“Resistir para existir, existir para reagir”: análise do direito social à saúde da população trans e travesti a partir do Ambulatório de Sexualidade de um Hospital de Alta Complexidade do Maranhão

Abstract

The qualitative research aimed to analyze the contradictions that permeate the social right to health of trans and transvestite people, based on the reality of the Ambulatório de Sexualidade of the University Hospital of the Federal University of Maranhão (HUUFMA). To this end, we sought to analyze the forms of exploitation and oppression to which trans and transvestite populations have been subjected within the framework of capitalism, with emphasis on their forms of social and political organization. Furthermore, it was discussed how public health policies have addressed the trans and transvestite population in Brazil, with an emphasis on the disputes between the Reforma Sanitária Project and the Privatist Project. Supported by historical-dialectic materialism, it adopted literature review, documentary and empirical research as methodological procedures. Occasion in which 10 users and 3 health professionals were interviewed. The results showed that the Ambulatório de Sexualidade has been sought out more by trans, black men, with completed high school and residing in the metropolitan region of São Luís-MA. It also revealed high dropout rates, as well as disparities between gender and race. It pointed to two major contradictions: the violent rejection of the existence of trans and transvestite people, functional to the preservation of a patriarchal and cisheteronormative society, and, at the same time, to their composition in the world of work – as a reserve, cheap and precarious workforce; and the limits to the implementation of the social right to health in neoliberal capitalist society, with the progressive dismantling of social policies and the introduction of business management methods in the field of public health. It was concluded that, in practice, the right to health – for everyone, without distinction, at the most varied levels of care – is not only partially guaranteed, but also threatened; that the historical struggle of the trans and transvestite population for access to this right culminated in important achievements in the search for citizenship, included in the plan of political emancipation, but still insufficient to break with the contradictions observed, as they take place within the current order established by the capital. This demands that the resistance strategies of organized and counter-hegemonic social movements be multiplied – not only to guarantee existences, but to stimulate new forms of reaction, with a view to overcoming the current reality towards human emancipation. Resisting and reacting is a necessity.