ADPF 787

ADPF 787 was a case of the Supreme Court of Brazil concerning ease of access of transgender people to public healthcare in Brazil, provided by the Sistema Único de Saúde (SUS). The case's rapporteur, minister Gilmar Mendes, cast the initial vote asserting the right of any person, regardless of gender, to access healthcare they require, and the Court unanimously agreed.

Specifically, the case concerned ease of access of transgender people to traditionally gendered care, such as gynecology and urology. Computer systems in place would sometimes prevent requests for appointments by people with the "incorrect" gender, which disproportionally affected transgender people. The Court unanimously ruled that such systems must be altered and improved to prevent further exclusions.

Background
The case was requested by the Workers' Party in objection to obstacles encountered by transgender people, during the presidency of Jair Bolsonaro, while attempting to access the country's public healthcare system.

"According to the Workers' Party, transgender people who alter their name in civil records to reflect their gender identities haven't had access to health services corresponding to their biological sex. That is, transsexual men and transmasculine people with their names already rectified, but that maintain the feminine reproductive apparatus, do not have access to appointments and treatment with gynecologists and obstetricians, while transsexual women and transvestites also have been denied access to medical specialties such as urology and proctology."

Minister Gilmar Mendes, as the case's rapporteur, cast the initial vote asserting the right of any person, regardless of gender, to access healthcare they require. Additionally, Mendes required the Ministry of Health implement a series of changes. Among them:


 * The adaptation of SUS to allow for exams and appointments of all specialties, regardless of the patient's gender, avoiding bureaucratic procedures that may cause embarrassment or difficulty of access to transsexual persons;
 * That changes are not restricted to appointments of SUS, but apply to all information systems in the public health network;
 * That the Ministry of Health inform state and municipal governments of changes made to SUS' systems, and that it also aid in the local systems' transition.

In May 2024, in response to the case, the Ministry of Health officially removed gender requirements from 271 medical procedures, including vasectomies and childbirth.

Ministers Alexandre de Moraes, Ricardo Lewandowski and Rosa Weber all concurred, but voting was halted as Nunes Marques requested a review of the case. Lewandowski and Weber have both since retired and been replaced by Cristiano Zanin and Flávio Dino, respectively; new ministers are usually not expected to recast their seats' vote.

Voting resumed with ministers Edson Fachin and Dias Toffoli's concurring votes, forming a majority. On 28 June 2024, ministers Roberto Barroso, Luiz Fux, Cármen Lúcia, Nunes Marques and André Mendonça all voted with the rapporteur, bringing the Court to an unanimous concurrence.

Minister Marques concurred in part, arguing there had been no omission by the State, but that the proposed changes are necessary. Ministers Fachin, Lúcia and Barroso concurred and additionally proposed that the Live Birth Declaration (Declaração de Nascido Vivo, DNV) should include the parents' gender identification.