Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil

Abstract

Health care for the Lesbian, Gay, Bisexual, Transvestite, Transgender and Transgender (LGBTTT) population, within the scope of the Unified Health System (SUS), has specific needs, both for the qualification of health team professionals and for the doors access to care at different levels of care. The objective of the study was to evaluate the quality of life (QoL) of transsexual users monitored at the sexuality and gender outpatient clinic of the University Hospital of the Federal University of Maranhão (HUUFMA) and to analyze their perception of the experience of transsexuality. To this end, a mixed quantitative and qualitative study was carried out between March 2018 and December 2021. Three questionnaires were used to collect data in the quantitative stage: one with identification, social and demographic data, another from the Brazilian Association of Research Companies, for economic classification; and the third, the WHOOQL-Bref, for measuring QoL, from the World Health Organization, all analyzed using the SPSS 21.0® statistical program. In the qualitative stage, data were collected through individual interviews with a script of open questions about QoL and transsexuality. The data were recorded, transcribed in full and submitted to Content Analysis. We interviewed 71 individuals, the majority between 18 and 26 years old (67.6%), with complete secondary education (71.8%), single (76.1%), unemployed (54.9%), living in the capital of the state (63.4%), brown (57.7%) and from social class D to E (50.7%). Low QoL rates were observed, with worse results for the Psychological Domain (12.5%) and Environment (37.5%), with no statistical significance for differences between trans men and women. In the qualitative study, three thematic categories were highlighted: discovering transsexuality: trans(training) and identity; the right to exist: obstacles to citizenship; and body transformation: feelings involved in the search for the desired and socially accepted body. For the participants, transsexuality is understood as a complicated and difficult process, which generates different feelings such as happiness, fear and shame. The perception of gender identity, different from biological sex, occurs since childhood, which causes suffering in social relationships and difficulties in having their rights respected. Living transsexuality means being able to exist as a unique individual and to guarantee this right it is necessary to deepen the debate on the sexuality of transgender people. It was concluded that the experience of transsexuality is associated with suffering and low QoL. There is a clear need to expand multidisciplinary discussions on sexuality and gender, public policies that encourage institutional/local actions, and the strengthening of support networks for vulnerable populations