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ORIGINAL ARTICLE • Rev. Bras. Enferm. 76 (Suppl 2) • 2023 • https://doi.org/10.1590/0034-7167-2022-0183 copiar

La transfobia como enfermedad social: discursos de vulnerabilidades en hombres trans y personas transmasculinas

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

analizar las repercusiones de la transfobia en la salud de hombres trans y personas transmasculinas.

Método:

estudio cualitativo, realizado con 38 participantes, 35 hombres trans y tres personas trans masculinas que asistieron a servicios de salud especializados transgénero en Bahía, Brasil. Se realizaron entrevistas en profundidad entre junio de 2019 y febrero de 2020. Se utilizó la técnica del Discurso del Sujeto Colectivo y la interpretación basada en el concepto teórico de transfobia.

Resultados:

la transfobia tiene repercusiones intra e interpersonales en la vida y salud de los hombres trans y personas transmasculinas que acuden a los servicios de salud. Hubo experiencias de violencia en el espacio privado, deshilachamiento de lazos familiares; discriminación en el espacio escolar; limitación en las oportunidades profesionales/laborales; barreras para el autocuidado y acceso a los servicios de salud; elaboración de estrategias de protección de la identidad trans; consecuencias de la transfobia en la salud psicoemocional.

Conclusión:

la transfobia es una enfermedad social que afecta diferentes dimensiones de la vida y la salud. Provoca perjuicios en la socialización de los hombres trans y personas transmasculinas, además de los espacios de los servicios de salud, así como en los entornos familiares, escolares, universitarios y laborales, que se traducen en falta de adherencia al autocuidado, alejamiento de los servicios de salud y sufrimiento psicoemocional.

Descriptores:
Transexualidad; Minorías Sexuales y de Género; Salud del Hombre; Vulnerabilidad en Salud; Atención de Enfermería

Key-Expressions

Discourse of Collective Subject

Non-acceptance

Fights

Rejection

Sin

Fear

Revolt

Alcohol and other drug use

Distancing

Break of bonds

[...] the relationship has always been very difficult. My parents did not accept me and the conflicts due to being transgender were constant, making the situation unsustainable. The justifications for fights and rejection were strongly influenced by religion, as my parents saw transgenderism as something sinful and wrong. I even got beaten up by my father, and because of that, I started to feel fear and revolt and it was during this same period that I started drinking and also using drugs. When they found out about my position on transgenderism, they threw me out of the house. Due to the transphobia that also affected the environment in which I lived, I ended up moving away from the whole family and with that the affective bond was affected. (DCS)

Key-Expressions

Discourse of Collective Subject

Isolation

Fear

Prejudice

Illness

Violence

Discrimination

Embarrassment in public

Disrespect

Denial

Family alienation

[...] I lived and still live largely isolated from people. I live discreetly in my neighborhood, as I am afraid of the violence generated by transphobia. Most of the time, I hide, because I’m afraid of being noticed as a feminine trait in me, like my breasts, and that being the target of violence. I avoid getting home late and hanging out on the street, and I spend most of my time alone. Going out into the street is always sickening, because I already know that I will face a lot of prejudice and violence. I have been through many embarrassing and discriminatory situations in public spaces, such as banks, health services, legal services and companies, making me feel embarrassed about my transgender identity, which is often not respected, such as the denial of the social name. I don’t have many friends, not much contact with family. What gives me great support is the group of trans friends and trans people allied with social movements and LGBT groups. It is also very difficult to get along at work, especially in places where transgenderism is not well accepted. Having to hide my breasts so as not to notice the volume and delegitimize my passing as a man is very uncomfortable and distressing, because I have to spend all the time thinking about this possibility. (DSC)

Key-Expressions	Discourse of Collective Subject
Discrimination in the school environment
Problems at school Lack of welcoming Discomfort Pain Violence Masculine woman Yield decrease Withdrawal from studies Job difficulty Daily prejudices Disrespecting the name	[...] since childhood, I had problems with the school, which never welcomed me. School has always been a place of great discomfort and pain, as it was a place of much violence. Several times, I failed to take advantage of recess time and stay inside the classroom to avoid violence. Since that time, I was already seen as a boy, but I didn’t have that understanding yet, and, because of that, I was seen as a masculine woman, and that was also the case in adolescence. Because of these problems, I didn’t have good income and I gave up studying. I was ashamed, afraid and all this prevented me from learning, from concentrating and from facing the challenges that school presented. The reflection of all this I try to recover nowadays, because without schooling everything became more difficult, including finding a job. I even get some opportunities, but they all require training. Getting to university is another challenge that seems unattainable, because I know that I will have to face more difficulties, including the breaking of daily prejudices that I suffer, such as, for example, respect for my social name. I had to fight to have my name on the attendance lists, in the registration system, and even so I suffered transphobia from professors. (DSC)
Professional limitations in the job market
Financial difficulty Difficulty in formal employability Hiding place Delegitimization of trans passing Discomfort Anguish Loss of food quality and access to health services – follow-up, hormone therapy, surgeries, survival Vulnerabilities	[...] all of this affects the quality of my diet, access to going to the health service to carry out my follow-up, hormone therapy, as the health system does not offer hormones for free, nor achieving breast adjustment surgery and even survive. Because of this, I have noticed many women and also trans men vulnerable to prostitution and trafficking. (DCS)

Key-Expressions

Discourse of Collective Subject

Daily transphobia

Contempt with care

Difficulties in services

Institutional violence

Adoption of risky practices

Hormonization on its own

Difficulty accessing hormones in the SUS

Challenges

Discomfort and fears

Transphobic professional approaches

Risks to physical, sexual and reproductive health

Loneliness

Search for other sources of care: groups of trans men

[...] due to the transphobia experienced daily, I started to despise taking care of my physical health. This fact is mainly due to the difficulties I have already faced in health services, which made me stop attending, to believe in the work of professionals, because I have already experienced a lot of institutional violence. Due to the need to carry out changes in my body, I ended up performing some risky and dangerous practices, such as using hormones on my own, and this is due to the fact that I had already suffered judgments from health professionals when asked to administer the hormones that are prescribed by the doctor of the municipal health network. And another complicating factor is that the SUS does not offer hormones for free and, with the financial difficulties, I end up not having access. Having to carry out gynecological care has also been a challenge that I struggled with for a long time, mainly because I did not feel comfortable with professionals’ approach and because of fear of transphobia. Many trans men do not undergo breast and uterus examinations due to this fear. I do not feel that health professionals are prepared to deal with physical health issues of trans men, such as, for example, menstruation, use of hormones and their risks to physical health, dietary care, sexual and reproductive practices, pregnancy and childbirth as well as the transition process, which ends up being lonely, most of the time without adequate follow-up, which makes me look for other sources of access to care, such as the groups of trans men present on social networks available on the internet and in collectives and support groups [...] all of this affects the quality of my diet, access to going to the health service to carry out my follow-up, hormone therapy, as the health system does not offer hormones for free, nor achieving breast adjustment surgery and even to survive. (DSC)

Key-Expressions

Discourse of Collective Subject

Decision conflict

Sexuality and body perception impairment

Negligence

Contempt

Disgust

Strangeness

Mental health impairment

Anxiety

Agitation

Irritability

Body dysphoria

Suicide

Psychiatric care

CAPS

Lack of welcoming

Disrespect for trans identity

Sadness

Revolt

treatment abandonment

[...] the most difficult were not the moments of conflict of decision with my gender identity, but the transphobia that I started to experience, affecting not only my sexuality, my perception of my body, my image and personality, but my existence. It has been almost a daily battle to survive in the face of transphobia that demonizes, exoticizes, neglects, harasses and denies the trans experience. They are games in bad taste, looks of contempt, disgust, strangeness, lack of acceptance and sensitivity that even happens in health services. These experiences generate real compromises in my mental health. I feel constantly anxious, agitated, irritable, with high stress, change in mood, appetite, in addition to the body dysphoria I’ve already experienced. I even tried to commit suicide, with the desire to end my life, due to a severe depression that I experienced. Due to the serious mental health situation I was in, I sought psychiatric care at a CAPS, but even in that space I already suffered transphobia and did not receive the care I needed. Several times, I was called by my registered name, delegitimizing my male identity. That situation humiliated me, made me sad and angry, and became the reason why I abandoned, missed subsequent appointments, abandoned treatment and became resistant to seeking a health service. (DCS)

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