Ways of (not) providing healthcare to trans women and travestis in the “liquid territory”

Abstract

From a dynamic space, in constant movement and transformation, here called “liquid territory”, we seek to understand the ways of (not) doing healthcare for trans women and travestis. This is a qualitative, descriptive, and comprehensive-interpretive study, based on the experiences narrated by primary health care workers and trans women and travestis, in Manaquiri, a municipality in the state of Amazonas. The analysis of the narratives revealed three main axes that organized the meanings of care or its absence: “I don’t know”; “I don’t attend to them”; and “So I don’t do anything about it”. This sequence of statements synthesizes the institutional logic that highlights, above all, practices of non-care, marked by silencing, omissions, and denial of the existence of these identities in the daily routine of the services. In conclusion, we emphasize that it is imperative to build inclusive and operational strategies that promote effective health care for trans women and travestis in primary care. These practices must be based on the awareness of the reality experienced by these bodies in different territorial contexts, articulating understandings and affections capable of breaking with the historical cycles of annihilation and opening the main gateway to the services of the Brazilian Unified Health System for trans women and travestis.