Although almost 0.7% of the Brazilian population identifies as transgender, there is currently no training for healthcare professionals to provide comprehensive care to these patients, including the discussion of reproductive planning. The use of testosterone promotes amenorrhea in the first months of use; however, this effect does not guarantee contraceptive efficacy, and, consequently, increases the risks of unplanned pregnancy. The present article is an integrative review with the objective of evaluating and organizing the approach of contraceptive counseling for the transgender population who were assigned female at birth. We used the PubMed and Embase databases for our search, as well as international guidelines on care for the transgender population. Of 88 articles, 7 were used to develop the contraceptive counseling model. The model follows the following steps: 1. Addressing the information related to the need for contraception; 2. Evaluation of contraindications to the use of contraceptive methods (hormonal and nonhormonal); and 3. Side effects and possible discomfort associated with the use of contraception. The contraceptive counseling model is composed of 18 questions that address the indications and contraindications to the use of these methods, and a flowchart to assist patients in choosing a method that suits their needs.

IntroductionFemale sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women.Methods and analysisThe systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool.Ethics and disseminationAs it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.

Cuidados integrais à população trans: o que cabe ao atendimento na atenção primária à saúde (APS)?Okano SHP INTRODUÇÃOPor muito tempo acreditou-se que o sexo anatômico, aquele que é designado ao nascimento e definido pelas características sexuais primárias, fosse o responsável pelo desenvolvimento de comportamentos binários conhecidos como masculinos e femininos. Ainda hoje é comum a confusão dos termos sexo e gênero, entretanto, é importante pontuar que pertencer ao sexo masculino ou feminino não define identidades de homem e de mulher, respectivamente. Abaixo encontram-se algumas definições que serão utilizadas neste artigo. Box 1: Terminologia e definiçõesSexo anatômico: termo utilizado para classificar uma pessoa de acordo com a expressão fenotípica da sua genitália, influenciada na vida intrauterina pela interação cromossômica e hormonal.Identidade de gênero: termo utilizado para classificar papéis tipificados em uma sociedade de acordo com o entendimento do masculino e feminino, ou do não binarismo.Cisgênero: termo utilizado para se referir à pessoa cuja identidade de gênero é congruente com o atribuído ao seu nascimento.Transgênero: termo utilizado para se referir à pessoa cuja identidade de gênero é incongruente com o sexo atribuído ao seu nascimento, independentemente de ter ou desejar afirmação do gênero hormonal ou cirúrgica. A Classificação Internacional de Doenças, em sua 11ª edição (CID-11), considera a transgeneridade como incongruência de gênero. 1Trans masculino (TM): termo utilizado para se referir às pessoas de identidade do espectro masculino designada mulher ao nascimento.Trans feminina (TF): termo utilizado para se referir às pessoas de identidade do espectro feminino designada homem ao nascimento.Travesti: termo utilizado para se referir às pessoas de identidade do espectro feminino designada homem ao nascimento, em ressignificação da marginalização atribuída à identidade no passado. Cuidados integrais à população trans: o que cabe ao atendimento na atenção primária à saúde (APS)?Okano SHP

Objective To identify the age when individuals first perceive gender incongruence (GI) and to compare sociodemographic data of female-to-male (FtM) and male-to-female (MtF) transgender individuals assisted at an outpatient service. Methods The present cross-sectional study was conducted through a review of the medical records of individuals diagnosed with GI at a single specialized outpatient service in the city of Ribeirão Preto, state of São Paulo, Brazil. Results A total of 193 medical records from 2010 to 2018 were evaluated, and 109 (56.5%) patients had GI since childhood. The FtM transgender individuals perceived GI in childhood more often than the MtF transgender individuals (odds ratio [OR]: 2.06, 95% confidence interval [95%CI]: 1.11–3.81) Unattended hormone use was highest among the MtF group (69.6% versus 32.3%; OR: 4.78, 95%CI: 2.53–9.03). All of the individuals who were engaged in prostitution or were diagnosed with a sexually-transmitted infection, including HIV, were in the MtF group. Conclusion Despite the more prevalent perception of GI in childhood among the FtM group, social issues were more prevalent among the MtF group, which may be the result of social marginalization.