TRANSformation – Widening knowledge and boundaries – Brazil (IFMSA-Brazil)

Name of the activity: TRANSformation – Widening knowledge and boundaries

Country/NMO: Brazil (IFMSA-Brazil)

Program: Sexuality & Gender Identity

Contact information: [email protected]

Type of the activity: Education

General description:

There is yet a lot of prejudice and discrimination when it comes to the transgender population, which lives aside of public and governmental care. Even if some improvements have been done by the brazilian health care system for this group, more discussion is required about transgender health care, since there is na insufficient prepare around this subject. Therefore, the TRANSformação project, composed by one training and three meetings, approached these issues through lectures ministered by members of a non profit organization called Transgrupo Marcela Prado, the general practicer Dr. André Filipak and the psychoanalyst and anthropologist Letícia Lans. The project provide the opportunity of understanding the transgender reality when in health care, encouraging feelings like empathy, respect and how to establish a good relation with the patients.

Focus area:

LGBTIQ+ issues

Problem statement:

The transgender population, in the current social panorama of the LGBTQ + population, is significantly exposed to prejudice and discrimination, since it has a gender identity that escapes the heteronormative patterns imposed by society. In this way, being in a category considered as different or unusual is often subject to a social marginalization that represses its potential as a human being. In the face of this stigmatization, acts of violence and repression are common, as well as an exclusion of the labor market and public services, testing their basic rights as citizens (BRAZIL, 2015). Public policies in Brazil, including health to enable access to rights that are commonly denied to the transgender population, and to promote access to integral health, eliminating discrimination and institutional prejudice, as well as contributing to the reduction of social inequalities and the consolidation of the Public Health System as a universal system , integral and equitable (BRAZIL, 2013). In the area of primary health care, in 2009, through Ministry of Health Ordinance no. 1820, the use of the social name was guaranteed both in the SUS card and in the medical records. Already? in the year 2013, Portaria no. 2803 was published, which reformulates and regulates the transexualization process in Brazil, thus offering greater attention to the psychological and endocrinological treatment for these patients (BRAZIL, 2015). However, transsexuality is classified as a pathology by the Manual of Diagnoses in Mental Health (DSM), which ends up generating a series of clinical procedures that pose obstacles to the access of this population to specialized services (ROGERS, 2016). Another aggravating factor is the worrying situation of unpreparedness of many health professionals facing the needs of the transgendered population, and there is a need for better professional training for those working in the area. Research carried out between 2008 and 2009 shows that transgender people have had difficulties to enjoy health care services, resulting in the discontinuity and abandonment of medical treatment (FACULTY OF MEDICAL SCIENCES OF SANTA CASA DE SÃO PAULO, 2017). In this context, it is necessary to discuss the role of primary health care (PHC) in the care of the transgender population, including the importance of educating future health professionals in the treatment of this social demand.

Target groups and beneficiaries:

The project was aimed at academics of medicine at the Federal University of Paraná with the aim of informing them about the barriers that the Transgender population faces in society and also about access to health, such as discrimination, prejudice. Through the information transmitted, students are able to bring to this public directly or indirectly the concepts learned and reflected during the event. In the current social panorama of the LGBTQ population there is stigmatization, violence, repression and exclusion in the labor market, placing their basic rights as citizens below other citizens. Access to information promotes the reduction of all this stigma from generation to generation that is embedded in society and so strong in public health.

Objectives and indicators of success:

The activity aims to address the reality and health of the transgender and transsexual population in the academic world of medicine.
As specific objectives, it aims to promote a lecture on the reality of transgenders and transsexuals in the context of doctor; Teach academics, residents and teachers about the best approach in the clinical care of this population. Provide a space for dialogue between students, residents and teachers and the transgender and transsexual population.
To insert the students in the context of life and conviviality of this population.
It was expected that medical professionals and students will understand the reality and health of the transgender and transgender population and
in this population. In addition, the transgender and transsexual population and the students, inserted in the TransGrupo, share experiences and talk at meetings.
The “Transformation” campaign, in all its phases, generated very positive results and revealed a large number of academics and health professionals interested in discussing the topic and improvement in the health care of the population transgender. After widespread dissemination via social media, the training session held in August counted on 155 registrations and 101 participants, in 4 lectures by 3 NGO activists Transgroup Marcela Prado (a transgender woman, a man transgender and an intersex transgender woman) and a family and community health, Dr. André Filipak. The repercussion of the discussion generated on the subject was perceptible on academic environment in the days that followed. Because impossibility of data for visits to the NGO Transgroup Marcela Prado as planned, it was decided to carry out conversation with small groups of students invited representatives of the transgender population and Dr. André Filipak, as well as academics and health professionals concerned.

Methodology:

Local Officers of a Local Committee of IFMSA Brazil from the Federal University of Paraná (UFPR) did get together and made the “TRANSformation – Widening Knowledge and Boundaries” project, before starts the project was made five discussion and organization meeting to construct and design the activitie. The project was composed by one capacitation event and three meetings, approached these issues through lectures ministered by members of a non profit organization called Transgroup Marcela Prado, the general practitioner Dr. André Filipak and the psychoanalyst and anthropologist Letícia Lans. The project was shared through the online social media, as a Facebook event and Whatsapp Groups, and the registration through Google Forms. The capacitation took place on August 15 at 7 pm in the auditorium of the Health Sciences Sector of UFPR and was attended by the Transgroup Marcela Prado organization, which brought three of its members to pass the experiences on the reality of health and medical care lived for them. In addition, Dr. André Filipak addressed the care for trans people, the psychological aspects and what our Public Health System offers. The Transgroup was expected to provide the meeting schedule so that the students could attend the meetings, but it could not occur in that way since they did not provide the dates. In this way, we organized talk wheels so that the next meetings were made with different professionals with knowledge about trans people. The first meeting was with the psychoanalyst Leticia Lans on 10/20/2017, the second meeting with Dione Freitas on 10/23/2017 and the closing with Dr. Andre Filipak on 11/28/2017.

Plans for evaluation:

To evaluate the activity were maid two questionnaires, one before the activity and one after it occurs. The first had the following questions: 1. Have you ever have the opportunity to attend a transgender patient? 2. The subject transexuality was adressed at any time during your academic education? 3. If YES, was there some kind of guidance about clinical evaluation and welcome to this group? 4. Do You think it’s necessary to include classes about the assistance to the transgender population in the curriculum of health area courses? 5. Do you think believe that this activity can help you to become more prepared to meet the transgender as a generalist physician or other health professional? 6. Of 0-10 how much you feel confident to take care of a transgender patient? 7. How much you believe that health professionals are prepared to take care of transgenders patients?
After the activity the same questions were repeated but also with the addition of the following question: 1. Do you have some interest in participating of the next steps of the project?