ABSTRACT:
Transgender populations experience persistent health inequities driven by stigma, discrimination and structural barriers within health systems. In brazil, despite the constitutional guarantee of universal health care through the unified health system (SUS), transgender people face limited access to specialized services and disproportionately poor mental health outcomes. This study aims to analyze mental health disparities and access to public health services among transgender populations in brazil using available official public health data. A descriptive and analytical study was conducted using secondary data from official brazilian sources, including the ministry of health, datasus and national public reports on the transgender health care process. Indicators analyzed included availability of specialized services, access to gender affirming care, mental health service coverage and reported violence as a social determinant of health. Policy documents regulating transgender health care in the SUS were also reviewed. As of 2023, fewer than 10 specialized services were officially accredited to provide comprehensive transgender health care within the SUS, concentrated primarily in large urban centers. Waiting times for gender affirming procedures frequently exceeded 48 months. National data indicate high exposure to violence, with over 130 reported murders of transgender individuals in a single year, contributing to elevated mental health risks. Studies based on public data report high prevalence of depression anxiety and suicidal ideation among transgender populations when compared to the general population. Limited access to mental health care and discontinuity of care remain significant barriers. Transgender populations in brazil face significant mental health inequities linked to structural limitations of health services and broader social exclusion. Strengthening the transgender health care process expanding service coverage and integrating mental health care into primary health services are essential to promote equity inclusion and sustainability in public health.