RJ Court considers denial based on civil gender “abusive”; decision follows the understanding of the STF
The unanimously determined that Unimed Nacional authorize PSA (Prostate-Specific Antigen) tests for a trans woman. Released this Friday (March 27, 2026), the decision reverses a 1st Instance understanding and obliges the health plan to cover the procedure immediately, under penalty of a fine. The information is from the newspaper The Globe.
The operator denied the examination prescribed by a doctor, arguing that the procedure would be “incompatible” with the female gender registered in the patient’s record. The judges considered the refusal abusive, highlighting that access to health cannot be limited by civil registration.
Unimed can still appeal the decision, but the obligation to authorize the exams is immediate.
BIOLOGICAL CONDITION AND IDENTITY
The legal understanding was based on the fact that trans women can keep biological organs that require preventive clinical monitoring throughout their lives. The decision reinforces that real medical need must prevail over administrative criteria or bureaucratic gender classifications.
The sentence cites the understanding of the Federal Supreme Court, which already obliges both the public and private systems to guarantee assistance to trans people or restrictions based on gender identity.
IMPACT ON THE HEALTHCARE SECTOR
The case is a decisive step towards consolidating jurisprudence in Brazil. The decision signals to healthcare operators:
- medical prevalence: the clinical indication of the health professional overlaps with the gender registered in the system;
- individual right: denials based on “gender incompatibility” can be interpreted as neglect or discrimination;
- universality: care must be comprehensive, sensitive to the biological specificities of the trans population.
