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OBJECTIVE: To evaluate and correlate the risk of dysphonia, the presence of vocal changes and their associated factors, and the vocal self-perception of transgender women. METHOD: Observational cross-sectional study in Brazilian transgender women. The analysis addressed their age, length of experience in the gender, perceptual-auditory and acoustic vocal aspects, scores in the General Dysphonia Risk Screening Protocol (DRSP-G), and the Voice Questionnaire for Male-to-Female Transsexuals (TVQ(MtF)). The sample was divided into two groups based on the grade of vocal deviation (Consensus Auditory-Perceptual Evaluation of Voice)-with (G.W.C.) and without vocal changes (G.N.C.)-to verify the association between the presence of vocal changes and other variables. The correlation between the grade of vocal deviation and DRSP and TVQ(MtF) scores was also verified. RESULTS: The sample included 32 transgender women with a mean age of 30.1 and 11.52 years of experience as females. Over half declared themselves Black, and a third of the sample did not have a defined profession. Use of female hormones was reported by 71.9%, the majority without a medical prescription. The mean grade of vocal deviation was 22, the dysphonia risk score was 43.47, and the TVQ(MtF) score was 59.46. Nasal and pharyngeal resonance was observed in 59.4%, and the mean fundamental frequency (f0) was 156.14 Hz. G.W.C. had a shorter experience living in the redesignated genre. The participants idealized more feminine voices than they currently had. The DRSP-G and TVQ(MtF) scores had a moderate positive correlation. CONCLUSION: The study sample had characteristics compatible with some degree of social and health vulnerability. There was a moderate impact of voice on their quality of life, and despite the high risk of dysphonia, there was a low occurrence of vocal changes. There was a correlation between the DRSP-G and TVQ(MtF) scores.
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The Argentine Osteoporosis Society convened renowned specialists in the care of transgender people to prepare the first local position on the evaluation of bone health in this population. Law 26.743 on "Gender Identity" recognize all identities and guarantees free care throughout the health system. The impact of different gender affirmation treatments on bone mass has been topic of international debate. To date the evidence remains limited and different societies have issued suggestions and recommendations. For this reason, we believe it is relevant to mention our experience, capturing through this document a series of suggestions to be used in medical care.
La Sociedad Argentina de Osteoporosis convocó a especialistas reconocidos en la atención de personas transgénero para la elaboración del primer posicionamiento local sobre la evaluación de la salud ósea en esta población. La ley 26.743 de "Identidad de género" reconoce todas las identidades y garantiza su atención de manera gratuita en el sistema de salud. El impacto de los diferentes tratamientos de afirmación de género sobre la masa ósea ha sido tópico de debate internacional. Hasta la fecha la evidencia sigue siendo limitada y diferentes sociedades han emitido sugerencias y recomendaciones. Por tal motivo, creemos relevante mencionar nuestra experiencia plasmando mediante este documento una serie de sugerencias para ser utilizadas en la atención médica.
Assuntos
Osteoporose , Pessoas Transgênero , Humanos , Densidade Óssea , Identidade de Gênero , Osteoporose/diagnósticoRESUMO
Resumen La Sociedad Argentina de Osteoporosis convocó a especialistas reconocidos en la atención de personas transgénero para la elaboración del primer posiciona miento local sobre la evaluación de la salud ósea en esta población. La ley 26.743 de "Identidad de género" reco noce todas las identidades y garantiza su atención de manera gratuita en el sistema de salud. El impacto de los diferentes tratamientos de afirmación de género sobre la masa ósea ha sido tópico de debate internacional. Hasta la fecha la evidencia sigue siendo limitada y diferentes sociedades han emitido sugerencias y recomendaciones. Por tal motivo, creemos relevante mencionar nuestra experiencia plasmando mediante este documento una serie de sugerencias para ser utilizadas en la atención médica.
Abstract The Argentine Osteoporosis Society convened renowned specialists in the care of transgender people to prepare the first local position on the evaluation of bone health in this population. Law 26.743 on "Gender Identity" recognize all identities and guarantees free care throughout the health system. The impact of different gender affirmation treatments on bone mass has been topic of international debate. To date the evidence remains limited and different societies have issued suggestions and recommendations. For this reason, we believe it is relevant to mention our experience, capturing through this document a series of suggestions to be used in medical care.
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Resumo O artigo objetivou analisar conhecimentos, percepções, práticas de cuidado e Itinerrários Terapêuticos (IT) para o diagnóstico e tratamento das Infecções Sexualmente Transmissíveis (IST), com destaque para sífilis, entre Travestis e Mulheres Trans (TrMT) em Salvador, Brasil. Foram realizados 05 grupos focais e 06 entrevistas semiestruturadas com 30 TrMT. Os achados apontam amplo desconhecimento e percepções contraditórias sobre as IST, especialmente a sífilis; identificação de duas importantes trajetórias de cuidado às IST e o destaque para IT marcados por estigmas e discriminação nos serviços de saúde. Sugere-se a ampliação das ações de saúde para essa população reconhecendo suas necessidades e a construção de novas estratégias de prevenção e tratamento para IST, dialogadas com as TrMT, e garantia de autonomia, ética e sigilo na produção do cuidado.
Abstract The article aimed to analyze knowledge, perceptions, care practices and Therapeutic Itineraries (TI) for the diagnosis and treatment of Sexually Transmitted Diseases (STD), with emphasis on syphilis, among travesti and transgender women (TGW) in Salvador, Brazil. 05 focus groups and 06 semi-structured interviews with travesti/TGW were carried out with a total of 30 participants. The findings point to a wide lack of knowledge and contradictory perceptions about STD, especially syphilis; identification of two important trajectories of care for STD and the emphasis on TI marked by stigma and discrimination in health services. The expansion of health actions for this population is suggested, recognizing their needs and the construction of new prevention and treatment strategies for STD, in dialogue with the travesti/TGW, and guaranteeing autonomy, ethics and confidentiality in the production of care.
Resumen El artículo tuvo como objetivo analizar conocimientos, percepciones, prácticas de atención y Rutas Terapêuticas (RT) para el diagnóstico y tratamiento de las Enfermedades de Transmisión Sexual (ETS), con énfasis en la sífilis, entre las travestidas y mujeres trans (TrMT) en Salvador, Brasil. Se realizaron 05 grupos focales y 06 entrevistas semiestructuradas con 30 TrMT. Los hallazgos apuntan a una amplia falta de conocimiento y percepciones contradictorias sobre las ETS, especialmente la sífilis; identificación de dos importantes trayectorias de atención a las ETS y el énfasis en las RT marcadas por el estigma y la discriminación en los servicios de salud. Se sugiere ampliar las acciones de salud para esta población, reconociendo sus necesidades y la construcción de nuevas estrategias de prevención y tratamiento de las ETS, en diálogo con el TrMT, y garantizando la autonomía, ética y confidencialidad en la producción de cuidados.
Assuntos
Humanos , Masculino , Feminino , Travestilidade , Sífilis/terapia , Infecções Sexualmente Transmissíveis/terapia , Estigma Social , Pessoas Transgênero , Itinerário Terapêutico , Preconceito , Sistema Único de Saúde , Brasil , Sífilis/diagnóstico , Sífilis/prevenção & controle , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/prevenção & controle , Saúde Sexual , Sexismo , Serviços de Saúde para Pessoas Transgênero , Barreiras ao Acesso aos Cuidados de Saúde , Acessibilidade aos Serviços de SaúdeRESUMO
INTRODUCTION: Monitoring the HIV epidemic and identifying populations among whom HIV is spreading is critical. We aimed to provide an estimate of the annualized HIV incidence rate using recency testing among cisgender men who have sex with men (MSM) and transgender women (TGW) at a reference centre in Rio de Janeiro, Brazil. METHODS: We evaluated MSM and TGW who sought HIV testing at the Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ between March 2018 and January 2020. The Limiting Avidity assay (LAg) as part of a recent infection testing algorithm (RITA) was employed to identify recent infections (those with a normalized optical density ≤1.5 in the LAg that met all RITA criteria) among those who tested positive for HIV and the annualized HIV incidence was estimated. RESULTS AND DISCUSSION: Out of 3053 individuals assessed, 2591 (84.9%) were HIV negative and 462 (15.1%) were living with HIV. Among these, 302 (65.4%) with stored samples available were evaluated and 73/302 (24.2%) were classified as recent infections. The annualized incidence rate estimate using a false recency rate of zero was 7.35% (95% CI 5.76% to 9.25%). CONCLUSIONS: Our results suggest that the HIV epidemic in Rio de Janeiro, Brazil, continues to disproportionately burden vulnerable populations, including MSM and TGW despite the existence and availability of effective preventive and therapeutic interventions.
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Epidemias , Infecções por HIV , Minorias Sexuais e de Gênero , Pessoas Transgênero , Brasil/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , MasculinoRESUMO
BACKGROUND: Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members' opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). METHODS: In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. RESULTS: Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM "never" discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them "at least once weekly" with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% "never") and most with transgender network members (27.1% "at least once weekly"). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. CONCLUSIONS: Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. TRIAL REGISTRATION: The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020 ) on January 4, 2017.
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Infecções por HIV , Saúde Sexual , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Pessoas Transgênero , Comunicação , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Peru/epidemiologia , Comportamento Sexual , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Rede SocialRESUMO
This study explores the community-based strategies that a group of trans women living in Lima, Peru, employed to resist the negative impact of the COVID-19 pandemic on their wellbeing. Data was collected through participant observation and focus group discussions during the implementation of a social aid campaign targeted to this population and analyzed through reflexive theoretical thematic analysis. Resistance strategies were understood as forms of social capital grounded in relations of support and connectedness. Results underscored the importance of social cohesion to ameliorate increasing levels of precarity, community leaders as key for linking trans women across different networks, and unified efforts of social groups who share values to influence institutional power. The analysis also captured barriers and challenges that could hinder the development and articulation of social capital. Fostering trust relations and community-organization should be fundamental components for advocacy programs that seek to support the trans women community.
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COVID-19 , Pandemias , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Saúde Pública , SARS-CoV-2 , Minorias Sexuais e de Gênero/psicologia , Capital Social , Adulto JovemRESUMO
Adult trans women in Brazil are highly impacted by HIV, but little is known about risk for young trans women. Our study was conducted to compare the HIV prevalence and correlates of risk for young trans women ages 18-24 years old to adult trans women in Brazil. Trans women were recruited from Rio de Janeiro and Baixada (the metropolitan area of Rio de Janeiro), Brazil (N = 345). Youth ages 18-24 years of age had significantly greater odds of being HIV negative than adults (OR 0.4, 95% CI 0.2-0.6, p = 0.0002), but significantly lower odds of having post-exposure prophylaxis (PEP) knowledge (OR 0.5, 95% CI:0.3-0.9, p = 0.02) and PrEP awareness (OR 0.5, 95% CI: 0.3-0.8, p = 0.01). Young trans women also had significantly higher odds of using substances (OR 1.8, 95% CI 1.1-2.9, p = 0.02) and condomless anal intercourse with their last three sexual partners (OR 1.8, 95% CI: 1.1-3.0, p = 0.03) compared to adults. Already by age 24, one in four trans women in Brazil were infected with HIV pointing to a new generation at high risk of acquiring HIV. HIV prevention interventions are needed to change the healthcare system to reach and engage young trans women.
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Infecções por HIV , Profilaxia Pré-Exposição , Pessoas Transgênero , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Parceiros Sexuais , Adulto JovemRESUMO
A nivel internacional se reconoce que las mujeres transgéneros, debido a su voz, experimentan diariamente consecuencias psicosociales. En Chile no se cuenta con antecedentes sobre esta temática, por lo que se requiere recabar información que permita constatar los antecedentes obtenidos en la literatura internacional. Por ello, el objetivo del trabajo es describir la autopercepción de la voz de un grupo de mujeres transgénero de la Región Metropolitana, según el instrumento Trans Woman Voice Questionnaire (TWVQ). Para ello, se realizó un estudio observacional, descriptivo correlacional de corte transversal con enfoque cuantitativo, el cual fue aprobado por el Comité de Ética de la Facultad de Medicina Clínica Alemana Universidad del Desarrollo (GP-70/2018).Participaron 30 mujeres transgénero que respondieron en primer lugar un cuestionario de antecedentes clínicos y luego el TWVQ. Este último se analizó en base al puntaje total y por sus tres ítems (ansiedad y evitación, función vocal e identidad vocal).Los resultados muestran que la autopercepción de la voz se ve afectada en primer lugar por el ítem de función vocal, posteriormente por el ítem de ansiedad y evitación y por último por el de identidad vocal, según la dificultad percibida. Los datos tambiénproporcionan evidencia preliminar de que la autopercepción de la voz podría asociarse con la asistencia al especialista de la voz y con el tiempo de terapia hormonal cursado. Finalmente, el estudio proporciona una forma empírica de analizar detalladamenteel TVWQ, en base a la propuesta de tres ítems.
At the international level, it is recognized that transgender women, due to their voice, experience psychosocial consequenceson a daily basis. In Chile there is no background on this issue, so it is necessary to collect information that allows verifying the background obtained in the international literature. Therefore, the objective of the work is to describe the self-perception of the voice of a group of transgender women from the Metropolitan Region, according to the Trans Woman Voice Questionnaire (TWVQ) instrument. For this, an observational, descriptive correlational cross-sectional study with a quantitative approach was carried out, which was approved by the Ethics Committee of the Faculty of Medicine -Clínica Alemana Universidad del Desarrollo (GP-70/2018). Thirty transgender women participated, responding first to a medical history questionnaire and then to the TWVQ. The latter was analyzed based on the total score and its three items (anxiety andavoidance, vocal function and vocal identity). The results show that voice self-perception is affected first by the vocal function item, then by the anxiety and avoidance item, and finally by the vocal identity item, according to perceived difficulty. The data also provide preliminary evidence that self-perception of the voice could be associated with attendance at the voice specialist and with the length of time on hormonal therapy. Finally, the study provides an empirical way to analyze the TVWQ in detail, based on the proposal of three items.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Autoimagem , Qualidade da Voz , Pessoas Transgênero , Chile , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
HIV partner-testing (PT) may represent a unique and empowering HIV prevention strategy for groups that face structural and institutional barriers to HIV testing and care, including transgender women. We report on in-depth interviews (IDIs) with N = 10 transgender women who used HIV self-test kits for three months to screen potential sexual partners in a randomized controlled trial (iSUM; "I'll Show You Mine") that took place in New York City and San Juan, Puerto Rico. Participants were assigned to intervention (supplied with 10 self-test kits immediately) or control groups (received 6 test kits after 3 months). We conducted IDIs with the first N = 10 transgender women to enroll in the intervention group after three months in the study (after participants used kits with partners) to understand their experiences. Themes discussed in IDIs included: partners' reaction to HIV testing, participants' reactions to partners' test results or refusal to test, partners' own reaction to their test results, and decision-making around test use. Data were independently analyzed by two coders. Overwhelmingly, participants' experiences with PT was positive. Participants reported kits were convenient and acceptable to most partners. Transgender women felt that PT could pose additional risk for them; one woman experienced violence related to kit use. Furthermore, the availability of kits appeared to encourage participants and their partners to think about their HIV status and, in some cases, modify sexual behavior. Work suggests that HIV PT could be a viable risk-reduction strategy for transgender women.
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Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Kit de Reagentes para Diagnóstico , Autocuidado/métodos , Parceiros Sexuais , Pessoas Transgênero/psicologia , Adulto , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Programas de Rastreamento/métodos , Cidade de Nova Iorque , Porto Rico , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes Sorológicos , Comportamento Sexual , Inquéritos e Questionários , Adulto JovemRESUMO
Esta dissertação visa contribuir com uma discussão genderizada e transviada no campo da saúde mental e sustentar uma discussão da saúde mental e processos de subjetivação no campo dos estudos transviad@s, tendo a dimensão racial como uma discussão transversal. A partir da noção de "sistema de gênero moderno colonial" e de uma perspectiva analítica interseccional, a questão que orientou a pesquisa foi: como tem se dado a gestão do sofrimento de mulheres trans que vivem ou já viveram na rua e quais estratégias para o cuidado de si essas pessoas estão lançando mão? O objetivo do trabalho é analisar as formas de gestão desse sofrimento em seu duplo sentido, isto é, o de gestar e o de gerir. Para isso, se baseia em uma etnografia multisituada em espaços que foram aqui nomeados como uma "rede de cuidado trans em (des) construção" e nas histórias de vida de quatro mulheres trans que atuam ou transitaram nos projetos. Na primeira parte da dissertação, que aborda a gestão do sofrimento no sentido de gestar, discute-se sobre a história da gestação do sofrimento a partir da produção de dor e do tornar-se sujeite de direitos, bem como sobre o que se chama de itinerários de vulnerabilização. Isso significou pensar sobre a história de gestação do sofrimento pela Casa-grande, mas também considerar fissuras e brechas que as mulheres trans precisaram construir por meio de ruas encruzilhadas e agenciamentos. Já a segunda parte, trata da gestão do sofrimento no sentido do gerir, seja por elas próprias; por meio de uma tentativa de construção do cuidado de si (nomeada como itinerário de encruzilhamento), seja por meio da rede formal e informal que está sendo costurada para dar conta de tal questão: Ong Casinha e o Serviço Noturno de um CAPSAd, localizado numa região periférica da cidade do Rio de Janeiro. Em termos analíticos, busca-se o afastamento de uma perspectiva salvacionista que contribua para a reificação do dispositivo transexualizador enquanto tutela, patologização e vitimização das pessoas trans. Para tal, propõe uma nova epistemologia do sofrimento, sugerindo a noção de sofrimento encruzilhado como a interseção entre o itinerário de vulnerabilização e o itinerário de encruzilhamento.
This thesis aims to contribute to a gender and transviada (queer) oriented discussion in the field of mental health, and to sustain a discussion of mental health and subjectivation processes in the field of transviados (queer) studies, having the racial dimension as a transversal discussion. From a notion of "modern colonial gender systems" and from an intersectional analytical perspective, the question that guided this work was: how has the suffering of trans women who live or have lived on the streets been managed, and what strategies this population has been using for self-care? The objective of this thesis is to analyze the forms of gestão of this suffering, in a double sense, that is, that of gestating and that of managing. For that, it is based on a multi-situated ethnography in spaces that have been named here as a "trans care network in (de) construction" and in the life stories of four trans women who work or transit in these projects. The first part of this thesis deals with the management of suffering in the sense of gestating, it discusses the history of the suffering gestation from the production of pain and to becoming a subject of rights, as well as about what is called vulnerability itineraries. This meant thinking about the history of gestation of suffering caused by the Casa-Grande, but also considering the cracks and breaches that trans women needed to build through crossroads and agencying. The second part, on the other hand, addresses the management of suffering in the sense of managing, either by themselves; through an attempt to build self-care (referred to as crossroads itinerary), either through the formal and informal network that is being sewn to account for this issue: NGO Casinha and night shift service in a CAPSAd, located in a peripheral region of the Rio de Janeiro City. In analytical terms, this work seeks to move away from a salvationist perspective that contributes to the rectification of the transsexualizing device as protection, pathologization, and victimization of trans people. To this end, it proposes a new epistemology of suffering, suggesting the notion of crossroads suffering as the intersection between the vulnerability itinerary and the crossroads itinerary.
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Humanos , Masculino , Feminino , Estresse Psicológico , Saúde Mental , Feminismo , Pessoas Transgênero , Pesquisa QualitativaRESUMO
Introducción Las personas transgénero (varones y mujeres trans, género neutro, etc.) realizan tratamientos médicos y/o quirúrgicos a fin de adecuarse a su identidad de género. Dentro de los procedimientos disponibles, se encuentran incluidos aquellos que pueden modificar la glándula mamaria (tratamiento hormonal cruzado, mastectomía/masculinización del tórax/colocación de prótesis mamarias). Se desconoce actualmente el riesgo de desarrollar cáncer de mama en la población trans. Sin embargo, están establecidas pautas de screening mamario que permitirían un adecuado seguimiento de la salud mamaria, tanto en varones trans como en mujeres trans. Objetivo El objetivo principal es estudiar la situación actual respecto del screening mamario realizado a pacientes trans por parte de sus médicos de cabecera en un hospital de la Ciudad de Buenos Aires. Material y método Se evaluaron las historias clínicas de un total de 489 personas trans atendidas en el Hospital Durand entre los años 2006 y 2017. 1. Se relevó la realización de estudios mamarios de screening previos a la instauración del tratamiento hormonal cruzado (thc) en pacientes trans. 2. Se analizó la valoración de riesgo de cáncer de mama previo al inicio del thc. 3. Finalmente, se propone un algoritmo de evaluación previo y posterior al comienzo del tratamiento hormonal en estos pacientes, según hormonoterapia recibida, y la realización de cirugía mamaria, acorde a normas internacionales y la revisión de la bibliografía. Resultados Se observó que un 37,7% de varones trans y un 18,1% de mujeres trans tenían estudios mamarios realizados. Respecto de la valoración de riesgo, en un 11,5 y un 11,1% (varones y mujeres trans) no estaban recolectados los antecedentes familiares, y, en los casos en que figuraban, estaban incompletos. Conclusiones Se postula mantener las pautas de screening mamario aplicadas para mujeres cis tanto en varones trans hasta la realización de la mastectomía/masculinización del tórax (luego mantener el examen físico) como en mujeres trans que reciben thc
Introduction Transgender patients perform both medical and surgical treatments in order to adapt to their gender identity. Within the procedures, those that can modify the mammary gland are included (cross-hormonal treatment, mastectomy / placement of breast prostheses). The risk of developing breast cancer in the trans population is currently unknown. However, screening guidelines are established and would allow adequate monitoring of mammary health, both in trans men and trans women. Objective The main objective is to study the current situation regarding breast screening performed on trans patients by their family doctors in a hospital in the City of Buenos Aires. Materials and method The clinical histories of a total of 489 transgender people attended at the Durand Hospital between 2006 and 2017 were evaluated. We studied: 1. breast screening studies prior to the initiation of cross-hormone treatment (thc) in trans patients; 2. the risk assessment of breast cancer prior to the start of thc; 3. finally, an algorithm of evaluation before and after the start of hormonal treatment is proposed in these patients, according to hormone therapy received and the performance of breast surgery, according to international standards and bibliographic review. Results It was observed that 37.7% of trans men and 18.1% of trans women had breast studies performed. Regarding the risk assessment, 11.5 and 11.1% (men and trans women) there was no family history collected, and most cases they were incomplete. Conclusions It is postulated to maintain the mammary screening guidelines for cis women both in trans men until the completion of the mastectomy (then maintain the physical examination) and in trans women who receive thc
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Próteses e Implantes , Terapêutica , Neoplasias da Mama , Pessoas TransgêneroRESUMO
O presente artigo problematiza violências vivenciadas por pessoas que se reconhecem ou já se reconheceram como mulheres travestis e mulheres transexuais uma das entrevistadas no momento da entrevista se reconheceu como crossdresser. Foram realizadas entrevistas na Região da Grande Florianópolis e a análise ocorreu a partir das referências de autores como Jacques Derrida e Judith Butler, considerando as suas críticas aos binarismos e as hierarquias entendendo-os como produtores de relações de violências. Também foram utilizadas contribuições do transfeminismo, como a noção de cisheteronormatividade. As performances de gênero de mulheres travestis e mulheres trans foram relacionadas à abjeção desses corpos que não condizem com os ideais normativos de gênero. Essa abjeção está relacionada à exposição a situações de violências associadas à sua concomitante naturalização. Desconstruir pares como homem/mulher, natureza/cultura, vítima/agressor, pode contribuir com o deslizamento de sentidos dessas cristalizações binárias, destituindo o lugar de violência ocupado por corpos trans e travestis.
The present paper discusses the violence experienced by people who recognize or have recognized themselves as transvestites women and transsexual women - one of the interviewees at the time of the interview identified herself as a crossdresser. Some interviews were conducted in the Region of Grande Florianópolis and the analyses occurred from the references of Jacques Derrida and Judith Butler, considering binarisms and hierarchies as producers of violence relations. Also, it was possible to use transfeminism contributions such as the notion of cis heteronormativity. Transvestites and transgender women's performances were related to the abjection of bodies that are not consistent with gender normative ideals. That abjection relates to the exposure to violent situations associated with the concomitant naturalization. Deconstructing pairs such as man/woman, nature/culture and victim/aggressor may contribute to the senses sliding of these binary crystallizations, depriving the place of violence occupied by transvestites and trans bodies.
El presente artículo problematiza la violencia vivida por personas que se reconocen o que ya se reconocieron como mujeres transexuales y mujeres travestis, y una de las participantes se consideró como crossdresser al momento de la entrevista. Fueron realizadas entrevistas en la Región de la Grande Florianópolis y el análisis se dio a partir de las referencias de Jacques Derrida y Judith Butler considerando los binarismos y las jerarquías como productores de relaciones de violencia. También, se utilizaron contribuciones del transfeminismo como la noción de cisheteronormatividad. Las performances de género de mujeres travestis y trans fueron relacionadas con la abyección de esos cuerpos que no condicen con los ideales normativos del género. Esa abyección está relacionada con la exposición a situaciones de violencia asociadas con su concomitante naturalización. Deconstruir pares como hombre/mujer, naturaleza/cultura, víctima/agresor puede contribuir con el deslizamiento de los sentidos de esas cristalizaciones binarias, destituyendo el lugar de la violencia ocupado por los cuerpos trans y travestis.
Assuntos
Humanos , Masculino , Feminino , Violência contra a Mulher , Pessoas Transgênero , Binarismo de Gênero , Identidade de GêneroRESUMO
O artigo tem como proposta central analisar um conjunto de racionalidades que perpassam a configuração dos processos de incriminação-criminalização de travestis. Tomando como acontecimento-chave uma operação policial que teve início em 27 de fevereiro de 1987 na cidade de São Paulo Operação Tarântula , almejou-se compreender como a mesma surge enquanto condição de possibilidade de um contexto sociopolítico específico; mas que, para além dele, apontam-se pistas para um modus operandi que produz corpos travestis a partir de uma política da inimizade e da abjeção. Investiga-se linhas de força que compõem a materialidade da operação policial e os processos de subjetivação produzidos e que se mantêm após mais de três décadas. A partir da análise de diferentes registros percebe-se que o acionamento de pânico moral direcionado a corpos travestis mobiliza circuitos de racionalidades capazes de agregar discursos sobre segurança pública em dinâmicas de seletividade penal advindas de composições necropolíticas. Entendendo as condições que possibilitam as relações entre o Estado penal e as pessoas travestis que ocorriam no momento de redemocratização do Brasil, podemos perceber rastros dos elementos que ainda hoje perpassam tais relações....(AU
The article has as a central proposal to analyze a set of rationalities that cross the configuration of the processes of incrimination-criminalization of trans women. Taking a police operation that began on February 27, 1987 in the city of São Paulo Tarantula Operation as a key event, the aim here is to understand how the so-called operation arises as a condition of possibility of a specific socio-political context; in addition to it, this article points to a modus operandi that understands trans women as bodies based on a politics of enmity and of abjection. Investigating whether such lines of force that make up the materiality of a police operation continue to produce effects 30 years later is also the purpose of this text. From the analysis of different records, we can see that the activation of moral panic directed to trans women bodies mobilizes circuits of rationalities capable of adding discourses on public security in dynamics of penal selectivity coming from necropolitcs compositions. Understanding the conditions that make possible the relations between the criminal state and the trans women that occurred at the moment of redemocratization of Brazil, we can perceive traces of the elements that still pervade these relations....(AU)
El artículo tiene como propuesta central analizar un conjunto de racionalidades que atraviesan la configuración de los procesos de incriminación-criminalización de travestis. Tomando como acontecimiento clave una operación policial que comenzó el 27 de febrero de 1987 en la ciudad de São Paulo Operación Tarántula , se anheló comprender cómo la misma surge como condición de posibilidad de un contexto sociopolítico específico; pero que, además de él, se apuntan pistas para un modus operandi que produce cuerpos travestis a partir de una política de la enemistad y de la abyección. Se investiga líneas de fuerza que componen la materialidad de la operación policial y los procesos de subjetivación producidos y que se mantienen después de más de tres décadas. A partir del análisis de diferentes registros podemos percibir que el accionar de pánico moral dirigido a cuerpos travestis moviliza circuitos de racionalidades capaces de agregar discursos sobre seguridad pública en dinámicas de selectividad penal provenientes de composiciones necropolíticas. Entendiendo las condiciones que posibilitan las relaciones entre el Estado penal y las personas travestis que ocurrían en el momento de redemocratización de Brasil, podemos percibir rastros de los elementos que aún hoy atraviesan....(AU) tales relaciones.
Assuntos
Humanos , Masculino , Psicologia , Segurança , TravestilidadeRESUMO
Resumen: A través de un uso crítico de la perspectiva de la interseccionalidad, la investigación etnográfica y exploratoria analiza las imbricaciones del género, la clase social, la etnicidad y la sexualidad en las trayectorias laborales de un conjunto de estilistas transfemeninas en Santiago de Cali y San Andrés Isla, Colombia. Las distancias sociales que se construyen entre diferentes actores (estilistas gais, estilistas de clase alta blancos heterosexuales, personas raizales heterosexuales y la clientela cisgénero) producen de manera específica los sentidos otorgados al trabajo en las peluquerías y sus fronteras difusas con la prostitución. Si por un lado el efecto de clase y la dominación cisgenerista imposibilitan el ascenso social de las mujeres trans caleñas, el tabú heterosexista del sistema étnico prohíbe y niega las feminidades trans como parte de la identidad raizal.
Resumo: Através de uma abordagem crítica interseccional, esta pesquisa etnográfica exploratória analisa as imbricações de gênero, classe, etnia e sexualidade nas trajetórias de trabalho de um grupo de estilistas composto por mulheres trans, em Santiago de Cali e na Ilha de San Andrés, Colômbia. As distâncias sociais construídas entre diversos atores (estilistas gays, estilistas heterossexuais brancos ricos, pessoas “raizais” heterossexuais e clientes cisgenênero) criam significados específicos no que se refere ao trabalho nos salões de cabeleireiro e seus limites confusos com a prostituição. Se, por um lado, o efeito da classe e da dominação cisgênero impedem a ascensão social das mulheres trans “caleñas”; por outro, o tabu heterosexista do sistema étnico proíbe e nega que as feminilidades trans façam parte da identidade “raizal”.
Abstract: Through a critical approach of intersectionality, this exploratory ethnographic research analyses the imbrications of gender, class, ethnicity and sexuality in the work trajectories of a transfeminine group of stylists in Santiago de Cali and San Andrés Island, Colombia. The social distances built between diverse actors (gay stylists, rich white heterosexual stylists, heterosexual raizal people, and cisgender clients) create specific meanings regarding work in the hairdressing salons and its blurred boundaries with prostitution. On one hand the effect of class and cisgender domination hinder social ascending of the caleñas trans women; on the other hand, the ethnic system’s heterosexist taboo prohibits and denies trans femininities as part of the raizal identity.
Assuntos
Humanos , Feminino , Barbearia , Sexualidade , Pessoas Transgênero , Identidade de Gênero , Preconceito , Trabalho Sexual , Classe Social , Colômbia , Pesquisa Qualitativa , Enquadramento InterseccionalRESUMO
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.