Entre vulnerabilidades e resiliências : um olhar trans sobre o cuidado em saúde mental

Abstract

Introduction: There are multiple pathways to social and psychological inclusion; however, many of these are constrained by the dominant cis-heteronormative framework. Homophobia, LGBTphobia, and hate crimes produce significant social impacts, including socio-affective disorders, suicide, trauma, and both physical and psychological harm.Objective: This study aimed to analyze mental health care from the perspective of transgender and travesti individuals receiving support at the LGBT Citizenship Center in João Pessoa, Brazil. The research focused on their lived experiences and specific needs related to gender identity and intersectional factors. Methodology: This is a descriptive and analytical study employing a qualitative approach to explore the perceptions, beliefs, motivations, and attitudes of participants. A convenience sampling strategy was adopted due to challenges in accessing the target population. Seven individuals who were either receiving or seeking services at the Center participated in the study. Data collection was conducted through semi-structured interviews in a private and welcoming environment, with audio recordings made upon obtaining informed consent. To preserve confidentiality, participants were anonymized using coded identifiers (e.g., E1, E2). Results: Findings indicate that mental health is a central concern in the health-illness continuum for transgender and travesti individuals. Participants reported experiences of anxiety crises, suicidal ideation, limited access to psychological support, and highlighted the critical role of psychotherapy in processes of self-knowledge and gender identity affirmation. The study also identified recurrent discrimination within general healthcare services, including misgendering, nonrecognition of chosen names and pronouns, and clinical recommendations that failed to address the specific needs of this population. These issues underscore a lack of professional training and sensitivity. In contrast, specialized services exhibited a higher level of preparedness and responsiveness, though the overall fragmentation of care was evident, revealing a pressing need to strengthen general healthcare provision for trans populations. Conclusion: The study concludes that mental health care for transgender and travesti individuals continues to face substantial barriers, including institutional prejudice and restricted access to appropriate services. There is an urgent need for trans-inclusive practices across all levels of the public health system—not limited to specialized services. The findings underscore the importance of evaluating and reinforcing public policies aimed at this population, ensuring the affirmation of gender identity and the provision of comprehensive, non-discriminatory care.