This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors “transgender people”, “violence”, and “health services”. The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity.

Introduction: Vaccines are a significant public health achievement, which are crucial for child survival and disease control globally. In Brazil, the National Immunization Program (PNI) manages vaccination schedules, including essential vaccines like BCG and Hepatitis B, administered at birth. Despite achieving over 95% coverage for years, vaccination rates have declined since 2016, a trend exacerbated by the COVID-19 pandemic. This study aims to analyze spatial and temporal trends in BCG and Hepatitis B vaccination coverage at birth, identify areas with spatial variation in these trends, classify the identified trends, and investigate the pandemic’s impact on vaccination adherence. Methods: This is an ecological study with real-world data from Brazil, focusing on vaccination coverage from 2014 to 2023. Utilizing the Spatial Variation in Temporal Trends (SVTT) technique, the study identifies municipalities’ vaccination trends. It also employs time series analysis and Interrupted Time Series methods to evaluate the pandemic’s impact on vaccination rates, using data from the PNI and the Information System on Live Births (SINASC). Results: Between January 2014 and December 2023, Brazil administered 25,902,207 doses of the BCG vaccine to children at birth, with 3911 municipalities (70.24%) showing declining trends, particularly in Florianópolis. Similarly, 22,962,434 doses of the Hepatitis B vaccine were administered, with 3284 municipalities also experiencing declines. Conclusions: It is crucial that public health policies be reevaluated to address regional disparities in vaccination coverage, particularly in more vulnerable areas. Focused interventions, such as awareness campaigns, improved access to vaccination services, and strengthened monitoring, are fundamental to reversing this trend.

This study aimed to identify scientific evidence that addresses women’s experiences in the process of illness and care during tuberculosis treatment. A systematic review of qualitative studies was conducted based on the Joanna Briggs Institute’s Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches were performed in the Web of Science, MEDLINE, Embase, SciVerse Scopus, and LILACS databases. The following descriptors were used: “Women,” “Tuberculosis,” “Gender Perspective,” and “Qualitative Approach.” Studies reporting the experiences of women with active tuberculosis, published in any language, without time restrictions, were included. Of the 16,029 studies initially identified, 7079 duplicates were removed and 8895 were excluded after title and abstract screening. A total of 55 studies were read in full, of which 41 did not meet the eligibility criteria, resulting in a final inclusion of 14 studies. Most selected studies were conducted in high-tuberculosis-burden, low- and middle-income countries between 2000 and 2024. All studies focused on pulmonary tuberculosis, with one addressing drug-resistant tuberculosis. The results revealed that women’s experiences with tuberculosis are shaped by the following four thematic categories: (1) stigma and social vulnerability of women with tuberculosis; (2) gender factors in access to health services and in the interruption of tuberculosis treatment among women; (3) intersectionality and social determinants of health; and (4) the importance of social, family, and healthcare support in the experience of tuberculosis illness. The experience of illness due to tuberculosis among women is profoundly shaped by vulnerabilities related to gender, stigma, and social class, which intensify social exclusion, hinder access to diagnosis and treatment, and deepen physical and emotional suffering. Stigma reinforces isolation and weakens support networks, while the burden of domestic labor, caregiving responsibilities, and economic dependence makes it difficult for women to prioritize their own health. In this context, family support and gender-sensitive, humanized healthcare are essential. Therefore, the implementation of public policies that address these specificities and confront structural inequalities is urgent to ensure comprehensive care and a dignified, effective recovery for women with tuberculosis.

Institutional violence against transgender individuals in healthcare is a structural phenomenon with multifactorial roots and is embedded in social, cultural, political, and economic dynamics. Drawing on Michel Foucault’s concept of the microphysics of power, this study analyzes how such violence unfolds within Brazil’s healthcare system. For Foucault, power is not solely exercised through centralized institutions but is diffuse and present in everyday practices, relationships, and discourses. Institutional violence, while often manifesting in individual acts, is defined by its persistence and systematic occurrence over time. In healthcare settings, this violence assumes symbolic, structural, psychological, and physical forms ranging from neglect and verbal abuse to sexual violence. Foucault’s framework allows for a deeper understanding of how power relations perpetuate exclusionary and dehumanizing practices. By interpreting these dynamics through the Microphysics of Power, the study reveals that institutional violence against transgender individuals extends beyond explicit acts, encompassing routine interactions that reproduce inequality and restrict access to fundamental rights such as healthcare. These practices sustain a logic of control and exclusion that operates subtly but effectively within healthcare systems, reinforcing the marginalization of trans people and undermining their right to dignified and equitable care.