The University Hospital Gaffrée e Guinle (HUGG), managed by the Brazilian Company of Hospital Services (Ebserh), is the newest hospital unit accredited by the Ministry of Health (MS) to offer sex reassignment surgeries by the Unified Health System (SUS). HUGG already performed urogenital reconstructive surgery and, with the support of the superintendence, requested the authorization of the new service. Last Friday (23), in LGBTQIA+ Pride Month, HUGG performed gender reassignment surgeries on three trans women. The procedures lasted about four hours and were coordinated by the Urology Service team, with the support of plastic surgeons and Argentine urologist Javier Belinky, from Hospital Carlos G Durand, in Buenos Aires. In an interview this Monday (26) to Agência Brasil, the coordinator of the Urology Service at Gaffrée and Guinle, André Cavalcanti, clarified that, in a first stage, the focus will be on trans women. Afterwards, the hospital will expand the service to other types of surgeries. “Why [essa] is the biggest demand for sex reassignment. There are other queues in this process, such as a mastectomy, which is an important demand for trans men; facial harmonization. A series of procedures. For genital surgery, the volume of trans women is higher.” After accreditation by the ministry, the HUGG is receiving patients who are already ready for outpatient public services, that is, who have already gone through the SUS guidelines for this type of surgery – such as the hormone treatment stage, for example. “She must have already gone through the other services. In fact, our objective is to generate more patients in the system and generate a greater number of surgical vacancies”. The coordinator of the Urological Service of Gaffrée and Guinle informed that the idea is to end 2023 with ten surgeries performed. New procedures are already being scheduled for August: “the August agenda is being finalized”. Steps To be able to undergo surgery, the patient must initially have been treated at the SUS outpatient clinic for reassignment at any level of care, whether municipal, state or federal. In the transsexualization process, she goes through a stage of the social issue – which includes changing her name, registration, among other stages –, and the hormonal stage, finally coming to the surgical stage. “To move on to the surgical stage, she has to be followed up in the outpatient clinic, with a multidisciplinary team that includes endocrinology and mental health, for at least two years”. The duration of the surgery differs from patient to patient, ranging from three and a half hours to five hours, on average, according to Cavalcanti. The patient remains hospitalized for about five days, when she is discharged and a neovagina dilation process begins, in addition to a series of outpatient procedures. Recovery is gradual, at home, and requires strict outpatient follow-up, stressed the HUGG urologist. According to him, it is necessary to do the process of dilation of the vagina for a long period. “Because all these surgeries have a chance of complications and we have to be very attentive to the patient. It is a long process”. Generally, operated transgender women are ready for penetrative sexual activity within two months. According to Cavalcanti, every hospital accredited by the Ministry of Health for this type of surgery is already considered a reference, given that the number of public hospitals that perform sexual reassignment is still small. In the state of Rio de Janeiro, in addition to the HUGG, this type of procedure is only performed at the Hospital Universitário Pedro Ernesto. In addition to these, there are four more units that perform these surgeries through the SUS: Hospital das Clínicas de Porto Alegre, Hospital of the Federal University of Goiás, Hospital of the Federal University of Pernambuco and Hospital of the University of São Paulo, informed the Ministry of Health.
Agência Brasil
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