Desigualdade de acesso ao processo transexualizador no SUS

Abstract

The transsexualizing process is regulated on SUS by the Attachment 1 of Attachment XXI of Consolidation Ordinance GM/MS nº 2 of 2017 and it is compound by a set of procedures that aim to guarantee integral attention to travesti and transexual people’s health. This research investigates the inequality of access to this health policy, seeking to identify and relate its explanatory factors. Therefore, three analytic dimensions are structured: institutional, related to the policy’s design; operative, linked to its implementation; and relational, associated to the users’ social network. The objective of this project is to answer the following question of research: how does the association of relational aspects (of users), institucional (of design) and operative (of implementation) produce inequality in the access to the Transsexualizing Process? In order to answer the question, it was built a metodology that combined various methods and techniques of reseach, with analysis of social network being the main one. The data analyzed were obtained through bibliographical and documentary research, interview with eleven people, besides the application of an online form and sociometric questionnaire with 34 trans and travesti people. The primary data collection was realized between November of 2022 and January of 2023 and followed the ethical premise in research, as previously approved by Opinion nº 5.723.490 of Ethics Committee in Research of UFMG. The results of this study validate the hypotesis that the design of the policy builds barriers of access to the Transsexualizing Process on SUS; also validate the hypotesis that this barriers are reinforced during the implementation, however with less active participation of street-level bureaucrats, as it was expected; finally, validate too the hypotesis that certain socioeconomic and social network characteristics of users benefit them in accessing the policy, in view of the mapped barriers. None of the sub-hypotesis were fully validated. In conclusion, it is seen that there is a strong interaction among the three analyzed dimensions — complex and with overlapping — in the production of inequality in the access of Transsexualizing Process on SUS.