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Gynecology and obstetrics call for an end to homophobia

Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) invites reflection

On May 17, 1990, a historic decision by the World Health Organization (WHO) marked a significant advance in the fight for the rights of the LGBT+ movement. In this context, the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) invites reflection on the vital importance of the comprehensive health of trans people, particularly highlighting the sphere of sexuality.

Dr. Eduardo Siqueira, member of the Febrasgo Sexology Commission, highlights the attention to gynecological recommendations for trans women. In addition to offering support in the hormoneization process, it is important to highlight that trans women, transvestites and trans feminine people may need regular gynecological evaluations. But if these women have been on hormones for five or more years, they must be screened for breast neoplasms after the age of 40 or 50 (depending on the different screening protocols), as established for cis women. “We are used to saying that the gynecologist is the “woman’s clinician”. Therefore, we must play this role, regardless of the patient’s gender identity – cis or trans -”, comments the specialist.

Regarding common procedures, the doctor emphasizes that trans women do not have a cervix and, therefore, do not need to undergo a Pap smear. However, if these women have been on hormones for five years or more, they should be screened for breast neoplasms starting at age 40 or 50 (depending on the different screening protocols), as established for cis women. “In short, the gynecologist is an important professional to support trans women and trans feminine people during the gender transition process,” explained the doctor.

Contraception and Family Planning

Transgender women are those who, at birth, have male genitalia (penis and testicles). Even during hormoneization, they continue to produce sperm and therefore maintain their fertility capacity. The hormones used during gender transition do not work as contraceptives. This means that if a transgender woman has sex with someone who has a vagina and uterus, that person can become pregnant normally. Therefore, it is always important to use contraceptive methods when you want to avoid pregnancy.

Eduardo: gynecologist is an important professional to support trans women

Reproductive Health

The main point is access to quality information and appropriate health services for trans people. There are some particularities that must be considered when providing assistance and offering these services, and health professionals must be trained to provide this information to the trans population.

Prevention of Sexually Transmitted Infections

Dr. Eduardo Siqueira explains that the prevention of sexually transmitted infections for trans women follows the same reasoning as measures aimed at the cis population. What perhaps differentiates is greater access to these measures for cis populations. “Today, we work with the concept of combined STI prevention, and as we can see, although it is a new concept, the practice is already known. We are talking about the use of condoms associated with lubricants during sexual intercourse”, explains the gynecologist.

In situations where these initial measures have failed, the use of PEP is recommended, that is, medications used after sexual intercourse, to prevent HIV infection. Other medicinal measures also exist to complement these preventions. “And, of course, we cannot forget to reinforce the need to keep vaccinations up to date: hepatitis A and B and HPV, for example, are vaccines that should always be remembered as preventive measures against STIs”, he adds.

Health professionals in reception, care and health care

“Today, the demands of the trans population are extremely neglected, either due to the lack of structured services that accommodate them, or the lack of engagement of health professionals themselves in this assistance. Caring for trans people has its particularities, but it is within the capabilities of health professionals. We may not be hormone specialists, but we are capable of carrying out clinical and preventive examinations and providing information on health risks. We have a fundamental role, especially because we deal with a vulnerable population that has limited access to health services, and we cannot and should not escape this responsibility”, concludes the doctor.

Source: Maxima

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