Friday, August 7, 2009

Hello from Brazil: sex reassignment surgeries as public healthcare

by Josh Franklin

Hello everybody, sorry it's been so long! I'm in Porto Alegre, Brazil doing anthropological research. I've started researching a court case involving a transgendered patient group that brought legal action against the Brazilian government, demanding that the public health system pay for their sex reassignment surgeries. The patients won the case, and while it was awaiting appeal, the government decided to accept the decision independently of the results of the appeal.

The case was brought on the basis of Brazil's constitutionally-guaranteed right to health, but the ruling judge made his decision not only on the basis of a right to health but also a concept of individual rights of gender, sexuality, and identity.

This decision is both exciting and problematic at the same time. It's thrilling to see such explicit progressivism in both the judicial system and the public health system, where decisions are made with an explicit challenge to binary gender and using a language of critical gender theory. At the same time, this program is situated in the context of conservative Catholic values that structure much of Brazilian culture. Is a federal court the appropriate place to conduct crucial public discourse? When social values are negotiated through bureaucratic procedures, it allows all the relevant actors to refuse accountability; when human dignity is understood through a complex language of legal-technical jargon, is it possible that the lived experiences of those whose dignity is at stake are ignored?

Over the next few weeks, I am going to speak with transgendered people in the public health system, as well as health professionals, lawyers, judges, and social activists. I'll keep you guys updates on what I learn, and I hope that you'll find it interesting.

And, as a bonus, here's a little piece of gender from Brazil, an anti-smoking ad. This image, or one of several similar ones, is put on all cigarette cartons:

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