"I feel under attack": Transgender pre- and adolescents and caregivers opposition to restrictions on gender-affirming medical care in Brazil.
In April 2025, Brazil's Federal Council of Medicine (CFM) issued Resolution 2.427/2025 banning puberty blockers, restricting hormone therapy until age 18, and delaying gender-affirming surgeries until age 21. These measures sharply contrast with previous national protocols aligned with international standards of care. We conducted a qualitative study to explore how transgender adolescents and their caregivers perceive these new restrictions.
Nine focus groups were held between May and June 2025 with 5 pre-adolescents and 26 adolescents (11-18 years) and 21 caregivers receiving care at Brazil's largest gender identity outpatient clinic. Discussions were transcribed verbatim, coded, and analyzed using qualitative content analysis.
Participants consistently viewed the resolution as unjust, ideologically motivated, and detached from scientific evidence. Adolescents described puberty blockers and hormone therapy as life-saving, emphasizing their positive physical and psychological effects. They rejected detransition as a valid justification for restrictions, framing it as rare and often driven by external pressures. Caregivers echoed these concerns, describing the resolution as harmful, unscientific, and likely to exacerbate inequalities, mental health challenges, and unsafe self-medication practices. Both groups highlighted that gender-affirming care is preceded by long-term, multidisciplinary follow-up under robust clinical protocols, minimizing risks of regret or adverse outcomes.
Findings show that restrictive policies are not perceived as neutral regulation but as an assault on the rights, health, and dignity of transgender youth. By amplifying the lived experiences of adolescents and caregivers, this study points out the urgent need for evidence-based, inclusive, and participatory health policies that do not exclude trans voices.
Nine focus groups were held between May and June 2025 with 5 pre-adolescents and 26 adolescents (11-18 years) and 21 caregivers receiving care at Brazil's largest gender identity outpatient clinic. Discussions were transcribed verbatim, coded, and analyzed using qualitative content analysis.
Participants consistently viewed the resolution as unjust, ideologically motivated, and detached from scientific evidence. Adolescents described puberty blockers and hormone therapy as life-saving, emphasizing their positive physical and psychological effects. They rejected detransition as a valid justification for restrictions, framing it as rare and often driven by external pressures. Caregivers echoed these concerns, describing the resolution as harmful, unscientific, and likely to exacerbate inequalities, mental health challenges, and unsafe self-medication practices. Both groups highlighted that gender-affirming care is preceded by long-term, multidisciplinary follow-up under robust clinical protocols, minimizing risks of regret or adverse outcomes.
Findings show that restrictive policies are not perceived as neutral regulation but as an assault on the rights, health, and dignity of transgender youth. By amplifying the lived experiences of adolescents and caregivers, this study points out the urgent need for evidence-based, inclusive, and participatory health policies that do not exclude trans voices.
Authors
Caruso Mazzolani Caruso Mazzolani, Cordeiro de Oliveira Cordeiro de Oliveira, Longobardi Longobardi, Infante Smaira Infante Smaira, Sabatini Sabatini, Evangelista Bandeira de Melo Evangelista Bandeira de Melo, Bittar Bittar, Helena Torres Helena Torres, Baeza Scagliusi Baeza Scagliusi, Saadeh Saadeh, Roschel Roschel, Gualano Gualano
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