The exercise of LGBTQIA+ parenthood and notes for occupational therapy

Abstract

This reflective article discusses the contributions of occupational therapy to the promotion and protection of the rights of LGBTQIA+ families, considering historical, structural, and cultural barriers that limit access to these rights and the exercise of citizenship. It proposes a critical analysis of heteronormativity and its influence on professional practice, highlighting the need for intersectional theoretical-practical approaches. Heteronormativity, which is embedded in the legal system and institutional frameworks, recognizes as legitimate only families that conform to binary and heteroaffective patterns, historically excluding diverse family configurations and perpetuating inequalities in the exercise of parenthood. In the field of occupational therapy, this topic remains unexplored, which underscores the need to develop theoretical and practical approaches that challenge these hegemonic frameworks. In this regard, concrete strategies are suggested, such as the creation and strengthening of community networks, collaboration with social movements, and the development of inclusive public policies, emphasizing the integration between micro- and macro-social levels to effectively support the everyday dynamics of these families.

Keywords:
Occupational Therapy; Social Justice; Intersectional Framework; Parenting; Family Structure; Sexual and Gender Minorities

Resumo

Este artigo de reflexão discute as contribuições da terapia ocupacional na promoção e garantia dos direitos das famílias LGBTQIA+, considerando barreiras históricas, estruturais e culturais que limitam o acesso a esses direitos e o exercício da cidadania. Propõe-se uma análise crítica da heteronormatividade e de sua influência na prática profissional, destacando a necessidade de abordagens teórico-práticas interseccionais. A heteronormatividade, presente no sistema legal e nos meandros institucionais, reconhece como legítimas apenas as famílias que se ajustam a padrões binários e heteroafetivos, excluindo historicamente diversas configurações familiares e perpetuando desigualdades no exercício das parentalidades. No campo da terapia ocupacional, ainda há exploração limitada dessa temática, o que evidencia a necessidade de desenvolver abordagens teóricas e práticas que desafiem esses marcos hegemônicos. Nesse sentido, sugerem-se estratégias concretas, como a criação e o fortalecimento de redes comunitárias, a articulação com movimentos sociais e a construção de políticas públicas inclusivas, enfatizando a integração entre níveis micro e macrossociais para efetivar o suporte às dinâmicas cotidianas dessas famílias.

Palavras-chave:
Terapia Ocupacional; Justiça Social; Enquadramento Interseccional; Parentalidade; Estrutura Familiar; Pessoas LGBT+

Resumen

Este artículo de reflexión aborda las contribuciones de la terapia ocupacional en la promoción y garantía de los derechos de las familias LGBTQIA+, abordando barreras históricas, estructurales y culturales que limitan el acceso a los derechos y el ejercicio de la ciudadanía. Se propone un análisis crítico de la heteronormatividad y su influencia en la práctica profesional, destacando la necesidad de enfoques teórico-prácticos interseccionales. La heteronormatividad, presente en el sistema legal y en los entramados institucionales, reconoce como “legítimas” a las familias que se ajustan a patrones binarios y heteroafectivos, excluyendo históricamente diversas configuraciones familiares y perpetuando desigualdades en el ejercicio de las parentalidades. En el campo de la terapia ocupacional, aún existe una exploración limitada sobre esta temática, lo que resalta la necesidad de desarrollar enfoques teóricos y prácticos que desafíen estos marcos hegemónicos. A partir de ello, se sugieren estrategias concretas, como la creación y fortalecimiento de redes comunitarias, la articulación con movimientos sociales y la construcción de políticas públicas inclusivas, enfatizando la integración entre niveles micro y macrosociales para efectivizar el soporte a las dinámicas cotidianas de estas familias.

Palabras clave:
Terapia Ocupacional; Justicia Social; Marco Interseccional; Responsabilidad Parental; Estructura Familiar; Minorías Sexuales y de Género

Introduction

The discussion on the exercise of parenthood and gender and sexual dissidences is relevant for reflections and practices in occupational therapy, as it directly impacts the everyday lives of many families. However, Latin American academic production on the parenthood of lesbians, gays, bisexuals, transgender and travesti ¹ persons, queers, intersex persons, asexuals, pansexuals, non-binary persons, and other identity categories (LGBTQIA+)² remains limited (Morrison et al., 2024).

In this context, this study reflects on the contributions of occupational therapy to promoting the rights of LGBTQIA+ families, considering the challenges imposed by normative and cultural barriers. The reflection is organized around the historical and cultural construction of families, the exercise of LGBTQIA+ parenthood, the process of ensuring social rights, and the academic production addressing parenthood in the field of occupational therapy and the possibilities for professional action.

Family: a Historical and Cultural Construction

The family, often conceived as a “natural and universal” institution, is in fact a historical and cultural construction whose forms and meanings change over time (Zambrano, 2006). Historically, the definition of family has been shaped by sociocultural, political, and economic factors, such as the consolidation of the nuclear family in modernity, especially in Western societies, linked to heterosexual normativity and to the interests of the State in regulating private life (Foucault, 1977; Donzelot, 1986).

The configurations and dynamics of family functioning, especially in colonized countries, result from the coexistence of different ethnic groups, the centuries-long introduction and maintenance of slavery, migratory and refugee flows, and intense internal mobility within territories. These factors, among others, contributed to the formation of complex and hierarchical societies, organized according to legal, ethnic, and socioeconomic criteria.

In this context, Federici (2017) points out that the consolidation of the nuclear family is intrinsically linked to the transition to capitalism, since this model ensured control over social reproduction and the perpetuation of the labor force. In the colonial context, the regulation of the family not only disciplined corporalities and subjectivities but also reinforced the social hierarchies imposed by colonization, becoming a fundamental instrument for maintaining the economic and political order.

The Catholic Church, in alliance with the State, was central in consolidating the family as a pillar of social and economic organization in the colonial system, standardizing monogamous marriage as the ideal model, regulating kinship relations, and ensuring the transmission of property within a patriarchal structure (Federici, 2017). However, even with the imposition of a normative model, families have historically been configured in different ways, highlighting a mismatch between institutional norms and lived reality (Scott, 2022).

Although there is a tendency to associate the plurality of family arrangements with contemporary families, consensual unions, the generation of children outside of marriage, the recurrence of single-parent families, as well as homoaffective relationships, were already part of the everyday lives of part of the Latin American population since the colonial period. Thus, family and household organization have always been plural, and relations of affection, solidarity, and coexistence have also been significant in the lived experience of family life (Scott, 2022).

Exercise of LGBTQIA+ Parenthood and the Guarantee of Social Rights

The different forms of relationships or successive marriages—new unions established after the end of a relationship (consensual or through divorce)—create the need to understand family life in other ways. The emergence of new expressions, which previously did not exist or were not yet recorded by the majority, contributes to identifying and describing the relationships built among individuals who share affective experiences (Scott, 2017). In this proposal for analysis and reflection, we use the concept of the exercise of parenthood, understood as the act of “parenting or mothering,” that is, fulfilling the role of parents and other identities that assume parenthood in the process of raising children (Morrison et al., 2024). This choice is supported by studies that highlight the need to deconstruct traditional models of parenthood, expanding the concept to include non-heteronormative practices (Hicks, 2011).

The family arrangements of persons with gender and sexual dissidences may question traditional norms associated with parenthood, shaped by heteronormativity and the binary distinction between the sexes (Warner, 1991).

Thus, we begin from the understanding that the exercise of LGBTQIA+ parenthood may take different forms: through a family group with children from a previous relationship, adoption, the use of reproductive technologies, or coparenting (Zambrano, 2006).

The relationship between the exercise of parenthood and social rights is especially relevant in contexts where institutional norms do not recognize certain family configurations. In the case of LGBTQIA+ families, the guarantee of rights involves not only the formal recognition of parental bonds but also access to reproductive technologies, adoption, and legal protection of affective ties. However, these families still face cultural, normative, and legal barriers that hinder the full recognition of their rights (Alday-Mondaca et al., 2022; Morrison et al., 2023).

In the neoliberal context, rights are often turned into individual goods, conditioned on conformity to pre-established norms. As Brown (2019) points out, neoliberal logic tends to reduce social and political issues to market dynamics, in which the recognition of social and family identities depends on the ability to adapt to a system that aims to normalize and regulate forms of existence.

In this way, by claiming the right to parenthood, LGBTQIA+ families face not only legal obstacles but also the demands of a society that seeks to homogenize ways of living and being. This transforms the idea of citizenship into mere access to individual goods, subordinating these families to the dominant normative standard.

Nevertheless, the guarantee of rights goes beyond legal and morally normative recognition of the family. It involves creating support networks and inclusive public policies that ensure legal equality and the right to dignity and freedom in family configuration. An important question that arises is: how can we advance in building an institutional system that recognizes the diverse forms of parenthood without imposing a heteronormative and patriarchal model?

For example, the legalization of same-sex marriage in several countries does not mean that LGBTQIA+ families have, in fact, been integrated into the institutional system. Although legislative progress has been made in several Latin American countries, such as the approval of marriage equality laws, these families still face difficulties in the processes of establishing filiation, which highlights structural and legal barriers in the formalization of kinship bonds recognized by the State (Alday Mondaca et al., 2022; Morrison et al., 2023).

In the past 15 years, several Latin American countries have expanded the legal recognition of LGBTQIA+ parenthood, authorizing joint adoption and access to assisted reproduction techniques. Uruguay inaugurated this agenda with the approval of joint adoption in Law 18.590 (República Oriental del Uruguay, 2009) and marriage equality in Law 19.075 (República Oriental del Uruguay, 2013). In 2010, Argentina approved Law 26 618/2010, which equated all marital and parental rights of same-sex couples (Argentina, 2010).

In Brazil, the Federal Supreme Court recognized stable homoaffective unions as family entities in Direct Action of Unconstitutionality 4.277 and Allegation of Breach of Fundamental Precept 132 (Brasil, 2009, 2008); later, the National Council of Justice determined, through Resolution No. 175/2013, that all registries celebrate marriages between persons of the same sex (Brasil, 2013). The Constitutional Court of Colombia extended adoption to same-sex couples in Ruling C-683/15 (Corte Constitucional de Colômbia, 2015). Chile enacted Law 21 400/2021 legalizing marriage equality and, in theory, adoption without distinction of sexual orientation (Chile, 2021).

But the existence of these provisions does not guarantee practices that break with heteronormativity. Qualitative research with lesbian mothers in Chile reveals persistent administrative barriers, such as forms that still assume the roles of “mother” and “father” and the resistance of registries to record dual motherhood (Alday-Mondaca & Lay-Lisboa, 2021a; Alday-Mondaca et al., 2022; Lagos-Cerón et al., 2025). Similar data were identified by gay fathers, reinforcing inequalities in access to civil registries, reproductive health, and social recognition.

By contrast, countries with restrictive frameworks maintain significant obstacles. Honduras explicitly prohibits joint adoption by same-sex couples in the Special Adoption Law/2018 (Congreso Nacional de la República de Honduras, 2019) and does not recognize marriage equality. In Guatemala, Decree 18-2022 sought to prohibit both marriage and adoption by same-sex couples (Congreso de la República de Guatemala, 2022). Although Mexico has overcome legislative barriers, administrative differences between states still affect deadlines, costs, and bureaucracy for LGBTQIA+ couples (México, 2010).

Finally, Latin American reviews indicate that even where advanced laws exist, a gap persists between formally guaranteed rights and everyday experience (Galaz et al., 2018; Morrison et al., 2024). Transforming legal equality into lived equality requires continuous efforts in education and professional training, as well as strengthening effective mechanisms of monitoring and accountability that ensure the realization of the principles of social justice and the full enforcement of social rights for these populations.

Between Legal Guarantees and Structural Exclusions: the Paradox of Legal Recognition

In Brazil, the hyper-judicialization of citizenship (Quinalha, 2024) emerges as a phenomenon that challenges the autonomy of LGBTQIA+ families by conditioning the recognition of their rights on judicial decisions and volatile public policies, subject to changes in the orientation of the judiciary or executive. This generates an unstable and precarious legal system in which advances do not always result in structural changes or permanent guarantees (Quinalha, 2024). The role of law as a central instrument in the organization of human coexistence, often presented as “modern,” “technical,” and “impartial” in relation to social and moral norms, reveals its ambiguities and limitations (Butler, 2004). The legal system, while promoting the enunciation of public freedom, also acts as a vigilant mechanism of normalization of ways of life. This duality raises questions about the emancipatory potential of law: are we, in fact, building effective equality or merely perpetuating a heteronormative matrix that informs legal and social structures? The categorization of individuals as “subjects of law,” even when seeking to include different forms of existence, often reduces the complexity of social relations, imposing fixed and delimited identities while hierarchizing ways of life, separating what is considered “licit” from “illicit,” the “normal” from the “abnormal” (Pimentel & Pimenta 2024; Quinalha, 2024; Ramos & Iotti, 2024; van Pelt, 2024).

Even while recognizing historically claimed guarantees, the legal system may reproduce conservative values, reinforcing assimilation to hegemonic models of family and conjugality. This is manifested, for example, in the excluding inclusion that protects same-sex couples if they align with traditional configurations of the heterosexual nuclear family. The lack of legal recognition for polyamorous unions in many countries illustrates this limitation, reiterating the notion of family as a restricted nucleus of two persons, while other arrangements remain marginalized. Thus, the law often contributes to the naturalization of differences, perpetuating power structures that sustain hierarchies of gender and sexuality (Barrientos, 2016; Galaz et al., 2018).

In this sense, the very constitution of kinship and filiation relations in LGBTQIA+ families could be understood as an alternative within heteronormative patterns (conceived as forms of performativity of resistance, for instance) in relation to some State policies. At the same time, it could be the opposite: a search for integration into power relations of double conditioning (Foucault, 2008), that is, relations that obey a global strategy, such as the preservation of the neoliberal economic system or of a homonormative system through the institutionalization of marriage (as a local focus of experience), for example.

How Does the State Promote or Limit this Process?

In this context, a possible example of the tactical polyvalence of power discourses (Foucault, 2008) is that, while on the one hand it is possible to perform new forms of kinship agreements or constitute diverse families that are, to some degree, “transgressive” of the patriarchal system; on the other hand, these families may, precisely, fall into the same dynamic of the patriarchal game, that is, a subjectivation expressed in a family model that reproduces heteronormative roles and practices in response to the “dispositifs” of sexuality.

Therefore, the dependence on judicial decisions rather than legislative changes reveals a structural limitation of the legal system in promoting effective equality of rights. The extension of legal guarantees without a transformation of the normative matrices that guide the recognition of LGBTQIA+ families shows that law, although essential, is not sufficient to deconstruct the hierarchies that sustain social exclusion. This scenario requires the construction of integrated and permanent public policies that engage with the plurality of family configurations and ways of life, challenging the heteronormative foundations that still orient legal and social structures.

Despite all legal and moral barriers, and numerous difficulties, such obstacles have not prevented LGBTQIA+ families from exercising parenthood. On the contrary, these families develop creative and resistant strategies, reaffirming their affective and parental bonds (Alday-Mondaca et al., 2022; Laguna Maqueda, 2018; Morrison et al., 2022; Tombolato et al., 2018). In this context, the exercise of parenthood goes beyond daily childcare, configuring itself as a constant struggle for social and legal recognition. However, as Butler (2006) argues, it is crucial to reflect on the risk that the search for State recognition may end up reinforcing exclusionary normative structures, limiting the possibility of more plural and emancipatory forms of existence.

Historically, LGBTQIA+ persons have challenged the centrality of blood ties and the heterosexual norm through the creation of “chosen families,”—an inventive alternative of bonds and solidarity that transcends the limits imposed by traditional structures. In the exercise of parenthood, these networks prove fundamental not only as spaces of support and care but also as bases for ways of life that challenge normative impositions on gender and sexuality. In this sense, the claim to the right to filiation and the constitution of affective bonds constitutes a political act of resistance, subverting traditional models and reaffirming other possible ways of existing and relating (Bento, 2012).

Dissident Parenthoods and Occupational Therapy

The articulation between dissident parenthoods and occupational therapy is based on the recognition that the exercise of parenthood, in its multiple forms, is relational and social, traversed by historical, cultural, and political processes. These processes not only shape the ways of living and experiencing parenthood but also directly affect the everyday lives of these families.

When we speak of families that construct their existence by challenging heteronormative frameworks, we encounter realities permeated by numerous social injustices, manifested in barriers to access to fundamental rights, with impacts on ways of life and social participation. These processes impose the need for the continuous construction of strategies of resistance and survival.

In this context, occupational therapy can offer support to the everyday dynamics of LGBTQIA+ families, understood as an articulated set of strategies and interventions that support the daily and relational processes of these families. Such dynamics may encompass multiple activities, practices, and interactions that structure family life, including personal and family care, work, leisure, socialization, as well as confronting violence, discrimination, and bureaucratic processes linked to legal and social recognition. Thus, support involves concrete actions of welcoming, active listening, facilitation of access to social and legal resources, strengthening community networks, and mediation with institutions. An approach centered on the experiences and specific needs of parents and other identities that exercise parenthood, valuing their differences and combating inequalities, is essential to ensure that these families have their rights guaranteed and their experiences fully recognized and validated (McGrath et al., 2025).

This leads us to fundamental questions: how can occupational therapists support LGBTQIA+ families in their specificities, considering, for example, challenges related to access to social rights, confronting prejudice and violence in school and community institutions, legal difficulties in the recognition of parenthood, as well as cultural and social barriers that limit the social participation of these families in different contexts? Who are the families or subjects considered “desirable” for political action and the exercise of social rights, in particular the exercise of parenthood? What attributes must they possess, or perform, to be recognized as such? What processes of subalternization are present in the relations between identity categories and the State, and how do these processes impact the recognition and guarantee of rights of these families?

These questions invite us to reflect on how the social markers of difference, such as gender, sexuality, race, nationality, disability, and others, intersect in the construction of ways of living and existing for different social groups. These categories do not operate in isolation but are articulated, generating experiences of agency or oppression (Melo et al., 2020). For occupational therapists, it is fundamental to understand, from an intersectional perspective, how these families create strategies to cope with their concrete conditions of existence, often marked by inequalities and oppressions.

Occupational therapy has an ethical and political commitment to the promotion of social justice (Lopes, 2021; Farias & Lopes, 2022). In this regard, Fraser (2006) argues that social justice requires confronting socioeconomic and cultural injustice through policies of economic redistribution, recognition, and representation (Fraser, 2002). These foundations are essential to combat the multiple dimensions of injustice that traverse the experiences of subalternized subjects and groups.

In this context, we advocate for an occupational therapy aligned with the assumptions of social justice, committed to developing actions that consider the multidimensionality of oppression, seeking to create conditions for LGBTQIA+ families to be protagonists in the struggle for their rights (Farias & Lopes, 2022; Farias & Lopes, 2023; Monzeli, 2022).

And What Have We Produced on Parenthood in Occupational Therapy?

Based on recent international occupational therapy literature, this essay takes as its starting point studies that discuss the practices of the profession in supporting dissident parenthoods. Although there have been relevant conceptual advances, such as the development of the Parenting Occupations and Purposes Framework (Lim et al., 2022), and qualitative studies that explore the experiences of mothers with physical disabilities regarding the support (or lack thereof) received from occupational therapy (Honey et al., 2025), production that directly relates LGBTQIA+ parenthood to professional practice is still scarce (Morrison et al., 2024). This scenario highlights a significant gap in the literature and reinforces the need to expand critical and intersectional approaches within occupational therapy. From this standpoint, this essay proposes a situated critical reflection, without the intention of exhausting the existing literature, but of contributing to its expansion and deepening.

In the Brazilian context, studies grounded in social occupational therapy have presented and promoted important reflections on strategies aimed at strengthening social support networks, through social technologies, to confront social injustices and oppressions related to gender (Monzeli et al., 2015; Melo, 2016; Braga et al., 2020; Monzeli et al., 2023). Social technologies are products, techniques, or methodologies developed in direct interaction with people and/or communities that represent concrete alternatives for social transformation, combining macro- and micro-social actions (Lopes et al., 2014). In this sense, specific practices of social occupational therapy, such as activity workshops, dynamics and projects, individualized and territorial follow-ups, and actions for the articulation and strengthening of social and institutional networks can fit into this perspective. However, it is essential to stress that the use of the concept of social technology requires continuous critical reflection on the technical, ethical, and political specificities that characterize these actions in the field of occupational therapy, to avoid generalizations (Lopes et al., 2014).

A scoping review conducted by Leite Júnior & Lopes (2022) highlighted the relevance of Brazilian academic production focused on the LGBTQIA+ population in the field of occupational therapy, addressing topics such as professional education, mental health, leisure, resistance, aging, sex work, educational contexts, and care demands for social occupational therapy. Furthermore, Leite Júnior & Lopes (2017) identified a gap in academic education regarding the discussion of transsexualities and travestilidades, pointing to the urgency of inclusive curricula.

Leite Júnior & Lopes (2025) mapped occupational therapists’ practices directed to the LGBTQIA+ population in Brazil, and revealed various initiatives, such as services, academic activities, and family support, but also identified a gap in theoretical-practical articulation, especially in dialogue with gender, sexuality, and occupational therapy studies.

Studies on occupation have played an important role in the development of occupational therapy, especially in the Anglo-Saxon context. These studies explore the interactions between subjects and the activities they perform, situating occupations as gender-reproductive, mediating human experiences and social participation (Cerón & Morrison, 2024). In this regard, a recent study concludes that occupation is one of the ways in which gender is constructed and, at the same time, continuously reproduced and reiterated in everyday life (Cerón & Morrison, 2024).

Leite Júnior & Lopes (2025) indicate that occupational therapists in Brazil have engaged with gender and sexual dissident populations based on specific demands identified in everyday professional practice, mostly related to mental health, social exclusion, and discrimination. However, practices specifically planned or exclusive for these identities are still lacking, and general approaches already established in the profession are more common.

Morrison et al. (2023) reviewed 24 studies on the LGBTQIA+ population in occupational science and identified a limited approach, centered on changes in social roles and gender performativity, without an intersectional perspective that allows for an understanding of structures of discrimination and exclusion.

In addition, Morrison et al. (2024), in a narrative and interpretive review on parenthood and occupation, emphasize that LGBTQIA+ families develop strategies to confront social and institutional structures based on regimes of truth that sustain the binary and heteronormative model of parenthood. This panorama is observed in several Latin American countries, in a context traversed by structural inequalities and marked by normative discourses that reinforce gender and sexuality hierarchies. In these contexts, stigmas that fall upon the exercise of LGBTQIA+ parenthood reveal the dynamics of disciplinary powers that regulate corporalities and affections. These discourses produce a supposed superiority of heterosexual persons in the exercise of parenthood, reiterating cultural stereotypes based on a binary model (Risk & Santos, 2021). These dispositifs marginalize and delegitimize the parental experiences and competencies of persons with gender and sexual dissidences (Alday-Mondaca & Lay-Lisboa, 2021b).

This logic of exclusion, grounded in the naturalization of heterosexuality as a regulatory ideal, raises critical reflections on the need to destabilize the discourses that institute such inequalities, expanding the possibilities of recognition and legitimacy for different forms of exercising parenthood.

Morrison et al. (2023) highlight the scarcity of research that directly addresses the specific experiences and needs of intersex, pansexual, asexual, and other identities often rendered invisible within the LGBTQIA+ acronym. This gap in the literature reinforces the urgent need for new research capable of guiding more inclusive, critical, and attentive occupational therapy practices for the realities of these populations.

On the other hand, the scoping review conducted by Lim et al. (2022) on occupational therapy and parenthood revealed a predominance of studies focused on motherhood and maternal figures, naturalizing binary gender roles and marginalizing other family compositions. The scarcity of research on LGBTQIA+ families may indicate both a lack of demand in occupational therapy services and a process of systematic invisibilization of these families. Furthermore, the absence of studies on the relationships of LGBTQIA+ families with the State and their access to rights represents a critical gap, preventing a broader understanding of the needs and challenges that these families face.

Thus, given the existing gap in knowledge production, and with the aim of advancing reflections on how occupational therapy can contribute to the promotion of the rights of LGBTQIA+ families, we propose some notes for occupational therapy practice.

First, it is necessary to reaffirm the commitment of occupational therapy to position itself against power dynamics that perpetuate processes of subordination and individualistic practices, assuming an active commitment to the emancipation of individuals and collectives (Laliberte Rudman, 2018, 2021). In this way, the profession can contribute to promoting the rights of LGBTQIA+ families, strengthening their autonomy, expanding their social participation, and combating the inequalities and social injustices that compromise their citizenship.

Occupational therapy practices directed to dissident parenthoods must be grounded in an intersectional approach. This implies recognizing that the experiences of these families are traversed by multiple social markers, such as race, gender, sexuality, class, and disability. These markers do not operate in isolation; rather, they intertwine and may generate specific oppressions and challenges. From this perspective, occupational therapy can contribute to the deconstruction of normative discourses and practices that perpetuate the invisibility and exclusion of these families, while also working to strengthen public policies (Crenshaw et al., 2021).

From the micro to the macro level, occupational therapy can both support the everyday life of families and contribute to the formulation of public policies that guarantee their recognition and protection. To this end, occupational therapists can, in a critical and reflective manner, develop practices that expand social participation and question mechanisms of disciplining bodies and ways of life (Leite Júnior & Lopes, 2025). Strengthening support networks and articulating with LGBTQIA+ social movements and organizations are fundamental strategies to ensure that the needs of these families are recognized and incorporated into public policies.

Destabilizing norms that privilege heteronormative forms of parenthood is an urgent and necessary task. To this end, it is essential to observe, question, and promote transformations in the structures that define who can or cannot legitimately exercise parenthood. This reflection should permeate both occupational therapy practices and academic education, preparing professionals to act in the face of dissident realities.

Final Considerations

The reflections produced here sought to shift the debate on the exercise of LGBTQIA+ parenthood from a strictly legal register to an analysis that combines normative frameworks, cultural logics, and material conditions of existence. The path taken demonstrates that, despite the advancement of laws recognizing conjugal and parental equality, heteronormative practices continue to mediate access to rights and impact the everyday lives of these families. Access to parenthood rights remains anchored in binary forms, exclusionary biomedical protocols, and public services that are not attentive to multiple configurations of care.

In this scenario, occupational therapy cannot be limited to decontextualized clinical interventions; it must instead adopt an anti-oppressive stance (Farias & Lopes, 2022) that confronts the hierarchies of gender, sexuality, race, ethnicity, and social class that permeate the everyday lives of these persons. This implies challenging curricula, investing in research, and occupying decision-making spaces to transform technical knowledge into political action. Only in this way can the gaps between proclaimed rights and lived rights be reduced, converting the profession’s repertoire into an instrument of material redistribution, recognition, and political representation (Fraser, 2002).

On the other hand, recognizing the limitations of this study, which did not systematically analyze the literature on the exercise of parenthood and occupational therapy, becomes an invitation to expand research networks situated in Latin American territories, marked by persistent colonial inequalities.

Ultimately, questioning who can be recognized as family and who deserves State protection is to confront the very ontology of occupational therapy, with the profession being responsible for disputing which worlds will be possible. This implies articulating interventions that simultaneously consider the everyday contexts of each subject and the macro-social structures that shape these experiences. Only in this way will occupational therapy be able to fulfill its commitment to social justice, fostering the transformation of the living conditions of the LGBTQIA+ population.

• 1
  Travesti: a Latin American gender identity, distinct from transgender or transvestite, with specific historical, political, and cultural meanings.
• 2
  The LGBTQIA+ nomenclature was adopted based on current literature and contemporary social movements, which emphasize the need to make visible and recognize the plurality of forms of existence and recognition. This nomenclature has been used among activists, academic institutions, and public and private organizations, both in Brazil and internationally (Morrison et al., 2024; Silva & Malfitano, 2023).
• How to cite:
  Braga, I. F., Morrison, R., & Monzeli, G. A. (2025). The exercise of LGBTQIA+ parenthood and notes for occupational therapy. Cadernos Brasileiros de Terapia Ocupacional, 33, e4074. https://doi.org/10.1590/2526-8910.cto414640742
• Data Availability
  The data that support the findings of this study are available from the corresponding author, upon reasonable request.
• Funding Source
  National Council for Scientific and Technological Development (CNPq), Finance code – 200045/2024-5.

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Edited by

• Section editor
  Profa. Dra. Késia Maximiano de Melo

Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Publication Dates

• Publication in this collection
  17 Nov 2025
• Date of issue
  2025

History

• Received
  11 Mar 2025
• Reviewed
  03 Apr 2025
• Accepted
  01 July 2025