Federal prosecutors from the state of Rio Grande do Sul had argued that sex reassignment surgery is covered under a constitutional clause guaranteeing medical care as a basic right.
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Brazil's public health system provides free sex reassignment surgery. One program in Rio de Janeiro focuses on the reintegration of transvestites into society through training and employment opportunities. There are, however, associations of transgender people in several Brazilian states and cities.
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Despite being included in Brazil's acronym in the struggle for LGBT rights, transgender people receive little outreach from the more mainstream gay and lesbian groups. In the central, north and northeastern regions of Brazil, transgender people from extremely poor families sometimes begin working as prostitutes as early as 12 years of age, especially if they have been expelled from home by their families. In some cases, even those who work as hairdressers, gay nightclub artists and domestic servants also double as sex workers.
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With few exceptions, the only professions open to them are nursing, domestic service, hairdressing, gay entertainment, and prostitution.
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