FROM SURGICAL TO COMPREHENSIVE CARE: THE RECONFIGURATION OF TRANSGENDER HEALTHCARE IN A UNIVERSITY HOSPITAL OF THE BRAZILIAN UNIFIED HEALTH SYSTEM (SUS)

The Brazilian Unified Health System (SUS) is the public health system in Brazil, established in 1990 and based on the principles of Universality, Comprehensiveness, and Equity.This model ensures free access to healthcare for the entire population, promoting comprehensive care and prioritizing investments in areas with greater needs, aiming to reduce social inequalities through inclusive policies.In this oral presentation, we will discuss a Specialized Outpatient Service in a University Hospital in Rio de Janeiro, which has become a reference in transgender healthcare.The service marks a transition from an exclusively surgical model to a comprehensive and interdisciplinary model.Initially focused on gender-affirming surgeries, in accordance with the Federal Medical Council Resolution (CFM) N 1.482/1997, the service was restructured following Ordinance N 2.803/2013, which expanded the Transsexualization Process.It now offers outpatient care through a multidisciplinary team, including specialists in Psychology, Psychiatry, Endocrinology, Dermatology, Urology, Nutrition, Physical Education, Social Work, Nursing, among others.This transformation fosters humanized care, recognizing gender diversity as an integral part of human diversity.Transgender identity, as a gender identity, reveals the constitutive aspects of the subject from the very first appointments.In the clinical context, we observe the impacts of transphobia, which delegitimizes existences and directly affects mental health.Many users report that these initial appointments are their first opportunity to talk about themselves and their gender affirmation process.The difficulty in accessing specialized public services and the urgent need for attentive listening make these encounters intense and transformative.This presentation will also share preliminary findings from research conducted in the service, offering an overview of the profile of the population served and their main mental health demands.These data guide more effective care strategies, considering the singularities of each individual.Our care model is biopsychosocial and depathologizing, avoiding reducing the experiences of the transgender population to a single aspect of their identity.Finally, we will emphasize the importance of promoting inclusive and diversity-sensitive public policies, as well as expanding discussions on gender issues in institutions that ensure citizenship and dignified health conditions, fostering humanized care.