» Vulnerability and challenges of access to health care for trans people: analysis of Brazil and the Federal District
“ Transgender people; Health vulnerability; Social vulnerability; Barriers to Access of Health Services: Review; Cross-Sectional Studies: Brazil
“Introduction: Trans people have their experiences like any human being and need to be recognized and respected in society. In this logic, they have health needs and demands that should be fully accepted and attended to in the service network. However, they face different situations of vulnerability on a daily basis, which generate inequalities and interfere with the conditions of access to health. Objective: This thesis aims to analyze conditions of vulnerability and barriers to access to health care for trans people. in the context of Brazil and the Federal District. Method: The first study refers to a scoping review to map and analyze conditions of social and/or programmatic vulnerability that interfere with access to health care for trans people. based on scientific evidence from Brazil. It was prepared in accordance with the recommendations of the Joanna Briggs Institute and the Prisma-ScR extension checklist, using the NCBI/PubMed. Web of Science, EMBASE. Scopus, SciELO and LILACS databases. Primary qualitative and/or quantitative studies were included. with a sample of trans people aged 18 or over; and research into situations of social and/or programmatic vulnerability, in any language and published between 2019 and April 2023. The titles and abstracts were imported into the Rayyan platform and selected by three independent reviewers. The full text was read by two reviewers to extract the data. The second study is a cross-sectional study. The descriptive analysis will characterize the sociodemographic profile, issues related to gender transition and conditions of access and health care of trans people admitted to the Trans Outpatient Clinic of the Specialized Center for Infectious Discases (Cedin) in the Federal District. The analytical part will measure the frequency and factors associated with not having access to other health services before being admitted to this clinic. The population to be included includes transvestites, trans women. trans men and non-binary people aged 18 or over who underwent an interdisciplinary intake interview between January 2018 and December 2019 and between January 2021 and December 2022. Preliminary results: In the scoping review. of the total of 1,332 identified in the databases. 46 articles were included at the end of the analysis. Around 61% and 7% of the research studied only trans women and trans men, respectively: 28% investigated both gender identity categories: only 4% included non-binary people. More than half (56%) of the research was carried out in the Southeast, while no research was identified in the North. Quantitative and qualitative studies were found in similar percentages. The same proportion of publications took place in national and foreign scientific journals. The social and programmatic vulnerability components were present in the majority (67%) of the studies and. in 20% and 13% of the articles. the conditions identified referred only to the social and programmatic component, respectively. The social dimension included discrimination and social exclusion; barriers to access to education, housing. work and income: and harmful use of alcohol and other drugs. The programmatic dimension involved general challenges of access to health; specific challenges in the process of gender transition; disarticulation of the health services network, gaps in public policies, programs and health actions. — '