{"id":130106,"date":"2026-09-10T07:05:00","date_gmt":"2026-09-10T10:05:00","guid":{"rendered":"https:\/\/www.ufrgs.br\/jornal\/?p=130106"},"modified":"2026-09-16T16:30:13","modified_gmt":"2026-09-16T19:30:13","slug":"transgender-men-and-transmasculine-people-face-stigma-in-gynecological-appointments","status":"publish","type":"post","link":"https:\/\/www.ufrgs.br\/jornal\/transgender-men-and-transmasculine-people-face-stigma-in-gynecological-appointments\/","title":{"rendered":"Transgender men and transmasculine people face stigma in gynecological appointments"},"content":{"rendered":"\n

Health | Despite advances in public policies, the trans population still fears seeking specialized medical care and demands safe spaces that accommodate their specific needs<\/h4>\n\n\n\n

*First published June 26th, 2025
*Photograph: Gynecological Unit of the Hospital de Cl\u00ednicas de Porto Alegre (Fl\u00e1vio Dutra\/JU)<\/em><\/p>\n\n\n\n

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The title of this article may have struck you as odd. After all, we know gynecology as the medical specialty that deals with the female reproductive system. So, why would a man need to see a gynecologist?<\/p>\n\n\n\n

Let’s get this straight. Trans men are people who were assigned female at birth but identify as male. In other words, their bodies have ovaries, a uterus, etc., and, therefore, require specialized gynecological medical care. However, they identify as men, for example, going by masculine names and wearing masculine clothing.<\/p>\n\n\n\n

Then, there are transmasculine people, who do not necessarily identify as men, but have masculine traits in their gender presentation, being often perceived as men.<\/p>\n\n\n\n

Now, imagine a person with a presumably male name trying to set an appointment at the gynecologist through their health insurance plan. That\u2019s what happened with Thallys de Sousa, 23-year old trans man, when he tried to schedule his first gynecological appointment after beginning his gender transition.<\/p>\n\n\n\n

“I spent over 30 minutes trying to schedule a gynecological appointment through my health plan. The attendant was confused and asked me to repeat my name several times; she didn’t say what her real question was, but I already knew,” he says.<\/p>\n\n\n\n

At the doctor\u2019s office, another embarrassment: \u201cLook, Thallys, you should see an urologist instead\u201d, the doctor said. Even after Thallys informed her that he did not have a penis, the doctor seemed not to understand the situation.<\/p>\n\n\n\n

Thallys’s story, unfortunately, is no exception. Besides the secretaries and doctors\u2019 lack of training, another significant obstacle to going to the gynecologist as a trans man concerns the way gynecological waiting rooms are designed and constructed. Pink walls and decorations, gendered infographics, and confused looks from other patients create an environment that asks: what are you doing here?<\/p>\n\n\n\n

“Nobody seemed to understand what I was doing there,” recalls Rafal Gaara, 21, about his visit to the gynecologist at 17. He says that, even after explaining his name change to the secretary, they still called him by his “deadname” (the given name, no longer used by the person) when he was to be seen.<\/p>\n\n\n\n

Both Rafal and Thallys say that these situations make them fear seeking medical care.<\/p>\n\n\n\n

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“Before [transitioning], I didn’t even think about it much. These days, I tend to go to the gynecologist less often because of insecurity and fear of not being welcomed. We expect healthcare professionals to be kind to us, but it turns out they’re often unqualified to treat trans people.” <\/p>\nThallys de Souza<\/cite><\/blockquote>\n\n\n\n

There is still no official data in Brazil on how many people identify as trans. The Brazilian Institute of Geography and Statistics began this survey in 2023, as part of the National Demographic and Health Survey, but, according to the Institute’s communications department, the results are expected to be released only in 2026.<\/p>\n\n\n\n

According to data collected in 2021 from the S\u00e3o Paulo State University (Unesp) School of Medicine, Botucatu Campus, 2% of the Brazilian population identifies as trans or nonbinary, meaning approximately 2 million people whose gender expression is nonconforming and outside of cisheteronormative standards.<\/p>\n\n\n\n

In recent years, the trans community has been fighting for its rights to be properly guaranteed and its specificities to be respected. In the healthcare sector, supported by Brazil\u2019s Unified Health System (SUS), whose operation is based on the principle of equity, these individuals have been able to access gender-affirming medical intervention.<\/p>\n\n\n\n

This is the case with the transsexualization process, which aims to provide surgeries and hormonal transition treatments for the trans population. Although it represents a milestone in the community’s rights, the Brazilian Institute of Transmasculinities (Ibrat) <\/a>considers it a pathologizing policy, as individuals require reports from a psychiatrist to undergo the process.<\/p>\n\n\n\n

There have also been significant advances in the hormone therapy process (the administration of hormones) and in the legalization of social names <\/a>(the name chosen by the trans or travesti<\/em> person), which represented the governmental recognition of trans people\u2019s rights.<\/p>\n\n\n\n

In July 2024, a Supreme Court ruling<\/a> guaranteed trans people\u2019s access to medical care related to their biological sex, for example, in cases of reproductive and sexual health. Until then, trans men and transmasculine people faced difficulties scheduling appointments because the system itself did not allow men to receive gynecological care.<\/p>\n\n\n\n

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Photograph: Gynecological Unit of the Hospital de Cl\u00ednicas de Porto Alegre (Fl\u00e1vio Dutra\/JU)<\/figcaption><\/figure>\n\n\n\n
The role of education<\/h5>\n\n\n\n

Despite those achievements, Thallys and Rafal’s accounts demonstrate some of the obstacles trans men and transmasculine individuals face when seeking medical care, such as unprepared professionals due to a lack of specific training on the specificities of the trans population.<\/p>\n\n\n\n

“There is no specific training for this population in the medical curriculum,” reports Marcia Appel, a professor in the Department of Gynecology and Obstetrics at UFRGS. According to her, what happens is that, through daily experience, some professionals find ways to provide more humane and personalized care, allowing patients to choose the terms to be used for their body parts.<\/p>\n\n\n\n

Professor at the School of Nursing and Public Health at UFRGS and activist for the sexual and reproductive rights of trans people, Sondre Schneck believes that, for a gynecological appointment to be successful, the professional must be willing to establish a relationship of trust with the patient, seeking to understand their experiences and particularities, without judgment.<\/p>\n\n\n

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Schneck, a heterosexual trans man, argues that all gender transitions are unique and characteristic of their time. (Photograph: Fl\u00e1vio Dutra\/JU)<\/figcaption><\/figure>\n<\/div>\n\n\n
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“What kind of designation will this trans man be able to express for his body parts? Those who assist him shouldn’t ask outright, ‘Do you have dysphoria?’ but rather understand, through that trans man’s narrative and subjectivities, how he refers to his own body.” <\/p>\nSondre Schneck<\/cite><\/blockquote>\n\n\n\n

For Sondre and Marcia, it is necessary to understand the patient’s particularities and offer them the opportunity to address issues comfortably and respectfully. Swapping “breasts” for “chest,” as Marcia suggests, or even asking the patient “what terms do you use?”, as Sondre recommends, are strategies for embracing that individual’s subjectivity.<\/p>\n\n\n\n

The contact with dissident experiences allows healthcare professionals to shift their understanding of their work, going beyond theory. And, ultimately, this is precisely the experience of a trans person: the subversion of a narrative, namely the narrative of gender.<\/p>\n\n\n\n

Even so, this kind of attention is not present in most medical appointments. Due to a lack of training and transphobia, prejudice directed at people in the trans community and travestis<\/em>, many professionals are unaware of the physical changes experienced by a trans man undergoing hormone therapy, for example.<\/p>\n\n\n\n

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“She [the doctor] examined me and noticed that my clitoris had grown. After I explained that bottom growth is normal during hormone therapy, she looked at me in astonishment and said, ‘So it won’t go back to normal?'” <\/p>\nThallys de Souza<\/cite><\/blockquote>\n\n\n\n

The JU team sought out the Brazilian Federation of Gynecology and Obstetrics (Febrasgo) to understand how the entity has guided professionals regarding the reception of trans men and transmasculine people.<\/p>\n\n\n\n

In a statement, the federation’s vice president, Lucia Alves da Silva Lara, emphasized that the competency matrix for obstetrics and gynecology, a normative document developed by the organization, requires the adaptation of care in a manner that the patient’s gender identity is respected.<\/p>\n\n\n\n

In a further statement, Lara reiterates that Febrasgo has provided training to professionals and that “progress is still incipient,” but “the expectation of implementing the matrix in university curricula is that theoretical and practical content will promote the inclusion of care for the trans population.” She cites as an example the initiative of the University of S\u00e3o Paulo (USP) School of Medicine in Ribeir\u00e3o Preto, which offers a module with 10 hours of theoretical and practical training for 5th and 6th-year students.<\/p>\n\n\n

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Photograph: Fl\u00e1vio Dutra\/JU<\/figcaption><\/figure>\n<\/div>\n\n\n
Trans and transmasculine men’s health<\/h5>\n\n\n\n

Sondre explains that healthcare professionals’ lack of knowledge about the experiences of trans people ends up mythologizing the procedures that should be performed. This is the case, for example, of professionals who assume that trans men do not have penetrative sex, leading them to neglect the collection of samples for Pap smears.<\/p>\n\n\n\n

This was the case with Rafal. When he told the doctor that he was a heterosexual trans man, he was told: “Oh, then it’s okay, you don’t need a Pap smear.”<\/p>\n\n\n\n

However, even in situations where penetration is performed with a prosthesis or finger, rather than a penis, there is still a risk of contamination from the exchange of fluids. Therefore, both Sondre and Marcia emphasize the importance of routine gynecological exams.<\/p>\n\n\n\n

Activists also emphasize the importance of information campaigns that reach the trans population. For Fabian Algarte, national coordinator of Ibrat, even contraception and cancer prevention booklets are a point of debate.<\/p>\n\n\n\n

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“I don’t want to be served by a manual that wasn’t written for me, a manual that calls me “ma’am.” This is deeply disrespectful to us, who struggle to have our identity respected. It’s a systematic disregard for proper conduct.”<\/p>\nFabian Algarte<\/cite><\/blockquote>\n\n\n\n

For Fabian, a trans activist and public policy consultant who has faced much stigma as a trans man, the government’s lack of commitment to campaigns that address the specific needs of trans men means that a culture of self-care is not nurtured within the community. Throughout this process, not only transmasculinities are harmed, but the very fundamental principle of the Unified Health System (SUS): welcoming everyone, without discrimination.<\/p>\n\n\n

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Obstetric nurse Karoline Ritter, from the Gynecological Unit of Hospital de Cl\u00ednicas de Porto Alegre, prepares the outpatient clinic for care (Photograph: Fl\u00e1vio Dutra\/JU)<\/figcaption><\/figure>\n<\/div>\n\n\n

Research on the effects of prolonged testosterone use by trans men, or even the prevalence of cervical cancer in this population, is still scarce. According to Fabian, this is one of the points on which Ibrat wants to pressure the government.<\/p>\n\n\n\n

Even so, Fabian, Rafal, Sondre, and Thallys celebrate the existence of trans outpatient clinics. Known as “Ambu Trans,” these clinics are part of a Ministry of Health initiative that has expanded throughout Brazil and specializes in providing care for the trans population.<\/p>\n\n\n\n

These centers are staffed with professionals from various fields, trained to understand and support the trans population. In Porto Alegre, the outpatient clinics are located at the Santa Marta Health Center in the Historic Center, and at the \u00c1lvaro Difini Family Clinic in the Restinga neighborhood. More information about services and opening hours is available on the Porto Alegre City Hall website<\/a>.<\/p>\n\n\n\n

Check some myths and facts related to trans men\u2019s health:<\/h5>\n\n\n
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Translated into English by J\u00falia Salvato de Oliveira<\/strong>, undergraduate student enrolled in the course \u201cSupervised Translation Training II (English)\u201d of the Undergraduate Program in Language and Literature, under the supervision and translation revision of Professor Rozane Rebechi (P.h.D.) \u2013 IL\/UFRGS.
<\/p>\n\n\n\n

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:: Read in portuguese<\/strong>
Homens trans e transmasculinos enfrentam estigmas em consultas ginecol\u00f3gicas<\/a><\/p>\n\n\n\n

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Explore the full section In English<\/strong> <\/a><\/div>\n<\/div>\n\n\n\n
<\/div>\n\n\n\n

<\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

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