O SUS em transição? Os ambulatórios TT e o direito à saúde para a população trans

Abstract

The recent and contradictory expansion of outpatient clinics for the Transvestite and Transsexual population (TT Outpatient Clinics) in the Unified Health System (SUS) during a period of advances in neoconservatism and setbacks in rights, demonstrates the need to develop studies that make it possible to understand this reality in a critical manner. Therefore, the present investigation has as its central objective to analyze the right to health of the trans population in Natal/RN through the TT Outpatient Clinic in the context of the advancement of neoconservatism. With regard to theoretical-methodological aspects, we carried out field research with a qualitative approach, supported by the historical-dialectical materialist method, which had as its investigation locus the TT Outpatient Clinic in Natal/RN. We used semi- structured interviews and document analysis as data collection instruments, using as sources: the main ordinances of the Ministry of Health on the transsexualization process; the resolutions of the Federal Council of Medicine; the National LGBT Comprehensive Health Policy; and other relevant documents and as subjects the trans user population of the TT Outpatient Clinic, the professionals and managers from the municipal network of Natal involved in the transsexualization process, as well as representatives of civil society, through the municipal and state councils for the rights of the LGBTI+ population, who participated in the process of creating the TT Outpatient Clinic. The SUS, despite being a universal health system, has not always taken care of different population segments as part of its actions, which have historically been made invisible and treated with prejudice and discrimination, the trans population being one of them. The creation of the TT Outpatient Clinic presents itself as a conquered right that was the result of a long process of dispute by the State and that, even marked by contradictions, is part of this power dynamics among societal projects. Through our analysis we can state that with the creation of the TT Outpatient Clinic there is a process that results in contributions for users, professionals, for the SUS itself, for public policies and for society. However, this process is also marked by challenges, namely: challenges in access to hormones, challenges in the expansion of the transsexualization process, difficulties in intersectoral articulation, organizational challenges faced by the SUS and the TT Outpatient Clinic in Natal and limitations related to human resources. We hope that this study can contribute to greater visibility of health policies for the trans population, for their strengthening and the recognition of the challenges that still need to be overcome, while also highlighting the construction of an experience that represents an accumulation concerning the legitimation of trans individuals as citizens and political subjects of rights