Re: Addressing Needs of Transgender Patients: The Role of Family Physicians
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* Isadora Ponticelli Mondini
* Emanuelle Nichele Luz
* Aline Baggio Oenning
* Chaiana Esmeraldino Mendes Marcon

*To the Editor:* The study from Radix1 exposes the circumstances faced by transgender individuals when seeking health services, and affirms the need for welcoming health care environments, with health care providers who are knowledgeable about their special needs. It also demonstrates strategies that family doctors can use to improve their clinical practices. The disparity in access to health was very well described in the present study, which showed that the difficulty in accessing care leads to higher rates of problems related to mental health, substance use disorder, violence, and poverty.

Furthermore, Radix et al1 show that heteronormativity is still a form of discrimination present in the health system, and transgender people may be harmed by the difficulty of finding professionals with aptitude to care for their needs. In South Africa, a study from Newman-Valentine and Duma2 corroborates the findings from Radix,1 stating that transgender individuals receiving transition-related treatments may suffer significant side effects, which can be managed successfully by knowledgeable health professionals. In this matter, it is evident that the knowledge derived from experiences in health fields must be shared, so that there will be awareness of procedures related to gender transition, helping in the process of building social intelligibility for these people. Thus, we need to produce scientific knowledge about transgenderism and expected social experiences related to transitioning to educate individual patients and their health professionals, to prepare for a successful transition.3

We congratulate Radix1 for providing data that reveals the considerable importance humanized care has to transgender individuals, requiring from the professional a general vision of gender and sexuality, to avoid discrimination, and to improve access of this population to primary health care. In addition to basic knowledge of hormonal therapies, appropriate individual HIV risk assessments and appropriate prevention strategies, the study also provides us a foundation to implement such practices more effectively in primary health care in Brazil.

## Notes

*   To see this article online, please go to: [http://jabfm.org/content/33/5/819.full](http://jabfm.org/content/33/5/819.full).

*   The original author was contacted and is in agreement.

## References

1.  1.Radix AE. Addressing needs of transgender patients: the role of family physicians. J Am Board Fam Med 2020;33:314–21.
    
    [Abstract/FREE Full Text](http://www.jabfm.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToiamFiZnAiO3M6NToicmVzaWQiO3M6ODoiMzMvMi8zMTQiO3M6NDoiYXRvbSI7czoyMDoiL2phYmZwLzMzLzUvODE4LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  2.Newman-Valentine D, Duma S. Injustice to transsexual women in a hetero-normative healthcare system. Afr J Prim Health Care Fam Med 2014;6:1–5.
    
    [PubMed](http://www.jabfm.org/lookup/external-ref?access_num=http://www.n&link_type=MED&atom=%2Fjabfp%2F33%2F5%2F818.atom) 

3.  3.Oliveira ID, Romanini M. (Re) writing (in) visible scripts: the trajectory of transgender women in public health policies. Saude soc 2020;29:(1). Epub ahead of print.