Processo transexualizador

Processo transexualizador (English: Transsexualization process) is a set of procedures and forms of care provided to the LGBTQ community in Brazil. It includes a complex of multidisciplinary services and forms of care offered by the Unified Health System (SUS), directed toward the care of this population who wish to make changes to their physical bodies and sexual characteristics. These also include assistance to enable the use of a social name, and psychological support among others. It was established in August 2008, and later expanded in November 2013.

Lack of access

The transgender population in Brazil often lives in extremely vulnerable situations across different social spheres, including barriers to healthcare access for this population. It is estimated that the life expectancy of the transsexual and transvestite population in Brazil is 35 years. This population has higher rates of depression, anxiety, suicide, and exposure to sexually transmitted infections (STIs), and human immunodeficiency virus (HIV).[1] It is estimated that at least 42% of transgender people in Brazil have attempted suicide, making it increasingly a public health issue.[2] When an easily accessible gender transition is not provided, procedures are carried out illegally and dangerously, putting lives at risk. These population frequently expose themselves to risks in order to carry out bodily transformations, for example, the injection of industrial silicone.[1]

Transsexualization

The processo transexualizador ("Transsexualization process" was evolved as a set of procedures and forms of care provided to the LGBTQ community. It includes a set of multidisciplinary services and forms of care offered by the Unified Health System (SUS), the public healthcare agency of Brazil. It is directed towards the care of the LGBTQ population who wish to make changes to their physical bodies and sexual characteristics, including hormone therapy, mastectomy, breast augmentation, and gender-affirming surgery among others. It also includes assistance for the use of social name, and psychological support.[3]

The process was established after pressure through social movements over the years. It was instituted by ordinance No.1,707 and No. 457 of August 2008,[4][5] and was subsequently expanded by ordinance No. 2,803 of November 2013.[6]

The expansion and strengthening of the care network for this population helps reduce inequality in terms of access to healthcare and provides historical reparation to those who are systematically subjected to violence within current social structure.[1] The SUS has ten accredited and locally functioning services, in addition to outpatient clinics specifically dedicated to this process. Currently, the minimum age for undergoing these surgeries is 18 years.[7]

On 16 April 2026, the Federal Council of Medicine approved a resolution to ban gender-affirming hormone therapy for children and adolescents and sterilization surgeries for those under 21 years of age.[8]

Depathologization

Pathologization refers to the act of considering human conditions as a disease or anomaly, even when it is not.[9] Depathologization refers to the process of listening to such conditions and their subsequent deconstruction to enable them to be declassified as diseases or anomalies.[10]

Resolution No. 1 enacted in December 2018 by the Federal Council of Psychology, emerged as a pioneering milestone in the struggle for and defense of the depathologization of genders and sexualities, because it calls upon the people in the psychology profession and other forms of care to move towards a more ethical practice.[11] The World Health Organization removed the category of transsexuality from that of a mental disorder, and defined it as a "condition related to sexual health", which indicated the earlier continued psychopatologization of the conditions related to transsexuals.[7]

See also

References

  1. 1 2 3 Lucena, Marcelle Medeiros; Ferreira, Guilherme Gomes; Floss, Mayara; Melo, Diego Azevedo Conte de (30 July 2022). "Para além do processo transexualizador: concepção e implementação de um serviço despatologizador e integral à saúde trans e travesti no contexto da atenção primária à saúde na cidade de Porto Alegre (RS)" [Beyond the Transexualization Process: Design and Implementation of a Depathologizing and Comprehensive Health Service for Trans and Travesti People in the Context of Primary Health Care in Porto Alegre (RS)]. Revista Brasileira de Medicina de Família e Comunidade (in Portuguese) (44): 2873. doi:10.5712/rbmfc17(44)2873. ISSN 2179-7994. Archived from the original on 12 November 2022. Retrieved 12 November 2022.
  2. ↑ Bruna Benevides (29 June 2018). "Precisamos falar sobre o Suicídio das pessoas Trans!" [We Need to Talk About Suicide Among Trans People!]. Associação Nacional de Travestis e Transexuais (in Brazilian Portuguese). Retrieved 12 November 2022.
  3. ↑ Andrade, T.C.O.R.; Andrade, P.A.R. (2017). Processo Transexualizador no SUS: Um mecanismo de garantia da inclusão e plena dignidade de transgêneros e travestis [Transsexualization Process in the SUS: A mechanism to guarantee the inclusion and full dignity of transgender and transvestite people]. Anais do Encontro Nacional de Pós-Graduação – VI ENPG (in Portuguese). Vol. 1.
  4. ↑ "Portaria nº 1.707, de 18 de agosto de 2008" [Ordinance No. 1,707 of 18 August 2008] (in Portuguese). Ministério da Saúde. 18 August 2008.
  5. ↑ "Portaria nº 457, de 18 de agosto de 2008" [Ordinance No. 457 of 18 August 2008] (in Portuguese). Ministério da Saúde. 19 August 2008.
  6. ↑ "Portaria nº 2.803, de 19 de novembro de 2013" [Ordinance No. 2,803 of 19 November 2013] (in Portuguese). Ministério da Saúde. 19 November 2013. Archived from the original on 16 June 2026. Retrieved 16 June 2026.
  7. 1 2 Cazeiro, F.; Galindo, D.; Souza, L.L.D.; Guimaraes, R.S.D. (2022). "Processo Transexualizador no SUS: questões para a psicologia a partir de itinerários terapêuticos e despatologização" [Transexualization Process in the SUS: Questions for Psychology Based on Therapeutic Itineraries and Depathologization]. Psicologia Em Estudo (in Portuguese). 27. Cuiabá: SciELO. doi:10.4025/psicolestud.v27i0.48503. hdl:11449/236973. Archived from the original on 2025-01-20. Retrieved 2026-06-16.
  8. ↑ Vieira, Lígia; Reis, Silvana (16 April 2025). "CFM veta terapias hormonais para menores de 18 anos e aumenta idade para cirurgias de transição" [Federal Council of Medicine bans hormone therapies for minors under 18 and raises the age for gender reassignment surgeries]. G1 (in Brazilian Portuguese). Retrieved 14 July 2026.
  9. ↑ "Despatologização: 'Precisamos reconhecer que as crianças sofrem'" [Depathologization: 'We Need to Recognize That Children Suffer']. Portal Lunetas (in Brazilian Portuguese). 23 April 2019. Archived from the original on 12 November 2022. Retrieved 12 November 2022.
  10. ↑ Coacci, Thiago (4 July 2019). "Como funciona a despatologização na prática?" [How Does Depathologization Work in Practice?]. Revista Estudos Feministas (in Portuguese). 27 (2) e58001. doi:10.1590/1806-9584-2019v27n258001. ISSN 0104-026X. Archived from the original on 12 November 2022. Retrieved 12 November 2022.
  11. ↑ "Resolução nº 1, de 29 de janeiro de 2018" [Resolution No. 1 of 29 January 2018] (PDF) (in Portuguese). Conselho Federal de Psicologia. 29 January 2018. Archived (PDF) from the original on 8 March 2021. Retrieved 16 June 2026.
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