When? Alexandre Sacramento is a trans personHe felt that he had discovered gunpowder. From then on, at the age of 16, it was clear to him that he wanted to get a head start. gender reassignment process, no matter what. “Our plan was to begin treatment with a dedicated endocrinologist and transplant as soon as we got a response from public health,” Sacramento explains. But when they told him he had to wait eight months to do initial consultation, gave up. “I sanity I hit rock bottom, I gotta have it suicidal thoughtsThat’s why I chose to do all the treatments in private health. “I’ve met people who had to wait two years to start hormone therapy,” she says.
The example of Sacramento is no exception in Portugal. Eleven years after hormonal treatments and surgeries for trans people were introduced into public health in the country, only two hospitals have the capacity to perform gender reassignment surgery throughout the region. The lack of community centers makes the process difficult for all people who want to do it, although not everyone feels the need to go through the operating room.
In response to requests from LGTBI+ associations, which have condemned long waiting lists for surgeries for years, the Government announced the opening of two new hospital units in mid-May, in Lisbon and the Algarve. Health Minister António Lacerda Sales said that with this measure “a equitable response across the national territory and reduce the pressure on waiting lists”. The opening of these units, which is planned to be held after the summer, adds to other measures approved by the Portuguese Parliament in favor of LGTBI+ rights, such as the possibility to change name and gender in the population register without the need for a prior medical report. has been in effect since 2018.
content optimism
Despite the government’s statements, LGTBI+ associations prefer to be cautious. Sara Malcato, clinical psychologist and coordinator of the ILGA association, assures that they have not yet received information on what the new units will look like. “State didn’t trust us to determine how the centers would work. We don’t know how many endocrinologists or surgeons there will be, or whether they will be ready for the volume of work they will be doing,” explains Malcato. “If the surgeon who comes to the new unit in Lisbon is the same surgeon who consults in other units, we cannot solve the problem,” he adds.
A criticism shared by Raffaello Dante, 36, who regrets the delays in consultations for a mastectomy. “Most of the doctors who do this type of surgery work in private health care facilities. I find it hard to believe we’ll have enough doctors to deal with waiting lists right now. I hope I’m wrong,” says Dante. In his case, after waiting a few months, he managed to be treated at the Coimbra hospital, which is just over two hours’ drive from the Lisbon area where he lives. consultation, I need to take an entire day. There’s no point in going that far”.
delays due to covid
Since 2011, the Portuguese public health system has performed a total of close to 200 surgeries on transgender people.. It’s a rhythm that dies off with the arrival of covid in 2020 and contributes to further fattening of waiting lists. According to the Ministry of Health, there are 129 interventions pending at the Coimbra hospital alone, a figure they hope to reduce once hospital activity returns to normal but will take time to recover. The backlog of other, more urgent interventions in mastectomies, such as those related to breast cancer, is one of the causes of delays. “We understand that Covid is extending waiting lists, but also lack of professional in this area”, condemns Malcato.
Despite criticism, the Government claims to have made progress in improving surgical services for transgender people. In the middle of last year, the transgender counseling unit of the Santo António de Porto hospital – the second center for all types of surgery in addition to Coimbra – announced the establishment of a specialist team of psychiatrists, endocrinologists and surgeons. , dedicated exclusively to this service, facilitating procedures and caring for patients.