Pais de adolescentes trans consideram medida um retrocesso
Paula Laboissière – Agência Brasil
Chloe Stanley tem 12 anos de idade e mora com a mãe, o irmão e a avó na cidade de São Paulo. Em fevereiro, a família conseguiu na Justiça a guarda unilateral da menina e, com isso, o direito de iniciar o Bloqueio Hormonal na adolescente, que é uma garota trans. O pai de Chloe não aceita a condição da filha. A previsão era que o tratamento começasse no dia 26 de agosto, sob a orientação de um Endocrinologista. Uma Resolução publicada no último dia 16 pelo Conselho Federal de Medicina (CFM) que proíbe o Bloqueio Hormonal em menores de idade, entretanto, pode alterar os planos da família.
Em entrevista à Agência Brasil, a mãe de Chloe, Tatiam Stanley, relata que a filha foi diagnosticada com Disforia de Gênero Severa e que o maior medo da menina é iniciar a puberdade e desenvolver características masculinas.
“De repente, fomos minados, bombardeados com essa notícia de uma Resolução onde o CFM proíbe o Bloqueio em crianças. Nosso mundo desabou. Simplesmente um retrocesso de anos na história. Chloe está desolada com toda essa situação. Estou tentando fazer com que ela se anime e tenha esperança”.
“Não é possível que não haja nada que possa ser feito diante dessa imposição do CFM. Eles não sabem o que é vivenciar essa história, o que é sentir ser alguém que a sociedade não acredita que existe, que impõe suas verdades e acha que nós temos que acatar. Retrocedemos anos. Anos! Demos passos pra trás absurdamente. Está na Constituição: saúde para todos. É dever do Estado, não é? Mas estão tirando os direitos das nossas crianças e adolescentes trans de existirem e de fazerem o uso do bloqueio”, acrescenta Tatiam.
Tatiam alerta que há risco de crianças e adolescentes trans, diante da proibição e em razão do desespero, buscarem outras formas de acesso e de fazer uso de Bloqueadores Hormonais, colocando em risco a saúde e a integridade de cada um deles e de suas famílias.
“O Direito à Saúde não é de todos? Não é um dever do Estado? Como é que eles agridem assim, proibindo e tirando um direito que é nosso? Para gente, foi lamentável, foi desolador”, afirma.
“É um ultraje o que o CFM está fazendo. Pra mim, chega a ser uma monstruosidade. Não houve nenhum diálogo com os Ambulatórios que tratam de crianças e adolescentes trans. Não conversaram com as famílias, nada. Simplesmente sentaram, se reuniram, decidiram por nós. E nós temos que acatar e ficar de braços cruzados, vendo o que eles estão fazendo com os nossos filhos, filhas e filhes? De forma alguma. A gente tem que fazer alguma coisa. Tem que ser feita alguma coisa. Não dá pra continuar desse jeito”.
Diogo Leal mora em Florianópolis com a esposa e a filha, uma menina trans de 9 anos de idade, e traz um relato muito similar ao de Tatiam. Ele conta que V [nome preservado a pedido da família], desde pequena, sempre curtiu brincadeiras diferentes das tradicionalmente definidas pela sociedade para meninos.
“Mas a gente pensa, essa coisa de brincadeira de menino e de menina é uma coisa inventada”, diz.
Foi em meio à pandemia da Covid-19, entretanto, que a identificação com o sexo feminino se mostrou mais intensa.
“Não sei se foi porque a gente acabou passando mais tempo juntos em casa e, com essa privacidade, ela se sentiu mais livre para ir se expondo. Foi nesse período que essas mudanças começaram a acontecer de forma mais intensa. Ela, primeiramente, quis usar fantasias de princesas e de super-heroínas, ela gostava muito da Batgirl e da Elza [personagem do filme Frozen, da Disney]. A partir daí, foi um passo para ela começar a querer usar apenas roupas de menina”, disse.
Com a retomada das aulas no período menos crítico da pandemia, V já voltou para o ambiente escolar com os cabelos mais compridos e vestindo uniforme do sexo feminino.
“No meio do 1º ano, ela decidiu que queria ser chamada de V. Ela já falava na Escola e também já tinha falado pra gente. Conversamos com o Colégio e deu tudo certo, não tivemos grandes problemas. É uma Escola Pública Municipal e eles aceitaram usar o nome social dela”, explicou.
“Tem sido um processo. A gente vai sempre acompanhando cada etapa. Às vezes, são coisas bobas, tipo deixá-la ir à casa de uma amiguinha. Acho que a maioria dos pais já fica preocupada, mas a gente fica ainda mais preocupado porque não sabe se vai haver algum tipo de preconceito. São coisas pequenas, mas a gente fica muito nervoso. A cada etapa da vida dela, a gente fica super preocupado. Se ela vai sofrer preconceito e como a gente pode ajudá-la e protegê-la”, relata.
Com 9 anos de idade, V se aproxima da puberdade. E a Resolução do CFM preocupa a família da menina.
“Até então, pais e responsáveis por crianças e adolescentes trans tinham a possibilidade, mediante acompanhamento médico, claro, de, nessa fase da puberdade, entrar com o bloqueio hormonal. Um meio para dar uma parada no desenvolvimento das características biológicas. No caso da minha filha, seria não crescer pelo no rosto, por exemplo”, explicou.
“Isso é muito importante para essas crianças e adolescentes, para que eles possam se afirmar como quem são de fato, como se sentem. E é também uma forma de proteger a V numa sociedade em que há bastante preconceito. Cabe lembrar que, no Brasil, a expectativa de vida de uma pessoa trans é 35 anos. Numa sociedade que tem tanto preconceito, a terapia hormonal é até uma forma de proteção. Essas crianças e adolescentes se sentem mais felizes consigo mesmos, com o corpo deles, graças a esse bloqueio hormonal”, defende.
“Essa medida do CFM atinge essas pessoas de duas maneiras. A primeira é negando que existem crianças e adolescentes trans e, por isso, não haveria necessidade de Bloqueio Hormonal e da Hormonização Cruzada, apenas na maioridade, a partir dos 18 anos. Uma negação do sentido da existência e, portanto, de todo tipo de auxílio, ajuda, acompanhamento médico e psicológico. E a segunda coisa é a consequência disso. Com certeza, vai fazer com que essas crianças e adolescentes e suas famílias sofram mais”.
O pai de V teme que a Resolução acabe abrindo caminho para que crianças e adolescentes trans fiquem ainda mais suscetíveis a sofrer transfobia.
“O índice de depressão e de tentativa de suicídio na população trans no Brasil é altíssimo na faixa de menores de 18 anos, 14%, muito maior que entre as pessoas cis. E esses dados, muitas vezes, são subestimados, você não consegue captar tão bem como é a realidade. Eu, como pai, fico extremamente preocupado”, alerta.
“Minha filha ainda não está tomando o Bloqueio. Ela é acompanhada por um Ambulatório Trans, que é onde nós tínhamos que fazer os exames para ver a questão dos hormônios e, em seguida, levar aos médicos para ver se já estaria no momento de iniciar o Bloqueio Hormonal ou se esperamos mais um pouco”, explica o pai de V.
“A gente sabe que isso é muito importante para a felicidade dela, e eu, como pai, e minha esposa, como mãe, a gente fica muito abalado e preocupado em relação a como isso pode afetar ela. Não só em relação à felicidade dela. Minha esposa, por exemplo, está arrasada. Tem tomado remédio para dormir. Ela tem medo de como a nossa filha pode reagir quando chegar nesse momento e ela não tiver como tomar o Bloqueio Hormonal. Ou mesmo quando chegar aos 16 anos e não puder tomar o hormônio”.
“Na Constituição está colocado que todas as pessoas têm Direito à Saúde e que é dever do Estado prover, garantir esse direito. E essa Resolução que saiu vai contra isso. Nega o acesso a direitos de crianças e adolescentes, da população trans em geral. Não só nega direitos como o Estado proíbe os médicos de proverem o Direito à Saúde para essa população. É gravíssimo. Arrasador. Os pais estão discutindo entre si como a gente pode lidar com isso”.
Entenda
A Resolução do CFM publicada em 16 de abril proíbe o Bloqueio Hormonal para Crianças e Adolescentes com Incongruência e/ou Disforia de Gênero. A Entidade estabelece ainda que Terapia Hormonal Cruzada – Administração de Hormônios Sexuais para induzir características secundárias condizentes com a identidade de gênero do paciente – só poderá ser iniciada a partir dos 18 anos de idade.
A Resolução também restringe o acesso a cirurgias de Redesignação de Gênero para pessoas trans antes dos 18 anos de idade e, nos casos em que o procedimento implicar potencial efeito esterilizador, antes de 21 anos.
Por fim, a Resolução determina que pessoas trans que mantêm seus órgãos reprodutivos biológicos devem buscar atendimento médico preventivo ou terapêutico com Especialistas do sexo biológico e não conforme sua identidade de gênero.
Ministério Público Federal (MPF) instaurou Procedimento para apurar a legalidade da Resolução.
Em nota, a Entidade destaca que a publicação altera as normas que definem o atendimento e a realização de Procedimentos Médicos ofertados a pessoas trans, incluindo crianças e adolescentes.
De acordo com o Ministério Público Federal, o Procedimento foi aberto a partir de denúncia feita pela Associação Mães pela Diversidade e de Nota Técnica publicada pela Antra (Associação Nacional de Travestis e Transexuais.
“As Entidades comunicaram o fato e demonstraram a preocupação de familiares de crianças com variabilidade de gênero ou adolescentes trans que sofrem de Disforia de g
Gênero e que têm acesso a Procedimentos Terapêuticos como Bloqueio Puberal e Hormonização Cruzada”, disse o MPF.
O que diz o CFM
Em coletiva de imprensa, o presidente do CFM, José Hiran Gallo, ressaltou que a Resolução foi aprovada por unanimidade pelo plenário da Entidade.
“Todos os 28 conselheiros presentes aprovaram essa resolução”, afirmou.
O Médico Ginecologista Rafael Câmara, conselheiro pelo Estado do Rio de Janeiro e um dos relatores da Resolução, destacou que se trata de um tema em que as evidências e os fatos mudam a todo instante.
“É natural que essas resoluções sejam alteradas”, disse.
Ao tratar da vedação da Terapia Hormonal Cruzada para menores de 18 anos de idade, ele lembrou que a Resolução anterior do CFM estabeleceu 16 anos de idade como a idade mínima para a administração de Hormônios Sexuais com essa finalidade.
“Não é algo inócuo”, disse, ao citar riscos como o aumento de Doenças Cardiovasculares e Hepáticas, incluindo Câncer, Fertilidade Reduzida, Calvície e Acne, no caso da Testosterona, e problemas Tromboembólicos e Câncer de Mama, no caso do Estrogênio.
Sobre Bloqueadores Hormonais, o médico destacou que o uso desse tipo de Terapia no intuito de suprimir a puberdade em crianças e adolescentes é motivo de discussões e questionamentos frequentes.
Câmara lembrou que, em abril do ano passado, o Reino Unido aboliu o uso de Bloqueadores Sexuais. Segundo ele, Finlândia, Suécia, Noruega e Dinamarca, “países com Sistemas de Saúde fortes e de tendência progressista”, também proibiram a Terapia.
“A exposição a Hormônios Sexuais é importante para a resistência óssea, para o crescimento adequado e para o desenvolvimento de órgãos sexuais”, lembrou, ao citar, dentre as consequências, densidade óssea comprometida, altura alterada e fertilidade reduzida.
O médico ressaltou que a vedação do uso de Bloqueadores não se aplica a situações clínicas reconhecidas pela literatura médica nas quais o uso é cientificamente comprovado, incluindo quadros de Puberdade Precoce e Doenças Endócrinas.
Câmara cita ainda o aumento de relatos de arrependimento de transição e mesmo de Destransição Sexual desde 2020, o que levou diversos países a revisarem seus Protocolos para lidar com a Incongruência e a Disforia de Gênero.
Outro ponto destacado pelo médico trata do sobrediagnóstico, sobretudo entre menores de idade.
“Mais crianças e adolescentes estão sendo diagnosticados com Disforia de Gênero e, com isso, levados a tratamentos. Muitos, baseado em estudos, no futuro, poderiam não ser trans, mas simplesmente gays e lésbicas”.
“Estudos mostram que, alguns anos atrás, a tendência, quando se tinha casos diagnosticados [de Disforia de Gênero], era tentar fazer com que a criança não mantivesse [o quadro]. Hoje, a tendência é fazer um viés de confirmação. Se a criança de 4 anos diz que é trans, muitos serviços acabam mantendo ou estimulando”, ressalta.
Foto: @ Antra/Divulgação
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