Brazilian researchers warn that healthcare for transgender people is under threat

Article published in Nature Medicine points to the risk of setbacks in research focused on this population. Experts question new rules in Brazil and other countries.

Fundação de Amparo à Pesquisa do Estado de São Paulo

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Recent restrictions on public policies and healthcare for transgender people in several countries, including Brazil, threaten to dismantle existing care structures for this population and could lead to setbacks. This warning is contained in an article published in the scientific journal Nature Medicine by a group of Brazilian researchers.

The text discusses the new resolution (No. 2,427), issued by the Federal Council of Medicine (CFM) in April. The resolution banned the use of hormone blockers for minors under 18 in Brazil, increased the minimum age for cross-sex hormone therapy from 16 to 18, and permitted gender transition surgeries only for individuals over 21.

In addition to prohibiting the clinical use of blockers in transgender youth, the Brazilian resolution also prevents research in this area. Hormone therapy involves administering sex hormones to promote physical changes compatible with gender identity. These procedures had been adopted based on the CFM’s previous resolution (No. 2,265) published in 2020.

According to the authors, these rules not only generate an intimidating effect among health professionals but also hinder the provision of adequate care. This can increase the risk of depression, social isolation, and even suicide among transgender youth – those who do not identify with their birth sex. The group also believes that science is being stifled by limits or prohibitions on research and treatments aimed specifically at this group.

The article also calls on professional entities and the academic community – including institutions, funding agencies, scientific journals, and researchers – to reaffirm their support for evidence-based care for transgender individuals.

“Public policies and health legislation need to be based on evidence and ethical principles, not ideology. Everyone, including transgender youth and their families, health professionals, and researchers, needs to participate, be heard, and understand what’s happening,” Alexandre Saadeh, a psychiatrist and one of the authors of the article, who has been working in the field for over 35 years, told Agência FAPESP.

Saadeh is the coordinator of the Transdisciplinary Outpatient Clinic for Gender Identity and Sexual Orientation (AMTIGOS), located at the Institute of Psychiatry of the Hospital das Clínicas, the hospital complex administered by the University of São Paulo. AMTIGOS is a pioneer in welcoming transgender youth in Brazil and is recognized for its care protocols for children and adolescents. Over the past ten years, approximately 120 children and over 350 adolescents have received treatment there, out of a total of 1,300 individuals who underwent screening.

When contacted by Agência FAPESP, the CFM cited Sweden, Norway, Finland, and England, as well as the United States, as “countries that have revised their guidelines in recent years and restricted the use of puberty blockers and hormone therapy for minors, reflecting the need for more research and a more cautious approach to prescribing these drugs.”

In a statement, the council said, “The Federal Council of Medicine respects opposing opinions and reiterates that one of the objectives of the changes proposed in the resolution, based on more than 100 scientific studies published in recent years, is to protect children and adolescents from procedures that are often completely irreversible and can cause lifelong problems and sequelae.” The council added that the standard was approved in a plenary session composed of 28 federal council members from all states “of different ideological hues.”

Principle of progressive autonomy

In Saadeh’s assessment, gender identity has always existed. “It isn’t a disease, it isn’t a disorder, it’s a variation that occurs in human beings in all cultures and in all countries. We have to look at these people, listen to them, and not try to prevent them from being who they are. It isn’t by restricting rights that we’ll protect children and adolescents,” the psychiatrist argues. 

The Statute of the Child and Adolescent (ECA) ensures that young people can participate in decisions about their health through the principle of progressive autonomy.

Bruno Gualano, professor and president of the Center for Lifestyle Medicine at USP and co-author of the article, believes that the new CFM standard hinders scientific production. “The resolution removes the possibility for doctors to prescribe, for example, hormone blockers, as was done under the council’s previous standard, which had specific rules. On the other hand, it demands more scientific evidence on the effects of this procedure on young people. But if it’s prohibited, how are we going to produce evidence?” he asks.

The researchers point out that the previous CFM resolution guided the care provided to 79 transgender adolescents with puberty blockers at AMTIGOS. “Adverse effects were rare, with few discontinuing the blockers and only one expressing a desire to detransition after hormone therapy, and this occurred without regret. These results are in line with international standards, showing detransition rates below 2% when appropriate assessment protocols are followed,” the group writes in Nature Medicine.

Gualano is currently the lead researcher on the project “Eating Behaviors, Symptoms of Eating Disorders, and Obesity in Transgender Youth: A Proposal for Assessment and Intervention,” developed by nutritionist Bruna Caruso Mazzolani, who is also a co-author of the text. Supported by FAPESP, the study aims to assess behaviors and possible eating disorders and to develop and implement a specific lifestyle intervention for this population.

Preliminary data obtained by Gualano’s team suggest that AMTIGOS patients and their guardians strongly oppose the major changes introduced by the new CFM resolution. “Naturally, any proposal to change the care of transgender people should take into account what they think,” the researcher argues, hoping that the new data will shed light on the discussion.

Brazil lacks official statistics on the transgender population and has few studies and research involving these individuals, especially young people. In 2021, a survey by the Botucatu School of Medicine at São Paulo State University (FMB-UNESP), published in Scientific Reports, showed that the country has 3 million people identified as transgender or non-binary, corresponding to approximately 2% of the adult population.

The 2023 National Demographic and Health Survey (PNDS), conducted by the Brazilian Institute of Geography and Statistics (IBGE) in partnership with the Ministry of Health, included the collection of data on the sexual orientation and gender identity of Brazilians aged 18 and over for the first time. However, the results have not yet been released.

Other cases

In the United Kingdom, the National Health Service (NHS) has restricted access to puberty blockers to research settings only.

Following an Executive Order by President Donald Trump’s administration (published in January this year) prohibiting gender-affirming care for minors under the age of 19, only 14 of the 50 states decided to maintain healthcare services for transgender people in the United States. The restriction was approved despite opposition from medical bodies such as the American Academy of Pediatrics and the American Medical Association, which support care for this population based on evidence-based protocols.

The new policies have serious ethical implications for researchers, compromising everything from the right to health – “when appropriate medical care is denied for political reasons” – to the possibility of transgender people seeking care from professionals who do not recognize their gender identity.

“In Brazil, the CFM resolution may lead these young people to seek out untrained doctors or even self-medicate, jeopardizing their health. In addition, these policies have a greater impact on low-income families, threatening important achievements in rights and health,” Saadeh says.

Care at AMTIGOS

The clinic receives individuals who seek health services on their own. They fill out a registration form and then undergo screening. Upon admission, the children and young people have access to follow-up care, including psychiatric evaluations and multidisciplinary teams specializing in speech therapy, social work, psychology, psychiatry, pediatrics, nutrition, physical education, and more. Families participate in the process and guidance. The clinic serves adolescents until they reach adulthood.

“This is a moment that tests medicine’s commitment to evidence over ideology. From AIDS to reproductive rights, the scientific community has defended equity in health and integrity. (...) Medical care is necessary, ethically grounded, and widely supported by evidence. Its rollback is unjustifiable,” the researchers conclude.

About São Paulo Research Foundation (FAPESP)
The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe. 

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Journal

Nature Medicine

DOI

10.1038/s41591-025-03805-5 

Article Title

The global rollback of transgender care, science and rights

 

Arts programs can help prevent heart disease, diabetes, and other leading causes of deaths, large study finds

NO MORE ARTSY FARTSY

University of Florida

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Art isn’t just for stages and studios. It can be a powerful public health resource.

That’s the takeaway from a new international study, commissioned by the Jameel Arts and Health Lab, which examined nearly 100 research projects from 27 countries to consider how arts programs, such as music, dance, theater, storytelling and other creative and cultural activities, can help prevent some of the world’s biggest killers: heart disease, diabetes, cancer, and other non-communicable diseases, which account for 74% of preventable deaths worldwide.

The release of these findings comes just one week before an international meeting convened by the World Health Organization dedicated to the prevention of non-communicable diseases. The study adds timely evidence to inform global commitments around disease prevention, showcasing how the arts are a public health resource and have the potential to strengthen health care systems.

“We don’t want to just treat these diseases, we want to prevent them,” said Jill Sonke, Ph.D., director of research initiatives in the UF Center for Arts in Medicine at the University of Florida, affiliated researcher with the Jameel Arts and Health Lab, and lead author of the new study. “We would love to see funding and interventions move upstream from treatment toward prevention, and the arts should be part of that prevention strategy, because they really can help.”

Sonke and Michael Tan, Ph.D., dean of research and knowledge exchange at the University of the Arts Singapore, co-led an international group of researchers that analyzed 95 studies representing over 230,000 participants, on the health benefits of arts programs. Their findings were published Sept. 18 in Nature Medicine. The study was supported in part by the State of Florida Division of Arts and Culture and New York University.

“If we are serious about reducing the global burden of non-communicable diseases, we must treat the arts as essential to public health infrastructure,” said Nisha Sajnani, Ph.D., professor at NYU Steinhardt and co-director of the Jameel Arts and Health Lab and co-author on the study. “Arts and cultural activities provide cost-effective and scalable tools for prevention that, when embedded in health promotion and grounded in community partnership, can expand access, close equity gaps and strengthen the uptake of healthy behaviors.” 

The researchers found that arts-based programs, whether a community play about healthy eating, a dance group that boosts physical activity or a gardening project that builds social connections, can make health messages more engaging, more memorable and more relevant to people’s lives.

Those connections, the study found, may be just as important as the health behaviors themselves. Health promotion campaigns often struggle to get people to participate long enough to make a difference. But when physical activity or health education is tied to a collective, enjoyable, creative experience, the chances of people showing up, and sticking around, can increase dramatically.

The study also found that arts programs can help improve the cultural relevance of disease prevention programs in useful ways. For example, community gardening or cultural dance programs that reflect local cultures and practices can enhance access, increase uptake of health information, encourage behavior change and boost participation.

There is still more to learn, the researchers said. Most studies have been done in high-income countries, and few projects track whether health benefits last over the long term. Still, the findings suggest that when it comes to promoting health and preventing disease, the arts could be a vital part of the toolkit.

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Journal

Nature Medicine

DOI

10.1038/s41591-025-03962-7 

Method of Research

Meta-analysis

Subject of Research

People

Article Title

The arts for disease prevention and health promotion: a systematic review

Article Publication Date

18-Sep-2025

 

Study finds most cancer patients exposed to misinformation. Researchers pilot 'information prescription.'

University of Florida

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Ninety-three percent of patients with a new cancer diagnosis were exposed to at least one type of misinformation about cancer treatments, a UF Health Cancer Center study has found.

Most patients encountered the misinformation — defined as unproven or disproven cancer treatments and myths or misconceptions — even when they weren’t looking for it.

The findings have major implications for cancer treatment decision-making. Specifically, doctors should assume the patient has seen or heard misinformation.

“Clinicians should assume when their patients are coming to them for a treatment discussion that they have been exposed to different types of information about cancer treatment, whether or not they went online and looked it up themselves,” said senior author Carma Bylund, Ph.D., a professor and associate chair of education in the UF Department of Health Outcomes and Biomedical Informatics. “One way or another, people are being exposed to a lot of misinformation.”

Working with oncologists, Bylund and study first author Naomi Parker, Ph.D., an assistant scientist in the UF Department of Health Outcomes and Biomedical Informatics, are piloting an “information prescription” to steer patients to sources of evidence-based information like the American Cancer Society. The study paves the way for other similar strategies.

Most notably, the study found the most common way patients were exposed to misinformation was second hand.

“Your algorithms pick up on your diagnosis, your friends and family pick up on it, and then you’re on Facebook and you become exposed to this media,” Parker said. “You’re not necessarily seeking out if vitamin C may be a cure for cancer, but you start being fed that content.”

And no, vitamin C does not cure cancer.

Health misinformation can prevent people from getting treatment that has evidence behind it, negatively affect relationships between patients and physicians, and increase the risk of death, research has shown. People with cancer are particularly vulnerable to misinformation because of the anxiety and fear that comes with a serious diagnosis, not to mention the overwhelming amount of new information they have to suddenly absorb.

While past research has studied misinformation by going directly to the source — for instance, studying what percentage of content on a platform like TikTok is nonsense — little research has looked at its prevalence or how it affects people.

The team first developed a way to identify the percentage of cancer patients exposed to misinformation. UF researchers collaborated with Skyler Johnson, M.D., at Huntsman Cancer Institute, an internationally known researcher in the field.

The survey questions were based on five categories of unproven or disproven cancer treatments — vitamins and minerals, herbs and supplements, special diets, mind-body interventions and miscellaneous treatments — and treatment misconceptions. The myths and misconceptions were adapted from National Cancer Institute materials and included statements like “Will eating sugar make my cancer worse?”

The team surveyed 110 UF Health patients diagnosed with prostate, breast, colorectal or lung cancer within the past six months, a time when patients typically make initial treatment decisions.

Most had heard of a potential cancer treatment beyond the standard of care, and most reported they had heard of at least one myth or misconception. The most common sources were close friends or family and websites, distant friends/associates or relatives, social media and news media.

The findings mark a shift in misinformation research, with major implications for the doctor-patient relationship, said Bylund, a member of the Cancer Control and Population Sciences research program at the UF Health Cancer Center.

“I still think media and the internet are the source and why misinformation can spread so rapidly, but it might come to a cancer patient interpersonally, from family or friends,” she said.

Most patients rarely discussed the potential cancer treatments they had heard about with an oncologist, the study also found.

Next, the researchers plan to survey a wider pool of patients, then study the outcomes of interventions designed to decrease misinformation exposure, like the information prescription.

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Journal

Journal of Cancer Education

DOI

10.1007/s13187-025-02712-0 

Method of Research

Survey

Subject of Research

People

Article Title

Assessing Cancer Patients’ Exposure to Treatment Misinformation

Article Publication Date

26-Sep-2025

 

Discovery expands understanding of Neolithic agricultural practices, diets in East Asia

Washington University in St. Louis

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image: 

Excavation at Xiaogao 

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Credit: (Image: Lang Jianfeng)

A discovery by researchers at Washington University in St. Louis and Shandong University — together with an international team of scientists working in China, Japan and South Korea — sheds new light on the historical use and domestication of the adzuki bean across East Asia.

Researchers recovered charred adzuki bean remains from the Xiaogao site in Shandong, China that were dated to 9,000 to 8,000 years ago, during the beginning of the Neolithic age when humans first began to cultivate plants and domesticate animals for food. The findings — published in the Proceedings of the National Academy of Sciences Sept. 22 — push the record of this significant legume back by at least 4,000 years in the Yellow River region.

The adzuki bean (Vigna angularis) is a staple crop widely cultivated in East Asia that is prized for both its nutritional value and nitrogen-fixing properties, meaning it also enriches the soil. It holds cultural significance and is featured prominently in various cuisines, even today.

According to the researchers, the new evidence suggests that adzuki beans formed part of an early Neolithic multi-cropping system alongside millet, rice and soybeans, in a well-established agricultural tradition in the Lower Yellow River region.

The discovery was a part of a larger analysis of charred adzuki bean remains from 41 archaeological sites across East Asia, including the Yellow River, Japan, Korea and Southern China environment. By combining newly available and previously published data, researchers also discovered significant regional differences in the size and utilization of the bean, providing a comprehensive look at the chronology and evolution of this important legume.

“At the global level, there has been considerable recent momentum in recognizing plant domestication as a protracted and widely dispersed process — one without singular geographical centers,” said Xinyi Liu, a professor and associate chair of anthropology in Arts & Sciences at WashU. “Our results align with this perspective by illustrating parallel developments in the Yellow River, Japan and South Korea during the Neolithic.

“The divergent trajectories of adzuki bean size in the Neolithic Yellow River and Jomon-period Japan are particularly revealing, as they demonstrate that culinary and dietary practices played a role in the domestication process as significant as the environmental factors.”

Modern adzuki bean and charred adzuki remain unearthed from Xiaogao 

Credit

(Image: Cai Haohong)

Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2510835122 

Article Title

The discovery of adzuki bean (<italic>Vigna angularis</italic>) in eastern China during the 9th millennium BP and its domestication in East Asia

Article Publication Date

22-Sep-2025

 

Can a mango a day keep diabetes away?

Pioneering study from George Mason University researcher shows the benefits of foods with natural sugars versus added sugars

George Mason University

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If presented with two snacks, one containing seven grams of sugar and another with over 30 grams of sugar, choosing the healthier option should be a no-brainer, correct? Well, maybe not. Less sugar is not automatically healthier.  

For the nearly 100 million adults in the United States who are currently living with prediabetes, a tropical fruit that can reduce the risk of diabetes sounds too good to be true. Tropical fruits contain anywhere between ten to 50 grams of sugar, with mangos on the high end of the spectrum, making them seem a poor snack choice based on that alone. But research by clinical nutrition researcher Raedeh Basiri indicates that mangos, despite having more sugar than many low-sugar snacks, may offer protective factors for adults with prediabetes.  

“It is not just the sugar content that matters, but the overall food context that matters,” said Basiri, assistant professor in George Mason’s Department of Nutrition and Food Studies. This study is the first long-term clinical trial to demonstrate both metabolic and body composition benefits of mangoes in prediabetes. 

Simply put, it’s more than the sugar in the food; it’s about the whole food. The sugars naturally found in mangos, and other fruits, are complemented by fiber and other vitamins and nutrients that offer additional health benefits. Food with added sugar, such as breakfast cereals, and even low-sugar snack options, may not have the same nutritional value and can even increase diabetes risk. 

“The goal is to encourage people to include whole fruits, like mango, as part of healthy eating behaviors and practical dietary strategies for diabetes prevention,” said Basiri. “Individuals at high risk of diabetes should not only focus on the sugar content of foods, but on how sugars are delivered.” 

Basiri and her team split study participants into two groups; one group received a fresh mango daily, while the other group was given a low-sugar granola bar each day. Over six months, researchers measured participants’ blood glucose levels, bodily responses to insulin, and body fat.  

At the conclusion of the study, findings revealed that the high-sugar mango (32 grams of sugar) proved more beneficial than a low-sugar granola bar (11 grams of sugar). The group that consumed the daily mango showed improved blood glucose control, enhanced insulin sensitivity, and reduced body fat.   

Daily Mango Intake Improves Glycemic and Body Composition Outcomes in Adults with Prediabetes: A Randomized Controlled Study was published in Foods in August 2025.  

This study was funded by the National Mango Board. The authors declare no other potential conflicts of interest. The funders had no role in the design of the study, in the collection, analysis, interpretation of data, or the decision to publish results.   

About the researcher 

Raedeh Basiri is a registered dietitian and an assistant professor in the Department of Nutrition and Food Studies at George Mason’s College of Public Health. Basiri is a clinical nutrition researcher specializing in personalized nutrition therapy and the use of emerging technologies, such as continuous glucose monitoring, to improve outcomes in individuals with prediabetes, diabetes, and metabolic syndrome. Her work combines randomized controlled trials and large-scale data analysis to investigate how whole foods and dietary patterns impact insulin resistance, glycemic control, sleep, and both mental and gut health. Basiri takes a rigorous, interdisciplinary approach and is deeply committed to chronic disease prevention, collaborative research, and mentoring future professionals. 

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Journal

Foods

DOI

10.3390/foods14172971 

Subject of Research

People

Article Title

Daily Mango Intake Improves Glycemic and Body Composition Outcomes in Adults with Prediabetes: A Randomized Controlled Study