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.

A partir da reconstituicao historica dos medos coletivos por tras da rejeicao social a gays e lesbicas e de como estes mesmos temores moldam as reacoes afirmativas desses grupos, este artigo discute as relacoes entre pânicos morais e formas de controle social. A luta pela parceria civil entre pessoas do mesmo sexo, ou casamento gay, serve de exemplo contemporâneo da forma como nossa sociedade renegocia padroes normativos e praticas sexuais na moeda do controle social.

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Pânicos morais e controle social: reflexões sobre o casamento gay

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

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

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

The purpose of this article is to reflect on the effectiveness of plans, programs, and conferences produced and carried out by the Brazilian federal government within the process of construction of public policies for the LGBT population in the country. The text privileges four documents that deal with the promotion of the human rights and citizenship of this population: the "Program Brazil Without Homophobia" ("Programa Brasil Sem Homofobia"), the "Proceedings of the I National LGBT Conference" (I Conferencia Nacional LGBT), the "National Plan for the Promotion of LGBT Citizenship and Human Rights" ("Plano Nacional de Promocao da Cidadania e Direitos Humanos LGBT"), and the"3rd National Program of Human Rights" ("Programa Nacional de Direitos Humanos 3"). In this article, we carry out a critical analysis of these proposals based on a series of interviews with public sector managers, in the federal, state, and municipal spheres, as well as with civil society representatives.

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Por onde andam as políticas públicas para a população LGBT no Brasil

Este artigo problematiza o tratamento dos direitos sexuais no Brasil, por meio da analise critica do processo de formulacao e implementacao de politicas publicas de combate a homofobia e de promocao da cidadania e dos direitos humanos da populacao LGBT. A despeito dos avancos nas iniciativas governamentais, especialmente no âmbito do Poder Executivo Federal, o que se observa e que nunca se teve tanto e o que ha e praticamente nada. Essa talvez seja uma boa formula geral para mostrar o paradoxo da situacao dos direitos da populacao LGBT no Brasil hoje.Abstract This article questions how sexual rights have been handled in Brazil, by means of a critical analysis of the process of formulation and implementation of public policies against homophobia and in favor of promoting citizenship and human rights for the LGBT people. Despite advancements in governmental initiatives, especially within the Executive Branch, it is evident that there has never been so much, nevertheless, very little is out there. This might be a good general formula to demonstrate the paradox present in the scenario of the rights for the LGBT people in Brazil at present.Key Words: LGBT, Public Policies, Citizenship, Human Rights, Homophobia

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Políticas públicas para a população LGBT no Brasil: notas sobre alcances e possibilidades

Este artigo propoe uma reflexao sobre a construcao social da conjugalidade homossexual no Brasil contemporâneo, especialmente no âmbito do Poder Legislativo, espaco privilegiado de discussao acerca do projeto de lei que institui a parceria civil entre pessoas do mesmo sexo. A analise dos elementos estruturantes nos embates ideologicos decorrentes das disputas em torno do reconhecimento social e juridico das unioes homossexuais como entidades familiares, tambem e perpassada por discursos originarios da Igreja Catolica e de representantes da populacao homossexual.

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Outras famílias: a construção social da conjugalidade homossexual no Brasil

/pdf/public-measures-for-the-lgbt-population-in-brazil-notes-33jh0nzodk.pdf

Luiz Mello

Papers

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

Por onde andam as políticas públicas para a população LGBT no Brasil

Políticas públicas para a população LGBT no Brasil: notas sobre alcances e possibilidades

Outras famílias: a construção social da conjugalidade homossexual no Brasil

Public measures for the LGBT population in Brazil: notes about reaches and possibilities