Weaving autonomy and challenging norms: the contribution of singular and territorial accompaniments with gender and sexuality dissidents

Abstract

This study presents the experiences of an extension project that operates in conjunction with the referral unit and specialized care for the LGBTQIAPNb+ population in Paraíba. This population experiences daily struggle and resistance in the construction of their identities, challenging gender and sexuality norms to ensure their survival. The objective of this work was to report an experience of university extension in a capital city in the Northeast, using one of the technologies of social occupational therapy, singular and territorial monitoring. This social technology was used to understand the reality of the gender and sexuality dissident population, in the search for joint solutions and strategies to face different forms of violence, promote access to social rights for this population and the construction of autonomy in their life projects. The choice of this technology considers the constitution of the social field as a possibility of action for occupational therapists, highlighting the relevance of social markers of difference as classification categories that organize social life. The monitoring took place over a year with two people. It was possible to explore ways to decentralize normative conceptions in relation to subjects and everyday life, developing joint strategies that contribute to the construction of autonomy, corroborating social participation and the exercise of citizenship.

Keywords:
Occupational Therapy; Gender-Inclusive Policies; Sexuality

Resumo

Este estudo apresenta as experiências de um projeto de extensão que atua integrado à unidade de referência e atendimento especializado à população LGBTQIAPNb+ da Paraíba. Essa população vivencia cotidianamente a luta e resistência na construção de suas identidades, desafiando normas de gênero e de sexualidade para garantir sua sobrevivência. O objetivo deste trabalho foi relatar uma experiência de extensão universitária em uma capital do Nordeste, utilizando uma das tecnologias da terapia ocupacional social, os acompanhamentos singulares e territoriais. Essa tecnologia social foi utilizada visando compreender a realidade da população dissidente de gêneros e sexualidades, na busca por soluções e estratégias conjuntas para enfrentar diferentes formas de violência, promover o acesso aos direitos sociais dessa população e a construção da autonomia em seus projetos de vida. A escolha dessa tecnologia considera a constituição do campo social como uma possibilidade de ação para terapeutas ocupacionais, ressaltando a relevância dos marcadores sociais da diferença como categorias de classificação que organizam a vida social. Os acompanhamentos aconteceram durante um ano com duas pessoas. Foi possível explorar maneiras de descentralizar as concepções normativas em relação aos sujeitos e à vida cotidiana, elaborando estratégias conjuntas que contribuam com a construção da autonomia, corroborando para participação social e o exercício da cidadania.

Palavras-chave:
Terapia Ocupacional; Políticas Inclusivas de Gênero; Sexualidade

Introduction

In the 1970s, a process of political unrest and effervescence began regarding the social inequalities that permeate Brazil. In a scenario of violence and oppression, there was also an effervescence in the struggle of social movements for the end of the military dictatorship and for the redemocratization of Brazil, a scenario that enabled occupational therapists to decentralize their practices and begin to develop action strategies that considered the socially located subject.

The reformulation of the professional practice of occupational therapists in the social field only became possible through contact with the people with whom these professionals develop their actions and through an understanding of the social issue¹ .

In 1998, occupational therapists created the Metuia Project, dedicating themselves to discussions on social occupational therapy. The project developed and, in 2019, the Metuia Network - Social Occupational Therapy was founded, composed of professors, students and professionals in various centers of higher education institutions. According to Galheigo (2023), the field was established based on critical reflection on the social place of occupational therapists, in which the aim was to develop action methodologies aimed at autonomy, citizenship and access to the rights of individuals and collectives. Based on this new professional proposition, resources and technologies were developed for understanding and acting in social reality.

Social technologies include “workshops for activities, dynamics and projects”, which use activities as a mediating resource in the work of approaching, monitoring and understanding the demands of individuals and groups. “Singular and territorial monitoring” enables direct perception and interaction with people’s daily lives and context, connecting their stories and trajectories, and considering their life projects; “Articulation of resources in the social field” mobilizes different levels of attention around common objectives, aiming at the use of possible resources, including financial, material, relational and emotional devices, both on a micro and macro social scale. Finally, “Dynamization of the care network”, which seeks to promote interaction and integration between programs, projects and services from different sectors and levels of activity, facilitates the effectiveness and orientation of strategies from an interprofessional and intersectoral perspective (Lopes et al., 2014).

Since the 2010s, occupational therapists have been working with the LGBTQIAPNb+ community² , understanding that “[…] these subjects and groups have, historically, in Brazil, restricted access to basic social rights, as well as non-recognition of their experiences in various spheres of social life” (Monzeli et al., 2023, p. 4).

Therefore, the production of reflections and actions of social occupational therapy with the gender and sexuality dissident population occurs based on the understanding that, because they produce their bodies and identities beyond cis-heteronormativity, this group is the target of various forms of violence, oppression, and neglect of social rights (Monzeli, 2022; Braga et al., 2020).

Thus, based on its objectives and using social technologies of social occupational therapy, the extension project ResisTO: genders, sexualities, and Social Occupational Therapy was founded in 2017. Comprising the Metuia Nucleus of Universidade Federal da Paraíba, ResisTO is dedicated to teaching, research, and extension actions, considering the social markers of difference as classification categories that organize social life, enabling the understanding of systems of inequality, in articulation with municipal and state public policies aimed at the gender and sexuality dissident population (Melo et al., 2020; Monzeli et al., 2023).

This experience report arises from the actions proposed by the project in partnership, since 2022, with the State Reference Center³ of the LGBTQIAPNb+ community and Confrontation of LGBTQIAPNb+phobia in Paraíba - Pedro Alves de Souza (Espaço LGBT+ Pedrinho) which aims to defend the rights of the LGBTQIAPNb+ population.

The actions presented here are based on the concept of autonomy, understood, according to Safatle (2019), as interrelated with the notions of freedom, emancipation, and democracy. For the author, autonomy, traditionally linked to a liberal notion of freedom, must be understood in a relational and collective manner, considering the interdependencies and social relations that shape subjectivity. Autonomy consists of a process of freedom that requires the individual to be aware of their own sense of belonging, that is, of how their actions and thoughts are shaped by the context in which they are embedded (Cavicchioni & Pan, 2024).

The actions developed in this facility, based on this understanding of autonomy, sought both the recognition and appreciation of dissident identities and an understanding of the social dynamics that affect the ways of life of the people being supported (Melo et al., 2020). Only by integrating these micro and macro-social dimensions was it possible to carry out actions capable of recognizing individuals’ singularities, while simultaneously confronting the structural barriers that limit their freedom and impact their autonomy.

Construction of identities and performativities: the experience of individual and territorial support

In the practices involving gender and sexuality dissident populations at this facility, we highlight the use of individual and territorial support. This approach allowed us to engage directly with some of the individuals with whom we developed our practices. These individuals sought out the service to access social rights and receive assistance in facing situations of violence in their daily lives. Initially, they participated in a process of identifying their priority needs, which guided the proposal of various care strategies. These strategies often involve a multidisciplinary team at the facility, including professionals such as lawyers, psychologists, social workers, social educators, receptionists, and an institutional coordinator.

Following the initial intake process by the professional team, among those referred for follow-up with occupational therapists, needs were identified that were related to the impacts of violence experienced in their daily lives, as well as difficulties in accessing social rights. Given the complexity of these demands, it was understood that an appropriate practical strategy could be the use of individual and territorial support (Lopes et al., 2014) within the facility.

It is important to highlight that, since its conceptualization as a social technology and in most of the documented experiences, individual and territorial support has been adopted as a strategy derived from demands identified in activity workshops, group dynamics, and projects. In this specific case, its use occurred in a different manner from what is described in the literature on social occupational therapy, being applied autonomously as a tool capable of both bringing practitioners closer to the population and identifying needs and collaboratively developing possible solutions (Lopes et al., 2014).

However, implementing strategies outside the institutional space proved to be complex. Territorial mobility for gender and sexuality dissident populations is often hindered or outright obstructed by the lack of safe spaces for access, transit, and belonging. While similar challenges are experienced by other populations facing various forms of social injustice, such as youth in territories controlled by drug trafficking factions, the historical specificities of exclusion and violence endured by this population make these restrictions particularly unique, contributing to a continuous struggle against violence.

Being located within a facility focused on guaranteeing rights for the LGBTQIAPNb+ population, it was possible to articulate both individual and collective aspects of the lived experiences of those being supported. Recognizing that territory informs narratives, this study proposes a new configuration of space, one that transcends geographical dimensions and is constructed through the stories and desires for belonging by occupying spaces that have previously subjected them to violence.

By proposing actions based on individual and territorial support for gender and sexuality dissident populations, there is a movement similar to that observed in the reformulation of professional practice, when we are faced with a new proposition of practice, based on what individuals present to us as urgent: the desire for life-making.

There is a very subtle “political technology of the body,” even among those with restricted geographic mobility. The body becomes a territory through its diffuse connections with the society that disciplines it, regardless of the physical spaces it accesses (Foucault, 1984). In light of the above, this study takes the form of an experience report produced and lived over the course of one year, between 2023 and 2024, with two individuals, one being 17 years old and the other 35 years old, both of whom participated in the ResisTO project.

The first contact with the participants was made through a voice call, during which the goals of social occupational therapy were presented in accordance with the facility's competencies.

Records of the meetings were kept in a field diary, and activities were planned in advance according to the proposed objectives. The photographs included in this report illustrate the actions and their developments, using the activities as a mediating resource.

Thinking about the lives of people who live on the margins⁴ requires, firstly, that we can question what dynamics these experiences assume and what, socially, authorizes and legitimizes them, so that we can then position ourselves as political agents. These lives experience the effects of the processes of marginalization and social stigmatization and have their exercise of citizenship and autonomy traversed by conditions of exclusion, being guided by the confrontation of hegemonies, through the struggle for existence and survival (Melo, 2016).

Through monitoring, it was possible to reflect and jointly construct possibilities for social participation and the construction of autonomy. Through the recognition and strengthening of their subjective identities, we were able to contribute to access and circulation in spaces of sociability⁵ autonomously by enabling the reconstruction of new life projects, confronting cis-heteronormative narratives and reaffirming the right to existence and citizenship.

“I feel like this is a safe place”: contributions of social occupational therapy to the gender non-conforming population

Julie is 35 years old, is the⁶ middle child between his two brothers; lives with their stepfather, his mother and his younger brother; self-identifies as white, has blond hair, green eyes, experiences their spirituality through Candomblé⁷ and considers herself a non-binary gay person.

Dante is 17 years old, the youngest of a family of three children, identifies as a transgender and bisexual man; has black hair, wears glasses and wants to conduct archaeological research; lives with his parents and studies at a private high school.

Dante

During the first meeting, we noticed that he was shy, wearing a school uniform and a coat, a common outfit at our meetings. He arrived at the service most of the time accompanied by his mother. Dante expressed many desires, but also many anxieties, given his experiences in very violent contexts for trans people.

Dante was restless during the follow-ups due to the challenging routine of being a high school student, which is closely linked to the experience of being the only trans man in his class, making him the target of transphobic comments from other students.

We carried out an activity that reflected on the “ideal school”. An episode of the series “Sex Education” was used⁸ (Nunn, 2019) as a trigger for our reflections on institutional crossings in the constitution of subjectivities in adolescence and youth. The episode shows the construction of a democratic school, where students can decide on the activities to be developed. After the screening, we discussed the challenges faced by dissident adolescents and young people and reflected on possible strategies for this scenario.

During the follow-up sessions, it was possible to access his experiences at school and his forms of self-representation. In one of these moments, an activity was proposed in which he could express, through a drawing, how he saw himself and how he thought he was seen by other people. At this stage, he brought up important elements about other people's perception of him, stating that some students called him a “girl” because he still had a “high-pitched voice”.

The voice is one of the components that allow us to communicate, and, within the school environment, active participation is considered, as in Dante's school, a contribution to evaluation. This situation made Dante feel disinterested, as even his voice could lead to episodes of judgment. According to Cardoso (2022), the body began to be considered a problem when there was an imposition of adaptation to cis-heteronormative gender standards, requiring conformity with the imaginary of the feminine or masculine in order to become a valid body. Another repercussion of this process was the desire for hormone replacement, via the so-called “transsexualization process”⁹ . If, on the one hand, hormone therapy can be an important part of the constitution of your body, your subjectivity and transmasculine identity, on the other hand, it is associated with an attempt to “alleviate” the violence suffered at school and in other contexts of sociability due to the cisnormative understanding of what it means to “be a man”.

The history of the recognition of the right to gender transition in Brazil has already been marked by structural obstacles such as judicialization, excessive medicalization, and pathologization, as highlighted by Rocon et al. (2016). The new regulation revives these exclusionary mechanisms, now under the guise of “ethical protection,” which, in practice, restricts the autonomy of trans people and reinforces the role of diagnosis as a validation tool.

In this sense, as Butler & Rios (2009) problematizes, the requirement of a diagnosis to access transition, although instrumentalized to guarantee certain rights, also traps the trans experience within a logic of legitimacy mediated by the medical norm. Dante, a subject whose life story is narrated in this study, expresses his indignation at the abusive costs of hormone therapy in the private sector, a reality he faced while waiting for a spot at the public reference clinic. His experience reveals not only the material obstacles to access but also the subjective impacts of a care model that prioritizes institutional criteria over listening to individual urgencies.

In the process of individual and territorial support, actions aligned with Dante’s desires were proposed, such as visiting an art exhibition and going downtown in search of materials necessary for his studies. However, moving through the city requires conditions of “passability” that placed him in constant tension between the desire for belonging and the normative demands of conformity. The impossibility of feeling comfortable attending certain spaces and moving around the city reinforced the paradox lived by Dante: while he fought for autonomy and validation of his identity, he ran up against the limitations imposed by the materiality of a socially normatized body.

Reflecting on Dante's discourses, which had their validation influenced by the legislation itself, refers to the materiality of the identification of a body that is already socially determined, hostage to normative territorialities. This body, ideally, would not be on the margins, invisibility, nor subject to violence. In our meetings, we evaluated what this desire reflected and how it materialized in his life and in his processes of autonomy, based on the understanding of passability¹⁰ , which relates to the notion of cultural intelligibility (Butler, 2003, p. 34), understood as:

[...] the “coherence” and “continuity” of the “person” are not logical or analytical characteristics of personhood, but, on the contrary, socially instituted and maintained norms of intelligibility. If “identity” is assured by stabilizing concepts of sex, gender and sexuality, the very notion of “person” would be questioned by the cultural emergence of those beings whose gender is “incoherent” or “discontinuous”, who appear to be persons, but do not conform to the gender norms of cultural intelligibility by which persons are defined.

Passability, which would be guaranteed to Dante each time his identity construction was adapted and submitted to power relations, was sought in order to guarantee him access, recognition and belonging in normative relationships and institutions, especially through the “production” of his body and its territorial repercussions.

During one of the sessions, it was suggested that he write a letter to himself with the aim of revisiting his emotions and experiences in a future time. It was agreed that this letter would be opened during the last meeting. When the time came, it became clear that Dante expressed his desires for better days, especially with the beginning of the hormonalization process. This desire was represented by him in a drawing (Figure 1), in which he portrayed himself wearing a coat as a kind of armor. This coat, by hiding parts of his body, offered him security, allowing him to move around more calmly and protected from the looks of abjection¹¹ . Based on a critical reading, which we carried out together, on the subtext of the meanings of the “transsexualizing process”, we identified what Foucault (1999) reports, since we validated and took as a model only cisgender and normative experiences.

Figure 1
The figure is a drawing made by Dante, in which he writes the following sentence in a balloon: “Don't worry, things will get better for us, just keep moving forward.”

Still on the prerogative of the contradictory normative production of bodies, in another meeting, it was proposed that he draw on each half of an A4 sheet the representation of two bodies, based on some triggering questions: “What validates a male body or a female body?” (see Figure 2); “Are there differences? What are they?”; “What are the similarities?”; “What are their characteristics?”, the objective was to encourage reflection on the representation of these bodies within a culturally binary understanding, which monitors and regulates their identities.

Figure 2
Male body × female body.

Figure 2 represents two drawings made by Dante, in which he used the identification of transgender bodies, challenging what is socially validated as a male body X a female body, bringing as an axis of differentiation the culture and beliefs in which the subjects construct themselves, another possible “body-territory”, which he had little experience with until then. In parallel, Dante continued to affirm that he still desires hormone replacement therapy, but presents aspects of a new subjectivity being forged, as he demonstrated that he understands that hormone replacement therapy is just one aspect of his identity and that this does not necessarily have to dictate the gender with which he identifies.

This statement, combined with Dante's imagery, led us to identify the moral discourses that reproduce normative identities, making dissent impossible. By recognizing himself in this frontier, we were able to develop resistance strategies, such as a critical reading of this historicity, which allowed him to validate his experience as a trans man and the struggle of social movements to guarantee rights.

Dante also had his access to public spaces crossed by violence. He believed that until he resembled the expectations of a cisgender body, he would not feel comfortable moving around in these spaces, which ended up resulting in the restriction of his territories of sociability. He mentioned that he only frequents the Pedrinho LGBT+ Space. According to him, “I feel that this is a safe place” (Dante's account during the follow-up). In addition, he considered school, the homes of some friends and the sessions with the clinical psychopedagogue¹² as spaces where transsexuality was permitted without constant confrontation with violence.

It is worth noting that, although Dante only mentions these spaces as possibilities for sociability, the territory accompanied him through the intersection of the most varied discourses, including family institutions and their political force to produce “body-territories” subject to norms. Regardless of the spatialities, Dante was and is in territories. In return, the accompaniments, then, forged incentives for his dissident gender performance, creating new places and new possibilities for performance.

In the meantime, in the last meeting, with the objective of identifying the subjective construction of his identity, based on the choice of names, race and age, the following question was proposed: “What would Dante be like, if he could choose?” (Figure 3). This moment was significant, as it marked the self-naming of the participant as Dante, giving meaning to the accounts of this experience, and producing a model that reflected an identity more aligned with his self-perception.

Figure 3
Self-image produced by the participant using biscuit.

Julie

Right from the first contact with Julie, still without any bonds formed, she presented demands arising from her experience, as she had accumulated numerous situations of violence, among them, her work relationships with prostitution and the consequences of misinformation about her HIV (Human Immunodeficiency Virus) diagnosis.

For a good part of her life, her source of income came from prostitution spaces, and she was routinely targeted by the “girls that prostitute”¹³ . It is worth highlighting the moment when Julie identified herself as “a target,” and we questioned which moral discourses produce this targeting of her. Could it be that the construction of her identity is rendered invisible because she does not submit to unsafe invasive procedures, such as the injection of industrial silicone and/or hormone replacement without supervision?

In one of the support sessions, an activity involving randomly selected questions was proposed, aiming to identify the strengths that Julie recognized in herself, betting that this recognition could unmask her subjective meanings. Julie commented that she enjoyed listening to music, being in contact with nature, and when she was “vain”: “I liked seeing myself all dressed up” (Julie’s statement during the session). Julie reported that she took pleasure in being able to create her own looks for work and in recognizing herself that way.

She then reflected, stating: “I had everything it took to be a transvestite, but I wasn’t, I think because of my mother, who didn’t accept it when I came out as gay” (Julie’s statement during the session). Regarding travestility, Duque (2008, p. 2) reveals that “[…] when transvestites came out, the domestic space of the family was, as a rule, unsustainable”. Therefore, being a transvestite in a society governed by certain moral values and customs would be, for Julie’s family, even more susceptible to violence.

According to Oliveira (2023, p. 160), based on the understanding of social representations,

[…] to be a transvestite is to be excluded from the capacity for epistemic and intelligible exercise, due to existing as a gender alternative distinct from cis-heteronormativity and the binary model centered on sexual dimorphism, constrained by stigmas and classified as ‘exotic, abnormal, monstrous, aberrant, aggressive, hysterical, perverted, pathological, grotesque, dirty, polluted, immoral, and abject’.

Not only at home, but also in the spaces where she worked, Julie was faced with the invalidation of her identity, even reporting a moment when she had just returned to the point¹⁴ , and, upon getting out of the car, she was attacked with glass bottles by another transvestite who was in that same territory: “[…] I think they were jealous, because I managed to make the same money as them or even more without needing to get breasts […]” (Julie’s statement during the session). Julie reported that, in order to belittle and disqualify her in the aesthetic construction of her body, they called her a “little gay boy in drag,” entangled in the power struggles of the body-territory relationship. Amid the routine violence on the streets and at home, Julie tried to navigate these challenges in an attempt to survive the stigma of being a dissident HIV-positive body.

When recounting her HIV diagnosis at the age of 20, Julie shared the following in one of our first meetings: “I thought I was going to die, to become full-blown AIDS like we saw in the movies, because back in my day no one talked about sex education and I think I was really dumb to let that happen” (Julie’s statement during the session). A key moment here is when Julie talks about the singer Cazuza, who went through moments of moral-sexual panic while fighting against [the stigma of] HIV, and says: “I saw that, I was afraid of ending up like him.”

According to Pelúcio & Miskolci (2009), the way public health addressed the AIDS epidemic created the figure of the “aidético” (AIDS patient), built upon a sense of guilt for being the source of one's own infection, and seen as a danger to others.

Having to live with the consequences of misinformation about her rights, the stigma of being “contaminated” persisted and daily undermined Julie’s ability to dream of new life projects, limiting her prospects for autonomy. Routinely subjected to comments like “Just be careful not to pass it on to the boys” (made by the manager at her workplace; Julie told us during the session), she has been experiencing various forms of violence for 15 years.

Silva (2012) brings in her research the responsibility of media representations in reinforcing this imaginary, denouncing the apparatus mobilized to instill guilt around the diagnosis and to exonerate those who deny the importance of sex education.

Recognizing the recurrence of this theme in Julie’s accounts, during the sessions it was proposed to watch the documentary Letters Beyond the Walls (Cartas para além dos muros) (Canto, 2019), to reflect on the meanings of the diagnosis in her life. After the screening, she was given a blank sheet of paper and a pen to express what she felt or what stood out to her during the viewing.

At the end, Julie had written “Death routine” and said, “It’s that thing, right, we live thinking we could die tomorrow” (Julie’s statement during the session). After the diagnosis, Julie identified, just like the people interviewed in the documentary, the panic of living daily with the fear of death, which carries a historical legacy of stigma against the LGBTQIAPNb+ population, limiting possibilities for autonomy and for reclaiming the body and life. Julie accesses healthcare services exclusively at a public hospital in the city of João Pessoa and constantly lives with the fear of being recognized and associated with the social imaginary of the “aidético” (person who has AIDS).

In Silva’s (2012, p. 192) research, we find that “[…] being publicly recognized as a person living with HIV means that one may be rejected by family, friends, and sexual and romantic partners, and also that one may be dismissed from a job or never even get hired.” When registering at the hospital, Julie chose to be called “Lucas” so her name would not be recognized at that institution, and at the end of each appointment, she always looked for the farthest exit from the one she entered, to avoid being identified as someone who uses that service.

The difficulties in carrying out territorial actions with Julie are deeply rooted in the social stigma associated with the HIV diagnosis, which limits not only her movement through public spaces but also the exercise of her autonomy. During this one-year follow-up with Julie, we worked on strengthening her singularity, seeking her recognition as a subject of rights. In this process, territorial actions were proposed to help strengthen her autonomy and reframe her relationship with public spaces, such as visits to the Universidade Federal da Paraíba (UFPB) and to a city museum. These initiatives were carried out respecting Julie’s limits and timing, always considering the symbolic and practical barriers that still challenge her in navigating and belonging to urban territories.

In our final meeting, the same activity proposed to Dante at the end of the sessions (Figure 4) was presented. During the activity, Julie identifies herself in this way and shares some moments she experienced in sex work. Julie says, during the construction: “girl on the street, boy on the site” (Julie’s statement during the session), referring to the moments when she dressed up to work on the street, and to the ads she posted on websites using a male identity to attract clients, since they often placed more value on a masculine performance in sex work. Julie completed the activity with teary eyes, emotionally moved by the chance to represent herself again with the clothing colors that “had more axé,” as she said.

Figure 4
Self-image produced by the participant using biscuit.

The pink and blue colors chosen by Julie, as well as the contact lenses, were used to represent the days when she managed to get more clients during her work. They symbolize the representation of what is expected from normative femininity.

During the sessions conducted, the narratives brought by Julie were accompanied by reflections that enabled the denaturalization of violent processes and the construction of new life projects for victims of the cultural stigma faced by people living with HIV.

Being alongside Dante and Julie made it possible to build, together, strategies to confront the disciplining processes of bodies (Foucault, 1987). This process of disciplining creates “[…] a binary division between the normal and the abnormal through coercive determinations that define the subject, their place, how to characterize them and, mainly, how to exercise constant surveillance over them” (Rodrigues et al., 2016, p. 92). This discipline is materialized in Dante's discourse and social dynamics, who, for example, wore his jacket every day when leaving home as his suit of armor to face transphobia.

Reflecting on how this abjection materializes in daily life, we find a series of negotiations that deny these subjects' citizenship. Thus, actions are produced that lead Dante to validate his identity only after undergoing the transsexualization process, and Julie to “dress up” and “undress” according to her access to 'spaces of sociability' (Monzeli, 2013). According to Bento (2014, p. 167), “[…] to become a citizen, each of these bodies had to constitute itself as a political body.” However, the process of political, economic, and social recognition has been (and continues to be) slow and discontinuous.

Final Considerations

In these experiences, the articulation between individual and territorial support was central as a strategy for weaving autonomy and confronting the norms imposed by normative cultural intelligibility. The proposal of actions that integrated subjective strengthening and the re-signification of sociability spaces allowed for questioning the naturalized logics of gender normativity and building paths for the recognition and expression of dissident performativities.

In this way, the experience generated crucial reflections on the concept of territoriality in individual and territorial support. We questioned whether territory is limited to the physical space where actions take place or whether it also refers to the meanings, cultures, and histories that cross different practices. Is it indispensable to leave the institutional space to carry out individual and territorial support?

The territorial dimension, therefore, reveals itself in the sessions through the participants' accounts of the places their bodies are directed to access; through speech that reflects the historicity of neglect in their trajectories, and even when expressing the desire to reconstruct spaces subjectively through strategies for confronting experienced violence. In order to propose such support, it was necessary to constantly construct and deconstruct both social norms and the very actions developed.

Considering the formation of dissident identities within a context of social inequalities, these subjects have historically had their subjectivities violated, having to build, on a daily basis, singular and collective strategies to confront these experiences in the production of life and autonomy due to the disciplinary crossings of their bodies.

The support provided not only strengthened the subjective and identity processes of Dante and Julie but also expanded their possibilities for mobility and belonging, by proposing new ways of narrating and inhabiting their body-territories, permeated by an important production of autonomy for these lives. This approach fostered the encouragement of dissidences and enabled experiences that challenged binary rules and cultural arrangements, recognizing that autonomy is built through constant negotiation with social norms.

In this sense, the resources aimed to question the directions of the sex-gender order and binary gender expressions as naturalized flows in culture through the reproduction of gestures and behaviors. Espaço LGBT+ Pedrinho, through its institutionalities, as a reference unit for the LGBTQIAPNb+ population of Paraíba, fosters this contest and attention within social policies, not implying for these subjects a game of subjugation, but of rediscovery: in one of the meetings when Dante went to Espaço, he did not wear his jacket-shield, for example, and Julie began to recognize her identity as a place of transit, challenging norms and exploring her desires and possibilities of existence.

Furthermore, the accounts presented here point to the experimentation and expansion of new ways of producing individual and territorial support.

• 1
  The social issue has its genesis in the way people organize themselves to produce in a given society and in a given historical context, and this organization has its expression in the sphere of social reproduction, that is, the social issue is determined by the specific and peculiar trait of the capital/labor relationship - exploitation (Lopes, 2023, p. 39).
• 2
  The acronym refers to the communities, respectively, of lesbian, gay, bisexual, transgender and transvestite people, queers, intersexuals, asexuals, pansexuals, non-binary people, among other existential possibilities in genders and sexualities.
• 3
  It is part of the administrative structure of the Government of Paraíba through the State Secretariat for Women and Human Diversity (SEMDH). This facility offers specialized psychosocial and socio-legal assistance to this population and their families in situations of social vulnerability, due to violation of rights, in addition to being a place to strengthen family and community ties (Marques Júnior, 2023, p. 85).
• 4
  “Gender and sexuality norms and conventions coined by the heterosexual matrix end up allocating them to the marginalizations that segregate them, since the entire social sphere is intertwined by a series of historically established factors, determining what should or should not be accepted” (Melo, 2016, p. 217).
• 5
  When articulating the discussion of territory and identity constructions, Monzeli (2013, p. 18) understands that the “[…] territory represents much more than the 'backdrop' of social life, that is, it effectively participates in the construction and deconstruction of relationships and subjectivities [...]” requiring a “[...] discussion on the very conceptualization of territory to the extent that sociabilities and the bodily, subjective and identity constructions themselves are directly related to the use that bodies make of these spaces [...]”, understanding the influence that subjective representation has on the territory and, consequently, on its spaces of sociability.
• 6
  Because she identifies as a non-binary person, Julie will be referred to with both he/him and she/her pronouns throughout this text, depending on the events in which they were used, and how she self-identified.
• 7
  Santos (2011) points out that Candomblé has a cultural heritage that combines elements from Africa and Brazil. This religion embraces differences and seeks acceptance and welcoming of people regardless of their gender identity, without the need to conform to certain standards of values ​​or social adjustments (Ferreira & Soares, 2021).
• 8
  Series produced by Netflix (2019-2023).
• 9
  The so-called “transsexualization process” has advanced institutionally with the publication of ordinances no. 1,707/2008, no. 457/2008 and, later, no. 2,803/2013 (Brasil, 2013), as well as with Resolution no. 2,265/2019 of the CFM. The consolidation of a national health policy aimed at the trans population remains strained by normative and political obstacles. A recent example is the non-publication of the Specialized Health Care Program for the Trans Population (Paes Pop Trans), announced in December 2024 by the Ministry of Health, fnar whose officialization was paralyzed due to the change in ministerial management, pressure from conservative sectors and conflicts with Resolution no. 2,427/2025 of the CFM.
• 10
  According to Demétrio (2019, p. 10), “Passability can also be defined as a social modus operandi of (re)production of cisheteronormativity, as a symbolic and political norm of gender and sexuality, hegemonic in society [...] if, on the one hand, trans passability enables greater ‘social recognition’ and social security for many trans and transvestite people, on the other hand, it can be a cis-political trap”.
• 11
  For Butler (2003, p. 178), “[…] the ‘abject’ designates that which has been expelled from the body, discarded as excrement, literally turned into ‘Other’. The construction of the ‘not self’ as abject establishes the boundaries of the body, which are also the first contours of the subject”.
• 12
  Dante was being investigated for Dyscalculia during part of the meetings with him, due to the difficulty that was presented at school in the area of ​​exact sciences.
• 13
  The way Julie names the people who worked with her.
• 14
  Place where he waited for his clients.
• How to cite:
  Marques, L. Z. M., Braga, I. F., Marques Júnior, K. N., & Monzeli, G. A. (2025). Weaving autonomy and challenging norms: the contribution of singular and territorial accompaniments with gender and sexuality dissidents. Cadernos Brasileiros de Terapia Ocupacional, 33, e3949. https://doi.org/10.1590/2526-8910.ctoRE404539492

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Edited by

• Section editor
  Profa. Dra. Patrícia Leme de Oliveira Borba

Publication Dates

• Publication in this collection
  01 Sept 2025
• Date of issue
  2025

History

• Received
  19 Sept 2024
• Reviewed
  22 Jan 2025
• Accepted
  09 Apr 2025