Brazil lowers
minimum age for sex-change surgery to 18
Hormone replacement
will be allowed for individuals aged 16 or above
Published in 10/01/2020
- 13:56 By Luciano Nascimento - Brasília
Brazil’s Federal Council of Medicine (CFM) yesterday (Jan. 9) issued a
resolution changing the rules governing procedures directed at transgender
people.
The new rules reduce the minimum age for gender reassignment surgery
from 21 to 18 years old and stipulate that cross-sex hormone therapy must not
be administered until the age of 16.
The move is believed to help monitor the health condition of trans
people and train health agents whose job is to offer assistance to this segment
of the population.
“This subject has been debated for 15 years. This resolution comes as an
enhancement, a maturing of concepts. It deals mainly with the inclusion of the
needs of these people in health care, encompassing treatments—like hormone
treatment. It also bring surgical procedures up to date,” said CFM head
Donizetti Giamberardino at a press conference.
“If no rules are made, you can end up causing a lot more harm and taking
inappropriate attitudes, often with no scientific criteria,” he added.
Care for transgender individuals must be offered by a multidisciplinary
team of doctors including a pediatrician, if the patient is younger than 18, a
psychiatrist, an endocrinologist, a gynecologist, a urologist, a plastic
surgeon, and more.
The text says that transgender children and adolescents must receive
treatment from a medical team, with no hormone or surgical intervention (see
below). An individual treatment plan must be adopted for any procedure.
The execution of surgical and hormone procedures in people diagnosed
with some severe forms of psychotic disorders, personality disorders, mental
retardation, and global developmental delay was banned.
Hormone therapy
The resolution also bans the use of hormone therapy procedures aimed at
blocking hormones in transgender children and adolescents that have not yet
reached puberty.
The procedure may be conducted following an evaluation by the medical
team or when the child is entering puberty—a period that may vary from 8 to 13
years old for children with female biological sex, and 9 to 14 for children
with male biological sex.
In such cases, after the assessment, patients may start taking a
substance to inhibit the development of secondary sex characteristics
associated with the gender the child or adolescent does not identify themselves
as, like breasts, menstruation, a beard, or a deep voice.
Also, cross-sex hormone therapy—when blockers are coupled with hormone
replacement—may be administered at 16 or above, experimentally.
From the age of 18 and above, the procedure now requires a special
prescription by an endocrinologist, gynecologist, or urologist.
Sexual affirmation
In the resolution, CFM also recognizes identity expressions such as
“trans man” and “trans woman,” as well as “travesti” and other phrases linked
to gender diversity.
Psychiatrist Leonardo Luz, rapporteur for CFM’s resolution, says the
move brings the de-pathologization of transsexuality to the center of the
debate and introduces world nomenclature to talk about the subject.
Among the terms updated are “gender incongruence”—used to indicate that
an individual’s experienced gender does not match the sex assigned at birth—and
“sexual affirmation,” for the hormone or surgical procedure, rather than
“sexual reassignment.”
“The council adopts the world nomenclature of gender incongruence and is
making strides in care from childhood to adult life and attempts to encourage
other professional to seek training and promote education through medical
residency programs so that we can have more centers for people who need this
kind of assistance,” he declared.
Translation: Fabrício Ferreira - Edition: Maria Claudia / Nira Foster
