Abstract
BACKGROUND: The Brazilian transgender movement has advocated for the establishment of transgender health clinics funded by the country's Unified Health System (SUS) to advance health equity for this population. We aimed to explore the perspectives of transgender women in sex work about the importance of initiating a SUS-funded transgender health clinic in a Brazilian urban center. Additionally, we investigated these women's perceptions on essential healthcare services that such a clinic must provide. MATERIALS AND METHODS: We collaborated with a Brazilian non-governmental organization focused on transgender rights advocacy. This cross-sectional study used quantitative and qualitative data from a larger mixed-method survey exploring the social determinants of health among 89 transgender sex workers from June 2022 to August 2022. RESULTS: The mean age of participants was 32 years old. Most participants were mixed-race, earned less than minimum wage monthly, and relied on hospital/urgent care as the primary source of care within SUS. Participants highlighted the potential benefits of having a SUS-funded transgender health clinic, including enhanced convenience, better care experiences, staff preparedness in transgender health, and addressing issues related to self-medication. Moreover, participants stressed the importance of integrated healthcare services within the clinic, advocating for the availability of interdisciplinary teams of healthcare professionals (e.g. endocrinologists, dentists, nutritionists, general health practitioners, and mental health providers) to meet the diverse healthcare needs of transgender individuals. CONCLUSION: This community-engaged study provides crucial insights that are essential for advocacy efforts aimed at establishing transgender health clinics funded by SUS.