IntroductionFemale sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women.Methods and analysisThe systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool.Ethics and disseminationAs it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.

Although almost 0.7% of the Brazilian population identifies as transgender, there is currently no training for healthcare professionals to provide comprehensive care to these patients, including the discussion of reproductive planning. The use of testosterone promotes amenorrhea in the first months of use; however, this effect does not guarantee contraceptive efficacy, and, consequently, increases the risks of unplanned pregnancy. The present article is an integrative review with the objective of evaluating and organizing the approach of contraceptive counseling for the transgender population who were assigned female at birth. We used the PubMed and Embase databases for our search, as well as international guidelines on care for the transgender population. Of 88 articles, 7 were used to develop the contraceptive counseling model. The model follows the following steps: 1. Addressing the information related to the need for contraception; 2. Evaluation of contraindications to the use of contraceptive methods (hormonal and nonhormonal); and 3. Side effects and possible discomfort associated with the use of contraception. The contraceptive counseling model is composed of 18 questions that address the indications and contraindications to the use of these methods, and a flowchart to assist patients in choosing a method that suits their needs.

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Objective To identify the age when individuals first perceive gender incongruence (GI) and to compare sociodemographic data of female-to-male (FtM) and male-to-female (MtF) transgender individuals assisted at an outpatient service. Methods The present cross-sectional study was conducted through a review of the medical records of individuals diagnosed with GI at a single specialized outpatient service in the city of Ribeirão Preto, state of São Paulo, Brazil. Results A total of 193 medical records from 2010 to 2018 were evaluated, and 109 (56.5%) patients had GI since childhood. The FtM transgender individuals perceived GI in childhood more often than the MtF transgender individuals (odds ratio [OR]: 2.06, 95% confidence interval [95%CI]: 1.11–3.81) Unattended hormone use was highest among the MtF group (69.6% versus 32.3%; OR: 4.78, 95%CI: 2.53–9.03). All of the individuals who were engaged in prostitution or were diagnosed with a sexually-transmitted infection, including HIV, were in the MtF group. Conclusion Despite the more prevalent perception of GI in childhood among the FtM group, social issues were more prevalent among the MtF group, which may be the result of social marginalization.

Objective: To implement a training protocol on intrauterine device (IUD) insertion for resident physicians to improve women’s access to this method. Methods: The staff identified poor access to family planning, in Vila Lobato health center, specially to IUD, there were only 15 IUD insertions in 2015. This implementation research evaluated and identified the barriers of access to IUD use. Then, stakeholders and staff defined the access flow of patients to the health unit and, eventually, the training provided to resident physicians in gynecology and obstetrics (GO) and family medicine (FM). This is a retrospective cohort of the IUD insertions performed by residents between 2016 and 2018.  Results : 252 copper IUDs were inserted from 2016 to 2018 and there was a progressive increase in the number of insertions (45 in 2016, 80 in 2017, and 126 in 2018). Thirty-four (16.4%) inadequate insertions and 15 (8.6%) expulsions were observed. There was no case of uterine perforation. Conclusion:  The implementation of the protocol on IUD insertion for residents in the primary care setting increased the local number of IUD insertion and might be a strategy to improve the access to the contraceptive method.

Aos meus amigos, aos familiares e a todos que estiveram envolvidos de alguma forma no desenvolvimento desta dissertação. Aos professores. À Dra. Lúcia Alves da Silva Lara, cuja dedicação ao estudo da Sexualidade Humana me tornou um apaixonado pelo tema, e por seu empenho em me trilhar nos caminhos da minha formação pessoal, não só como mestrando, mas como um especialista nesta área de atuação da Sexologia. Ao prof. Omero Benedicto Poli Neto e a prof. Giordana Campos Braga pela clarividência diante dos desafios da estatística e da metodologia científica, tão essenciais a minha formação. À minha família, por apoiar minhas decisões e por estarem ao meu lado nos momentos de alegria e nos momentos de desespero. Aos meus pais, Sérgio e Cristina, por todo carinho e dedicação durante a trajetória da vida; ao meu irmão, Guilherme, pelo incentivo e companheirismo; à minha família de ribeirão, Sarah e Gabriele, e à Thais, ombro direito de sofrimento conjunto nesta trajetória, e ao meu querido Matheus pela paciência e cumplicidade durante esse trabalho. Aos amigos, que são muitos e seria desonroso citá-los e, por ventura, me esquecer de alguém. E, finalmente, o presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES) por meio do Programa de Excelência Acadêmica (PROEX). RESUMO OKANO, Sergio Henrique Pires Okano. Características clínicas e sociodemográficas de uma população com disforia/incongruência de gênero.

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