Diversity and inclusion in public health care: the perspective of sexual and gender minorities in municipal services in Brazil
1
Graduate in Hospital Management, Federal Institute of Santa Catarina, Joinville, Brazil
2
Health and Services Department, Federal Institute of Santa Catarina, Joinville, Brazil
3
Graduate in Law, Centro Universitário Católica de Santa Catarina, Joinville, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2754
ABSTRACT
INTRODUCTION:
Brazil’s Unified Health System (SUS) is founded on the principles of universality, equity, and non-discrimination. Despite advances in legal and policy frameworks, lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals continue to face significant barriers to accessing humanized and inclusive health care. This study aimed to describe the perceptions of the LGBTQ community regarding health care provided by public health services in Joinville, southern Brazil.
METHODS:
A cross-sectional survey was conducted in 2023 with adult LGBTQ individuals who use the public health system and reside in Joinville, Santa Catarina. Data were collected using a self-administered online questionnaire developed by the researchers, consisting of 30 questions. Participants were recruited through virtual outreach strategies. A total of 112 valid responses were obtained. Data analysis included descriptive statistics and qualitative content analysis.
RESULTS:
The sample was predominantly composed of cisgender women (45.5%), homosexual individuals (50.8%), participants aged 18–29 years (51.7%), and single individuals (60.7%). The most frequently used services were primary health care units (41%), emergency care units (35.1%), hospitals (16.4%) and psychosocial care centers (5.8%). Overall satisfaction with public health services was reported. However, discriminatory practices were more frequently experienced by transgender participants. Reported access barriers included inadequate reception and humanization of care, insufficient professional training, limited access to hormone therapy, gaps in trans-specific care, low dissemination of the National Policy for Comprehensive LGBTQ Health, and weaknesses in health education initiatives.
CONCLUSIONS:
Strengthening inclusive policies, professional training, and institutional accountability is essential to promoting equity, diversity, and inclusion within public health systems. Engaging LGBTQ populations, particularly transgender individuals, in this effort remains challenging due to persistent social exclusion, stigma and limited community articulation. Further studies exploring health professionals’ and managers’ knowledge and perceptions of LGBTQ health are recommended to support inclusive and rights-based health care.
Brazil’s Unified Health System (SUS) is founded on the principles of universality, equity, and non-discrimination. Despite advances in legal and policy frameworks, lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals continue to face significant barriers to accessing humanized and inclusive health care. This study aimed to describe the perceptions of the LGBTQ community regarding health care provided by public health services in Joinville, southern Brazil.
METHODS:
A cross-sectional survey was conducted in 2023 with adult LGBTQ individuals who use the public health system and reside in Joinville, Santa Catarina. Data were collected using a self-administered online questionnaire developed by the researchers, consisting of 30 questions. Participants were recruited through virtual outreach strategies. A total of 112 valid responses were obtained. Data analysis included descriptive statistics and qualitative content analysis.
RESULTS:
The sample was predominantly composed of cisgender women (45.5%), homosexual individuals (50.8%), participants aged 18–29 years (51.7%), and single individuals (60.7%). The most frequently used services were primary health care units (41%), emergency care units (35.1%), hospitals (16.4%) and psychosocial care centers (5.8%). Overall satisfaction with public health services was reported. However, discriminatory practices were more frequently experienced by transgender participants. Reported access barriers included inadequate reception and humanization of care, insufficient professional training, limited access to hormone therapy, gaps in trans-specific care, low dissemination of the National Policy for Comprehensive LGBTQ Health, and weaknesses in health education initiatives.
CONCLUSIONS:
Strengthening inclusive policies, professional training, and institutional accountability is essential to promoting equity, diversity, and inclusion within public health systems. Engaging LGBTQ populations, particularly transgender individuals, in this effort remains challenging due to persistent social exclusion, stigma and limited community articulation. Further studies exploring health professionals’ and managers’ knowledge and perceptions of LGBTQ health are recommended to support inclusive and rights-based health care.
| eISSN: | 2654-1459 |
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