Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil

Detalhes bibliográficos
Autor(a) principal: Ramos, Aline Sharlon Maciel Batista
Data de Publicação: 2022
Outros Autores: alinesharlon@gmail.com
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/20961
Resumo: Health care for the Lesbian, Gay, Bisexual, Transvestite, Transgender and Transgender (LGBTTT) population, within the scope of the Unified Health System (SUS), has specific needs, both for the qualification of health team professionals and for the doors access to care at different levels of care. The objective of the study was to evaluate the quality of life (QoL) of transsexual users monitored at the sexuality and gender outpatient clinic of the University Hospital of the Federal University of Maranhão (HUUFMA) and to analyze their perception of the experience of transsexuality. To this end, a mixed quantitative and qualitative study was carried out between March 2018 and December 2021. Three questionnaires were used to collect data in the quantitative stage: one with identification, social and demographic data, another from the Brazilian Association of Research Companies, for economic classification; and the third, the WHOOQL-Bref, for measuring QoL, from the World Health Organization, all analyzed using the SPSS 21.0® statistical program. In the qualitative stage, data were collected through individual interviews with a script of open questions about QoL and transsexuality. The data were recorded, transcribed in full and submitted to Content Analysis. We interviewed 71 individuals, the majority between 18 and 26 years old (67.6%), with complete secondary education (71.8%), single (76.1%), unemployed (54.9%), living in the capital of the state (63.4%), brown (57.7%) and from social class D to E (50.7%). Low QoL rates were observed, with worse results for the Psychological Domain (12.5%) and Environment (37.5%), with no statistical significance for differences between trans men and women. In the qualitative study, three thematic categories were highlighted: discovering transsexuality: trans(training) and identity; the right to exist: obstacles to citizenship; and body transformation: feelings involved in the search for the desired and socially accepted body. For the participants, transsexuality is understood as a complicated and difficult process, which generates different feelings such as happiness, fear and shame. The perception of gender identity, different from biological sex, occurs since childhood, which causes suffering in social relationships and difficulties in having their rights respected. Living transsexuality means being able to exist as a unique individual and to guarantee this right it is necessary to deepen the debate on the sexuality of transgender people. It was concluded that the experience of transsexuality is associated with suffering and low QoL. There is a clear need to expand multidisciplinary discussions on sexuality and gender, public policies that encourage institutional/local actions, and the strengthening of support networks for vulnerable populations
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spelling Taquette, Stella Reginahttp://lattes.cnpq.br/0311106771021992Fortes, Sandra Lucia Correia Limahttp://lattes.cnpq.br/8632178826165568Laurentino , Arnaldo Cezar Nogueirahttp://lattes.cnpq.br/7576535958374127Souza, Luciana Maria Borges da Mattahttp://lattes.cnpq.br/1111943713453607Sousa, Silvia Helena Cavalcante dettp://lattes.cnpq.br/4105291419210575Ramos, Aline Sharlon Maciel Batistaalinesharlon@gmail.com2024-01-19T19:45:38Z2022-12-23RAMOS, Aline Sharlon Maciel Batista. Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil. 2022. 122 f. Tese (Doutorado em Ciências Médicas) - Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.http://www.bdtd.uerj.br/handle/1/20961Health care for the Lesbian, Gay, Bisexual, Transvestite, Transgender and Transgender (LGBTTT) population, within the scope of the Unified Health System (SUS), has specific needs, both for the qualification of health team professionals and for the doors access to care at different levels of care. The objective of the study was to evaluate the quality of life (QoL) of transsexual users monitored at the sexuality and gender outpatient clinic of the University Hospital of the Federal University of Maranhão (HUUFMA) and to analyze their perception of the experience of transsexuality. To this end, a mixed quantitative and qualitative study was carried out between March 2018 and December 2021. Three questionnaires were used to collect data in the quantitative stage: one with identification, social and demographic data, another from the Brazilian Association of Research Companies, for economic classification; and the third, the WHOOQL-Bref, for measuring QoL, from the World Health Organization, all analyzed using the SPSS 21.0® statistical program. In the qualitative stage, data were collected through individual interviews with a script of open questions about QoL and transsexuality. The data were recorded, transcribed in full and submitted to Content Analysis. We interviewed 71 individuals, the majority between 18 and 26 years old (67.6%), with complete secondary education (71.8%), single (76.1%), unemployed (54.9%), living in the capital of the state (63.4%), brown (57.7%) and from social class D to E (50.7%). Low QoL rates were observed, with worse results for the Psychological Domain (12.5%) and Environment (37.5%), with no statistical significance for differences between trans men and women. In the qualitative study, three thematic categories were highlighted: discovering transsexuality: trans(training) and identity; the right to exist: obstacles to citizenship; and body transformation: feelings involved in the search for the desired and socially accepted body. For the participants, transsexuality is understood as a complicated and difficult process, which generates different feelings such as happiness, fear and shame. The perception of gender identity, different from biological sex, occurs since childhood, which causes suffering in social relationships and difficulties in having their rights respected. Living transsexuality means being able to exist as a unique individual and to guarantee this right it is necessary to deepen the debate on the sexuality of transgender people. It was concluded that the experience of transsexuality is associated with suffering and low QoL. There is a clear need to expand multidisciplinary discussions on sexuality and gender, public policies that encourage institutional/local actions, and the strengthening of support networks for vulnerable populationsA assistência à saúde da população de Lésbicas, Gays, Bissexuais,Travestis, Transexuais e Transgêneros (LGBTTT), no âmbito do Sistema Único de Saúde (SUS), detém necessidades específicas, tanto de qualificação dos profissionais da equipe de saúde, quanto das portas de acesso ao atendimento nos diversos níveis de atenção. O objetivo do estudo foi avaliar a qualidade de vida (QV) dos usuários transexuais acompanhados no ambulatório de sexualidade e gênero do Hospital Universitário da Universidade Federal do Maranhão (HUUFMA) e de analisar a percepção que têm sobre a vivência da transexualidade. Para tal, foi realizado um estudo misto quanti e qualitativo, entre março de 2018 a dezembro de 2021. Para a coleta dos dados na etapa quantitativa foram utilizados três questionários: um com dados de identificação, sociais e demográficos, outro da Associação Brasileira de Empresas de Pesquisa, para a classificação econômica; e o terceiro, o WHOOQL-Bref, para mensuração da QV, da Organização Mundial de Saúde, todos analisados a partir do programa estatístico SPSS 21.0®. Na etapa qualitativa, coleta aatravés de entrevistas individuais com roteiro de perguntas abertas sobre a QV e transexualidade. Os dados foram gravados, transcritos na íntegra e submetidos à Análise de Conteúdo. Entrevistamos 71 indivíduos, sendo a maioria entre 18 e 26 anos (67,6%), com ensino médio completo (71,8%), solteiros ( 76,1%), desempregados (54,9%), residentes na capital do estado (63,4%), pardos (57,7%) e de classe social D a E (50,7%). Foram observados baixos índices de QV, com pior resultado para os Domínio Psicológico (12,5%) e Meio Ambiente (37,5%), sem significado estatístico para diferenças entre homens e mulheres trans. No estudo qualitativo, foram evidenciadas três categorias temáticas: descobrindo a transexualidade: trans(formação) e identidade; o direito de existir: obstáculos à cidadania; e transformação corporal: sentimentos envolvidos na busca do corpo desejado e socialmente aceito. Para os participantes a transexualidade é entendida como um processo complicado e difícil, que gera sentimentos diversos como felicidade, medo e vergonha. A percepção da identidade de gênero, diferente do sexo biológico, ocorre desde a infância, o que provoca sofrimento nas relações sociais e dificuldades em ter seus direitos respeitados. Viver a transexualidade significa poder existir enquanto indivíduo único e para a garantia deste direito é necessário aprofundar o debate sobre a sexualidade de pessoas trans. Concluiu-se que a vivência da transexualidade está associada à sofrimento e à baixa QV. Fica clara a necessidade de se ampliar discussões sobre sexualidade e gênero em caráter multidisciplinar, de políticas públicas que fomentem ações institucionais/ locais, e de fortalececimento das redes de apoio a populações vulneráveisSubmitted by Felipe CB/A (felipebibliotecario@gmail.com) on 2024-01-19T19:45:38Z No. of bitstreams: 1 Tese - Aline Sharlon Maciel Batista Ramos - 2022 - Completa.pdf: 4306720 bytes, checksum: ba83e9b2fa8a4bb4a30f25d011df4d6a (MD5)Made available in DSpace on 2024-01-19T19:45:38Z (GMT). No. of bitstreams: 1 Tese - Aline Sharlon Maciel Batista Ramos - 2022 - Completa.pdf: 4306720 bytes, checksum: ba83e9b2fa8a4bb4a30f25d011df4d6a (MD5) Previous issue date: 2022-12-23application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico::Faculdade de Ciências MédicasQuality of lifeSexualityFeelingsTransgender peoplePessoas transgênero – Qualdade de vidaHospitais – Serviços de ambulatórioAssistência à saúdeSexualidadeSentimentosPessoas transexuaisCIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICAQualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do BrasilQuality of Life of Transgender Users treated at the outpatient clinic of a university hospital in northeast, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Aline Sharlon Maciel Batista Ramos - 2022 - Completa.pdfTese - Aline Sharlon Maciel Batista Ramos - 2022 - Completa.pdfapplication/pdf4306720http://www.bdtd.uerj.br/bitstream/1/20961/2/Tese+-+Aline+Sharlon+Maciel+Batista+Ramos+-+2022+-+Completa.pdfba83e9b2fa8a4bb4a30f25d011df4d6aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/20961/1/license.txte5502652da718045d7fcd832b79fca29MD511/209612024-02-26 15:59:55.719oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:55Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
dc.title.alternative.eng.fl_str_mv Quality of Life of Transgender Users treated at the outpatient clinic of a university hospital in northeast, Brazil
title Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
spellingShingle Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
Ramos, Aline Sharlon Maciel Batista
Quality of life
Sexuality
Feelings
Transgender people
Pessoas transgênero – Qualdade de vida
Hospitais – Serviços de ambulatório
Assistência à saúde
Sexualidade
Sentimentos
Pessoas transexuais
CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA
title_short Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
title_full Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
title_fullStr Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
title_full_unstemmed Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
title_sort Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil
author Ramos, Aline Sharlon Maciel Batista
author_facet Ramos, Aline Sharlon Maciel Batista
alinesharlon@gmail.com
author_role author
author2 alinesharlon@gmail.com
author2_role author
dc.contributor.advisor1.fl_str_mv Taquette, Stella Regina
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/0311106771021992
dc.contributor.referee1.fl_str_mv Fortes, Sandra Lucia Correia Lima
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/8632178826165568
dc.contributor.referee2.fl_str_mv Laurentino , Arnaldo Cezar Nogueira
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/7576535958374127
dc.contributor.referee3.fl_str_mv Souza, Luciana Maria Borges da Matta
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/1111943713453607
dc.contributor.referee4.fl_str_mv Sousa, Silvia Helena Cavalcante de
dc.contributor.authorLattes.fl_str_mv ttp://lattes.cnpq.br/4105291419210575
dc.contributor.author.fl_str_mv Ramos, Aline Sharlon Maciel Batista
alinesharlon@gmail.com
contributor_str_mv Taquette, Stella Regina
Fortes, Sandra Lucia Correia Lima
Laurentino , Arnaldo Cezar Nogueira
Souza, Luciana Maria Borges da Matta
Sousa, Silvia Helena Cavalcante de
dc.subject.eng.fl_str_mv Quality of life
Sexuality
Feelings
Transgender people
topic Quality of life
Sexuality
Feelings
Transgender people
Pessoas transgênero – Qualdade de vida
Hospitais – Serviços de ambulatório
Assistência à saúde
Sexualidade
Sentimentos
Pessoas transexuais
CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA
dc.subject.por.fl_str_mv Pessoas transgênero – Qualdade de vida
Hospitais – Serviços de ambulatório
Assistência à saúde
Sexualidade
Sentimentos
Pessoas transexuais
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA
description Health care for the Lesbian, Gay, Bisexual, Transvestite, Transgender and Transgender (LGBTTT) population, within the scope of the Unified Health System (SUS), has specific needs, both for the qualification of health team professionals and for the doors access to care at different levels of care. The objective of the study was to evaluate the quality of life (QoL) of transsexual users monitored at the sexuality and gender outpatient clinic of the University Hospital of the Federal University of Maranhão (HUUFMA) and to analyze their perception of the experience of transsexuality. To this end, a mixed quantitative and qualitative study was carried out between March 2018 and December 2021. Three questionnaires were used to collect data in the quantitative stage: one with identification, social and demographic data, another from the Brazilian Association of Research Companies, for economic classification; and the third, the WHOOQL-Bref, for measuring QoL, from the World Health Organization, all analyzed using the SPSS 21.0® statistical program. In the qualitative stage, data were collected through individual interviews with a script of open questions about QoL and transsexuality. The data were recorded, transcribed in full and submitted to Content Analysis. We interviewed 71 individuals, the majority between 18 and 26 years old (67.6%), with complete secondary education (71.8%), single (76.1%), unemployed (54.9%), living in the capital of the state (63.4%), brown (57.7%) and from social class D to E (50.7%). Low QoL rates were observed, with worse results for the Psychological Domain (12.5%) and Environment (37.5%), with no statistical significance for differences between trans men and women. In the qualitative study, three thematic categories were highlighted: discovering transsexuality: trans(training) and identity; the right to exist: obstacles to citizenship; and body transformation: feelings involved in the search for the desired and socially accepted body. For the participants, transsexuality is understood as a complicated and difficult process, which generates different feelings such as happiness, fear and shame. The perception of gender identity, different from biological sex, occurs since childhood, which causes suffering in social relationships and difficulties in having their rights respected. Living transsexuality means being able to exist as a unique individual and to guarantee this right it is necessary to deepen the debate on the sexuality of transgender people. It was concluded that the experience of transsexuality is associated with suffering and low QoL. There is a clear need to expand multidisciplinary discussions on sexuality and gender, public policies that encourage institutional/local actions, and the strengthening of support networks for vulnerable populations
publishDate 2022
dc.date.issued.fl_str_mv 2022-12-23
dc.date.accessioned.fl_str_mv 2024-01-19T19:45:38Z
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dc.identifier.citation.fl_str_mv RAMOS, Aline Sharlon Maciel Batista. Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil. 2022. 122 f. Tese (Doutorado em Ciências Médicas) - Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/20961
identifier_str_mv RAMOS, Aline Sharlon Maciel Batista. Qualidade de vida de usuários transexuais atendidos em ambulatório de um hospital universitário no nordeste do Brasil. 2022. 122 f. Tese (Doutorado em Ciências Médicas) - Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.
url http://www.bdtd.uerj.br/handle/1/20961
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dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Ciências Médicas
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico::Faculdade de Ciências Médicas
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
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