Healthcare Needs of and Access Barriers for Brazilian Transgender and Gender Diverse People

Abstract

Transgender and gender diverse people (TGD) have specific healthcare needs and struggles with access barriers that should be addressed by public health systems. Our study aimed to address this topic in the Brazilian context. A hospital and web-based cross-sectional survey built with input from the medical and transgender communities was developed to assess TGD healthcare needs of and access barriers in two Brazilian states. Although services that assist this population have existed in Brazil since the 1990s, TGD have difficulty accessing these services due to discrimination, lack of information and a policy design that does not meet the needs of TGD. A history of discrimination was associated with a 6.72-fold increase in the frequency of health service avoidance [95% CI (4.5, 10.1)]. This article discusses the urgent necessity for adequate health policies and for the training of professionals regarding the needs of Brazilian TGD.

Improving Equity of Access Through Electronic Consultation: A Case Study of an eConsult Service

“…Likewise, patients of low socioeconomic status face their own barriers to care access, including a lack of health insurance or benefits, a complicated registration process (particularly among patients with no fixed address), negative attitudes among providers, and the necessity of focusing on other needs at the expense of managing their health, such as seeking food and shelter (19–21). Other populations with complex circumstances report their own barriers to access, such as the stigma often faced by transgender patients (22–24) or those suffering from addiction (25, 26), or the anxiety and communication issues experienced by patients with developmental disorders (27, 28). In the cases highlighted by our study, eConsult proved an effective way to mitigate the inequities commonly experienced by patients in these populations.…”

HIV Testing in Urban Transgender Individuals: A Descriptive Study

“…The transgender community experiences numerous access barriers to care, such as perceived social discrimination or limited clinical knowledge by care providers regarding transgender health needs. 1–4 Although there are no national databases regarding the HIV burden in the transgender population, there is a small body of literature that confirms additional HIV burden and poorer outcomes in the transgender male to female population. 3 , 5 , 6 Transgendered individuals experience additional disparities as compared with other LGBT subgroups, including socioeconomic discrepancies, access barriers, increased risk behaviors, increased stigmatization, higher rates of self-perceived discrimination, physical violence, depression, suicide, substance abuse, prostitution, homelessness, and lack of financial support.…”

Dealing with gender-related and general stress: Substance use among Brazilian transgender youth

“…Bearing in mind the adverse social, physical and emotional costs that substance use during adolescence causes, it is of great importance to identify groups, such as transgender youth, that are especially vulnerable to substance use, as well as further explore modifiable factors associated to substance use. Transgender adolescents and young adults endure many challenges related to stigma and discrimination: from subtle (such as barriers to access health care ( Costa et al, 2016 )) to explicit aggressions (i.e., homicide ( Balzer, Hutta, Adrián, & Hyndal, 2012 )). Furthermore, they report more frequent episodes of psychological distress, self-harm, depression symptoms, and suicide both ideation and attempts when compared to their cisgender peers ( Veale et al, 2015 ).…”

“…In addition, hostile school environments ( Tharp-Taylor, Haviland, & D'Amico, 2009 ) and gender minority social stress ( Reisner et al, 2015 ) contribute to substance use among LGBT youth. Substance use among transgender youth may be especially deleterious since they face difficulties to access health services ( Costa et al, 2016 ; Reisner et al, 2015 ) and to mobilize network support when necessary ( Seibel et al, 2018 ). Thus, “risk environment” plays a vital role in substance use among transgender youth.…”