PRENATAL CARE FOR TRANS MEN: CHALLENGES AND INCLUSION STRATEGIES IN THE SUS

Abstract

Introduction: Gender identity significantly influences the reproductive experience of trans men, especially in access to prenatal care. In Brazil, the Unified Health System (SUS) guarantees this right, but there are still challenges in adapting public policies to serve this population adequately. The cisnormativity present in health services makes it difficult to include pregnant women who have the female biological sex, but who do not identify with the gender assigned at birth, resulting in institutional and social barriers. In addition, the lack of training of professionals and the scarcity of specific guidelines increase the vulnerability of trans men during pregnancy, affecting both their physical and mental health. Objective: to analyze the barriers faced by trans men in accessing prenatal care and to discuss strategies to make the SUS more inclusive and accessible. Methodology: This is a narrative literature review, carried out through the search of scientific articles, theses, dissertations and technical documents in databases such as PubMed, SciELO, LILACS and Google Scholar. Descriptors related to the reproductive health of trans men and inclusive prenatal care were used. The inclusion criteria involved publications from the last 8 years (2017-2025), available in full and written in Portuguese, English or Spanish. The data were analyzed qualitatively, seeking to identify patterns and recommendations to improve care in the SUS. Results and Discussion: The findings demonstrated that prenatal care for trans men in Brazil is still precarious, due to the absence of specific protocols and the lack of preparation of health professionals. The fear of discrimination and the intensification of gender dysphoria during pregnancy keep many trans men away from adequate follow-up, increasing obstetric and psychological risks. Strategies such as professional training, adoption of neutral language, creation of welcoming environments and psychological support were identified as fundamental for the inclusion of this population in prenatal care. In addition, international experience shows that public policies aimed at gender diversity significantly improve adherence and quality of care. Conclusion: The inclusion of trans men in SUS prenatal services is a challenge that requires structural and cultural changes. The creation of specific guidelines, investment in the training of professionals, and the strengthening of scientific research on trans reproductive health are essential to ensure a more humanized and equitable service. Only with concrete actions will it be possible to ensure that this population has access to dignified prenatal care, promoting equity in the Brazilian health system.