Access

https://doi.org/10.1590/1413-81232017225.32782016

Copy DOI

Abstract

This study aimed to analyze how the Brazilian Ministry of Health (MS) is implementing the Sex Reassignment Process (SRP) in the Unified Health System (SUS), through research of public domain official documents, systematization of surgery's quantitative data and analysis of meeting reports of the LGBT Health Technical Committee (CTSLGBT) of the MS. We conducted exploratory research combining quantitative and qualitative methods, using as methodological basis the normative proposal of health programs and systems evaluation study. The study resulted in the total data calculation of sex reassignment surgeries performed by the SUS (2008-2016), which highlight no deaths and unequal regional access; and in the monitoring of the implementation of actions of the National LGBT Health Policy by a specific committee appointed by the MS. Despite considerable progress, challenges remain. Currently, the most threatening hurdle is the possibility of a setback imposed by conservative sectors from the Executive and Legislative branches. Therefore, the visibility of achievements is a decisive step toward maintaining and enhancing SRP in the SUS.

Highlights

Transgender people, including transvestites and transsexuals, are among the most prone to prejudice, discrimination and violence[1]
In order to organize the systematization of the results, we opted for the presentation of data grouped : 1) Timeline of the public policies highlighting the achievement of the right to Sex Reassignment Process (SRP) in the SUS; 2) Quantitative analysis of SRP indicators in the SUS; 3) Qualitative analysis of SRP follow-up in SUS and its major challenges
Public policies timeline: how did transsexuals achieve the right to the sex reassignment process in the SUS?

Summary

Introduction

Transgender people, including transvestites and transsexuals, are among the most prone to prejudice, discrimination and violence[1] They have different gender identities than those imposed by heteronormative patterns in society. They question the hegemonic logic of biological sex as a determinant of gender identity and, for this reason, as anyone fleeing from binary and dichotomous logic, they are viewed with estrangement[2] To demonstrate this setting, data from the Reports on Homophobic Violence in Brazil (2012) of the Office of Human Rights of the Presidency of the Republic (SDH/PR) showed that, in that year, 3,084 complaints and 9,982 violations related to the LGBT population were recorded, with 4,851 Victims. The hemerographic data of these reports point out that transgender people continue to be the main victims of LGBT violence and, precisely, the most serious violence, homicides and bodily injuries[3]. From the recognition of the complexity of the social determinants of life and health[5] of transgender people, it is necessary to implement public policies that reduce stigma and contribute to the health-disease process[6]

Objectives

Methods

Results