<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-7459</journal-id>
<journal-title><![CDATA[Horizonte sanitario]]></journal-title>
<abbrev-journal-title><![CDATA[Horiz. sanitario]]></abbrev-journal-title>
<issn>2007-7459</issn>
<publisher>
<publisher-name><![CDATA[Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-74592020000100019</article-id>
<article-id pub-id-type="doi">10.19136/hs.a19n1.3279</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Barreras de acceso a los servicios de salud en la comunidad transgénero y transexual]]></article-title>
<article-title xml:lang="en"><![CDATA[Barriers to access to health services in the transgender and transsexual community]]></article-title>
<article-title xml:lang="pt"><![CDATA[Barreiras ao acesso aos serviços de saúde na comunidade transgênero e transexual]]></article-title>
<article-title xml:lang="fr"><![CDATA[Barriere á l&#8217;acces de la communauté transgenre et transsexuelle aux services de santé]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Valles]]></surname>
<given-names><![CDATA[Jonathan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arredondo-López]]></surname>
<given-names><![CDATA[Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Salud Pública  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Salud Pública  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<volume>19</volume>
<numero>1</numero>
<fpage>19</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-74592020000100019&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-74592020000100019&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-74592020000100019&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo Identificar las barreras que presentan las personas transgénero y transexuales en el acceso a los servicios de salud.  Material y métodos Se realizó un estudio de tipo descriptivo basado en una revisión y análisis de evidencias publicadas de estudios cuantitativos y cualitativos, en el periodo de 2005 a 2019 en idiomas inglés y español. La búsqueda se realizó utilizando palabras clave para identificar las barreras de acceso en la población transgénero y transexual. Los resultados se clasificaron de acuerdo con las principales barreras de acceso en diferentes categorías analíticas de barreras: económicas, organizacionales, geográficas y culturales.  Resultados De acuerdo con la búsqueda en las bases de datos analizadas, se encontraron 230 artículos, de los cuales, tras ser revisados los títulos y resúmenes, se excluyeron 200 por no estar relacionados con el fenómeno en estudio. Revisador el texto completo de los 30 artículos restantes, 22 fueron excluidos por los siguientes motivos: 16 por no analizar el fenómeno em estudio y 6 por no incluir expresamente a la población objeto de estudio. Finalmente fueron seleccionados ocho artículos. Se destacó que los Profesionales de la Salud presentan incertidumbre para atender a personas transgénero y transexuales, aunado a su escasa formación académica. Las personas transgénero y transexuales, mencionan como principal barrera el estigma y la discriminación; igualmente, la escasa información que tienen los Profesionales de Salud hacia esta comunidad.  Conclusiones Aunque existe evidencia de barreras geográficas y financieras para el acceso a los servicios de salud de personas transgénero y transexuales en México, la principal barrera de problemas y retos en el acceso, la constituyen las barreras culturales, acompañadas del estigma socio-cultural para este grupo poblacional.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective Identify the barriere that transgender and transsexual people have in accessing health services.  Material and methods A descriptive study was carried out based on a review and analysis of published evidences of quantitative and qualitative studies, in the period from 2005 to 2019 in English and Spanish. The search was conducted using keywords to identify access barriere in the transgender and transsexual population. The results were classified according to the main access barriere in different analytical categories of barriere: economic, organizational, geographic and cultural.  Results According to the search in the databases analyzed, 230 articles were found, of which, after reviewing the titles and abstracts, 200 were excluded because they were not related to the study phenomenon. After reviewing the full text of the remaining 30 articles, 22 of them were excluded for the following reasons: 16 for not analyzing the study phenomenon and 6 for not expressly including the population under study. Finally, 8 articles were selected. It was pointed out that health professionals have uncertainty when dealing with transgender and transsexual people, coupled with poor academic training. Transgender and transsexual people mention stigma and discrimination as the main barrier, as well as the limited information that health professionals have about this community.  Conclusions Although there is evidence of geographical and financial barriere to access to health services for transgender and transsexual people in Mexico, the main barrier of problems and challenges are cultural barriere accompanied by socio-cultural stigma for this population community.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Objetivo Identificar as barreiras que transgêneros e pessoas trans têm no acesso aos serviços de saúde.  Material e métodos Foi realizado um estudo descritivo, com base em revisão e análise de evidências publicadas de estudos quantitativos e qualitativos, no período de 2005 a 2019, em inglês e espanhol. A busca foi realizada utilizando palavras-chave para identificar barreiras de acesso na população transexual e transexual. Os resultados foram classificados de acordo com as principais barreiras de acesso em diferentes categorias analíticas de barreiras: econômicas, organizacionais, geográficas e culturais.  Resultados De acordo com a busca nas bases de dados analisadas, foram encontrados 230 artigos, dos quais, após revisão dos títulos e resumos, foram excluídos 200, por não estarem relacionados ao fenômeno do estudo. Após revisão do texto completo dos 30 artigos restantes, 22 artigos foram excluídos pelos seguintes motivos: 16 por não analisar o fenômeno do estudo e 6 por não incluir expressamente a população em estudo. Finalmente, 8 artigos foram selecionados. Assinalou-se que os profissionais de saúde têm incertezas ao lidar com pessoas transexuais e transgênero, aliadas a uma baixa formação acadêmica. As pessoas trans e transgênero mencionam o estigma e a discriminação como a principal barreira, bem como a escassa informação que os profissionais de saúde têm sobre essa comunidade.  Conclusões Embora existam evidências de barreiras geográficas e financeiras para o acesso a serviços de saúde para transgêneros e pessoas transexuais no México, a principal barreira para o acesso a problemas e desafios são as barreiras culturais acompanhadas pelo estigma sócio-cultural para este grupo. população.]]></p></abstract>
<abstract abstract-type="short" xml:lang="fr"><p><![CDATA[Résumé  Objectif Identifier les barriéres á l&#8217;accés de la communauté transgenre et transsexuelle aux services de santé.  Matériel et méthodes Une étude descriptive a été réalisée á partir d&#8217;une revue et d&#8217;une analyse des données issues d&#8217;études quantitatives et qualitatives publiées au cours de la période 2005- 2019, en anglais et en espagnol. La recherche a été effectuée á l&#8217;aide de mots clés pour identifier les barriéres á l&#8217;accés de la population transgenre et transsexuelle. Les résultats ont été classés selon les principales barriéres, en différentes catégories analytiques (barriéres économiques, organisationnelles, géographiques et culturelles).  Résultats Les bases de données consultées ont permis de localiser 230 articles. Aprés examen des titres et des résumés, 200 d&#8217;entre eux ont été exclus parce qu&#8217;ils ne correspondaient pas au phénoméne á l&#8217;étude. La révision du texte intégral des 30 articles restants a ensuite amené á en exclure 22, pour les raisons suivantes : 16 pour ne pas analyser suffisamment le phénoméne en question et 6 pour ne pas avoir expressément inclus la population á l&#8217;étude. Finalement, huit articles ont donc été sélectionnés. Leur analyse signale que les professionnels de santé présentent certaines incertitudes sur la maniére de s&#8217;occuper de personnes transgenres et transsexuelles, ainsi qu&#8217;une formation académique insuffisante dans ce domaine. Les personnes transgenres et transsexuelles mentionnent comme principales barriéres la stigmatisation et la discrimination, ainsi que le manque d&#8217;information des professionnels de santé en relation á cette communauté.  Conclusions  Malgré les preuves de barriéres géographiques et financiéres á l&#8217;accés aux services de santé de la part des personnes transgenres et transsexuelles au Mexique, la principale barriére de problémes et défis est d&#8217;ordre culturel et s'accompagne de stigmatisation socioculturelle envers ce groupe de population.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Personas transgénero]]></kwd>
<kwd lng="es"><![CDATA[Accesibilidad a los servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[Equidad en el Acceso a los Servicios de Salud]]></kwd>
<kwd lng="en"><![CDATA[Transgender people]]></kwd>
<kwd lng="en"><![CDATA[Accessibility to health services]]></kwd>
<kwd lng="en"><![CDATA[Equity in Access to Health Services]]></kwd>
<kwd lng="pt"><![CDATA[pessoas transgéneras]]></kwd>
<kwd lng="pt"><![CDATA[Acessibilidade aos servijos de saúde]]></kwd>
<kwd lng="pt"><![CDATA[Equidade no acesso aos servijos de saúde]]></kwd>
<kwd lng="fr"><![CDATA[Personnes transgenres]]></kwd>
<kwd lng="fr"><![CDATA[Accessibilité aux services de santé]]></kwd>
<kwd lng="fr"><![CDATA[Équité dans l&#8217;accés aux services de santé]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Frenk]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;El concepto y La medición de la accesibilidad&#8221;]]></article-title>
<source><![CDATA[Salud Publica Mex]]></source>
<year>1985</year>
<volume>27</volume>
<page-range>438-56</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Logie]]></surname>
<given-names><![CDATA[CH.]]></given-names>
</name>
<name>
<surname><![CDATA[James]]></surname>
<given-names><![CDATA[LL.]]></given-names>
</name>
<name>
<surname><![CDATA[Tharao]]></surname>
<given-names><![CDATA[W.]]></given-names>
</name>
<name>
<surname><![CDATA[Loutfy]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;We don&#8217;t exist&#8221;: a qualitative study of marginalization experienced by HIV-positive lesbian, bisexual, queer and transgender women in Toronto, Canada.]]></article-title>
<source><![CDATA[JIAS]]></source>
<year>2012</year>
<volume>15</volume>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Usman-Shah]]></surname>
<given-names><![CDATA[HB.]]></given-names>
</name>
<name>
<surname><![CDATA[Rashid]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
<name>
<surname><![CDATA[Atif]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Zafar-Hydrie]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Bin- Fawad]]></surname>
<given-names><![CDATA[MW.]]></given-names>
</name>
<name>
<surname><![CDATA[Zeeshan-Muzaffar]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Challenges faced by marginalized communities such as transgenders in Pakistan.]]></article-title>
<source><![CDATA[PAMJ]]></source>
<year>2018</year>
<volume>32</volume>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<collab>Comisión Nacional de Derechos Humanos</collab>
<source><![CDATA[Los derechos humanos de las personas transgénero, transexuales y travestís]]></source>
<year>2018</year>
<publisher-name><![CDATA[México]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gonzales]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[Henning-Smith]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Barriers to care among transgender and gender nonconforming adults]]></article-title>
<source><![CDATA[Milbank Q]]></source>
<year>2017</year>
<volume>95</volume>
<page-range>726-48</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Goffman]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Estigma: la identidad deteriorada]]></source>
<year>2009</year>
<edition>2a</edition>
<publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
<publisher-name><![CDATA[Amorrortu]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hyemin]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Jooyoung]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<name>
<surname><![CDATA[Bokyoung]]></surname>
<given-names><![CDATA[Ch.]]></given-names>
</name>
<name>
<surname><![CDATA[Horim]]></surname>
<given-names><![CDATA[Y.]]></given-names>
</name>
<name>
<surname><![CDATA[Seung]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery]]></article-title>
<source><![CDATA[Epidemiol Health]]></source>
<year>2018</year>
<volume>40</volume>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brandelli]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Tome]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
<name>
<surname><![CDATA[Fagundes]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<name>
<surname><![CDATA[Vaitses]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Mueller]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Healthcare Needs of and Access Barriers for Brazilian Transgender and Gender Diverse People.]]></article-title>
<source><![CDATA[J. Immigr. Minor. Health]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Snelgrove]]></surname>
<given-names><![CDATA[JW.]]></given-names>
</name>
<name>
<surname><![CDATA[Jasudavisius]]></surname>
<given-names><![CDATA[AM.]]></given-names>
</name>
<name>
<surname><![CDATA[Rowe]]></surname>
<given-names><![CDATA[BW.]]></given-names>
</name>
<name>
<surname><![CDATA[Head]]></surname>
<given-names><![CDATA[EM.]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[«Completely out-at-sea» with «two-gender medicine»: A qualitative analysis of physician side barriers to providing healthcarefor transgender patients]]></article-title>
<source><![CDATA[BMC Health Serv Res]]></source>
<year>2012</year>
<volume>12</volume>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[CG.]]></given-names>
</name>
<name>
<surname><![CDATA[Renfrew]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Kenst]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
<name>
<surname><![CDATA[Tan-McGrory]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Betancourt]]></surname>
<given-names><![CDATA[JR.]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Improving transgender health by building safe clinical environments that promote existing resilience: Results from a qualitative analysis of providers]]></article-title>
<source><![CDATA[BMC Pediatr]]></source>
<year>2015</year>
<volume>15</volume>
<numero>187</numero>
<issue>187</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Perez]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Nunn]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Hsiang]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
<name>
<surname><![CDATA[Oldenburg]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Bender]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Beauchamps]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;We don&#8217;t treat your kind&#8221;: Assessing HIV health needs holistically among transgender people in Jackson, Mississippi]]></article-title>
<source><![CDATA[Plos One]]></source>
<year>2018</year>
<volume>11</volume>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kano]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Silva-Bañuelos]]></surname>
<given-names><![CDATA[AR.]]></given-names>
</name>
<name>
<surname><![CDATA[Sturm]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Willging]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stakeholders&#8217;recommendations to improve patient centered «LGBT» primary care in rural and multicultural practices]]></article-title>
<source><![CDATA[J. Am. Board Fam. Med]]></source>
<year>2016</year>
<volume>29</volume>
<page-range>156-60</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rounds]]></surname>
<given-names><![CDATA[KE.]]></given-names>
</name>
<name>
<surname><![CDATA[Burns-McGrath]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perspectives on provider behaviors: A qualitative study of sexual and genderminorities regarding quality of care]]></article-title>
<source><![CDATA[Contemp Nurse]]></source>
<year>2013</year>
<volume>44</volume>
<page-range>99-110</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
