Health for LGBT groups demands democratic radicalization



Lesbian, Gay, Bisexual, Transvestite and Transsexual (LGBT) social movements are building paths and narratives which enlarge directions and goals towards the desirable nationwide radicalization of democracy. Feminism and AIDS-related movements, set as fights for social inclusion and emancipation, bring sexuality, sexual rights and private life to the range of the new democratic practice and construction, and tear limits set by interests so far considered hegemonic.

The health sector needs, in a fundamental way, to comprehend these movements and incorporate the social groups' demands, not only in order to fulfil Sistema Único de Saude's universality and integrality principle, but essentially for the relevance that social involvement and participative democracy have and had on the genesis and survival of both the universal right to health and Sistema Único de Saúde (SUS).

At least two situations can be indentified while analyzing the services offered by SUS by LGBT group's point of view: Discrimination and improper attention and care offerings. Discrimination, associated to prejudice and moralities is a situation hard to reverse, as it involves complex measures that range from the training of professionals to the immediate adoption of mechanisms capable of indentifying those situations and applying proper punishment, while the problems regarding offer demand a better identification of these groups' problems and demands, since they are not exclusively restricted to sexually transmitted diseases.

There is a big recognition that LGBT's human rights are violated or neglected. The health sector has showed itself open to debating and incorporating various types of challenges and innovations, what supports positive expectations for changes. However, to satisfy and consolidate the right to integral health for this part of the population, reproductive and sexual rights have to have their meanings modified by denaturalizing sexuality and its expression forms.

To achieve such goal, it is fundamental to consider the extinction of the sexuality medicalization, what tends to standardize human sexuality expressions by a "standard" and a heteronormative and linear logic, dominant on the determination based on the biological imposition over gender identities, constructed by complex factors and determinants.

Within the extent of these changes, it's necessary to consider legitimate other thoughts about human sexuality, and at the same time, deconstruct knowledge and power linked to medicine that tend to treat as pathology everything that is "different" or "deviant from what's normal". These prejudice and medical practices surface the persistence of the essentialist point of view and the human lack of recognition of the of the building processes and social practices linked to sexuality.

Brazilian society has lately "discovered" that is home to a diversity of social groups, with distinct cultures and multiple sexualities and gender identities, once hidden and suffocated by moralities and patriarchal conservative values. Diversity, finally recognized nowadays, shows the plural possibilities of human constitution, and also states that actions by professionals from health services have to be guided by guaranteeing to humans their right to autonomy, free personality development, privacy and dignity. This means accepting homosexuality, transsexuality and transvestism as legit human possibilities, just as it is with heterosexuality, other than considering them a deviation from standardized normality.

In Brazil, there is a dangerous conservative front in relation to LGBT rights, in spite of the removal of homosexualism from nosographic compendia and of the fact that, in various fields of knowledge, there is a consensus regarding the non-pathologic characteristics of homoerotic practices. Under this perspective, specific regulations inside professional areas must be celebrated, particularly, the resolution number 001/99 from the Brazilian Federal Council of Psychology, which establishes rules to psychologists when it comes to sexual orientation. These regulations state that professionals should contribute with their knowledge to crucial reflexions about prejudices and prize the combat to discrimination and stigma against those who demonstrate homoerotic practices or behaviours, neither acting in any way to treat these people as ill, nor adopting coercive actions that tend to guide homosexuals towards not requested treatment.

The Social Service Federal Council(2006), through the resolution number 489/2006, has established rules voiding discriminatory or prejudicious behaviours due to sexual orientation or expression, within the social assistant professional practice, granting the individual with right to singularity and subjective difference.

The letter for Health system Users' rights(Ordinance number 675/GM, D.O.U 31/03/2006) (BRAZIL, 2006), from SUS, has stepped ahead to assure human and prejudice/discrimination-free care, also, assuring the use of the name Social for Transvestites and Transsexuals as a strategy to promote access to the health system.

Another challenge for SUS is to end the concept that recognizes an heterosexual family as the natural configuration of a family, particularly inside the Family Health strategy, performed by health professionals that need to know and recognize the legitimacy of families distinct from the heterosexual standard.

The recent world history has been consolidating popular movements and reassuring a new ideal of democracy, which requires the real social emancipation of social classes and moral groups subjected to oppression. These ideals must be built from the break with capitalist values and impositions.

Under this perspective, are imposed the rescue and radicalization of democracy, nowadays consumed and worn out by the liberalist capitalism. Regarding this, Boaventura Souza Santos alerts emphatically that "capitalism does not exercise its dominance in ways different of oppression towards colonialism and patriarcy". Boaventura also states that the new democracy should be "radical, besides being anticapitalist, also being anticolonialist and antipatriarchal".


Cebes' National Board.

Centro Brasileiro de Estudos de Saúde RJ - Brazil
E-mail: revista@saudeemdebate.org.br