The Hospital das Clínicas at USP (University of São Paulo) has an integrated monitoring center for children and adolescents who show signs of gender dysphoria —anxiety related to the feeling that the gender at birth does not correspond to the identity.
The manifestation of dysphoria does not always mean the individual’s transsexuality and can be something specific. For this reason, the Amtigos (Transdisciplinary Gender Identity and Sexual Orientation Outpatient Clinic), made up of psychiatrists, psychologists, pediatricians and endocrinologists, performs a careful analysis of the cases.
Those assisted are submitted to a detailed process that can culminate, if so, in the evaluation of the patient, doctor and family, in hormone injection, allowed from the age of 16, and in sexual affirmation surgery, from the age of 18. All procedures follow CFM (Federal Council of Medicine) guidelines.
Last Wednesday (1st), a councilor from São Paulo submitted a request for the opening of a CPI (Parliamentary Commission of Inquiry) to investigate the monitoring of gender transition of children and adolescents carried out by Amtigos.
The proposal by Rubinho Nunes (União Brasil) was motivated by a report on the G1 portal published on Trans Visibility Day, on Sunday (29). According to the text, currently 100 children aged between 4 and 12 years are undergoing gender transition treatment at the site, as well as 180 young people aged 13 to 17 years. There are also 160 families on the waiting list, the Sheet.
“Performing hormone treatment or preparatory procedure for sex change in children is a crime. While these parents use USP’s HC to satisfy their own ideological schizophrenia and submit their children to experiments, people with serious illnesses are left without adequate care”, he said. Nunes. The plenary of the City Council will still decide whether to authorize the investigation – the approval of a simple majority of the 55 councilors is required.
Alexandre Saadeh, coordinator of Amtigos, says that the purpose of the clinic is to alleviate the suffering of children and young people with their bodies, thus providing a better quality of life.
“We do not experiment with anyone, we are not talking about laboratory rats, they are human beings who deserve dignified treatment and, above all, a lot of respect. Nobody is obliged to take hormones and undergo surgeries. This, if it happens, is the result of a careful follow-up based on medical concepts, not ideological ones”, he says.
According to Saadeh, the purpose of the center is to alleviate the suffering of all those involved. “We defend the diagnosis not as pathologizing, but as a protector. We want to shield these people from the pain of living a reality that is not theirs, in addition to protecting their families from the pain caused by ignorance.”
Amtigos was founded in 2010. Initially, it received adults, but since 2015, only children and adolescents have been treated — there are adult patients who began to be followed up when they were minors.
At the time, there was no specific legislation on the subject in Brazil. Provoked, the Federal Council of Medicine, with the support of experts, formulated a resolution that established that cases of dysphoria would be addressed in multidisciplinary research centers. With this, the results can help in the universalization of therapies.
There are few qualified places in the country. In addition to the HC, there is an outpatient clinic in Porto Alegre and another in Campinas, in the interior of São Paulo.
Amtigos tends to serve people aged 4 to 13 years. Those older than 13 are referred to the health network of the City of São Paulo, a partner in the project in advanced sexual reassignment procedures, such as the use of hormones.
Puberty suppression is the initial treatment for transgender people. It prevents the development of adult biological characteristics, before using gender-affirming hormones.
Guilherme Polanczyk, head professor of child and adolescent psychiatry at USP’s Hospital das Clínicas, points out that suppression is also a way to gain time. “No one is going to arrive with hormones and a scalpel. It takes time and a lot of conversation to really understand those people, and they understand themselves. Puberty is paralyzed for everyone to think. We follow everyone closely, parents and children”, declares Polanczyk
Like young people, family members are analyzed by professionals. Doubts and anxieties also affect those responsible a lot, says the professor.
One of the assisted relatives is Aline, 40. Her son, 14 years old, started his sexual reassignment process two years ago. The family is from Diadema, in Greater São Paulo.
The boy had already started his puberty process, but he was still selected. “My son started to be accompanied, as well as me, and this has been extremely important.” The family receives psychological support from the center and participates in monthly meetings with other members.
Laura, 46, is in a similar situation. Her 13-year-old son began to express discomfort with his body two years ago.
Born in Vitória, Espírito Santo, the family acted promptly so that the son, who had just menstruated, had the body that suited his reality.
The teenager was taken to Amtigos. Her female maturation process was stopped with blockers and her psychological follow-up began, as well as that of her family.
“Today, my son seems like a different person. From shy, he became expansive. From shy, he began to participate in various activities. He lives who he is fully”, adds Laura.
Karen de Marca, director of the Brazilian Society of Endocrinology and Metabology, that the outpatient work is a milestone in Brazilian public health. “We are doctors and we provide technical support, but the purpose of everything is a dignified life for the trans population.”
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