Barreiras enfrentadas pela comunidade LGBTQIAPN+ no acesso à atenção primária à saúde: uma revisão de escopo

Abstract

Introduction:The LGBTQIAPN+ population faces several barriers in accessing primary health care, including prejudice, discrimination, and the lack of preparedness among health professionals. Although the National Policy for Comprehensive LGBTQIAPN+Health has been an advancement in ensuring equity in the Brazilian Unified Health System (SUS), its implementation still faces structural and institutional challenges. In this context, conducting a scoping review is essential to map the difficulties encountered by this population and provide insights for improving healthcare practices and public policies.Objective:To identify and synthesize the barriers faced by the LGBTQIAPN+ community in accessing primary health care, providing a comprehensive view of the challenges and available evidence in the scientific literature.Method:This is a scoping review with a qualitative approach, following the Joanna Briggs Institute (JBI) guidelines. The research protocol was registered in the Open Science Framework (OSF). The research question was formulated using the PCC strategy (Population, Concept, and Context). Relevant databases were searched, including BDENF, CINAHL, LILACS, EMBASE, PUBMED/MEDLINE, SciELO, and SCOPUS, covering publications from September to November 2024.For study selection, the Rayyan software was used to assist in the screening and organization of articles. Additionally, the JBI Checklist was applied to assess the methodological quality of the included studies, ensuring the reliability of the analyzed evidence.Results:From the 19 studies selected for this review, the main barriers identified were: lack of training among health professionals to address the specific needs of the LGBTQIAPN+ population; invisibility and absence of epidemiological data on this population in health information systems; a heteronormative and cisnormative structure in health services, disregarding needs such as hormone therapy, mental health care, and gynecological care for trans men; difficulties in accessing specialized services, especially outside major urban centers; and the impact of political instability on the continuity of the National Policy for Comprehensive LGBTQIAPN+Health.Final Considerations:The review demonstrated that primary health care is still not fully accessible and inclusive for the LGBTQIAPN+ population, reinforcing the need for more effective public policies, training for health professionals, and improvements in epidemiological data collection. Overcoming these barriers is essential to ensuring universal health rights and equitable care within the SUS.