The SUS (Unified Health System) has few units prepared to serve trans children and adolescents.
There are only six establishments across the country that offer pubertal block – which prevent the development of secondary sexual characteristics, such as breast growth and the onset of menstruation – or hormone therapy for this public.
Other units offer outpatient care, but do not perform these medical procedures. The care is usually provided by a multidisciplinary team and covers other health-related issues in this age group.
The North and Midwest regions are unassisted.
The performance of pubertal block and hormoneization in trans children and adolescents is not prohibited in Brazil, but suffers from a lack of regulation. The CFM (Federal Council of Medicine), by means of a 2019 resolution, indicates blockers from the first signs of puberty, and hormonalization from the age of 16. Body modification surgeries are prohibited for anyone under the age of 18.
On the other hand, the Ministry of Health does not recommend such procedures for transgender patients under the age of 18. The decision is supported by an ordinance of 2013. “It is up to the medical team of each location to indicate the appropriate procedures for each case”, says the folder, in a note.
Those who live far from the units that offer this type of service are entitled to Out-of-Home Treatment, an allowance for food, travel and overnight accommodation paid for by the SUS (Unified Health System).
See below for locations that serve trans children and adolescents. You must have authorization from a legal guardian to access the services. The information was collected from the units.
Sao Paulo-SP)
The Transdisciplinary Gender Identity and Sexual Orientation Outpatient Clinic (Amtigos), linked to the Psychiatry Institute of the Hospital das Clínicas, University of São Paulo, offers pubertal block and hormone therapy. The establishment welcomes patients from 3 years to 14 years and 11 months. Currently, the clinic serves 270 children and adolescents, in addition to 100 remaining adults, and has 180 families on the waiting list.
The Barra Funda School Health Center, linked to Santa Casa, monitors the public of trans adolescents at the beginning of puberty. In order to use the blocks and hormones, a person in charge must also attend the initial care.
The Municipal Health Department of São Paulo informs that the health centers in the city do not perform hormone therapy in transgender patients under 18 years of age. Even so, this group must be supported and guided at the 43 stations of the Sampa Trans network, distributed throughout the six regions of the municipality.
Porto Alegre (RS)
The Hospital de Clínicas de Porto Alegre, linked to UFRS (Federal University of Rio Grande do Sul), offers pubertal block and hormone therapy for transgender patients under 18 years of age. Currently, it serves 25 patients in this age group.
Uberlândia (MG)
The Hospital de Clínicas da UFU (Federal University of Uberlândia) also offers pubertal block and hormone therapy for transgender patients under 18 years of age. The unit treated 40 patients in this group last year.
Salvador BA)
The Professor Edgard Santos University Hospital of UFBA (Federal University of Bahia) offers treatments for underage trans patients. The site did not say how many patients are seen.
Recife PE)
Policlínica Lessa de Andrade, which is part of Recife’s municipal health network, offers hormone therapy for transgender patients over 16 years of age, but does not perform pubertal block.
The Hospital das Clínicas at UFPE (Federal University of Pernambuco) has spaces for dialogue to exchange experiences for trans children and adolescents, but does not offer pubertal block or hormone therapy for minors.
Rio de Janeiro – RJ)
The Aquarela program, linked to the Center for Adolescent Health Studies at the Pedro Ernesto University Hospital of UERJ (Rio de Janeiro State University), offers outpatient care for transgender patients under the age of 18. The place serves 34 patients in this age group, with no waiting list. It does not offer pubertal block or hormoneization at this time.
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