Barriers to accessing healthcare for transgender individuais in primary health

Authors

DOI:

https://doi.org/10.33448/rsd-v14i6.49104

Keywords:

Primary Health Care, Health Equity, Transgender Persons, Barriers to Access of Health Services.

Abstract

This study aimed to analyze the main barriers faced by transgender people in accessing Primary Health Care (PHC). It is an integrative literature review, conducted through a search in the Virtual Health Library (VHL) between February and June 2025, using controlled descriptors, the PICo strategy, and the PRISMA protocol for study selection. A total of 62 articles were identified, of which 10 met the inclusion criteria and composed the corpus of analysis. The results identified eight main barriers that hinder transgender people's access to PHC services, including the incorrect use of the social name, fear of discrimination, self-medication without professional supervision, lack of adequate structures, shortage of trained professionals, failures in the implementation of public policies, and significant impacts on the mental health of this population. It was observed that the lack of professional preparation, combined with the absence of specific training on gender diversity, exacerbates social and institutional exclusion. Moreover, the concentration of specialized services in large urban centers makes access difficult, especially for those living in peripheral regions. It is concluded that it is urgent to strengthen public policies, promote ongoing training for health professionals, and adopt welcoming practices and active listening to ensure comprehensive, humane, and discrimination-free care, contributing to the construction of a more equitable and inclusive Unified Health System (SUS).

References

Bender, M. S., Paz, I., Beranger, K. S., & Garcia, E. L. (2024). Itinerários de acesso ao processo transexualizador no Brasil: Uma revisão de escopo. Epidemiologia e Serviços de Saúde, 33(1), 2024311. https://doi.org/10.1590/S2237-96222024v33e2024311.especial.pt.

Bonifácio, J. H., Maser, C., Stadelman, K., & Palmert, M. (2019). Management of gender dysphoria in adolescents in primary care. Canadian Medical Association Journal, 191(3), 69–75. https://doi.org/10.1503/cmaj.180672.

Borgert, V., Stefanello, S., & Signorelli, M. C. (2022). “A gente só quer ser atendida com profissionalismo”: Experiências de pessoas trans sobre atendimentos de saúde em Curitiba-PR, Brasil. Physis: Revista de Saúde Coletiva, 33, 33036. http://doi.org/10.1590/S0103-7331202333036.

Brasil. (1998). Constituição da República Federativa do Brasil de 1988. Presidência da República. http://www.planalto.gov.br/ccivil03/constituicao/constituicao.htm.

Brasil. Ministério da Saúde. (2024). Saiba mais sobre a Atenção Primária à Saúde. https://www.gov.br/saude/pt-br/composicao/saps/saiba-mais-sobre-a-aps.

Gomes, A. C. M. da S., Sousa, F. J. G., Janini, J. P., Vargas, L. A., Gomes, M. dos S., & Lemos, A. (2023). Atendimento na atenção primária à saúde: Olhares de pessoas trans. Revista de Pesquisa: Cuidado é Fundamental, 15, 12260. https://doi.org/10.9789/2175-5361.rpcfo.v15.12260.

Gomes, D. de F., Teixeira, E. R., Sauthier, M., & Paes, G. O. (2022). Restrição de políticas públicas de saúde: um desafio dos transexuais na atenção básica. Escola Anna Nery, 26, 20210425, 2022. https://doi.org/10.1590/2177-9465-EAN-2021-0425en.

Dantas, H. L. de L., Costa, C. R. B., Costa, L. de M. C., Lúcio, I. M. L., & Comassetto, I. (2021). Como elaborar uma revisão integrativa: Sistematização do método científico. Revista Recien, 37, 334-345. https://doi.org/10.24276/rrecien2022.12.37.334-345.

Jesus, M. K. M. R. de, Moré, I. A. A., Querino, R. A., & Oliveira, V. H. de. (2023). Experiências de mulheres transexuais no sistema de saúde: Visibilidade em direção à equidade. Interface – Comunicação, Saúde, Educação, 27, 220369. https://doi.org/10.1590/interface.220369.

Lampalzer, U., Behrendt, P., Dekker, A., & Nieder, P. B. T. O. (2019). The needs of LGBTI people regarding health care structures, prevention measures and diagnostic and treatment procedures: A qualitative study in a German metropolis. International Journal of Environmental Research and Public Health, 16(19), 3547. https://doi.org/10.3390/ijerph16193547.

Ministério da Saúde. (2011, 1 de dezembro). Portaria n. 2.836, de 1º de dezembro de 2011 (Institui a Política Nacional de Saúde Integral LGBT no âmbito do SUS). Diário Oficial da União.

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice. (6rd ed.) Wolters Kluwer.

Menezes, L., Silva, L. da S., Murgo, C., & Rahe, B. (2024). Invisibilização e preconceitos velados: barreiras para o acesso aos serviços de atenção básica pela população trans. Revista Brasileira de Medicina de Família e Comunidade, 19(46), 3961. https://doi.org/10.5712/rbmfc19(46)3961.

Morenz, A. M., Goldhammer, H., Lambert, C. A., Hopwood, R., & Keuroghlian, A. S. (2025). A blueprint for planning and implementing a transgender health program. Annals of Family Medicine, 18(1), 73–79. https://doi.org/10.1370/afm.2473.

ONUSIDA Brasil. (2020, janeiro). Mais de 90% da população trans já sofreu discriminação na vida. https://unaids.org.br/2020/01/mais-de-90-da-populacao-trans-ja-sofreu-discriminacao-na-vida.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Stewart, L. A., Thomas, J., Tricco, A. C., Welch, V. A., Whiting, P., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Systematic Reviews, 10(1), 89. https://doi.org/10.1186/s13643-021-01626-4.

Pereira A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.

Roever, L., Gomes-Neto, M., Durães, A. R., Reis, P. E. O, Pollo-Flores, P., Silva, R. M. L., & Resende, E. S. (2021). Compreendendo o GRADE: PICO e qualidade dos estudos. Revista Sociedade Brasileira de Clínica Médica, 19(1), 54–61. https://docs.bvsalud.org/biblioref/2022/03/1361752/54-61.pdf.

Sampaio, L. L. P, & Coelho, M. T. Á. D. (2012). Transsexuality: Psychological characteristics and new demands on the healthcare sector. Interface – Comunicação, Saúde, Educação, 6(42), 637–649. https://doi.org/10.1590/S1414-32832012000300005.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333-339. https://doi.org/10.1016/j.jbusres.2019.07.039.

UNAIDS. (2023). HIV and transgender people [Thematic briefing note]. UNAIDS. Recuperado de https://thepath.unaids.org/wp-content/themes/unaids2023/assets/files/thematic_fs_hiv_transgender_people.pdf

Ziegler, E. Carrol, B., Chyzzy, B., Rose, D. N., & Espin, S. (2024). ‘A void in our community’: Exploring the complexities of delivering and implementing primary care services for transgender individuals in Northern Ontario. Primary Health Care Research & Development, 25(36), 1–8. https://doi.org/10.1017/S1463423624000203.

Published

2025-06-30

Issue

Section

Health Sciences

How to Cite

Barriers to accessing healthcare for transgender individuais in primary health. Research, Society and Development, [S. l.], v. 14, n. 6, p. e11214649104, 2025. DOI: 10.33448/rsd-v14i6.49104. Disponível em: https://rsdjournal.org/rsd/article/view/49104. Acesso em: 5 dec. 2025.