Invisibilidade na assistência ao público transexual na atenção primária à saúde: uma revisão integrativa

Abstract

The terminologies “trans” and “cisgender” are widely used to distinguish individuals with different gender expressions. While "trans" refers to those whose gender identity differs from the sex assigned at birth, "cisgender" describes those whose gender identity aligns with the sex assigned at birth. The term "transgender" encompasses a diversity of people whose gender identities vary from their sex assigned at birth. These definitions are permeated by ideologies, have diffuse boundaries and are subject to continuous evolution. OBJECTIVE: Identify the barriers that promote the invisibility of the transsexual population in basic health services. METHODOLOGY: This is an integrative literature review, divided into six stages, based on the recommendations of Mendes, Silveira and Galvão (2008). The acronym PCC was used, where "P" refers to Patient (transsexual people), "C" to Concept (nurses care barriers) and "C" to Context (primary health care). Based on this, the following guiding question was formulated: “What are the barriers that lead to the invisibility of the transsexual population in primary health care?” The scientific databases selected were: Scopus, MEDLINE via PubMed, Embase and Latin American and Caribbean Literature in Health Sciences (LILACS) via the Virtual Health Library (BVS). RESULTS: 9.282 studies were identified at the end of the searches in the chosen databases. Of these, after passing the eligibility criteria, 15 articles were part of the final sample for analysis. Regarding the year of publication, studies published in 2023 prevailed. Regarding language, the majority of studies were in Portuguese, with one in English and none in Spanish. After analyzing the identified strategies, it was possible to define groups to classify them, which are: discrimination and prejudice on the part of health professionals, lack of specific training on trans health in health course curricula, institutional invisibility, socioeconomic barriers almost all articles cited the health team's lack of preparation in caring for the transgender population. CONCLUSION: Data extracted from the 15 selected studies revealed that there are four main groups of barriers that contribute to the invisibility of the trans population in primary health care the most cited was the lack of specific training on trans health in the curricula of health courses, resulting in professionals lack of knowledge and sensitivity to deal with the specific demands of this population, which compromises the quality of care.