The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population’s access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.

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Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review.

The objective of this study was to discuss the difficulties of trans people living in the metropolitan region of Greater Vitoria, Espirito Santo, Brazil, in accessing the health services of the Unified Health System (Sistema Unico de Saude - SUS). We used a qualitative approach through semi-structured interviews with 15 trans people. The results point to disrespect toward the adopted name, discrimination, and the diagnosis required for the gender reassignment process as major limitations to accessing the healthcare system. The diagnosis helps hide the responsibility of heteronormativity and gender binarism in the social marginalization of trans people. It is concluded that it is necessary to review the issue of diagnosis, given that the existence of a prior pathology is not required to access the SUS. It is important to develop educational programmes and permanent campaigns concerning the right to access the healthcare system free from discrimination and to use the adopted name.

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Dificuldades vividas por pessoas trans no acesso ao Sistema Único de Saúde

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.

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

Este articulo procura reconstruir, a traves de los relatos de sus lideres, una historia del movimiento social de travestis y transexuales en Brasil. A partir de la emergencia de la "travesti" como categoria identitaria, se narra el surgimiento de las primeras organizaciones, destacando sus conexiones con las politicas de combate a la epidemia del SIDA. Se abordan asimismo dos procesos de disputa que fueron cruciales para la configuracion de este movimiento en Brasil: la lucha por la inclusion de travestis en el movimiento homosexual emergente de los anos 1980-1990, y el debate reciente en torno de los sentidos y usos de las categorias "travesti" y "transexual".

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¿Rumbo a un futuro trans?: contribuciones a una historia del movimiento de travestis y transexuales en Brasil

Objetivou-se evidenciar a atuacao das politicas publicas direcionadas a saude da populacao homossexual brasileira. Trata-se de uma revisao integrativa da literatura, realizada na Scientific Eletronic Library Online (SciELO) e na Literatura Latino-Americana e do Caribe em Ciencias da Saude (Lilacs), utilizando os Decs: politicas publicas, assistencia integral a saude e homossexualidade. A saude LGBT e apontada como vulneravel mesmo apos a publicacao de importantes documentos que garantem o acesso e a inclusao do grupo na saude. A fragilidade na efetivacao das propostas preconizadas vao ao encontro ao atendimento discriminatorio e heteronormativo prestado pelos profissionais de saude.

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Homossexualidade e o direito à saúde: um desafio para as políticas públicas de saúde no Brasil

Resumo: Neste artigo sao analisadas as politicas publicas de saude voltadas a populacao LGBT (lesbicas, gays, bissexuais, travestis e transexuais) no Brasil, a partir de entrevistas com gestoras governamentais e com integrantes da sociedade civil organizada, alem da analise critica de planos, programas e outros documentos de referencia. Destacamos acoes no âmbito do Poder Executivo Federal, concebidas e executadas por parcerias intragovernamentais e com a sociedade civil, tendo LGBT como publico-alvo. Identificamos, por fim, que tais acoes, quando comparadas as de outras areas, caracterizam-se como mais consolidadas, transversalizadas, intersetorializadas e pioneiras, embora ainda nao plenamente estruturadas segundo os principios de universalidade, integralidade e equidade. Palavras-chave: politicas publicas; saude; sexualidade; genero; LGBT Politicas de salud para lesbianas, gays, bisexuales, travestis y transexuales en el Brasil: en busca de la universalidad, integralidad y equidad Resumen . En este articulo se analizan politicas publicas de salud dirigidas a la poblacion LGBT (lesbianas, gays, bisexuales, travestis y transexuales) en el Brasil, a partir de entrevistas con gestoras gubernamentales e integrantes de la sociedad civil organizada, y de una critica de planes, programas y otros documentos de referencia. Se destacan acciones orientadas al publico LGBT desde el ambito del Poder Ejecutivo nacional, concebidas y ejecutadas por instancias gubernamentales asi como otras realizadas conjuntamente con la sociedad civil. Por ultimo, se plantea que tales acciones, en comparacion a las de otras areas, pueden caracterizarse como mas consolidadas, transversalizadas, intersectorializadas y pioneras, aunque no plenamente estructuradas todavia segun los principios de universalidad, integralidad y equidad. Palabras clave: politicas publicas; salud; sexualidad; genero; LGBT; Brasil Health policies for lesbians, gays, bisexuals, transsexuals and travestis in Brazil: the pursuit of universality, integrality and equity Abstract. In this article we analyze health policies targeting the Brazilian LGBT population (lesbian, gay, bisexual, travesti, and transexual), based on interviews with government civil society actors, and a critical reading of programmatic documents and other sources. We highlight courses of action by the Federal Executive branch of government, conceived and carried out by means on intra-governmental and civil society partnership. In conclusion, we find that, when compared with with actions in other areas, LGBT health policies seem more consolidated, transversalized, intersectorialized, therefore pioneering, although not yet fully structured on the principles of universality, integrality and equity. Keywords: public policy; health; sexuality; gender; LGBT; Brazil

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Políticas de saúde para lésbicas, gays, bissexuais, travestis e transexuais no Brasil: em busca de universalidade, integralidade e equidade

Resumo: Neste trabalho, interpreto comparativamente os itinerarios agenciados por homens trans para lidar com a questao da espera, quando confrontados por desafios relacionados ao acesso a servicos de saude no Brasil na Argentina. O texto, fruto de pesquisa antropologica nas regioes metropolitanas de Goiânia e de Buenos Aires, visa a contribuir para as discussoes em torno do acesso a saude para homens trans nesses dois contextos, buscando apontar para as ambivalencias relacionadas a seus itinerarios terapeuticos em busca de cuidados biomedicos.

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Lives on hold? Itineraries in access by trans men to health services in Brazil and Argentina.

Neste artigo, apresentamos uma revisao critica com base em 78 trabalhos antropologicos produzidos no Brasil a partir do entrecruzamento das tematicas da sexualidade, da sociabilidade e do mercado. Relacionamos o conjunto de pesquisas aqui trazido com processos sociais e relativos ao campo de estudos antropologicos mais amplos. Identificamos processos de mudanca relativos aos objetos empiricos e enquadramentos analiticos mobilizados por tais estudos, produzidos no pais desde os anos 1960. Por fim, apontamos como os estudos que partiram de locais de sociabilidade e que, mais recentemente, passaram a tematizar de algum modo o mercado de consumo, constituiram parte muito significativa da producao antropologica brasileira sobre sexualidade, que nas duas ultimas decadas cresceu e se diversificou.

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Estudos sobre sexualidade, sociabilidade e mercado: olhares antropológicos contemporâneos

In this work, I intend to investigate homoerotic practices among men in Sao Paulo city in sites for casual, group or anonymous sex, involving sometimes fetishisms and/or sadomasochism. Preliminary field data, most of which collected in the Internet, shed light on the existence of discourses that grant great value to masculinity in some of these contexts. My hypothesis is that such valorization must be taken into account so as to fathom out the processes of body materialization and subjectivity construction in each of these men.

Macho versus Macho: um olhar antropológico sobre práticas homoeróticas entre homens em São Paulo

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Camilo Albuquerque de Braz

Papers

Políticas de saúde para lésbicas, gays, bissexuais, travestis e transexuais no Brasil: em busca de universalidade, integralidade e equidade

Lives on hold? Itineraries in access by trans men to health services in Brazil and Argentina.

Estudos sobre sexualidade, sociabilidade e mercado: olhares antropológicos contemporâneos

Macho versus Macho: um olhar antropológico sobre práticas homoeróticas entre homens em São Paulo

Studies on sexuality, sociability and market: contemporary anthropological looks