Trans-Specific Health Care: Challenges in the Context of New Policies for Transgender People.

This study aims to understand transgender people's access to the Brazilian public health care system in light of the new public policies for this group in Brazil. Our ethnographic study involved interviews with transgender women at a nongovernmental organization and a direct participant-observation study conducted 2 years later to observe how a new specialized service was providing health care for transgender people. Transgender people reported difficult personal life trajectories, marked by discrimination and binary standards, in their struggle to become recognized as women/men. At the specialized service, gender norms and stereotyping were observed being put into operation by untrained service providers. This dominance of pathologizing models ended up not decreasing transgender patients' access to unsafe care outside of the public sector. The promotion and protection of the right to health thus depends on cultural changes. This may well include changes in technical-scientific discourse regarding the transgender experience to account for the depathologization and gender fluidity recognition.