"Fazer emergir o masculino": noções de "terapia" e patologização na hormonização de homens trans

Abstract

Resumo Descreve-se as noções de "terapia" hormonal em cenários medicalizantes nos quais homens transexuais se movem na constituição de transições de gênero. Em meio aos acessos e práticas à (auto)administração de ésteres de testosterona (cipionato e/ou propionato), esses sujeitos acionam a ideia de "terapia" - seja para se afastar ou para reiterá-la -, levando-nos a uma reflexão sobre a atual classificação da transexualidade como doença mental. Realizou-se pesquisa etnográfica em grupos de ativismo trans no Brasil com entrevistas em profundidade no período de 2014 a 2015.

Transphobia as a social disease: discourses of vulnerabilities in trans men and transmasculine people

“…With contexts demarcated by religion, whose logic of sinfulness, the idea of a “dirty, unworthy, sinful and erroneous body”, can intensify the transphobia perpetrated by family members against the “gender-divergent person”. This reality can revert to triggering negative feelings/emotions, reflecting the indignation and impact suffered by those who should be the primary source of support/ support, safety/protection and expression of affection/love ( 23 , 24 ) .…”

“…Faced with these circumstances, trans and transmasculine men can become discreet, almost invisible to people’s eyes, due to the fear of expressing their identities socially and establishing their body readings in front of others, through the fear of delegitimization, embarrassment, humiliation and other forms of violence and social oppression ( 23 , 24 ) . Under this issue, our findings in this present study revealed that this fact may be related to the way trans men and transmasculine people deal with self-image and body image, as in the case of the breasts, an organ that compromises the body archetype “passing” and configuration and the male figure aesthetics ( 23 ) in social imaginary. In view of this, it is salutary to create specific lines of care for specialized, comprehensive and equitable health care in the health network available to the trans population, in addition to qualification of nursing teams in health care promotion with a view to valuing trans identities, self-image/perception and self-concept.…”

“…The existence of transphobia in health services constitutes an error and serious violation of the guarantee of the SUS principles, which provides for universality, comprehensiveness and equity in health care ( 23 ) . Although there is, on a daily basis, non-compliance with these principles and assumptions contained in the Charter of Rights of SUS Users ( Carta dos Direitos dos Usuários do SUS ) ( 23 ) (a disturbing problem for the health of transgender people), transphobia needs to be seen as a significant public health problem. Deleterious effects of transphobia imply a decrease in survival, precariousness in health care production, distancing of the trans population from health services and distancing from healthy community spaces for coexistence (parks, squares, outdoor gyms).…”

“…Transphobia can cause difficulty in the insertion of trans men and transmasculine people in the formal job market, in maintaining employability, income and financial security ( 29 ) , impacting the livelihood of trans people ( 28 , 29 , 30 ) , given the institutional regulation of cisgender dependent gender ( 9 ) . Thus, financial precariousness brings real harm to physical health: low quality of life; difficult access to inputs necessary for desired body changes (acquisition of safe and quality hormones); non-compliance with therapeutic agendas (clinical consultations/assessments, follow-up, diagnostic tests, surgical or non-surgical body procedures) ( 23 ) . In view of this, the need to maintain income may imply the adoption of strategies that guarantee transmasculine “passing”, by hiding any characteristics socially perceived as feminine, which may explain the constant use of a device called “binder”, used by many trans men and transmasculine people for devices to disguise the breasts, compressing them, considering the fear of punishment and degradation of identity in the work environment ( 9 ) , as evidenced in this study.…”

Condições Bucais De Transexuais Em Processo De Hormonização

“…A Organização Mundial da Saúde (OMS), em 2018, através da nova Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-11), removeu o chamado transtorno de identidade sexual constante no CID-10 como doença mental, colocando a situação de incongruência de gênero como parte do item Condições Relacionadas à Saúde Sexual para identificar a pessoa transexual 4 No Brasil, a hormonização é disponibilizada pelo Ministério da Saúde, sendo denominada de Processo Transexualizador. O usuário que procura no sistema de saúde o amparo para sua condição de sofrimento decorrente da incompatibilidade entre o sexo biológico e o sentimento de pertencimento a um gênero de identificação será acolhido e submetido à avaliação inicial, feita por um psicólogo e outro profissional da equipe multiprofissional, em ambulatório ou hospital credenciado, com a finalidade de confirmar a Disforia de Gênero 6 . A prevalência de tal condição é bastante variável, podendo ser de 6 à 521 por 100.000 habitantes, em se tratando de mulheres trans e 2,5 a 256 por 100.000 habitantes para homens trans 7 .…”