Caso Roberto Farina

The Roberto Farina Case was a legal proceeding that attracted international attention to Brazil during the late 1970s. The case stemmed from the first male-to-female gender-affirming surgery performed in Brazil in the city of São Paulo.

Dr. Farina was sentenced to two years in prison but was subsequently absolved after the Brazilian courts concluded that gender-affirming surgery was the only way to alleviate gender dysphoria in Farina's patient, Waldirene Nogueira.

Background In 1969, Waldirene Nogueira, a transgender manicurist and hairstylist, left Lins and went to Hospital das Clínicas da Universidade de São Paulo to seek treatment for her gender dysphoria. She was initially seen by Dorina Epps, and went on to attend weekly therapy sessions, where she was diagnosed with gender dysphoria and told that gender-affirming surgery might be a viable treatment for her. The request generated significant publicity, as medical and legal professionals had not anticipated such a surgery and which was, at the time, illegal. As a result, the Brazilian authorities opened an investigation into both Farina and Nogueira.

In 1976, the Ministério Público do Estado de São Paulo subpoenaed Farina, asking him to provide the names and addresses of all of his surgical patients. Farina had publicized his surgeries during a medical conference, but refused to turn over the information. During this time, Nogueira was made to submit to many invasive procedures, including a nude photo shoot and gynecological exam that measured the size of her vaginal canal to determine whether she had been born a woman. Although passed through the Congress, President João Figueiredo vetoed the bill. According to Trip magazine, 270 gender-affirming surgeries were performed in Brazil between 1972 and 1997, all of them clandestinely. Even so, there are records of authorized gender-affirming surgeries from this period. On 25 May 1995, for instance, plastic surgeon Antonio Lino de Araújo performed a gender-affirming surgery on 22-year-old Valéria José dos Santos at the regional hospital of Asa Norte in Brasília. The resolution was subsequently updated in 2002, 2010, and 2019. The first trans woman to undergo gender-affirming surgery after the resolution legalizing the procedure was Bianca Magro at the Hospital das Clínicas da Unicamp in Campinas on 8 April 1998.

In 2008, the Sistema Único de Saúde (SUS) approved many gender-affirming surgical procedures, including a neocolpovulvoplasty (for trans women).

In 2018, the Supreme Federal Court ruled that transgender people, transsexual people, and transvestites have the right to change their name and gender on the civil registration without having to undergo gender-affirming surgery.

In 2019, the SUS allowed metoidioplasty (for transgender men).

On 10 February 2021, José Carlos Martins e Claudio Eduardo Pereira de Souza at the Santo Antônio Hospital in Blumenau performed near-simultaneous surgeries on two identical twin sisters, Sofia Albuquerck and Mayla Phoebe. The procedure was considered groundbreaking.