Os desafios da despatologização da transexualidade: reflexões sobre a assistência a transexuais no Brasil

Abstract

In 2008, by 1707 Decree from the Ministry of Health, was established on the brazilian National Health System the Transsexual s Sex Reassigment Process who laid the basis for the regulation of access to the programs that perform transsexual sex reassignment procedures. This Decree, which is based on the recognition that sexual orientation and gender identity are determinants of health status and that the discomfort and inadequacy feeling related to the anatomical sex of transsexuals should be treated within the comprehensiveness care recommended by National Health System, has meant significant advances in legitimizing the demand for sex reassignment of transsexuals and facilitated access of population to health care. Although the transgender s attention proposal instituted in Brazil is about a comprehensive health policy that overtake the surgical issue and considers psychosocial factors of this experience, it is based on a biomedical model that considers transsexualism a mental disorder which diagnosis is a condition of access to care and its treatment is directed to achieving sexual reassignment surgery. In this sense, only those individuals who fit into the Gender Identity Disorder nosological category and, therefore, express the desire to adapt their body to the gender with which they identify themselves through body modification have their right to health care guaranteed. Thus, whereas in Brazil the attention to transsexuals is absolutely restricted by a psychiatric diagnosis, that at the same time legitimates the demand for sex reassignment and make feasible the access to health care is an array of pathologization and stigma that restricts the right to medical care and limits the autonomy, this study intends to discuss the challenges of depathologization of transsexuality in the management of public policies for the transgender population in the country. From a research about the historical, social and political issues that defined transsexualism as a mental disorder and about the processes that associated the regulation of access to health care to the diagnosis of transsexualism, it is expected to question the current model of trans persons s care and to build new opportunities for building inclusive and comprehensiveness policies that guarantee for trans people the right to health and exercise of autonomy.