ABSTRACT Non-attendance at dental appointments is a relevant problem in health care due to the negative consequences it entails. This article aims to review the causes of nonattendance and the strategies implemented for its prevention at the international level. Socioeconomic, cultural, geographic, and demographic factors are identified as the main causes of absenteeism. An inversely proportional relationship has been observed between socioeconomic status and absenteeism, with those patients with greater resources tending to have lower absenteeism. Socioeconomic and cultural factors, together with oral health education, influence the concern and frequency of dental checkups. Various solutions have been proposed, such as telephone or SMS reminders, although their effectiveness may vary due to patient familiarity and access to technology. There is a need to address this problem comprehensively and consider different approaches to reduce missed dental appointments.

RESUMEN La inasistencia a citas dentales es un problema relevante en la atención sanitaria debido a las consecuencias negativas que implica. El presente artículo tiene como objetivo revisar las causas de la inasistencia y las estrategias implementadas para su prevención a nivel internacional. Los factores socioeconómicos, culturales, geográficos y demográficos son identificados como las principales causas del ausentismo. Se ha observado una relación inversamente proporcional entre el nivel socioeconómico y el ausentismo, donde aquellos pacientes con mayores recursos tienden a tener una menor inasistencia. El factor socioeconómico y cultural, junto con la educación en salud oral, influyen en la preocupación y la frecuencia de los controles dentales. Se han propuesto diversas soluciones, como el recordatorio telefónico o mediante mensajes de texto (SMS), aunque su efectividad puede variar debido a la familiaridad y el acceso de los pacientes a la tecnología. Se requiere abordar este problema de manera integral y considerar diferentes enfoques para reducir la inasistencia a citas dentales.

RESUMO A não comparência às consultas de medicina dentária é um problema relevante nos cuidados de saúde pelas consequências negativas que acarreta. Este artigo tem como objetivo rever as causas do absentismo e as estratégias implementadas para a sua prevenção a nível internacional. Os fatores socioeconómicos, culturais, geográficos e demográficos são identificados como as principais causas do absentismo. Foi observada uma relação inversamente proporcional entre o estatuto socioeconómico e o absentismo, sendo que os doentes com mais recursos tendem a ter menos absentismo. Os fatores socioeconómicos e culturais, juntamente com a educação para a saúde oral, influenciam a preocupação e a frequência das consultas dentárias. Têm sido propostas várias soluções, como lembretes por telefone ou SMS, embora a sua eficácia possa variar devido à familiaridade do paciente e ao acesso à tecnologia. É necessário abordar este problema de forma abrangente e considerar diferentes abordagens para reduzir a não comparência às consultas dentárias.

ABSTRACT: Several methods have been described to shorten orthodontic treatments, but the main disadvantage is their invasiveness. Animal studies have shown that piezopuncture can accelerate the rate of tooth movement without causing collateral damage. Objective: To evaluate the clinical outcome, in terms of safety and efficacy, of a flapless piezopuncture on maxillary canine distalization. Methods: A split-mouth randomized clinical trial was carried out on five patients. Piezopuncture was performed on a random side of the maxillary arch to assess the rate of canine movement on the stimulated side, compared to the non-stimulated control side after 15 (T1), 30 (T2), and 60 (T3) days. Also, immediate side effects and changes in buccal bone thickness after one year were assessed. Results: Distalization on the intervention versus control side at T1 was 1.24±0.21mm versus 0.64±0.33mm (p=0.005); at T2 it was 2.00±0.28mm versus 1.36±0.49mm (p=0.046); and at T3 it was 4.28±0.66mm versus 3.65±0.88mm (p=0.102). No adverse effects related to the surgical procedure were observed or reported by patients. The thickness of the buccal bone plate showed no significant changes. Conclusions: Flapless piezopuncture accelerates the rate of tooth movement in orthodontic patients over the first 15 days and its effect declines over the next 45 days.

Aim The educational environment affects dental students’ well-being and academic achievement, with unclear impact from clinical instructors on burnout levels. This study is aimed to determine the impact of students’ perception about their clinical instructors in its burnout levels in a sample of Chilean dental students. Methods A cross-sectional study was conducted among fourth and fifth-year dental students at the University of Concepción (Chile), collecting data on various variables including demographics, effective teaching hours, instructor treatment, knowledge delivery, student appreciation, and burnout assessed using Maslach’s Burnout Inventory (MBI). Data were gathered through a self-administered survey and analyzed using STATA 10/SE software (p<0.05). Results One-hundred and seventy students participated, high levels of emotional exhaustion (51.76%), depersonalization (56.47%), and personal accomplishment (60.59%) were found. Female students (p=0.0008), those who perceive inadequate treatment from instructors towards patients (p=0.0496), and those who rate the instructor as obstructionist (p=0.0208) reported higher levels of emotional exhaustion. 5th year students (p=0.0142), students who perceive indifferent treatment from instructors towards students (p=0.0002), and those who rate the instructor as obstructionist (p=0.0026) exhibited higher levels of depersonalization. 4th year students (p=0.0475) and those who perceive indifferent treatment from instructors towards students (p=0.0221) showed lower levels of personal accomplishment. There was a correlation between depersonalization and effective teaching hours (rho=-0.2166, p=0.0046). Conclusion Students’ perception about their clinical instructors as indifferent towards the students, obstructionist in the teaching process, with inadequate treatment towards the patients, and less effective teaching hours is associated with higher students’ burnout levels. wellbeing well being achievement crosssectional cross sectional fifthyear fifth Chile, Chile , (Chile) demographics delivery appreciation Maslachs Maslach s MBI. MBI . (MBI) selfadministered self administered 10SE SE 10 p<0.05. p005 p p<0.05 0 05 (p<0.05) Onehundred One hundred participated 51.76%, 5176 51.76% 51 76 (51.76%) 56.47%, 5647 56.47% 56 47 (56.47%) 60.59% 6059 60 59 (60.59% found p=0.0008, p00008 p=0.0008 0008 (p=0.0008) p=0.0496, p00496 p=0.0496 0496 (p=0.0496) p=0.0208 p00208 0208 (p=0.0208 th p=0.0142, p00142 p=0.0142 0142 (p=0.0142) p=0.0002, p00002 p=0.0002 0002 (p=0.0002) p=0.0026 p00026 0026 (p=0.0026 p=0.0475 p00475 0475 (p=0.0475 p=0.0221 p00221 0221 (p=0.0221 rho=0.2166, rho02166 rho rho= 0.2166, 2166 (rho=-0.2166 p=0.0046. p00046 p=0.0046 0046 p=0.0046) Students process (Chile (MBI 1 p00 p<0.0 (p<0.05 517 51.76 5 7 (51.76% 564 56.47 4 (56.47% 60.59 605 6 (60.59 p0000 p=0.000 000 (p=0.0008 p0049 p=0.049 049 (p=0.0496 p=0.020 p0020 020 (p=0.020 p0014 p=0.014 014 (p=0.0142 (p=0.0002 p=0.002 p0002 002 (p=0.002 p=0.047 p0047 047 (p=0.047 p=0.022 p0022 022 (p=0.022 rho=0.2166 rho0216 02166 0.2166 216 (rho=-0.216 p0004 p=0.004 004 p0 p<0. (p<0.0 51.7 (51.76 56.4 (56.47 60.5 (60.5 p000 p=0.00 00 (p=0.000 p004 p=0.04 04 (p=0.049 p=0.02 p002 02 (p=0.02 p001 p=0.01 01 (p=0.014 (p=0.00 (p=0.04 rho=0.216 rho021 0216 0.216 21 (rho=-0.21 p<0 (p<0. 51. (51.7 56. (56.4 60. (60. p=0.0 (p=0.0 (p=0.01 rho=0.21 rho02 021 0.21 2 (rho=-0.2 p< (p<0 (51. (56. (60 p=0. (p=0. rho=0.2 rho0 0.2 (rho=-0. (p< (51 (56 (6 p=0 (p=0 rho=0. 0. (rho=-0 (p (5 ( p= (p= rho=0 (rho=- (rho= (rho

Background: People with Sensory Disabilities (PcDS) face barriers for equal access to health care. Thus, health centers require adjustments to comply with equal access that allows an universal coverage of care. Aim: To characterize the adjustments for the care of PcDS in primary health centers in Concepción, Chile. Material and Methods: Cross-sectional study using data obtained through a questionnaire to key informants or via Transparency Law, and direct observation. The variables were subdivided into four categories, namely infrastructure, communication, skills, and environment. Results: The analyzed health centers have a high proportion of general adjustments of their physical settings. However, there is a lack of specific adjustments for deaf and blind people, especially communicational ones. Conclusions: There is a paucity of adjustments for the health care of PcDS in the analyzed health centers. This deficiency underscores the barriers faced by PcDS for receiving care in the Chilean public health system.

Abstract Objective: To identify the factors associated with Oral Health-Related Quality of Life (OHRQoL) in preschool children of Concepción, Chile. Material and Methods: A cross-sectional study was conducted in a sample of enrolled preschoolers who attend public schools in Concepción, Chile. To measure OHRQoL, the chilean version of the Early Childhood Oral Health Impact Scale (ECOHIS) was used; sociodemographic variables of the children and their parents were also recorded, as well as variables regarding the last visit to the dentist. To determine differences in the ECOHIS score for categorical variables, ANOVA and t-test were used, while Pearson's r was used to correlate ECOHIS with quantitative variables (p<0.05). Results: A total of 175 children were surveyed, with a distribution of 89 boys and 86 girls aged 56-to-79 months. The total score of the ECOHIS had a mean of 4.48 ±5.96, with a score between 0-38. Statistically significant associations were with parent's educational attainment (r=−0.159), dmft (r=0.380), OHI-S debris (r=0.174) and reason for the last visit to the dentist, the highest average in the ECOHIS scores was registered in the urgency reason. Conclusion: Oral health status, dental service utilization and educational level are associated with the OHRQoL of preschoolers of Concepción. Objective HealthRelated Related (OHRQoL Concepción Chile Methods crosssectional cross sectional (ECOHIS recorded dentist ttest t test Pearsons Pearson s p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Results 17 surveyed 8 56to79 56 79 56-to-7 months 448 4 48 4.4 596 5 96 ±5.96 038. 038 38. 38 0-38 parent r=−0.159, r0159 r=−0.159 , 159 (r=−0.159) r=0.380, r0380 r=0.380 380 (r=0.380) OHIS OHI S r=0.174 r0174 174 (r=0.174 Conclusion status p00 p<0.0 (p<0.05 1 56to7 7 56-to- 44 4. 59 9 ±5.9 03 3 0-3 r015 r=−0.15 15 (r=−0.159 r038 r=0.38 (r=0.380 r=0.17 r017 (r=0.17 p0 p<0. (p<0.0 56to 56-to ±5. 0- r01 r=−0.1 (r=−0.15 r03 r=0.3 (r=0.38 r=0.1 (r=0.1 p<0 (p<0. ±5 r0 r=−0. (r=−0.1 r=0. (r=0.3 (r=0. p< (p<0 ± r=−0 (r=−0. r=0 (r=0 (p< r=− (r=−0 r= (r= (p (r=− (r

ABSTRACT OBJECTIVE Determine and measure the association of social factors and health conditions with worse capacity and performance levels. METHODS Dependent variables consisted of performance and capacity; independent variables comprised age, gender, level of education, personal income, and health conditions. Means (95%CI) of performance and capacity were presented according to the independent variables. Generalized linear models, using a mutual adjustment for all variables considered statistically significant (p < 0.05), measured the associations between each exposure and outcomes. Study population included 12,265 individuals. RESULTS Older women with lower education and income levels and with some health condition showed the worst performance and capacity. CONCLUSION Results showed that the capacity and performance levels of the Chilean population changed according to social demographic characteristics and health conditions.

ABSTRACT OBJECTIVE Determine and measure the association of social factors and health conditions with worse capacity and performance levels. METHODS Dependent variables consisted of performance and capacity; independent variables comprised age, gender, level of education, personal income, and health conditions. Means (95%CI) of performance and capacity were presented according to the independent variables. Generalized linear models, using a mutual adjustment for all variables considered statistically significant (p < 0.05), measured the associations between each exposure and outcomes. Study population included 12,265 individuals. RESULTS Older women with lower education and income levels and with some health condition showed the worst performance and capacity. CONCLUSION Results showed that the capacity and performance levels of the Chilean population changed according to social demographic characteristics and health conditions.

ABSTRACT: Introduction: A telemedicine program in oral pathology (TOP) and a preventive oral examination (POE) to identify oral lesions was implemented in Hualqui, Chile. The objective of this study is to describe the results of the TOP plus POE strategy at CESFAM Hualqui, Chile, during the period of 2016 to 2019. Materials and methods: A prospective cohort study was conducted with 152 Hualqui patients between 2016 and 2019. The following variables were recorded: diagnosis; injury diagnosis dates; date of teleconsultation; date and response of the specialist and subsequent control; waiting time for response (WTR) and waiting time for attention (WTA). Results: The WTR was 19.7 ± 12.8 days and WTA presented a median of 20 days (1−125) days. A total of 45 different oral pathologies were identified, the most frequent being stomatitis 8.6% (13), fibroma 8.6% (13) and mucocele 7.9% (12), and among the least frequent highlights three cases of oral cancer. Conclusions: The waiting periods until a response from the specialist and then until the face-to-face control were around 3 weeks each, most of the cases were identified through POE and correspond mostly to benign pathologies.

Resumen La pornografía en internet se presenta como un fenómeno sin precedentes en la historia de la humanidad. Este trabajo expone una revisión teórico-histórica que da cuenta de las transformaciones culturales y sociojurídicas que permitieron su conformación, y al mismo tiempo destaca los rasgos distintivos que la separan cualitativamente de formas similares de material erotizante. En un movimiento dialéctico, caracterizado inicialmente por la unión entre sexualidad y divinidad, posteriormente por una era oscura de censura y opresión y, finalmente, por una nueva liberación como mercancía y entretenimiento en la era de la información, la pornografía ha sufrido transformaciones vertiginosas que adelantan con creces el estudio de la academia, particularmente en nuestra realidad latinoamericana.

Abstract Internet pornography is an unprecedented phenomenon in the history of mankind. The present article seeks to exhibit a theoretical-historical review that accounts for the cultural and socio-legal transformations that allowed its conformation, while highlighting the distinctive features that separate it qualitatively from other similar forms of eroticizing material. In a dialectical movement characterized initially by sexuality and divinity’s merging, later by a dark era of censorship and oppression, and finally by a new liberation as commodity and entertainment in the information age, pornography undergoes vertiginous transformations far ahead the study of academia, particularly in the Latin American context.

Resumen En los últimos años, la tecnología y la medicina han podido complementarse para la optimización de tiempo, conocimientos y recursos, aumentando la posibilidad de tratamientos personalizados en más pacientes. A nivel maxilofacial, la reconstrucción de defectos mandibulares se ha visto en la necesidad de progresar sus técnicas debido a la serie de orígenes que afectan el hueso mandibular de manera drástica, como lesiones traumáticas, cáncer, infecciones, enfermedad congénita u otros, y las innumerables consecuencias tanto estéticas como funcionales, restringiendo significativamente la calidad de vida. El objetivo de este artículo es revisar conceptos básicos del uso de tecnologías de impresión 3D en la reconstrucción mandibular. La impresión 3D ha aparecido en diversos ámbitos, siendo en el área de la medicina, un aporte fundamental para la creación de formas anatómicas de alta precisión con el que se pueden diseñar objetos con reproducción de detalles de manera rápida, luego de una serie de pasos que incluyen la obtención de una imagen radiográfica, uso de software y reparación de archivos, y la obtención de un modelo tridimensional. Los últimos estudios han validado el uso de impresiones 3D para una reconstrucción mandibular, con claros beneficios de costos y calidad de detalles. Es necesario crear un enfoque en las técnicas quirúrgicas utilizadas con un objeto impreso tridimensionalmente y un análisis post operatorio de los pacientes sometidos a estos procedimientos más allá de los detalles técnicos.

Abstract In recent years, technology and medicine have been able to complement each other to optimize time, knowledge and resources, increasing the possibility of personalized treatments in more patients. At the maxillofacial level, the reconstruction of mandibular defects has seen the need to progress its techniques due to the series of origins that drastically affect the mandibular bone, such as traumatic injuries, cancer, infections, congenital disease or others, and the innumerable both aesthetic and functional consequences, significantly restricting the quality of life. The objective of this article is to review basic concepts of the use of 3D printing technologies in mandibular reconstruction. 3D printing has appeared in various fields, being in the area of medicine, a fundamental contribution to the creation of high-precision anatomical shapes with which objects with reproduction of details can be designed quickly, after a series of steps which include obtaining a radiographic image, use of software and file repair, and obtaining a three-dimensional model. The latest studies have validated the use of 3D impressions for mandibular reconstruction, with clear benefits in cost and quality of details. It is necessary to create a focus on the surgical techniques used with a three-dimensional printed object and a post-operative analysis of the patients undergoing these procedures beyond the technical details.

Resumo Nos últimos anos, tecnologia e medicina têm se complementado para otimizar tempo, conhecimento e recursos, aumentando a possibilidade de tratamentos personalizados em mais pacientes. No nível maxilofacial, a reconstrução dos defeitos mandibulares tem visto a necessidade de progredir em suas técnicas devido à série de origens que afetam drasticamente o osso mandibular, como lesões traumáticas, câncer, infecções, doenças congênitas ou outras, e as inúmeras ambas estéticas. e consequências funcionais, restringindo significativamente a qualidade de vida. O objetivo deste artigo é revisar os conceitos básicos do uso das tecnologias de impressão 3D na reconstrução mandibular. A impressão 3D tem surgido em vários campos, sendo na área da medicina uma contribuição fundamental para a criação de formas anatômicas de alta precisão com as quais objetos com reprodução de detalhes podem ser desenhados rapidamente, após uma série de etapas que incluem a obtenção de uma imagem radiográfica, uso de software e reparo de arquivos e obtenção de um modelo tridimensional. Os estudos mais recentes têm validado o uso de impressões 3D para reconstruções mandibulares, com claros benefícios em custo e qualidade de detalhes. É necessário criar um foco nas técnicas cirúrgicas utilizadas com um objeto impresso tridimensional e uma análise pós-operatória dos pacientes submetidos a esses procedimentos para além dos detalhes técnicos.

Resumen Internet ha cambiado los modos de relacionarse, específicamente el uso de redes sociales y el consumo de contenido multimedia, incluyendo la pornografía. A pesar de lo anterior, existe escasa literatura empírica nacional que aborde el fenómeno de la pornografía en internet. El presente trabajo tiene como objetivo describir los efectos de la pornografía desde una perspectiva biopsicosocial, dando particular énfasis a la pornografía en internet, a fin de contextualizar dichocampo. Dentro de las tres dimensiones cubiertas, los estudios tienden a descartar la existencia de efectos evidentes, de alto impacto y a corto plazo, como también destacan la importancia del contexto en su modulación. Se presentan limitantes y observaciones críticas a los estudios reportados, como también se insta a abrir el debate académico nacional en torno a un fenómeno que, hace bastante, escapa de nuestras pantallas y demanda una aproximación científica críticamente actualizada.

Abstract The Internet has changed the ways of relating, specifically the use of social networks and the consumption of multimedia content, including pornography. Despite the above, there is scarce national empiric literature that addresses the phenomenon of pornography on the Internet. This paper’s aim is to describe the biopsychosocial effects of pornography, focusing on internet pornography, in order to contextualize the field. Within the three dimensions covered, studies tend to rule out the existence of obvious, high-impact, and short-term effects, as well as highlighting theimportance of context in its modulation. There are limitations and critical observations to the studies reported, as well as calls for opening the national academic debate around a phenomenon that, already for some time, escapes our screens and demands a critically updated scientific approach.

Abstract Migratory flows are part of Chilean history, and have experienced changes throughout the years. Nowadays, there are multiple violations to migrants’ rights, which hinder their access to employment. This goes against migration’s main purpose, which is to improve one’s living conditions. This review explores the main reasons that lead migrants to leave their nations of origin; ethnicity, cultural diversity and acculturation processes; migrants’ rights violations, highlighting legal rights violations; and employment as a social phenomenon, in which training courses and workshops become extremely relevant for migrant population. It is concluded that through multiple interventions, migrants’ rights violations might be diminished, improving their living conditions and facilitating their access to employment.

Resumen Los flujos migratorios son parte de la historia de Chile, y han tenido cambios a través del tiempo. Actualmente, existen múltiples vulneraciones a los derechos de las personas migrantes, que conllevan a que tengan dificultades para acceder a la esfera laboral. Esto dificulta cumplir el objetivo principal de la migración, correspondiente a mejorar las condiciones de vida. Se exploran en esta revisión bibliográfica los principales motivos para abandonar las naciones de origen; la etnicidad, diversidad cultural y procesos de aculturación; la vulneración de derechos de personas migrantes, destacándose las vulneraciones legales; y el trabajo como fenómeno social, donde se incluye la relevancia de los cursos y talleres de formación laboral para la población migrante. Se concluye que a través de múltiples intervenciones pueden disminuirse las vulneraciones de derechos a las personas migrantes y mejorar sus condiciones de vida, facilitando su acceso a la esfera laboral.

Resumen Introducción: en Chile, la legislación existente asegura la atención médica en el sistema de salud público para las personas trans; sin embargo, esto no se cumple en todos los servicios de salud. El objetivo de este trabajo es describir las características y relevancia del Protocolo de Atención de Personas Trans, implementado por el Servicio de Salud Talcahuano. Se realizó una investigación cualitativa, con recolección de datos a través de entrevistas semiestructuradas y grupo focal. La información se analizó a través de teoría fundamentada y una matriz FODA. Desarrollo: desde la teoría fundamentada se desprenden dos categorías principales, correspondientes a la "necesidad de despatologización y buen trato" y el "protocolo" como tal, que se articulan desde la comunidad trans y la institucionalidad. El protocolo se caracteriza por ser pionero, participativo, vinculante y reconocido. Desde la matriz FODA, se observa que las fortalezas principales corresponden al diálogo entre comunidad y profesionales, y la apertura del equipo profesional a actualizar sus conocimientos en atención en salud a personas trans. Las debilidades principales refieren a la discriminación pasiva hacia personas trans de parte de algunos profesionales, la falta de algunas prestaciones específicas en el protocolo y las pocas horas disponibles para los especialistas que son parte del programa. Conclusiones: el Protocolo de Atención de Personas Trans es considerado pionero en el país y es valorado positivamente por la comunidad trans nacional, lo cual la valida. Por lo mismo, deben buscarse formas de replicar el trabajo en otros servicios de salud.

Abstract Introduction: In Chile, current legislation ensures medical care for trans people in the national public health system. However, this does not apply to all of the national health services. This paper aims to describe the features and relevance of the Attention Protocol implemented by the Talcahuano's Health Service. A qualitative research study was conducted, and data was collected through semi-structured interviews and focus groups. The information was analyzed with Grounded Theory and a SWOT Matrix. Development: From the Grounded Theory, two main categories were obtained, which were "Need for despathologization and good treatment" and "Protocol" as such, categories that are articulated through the trans community and the institution. The Protocol's main features include its pioneering work, participatory specifications, binding for healthcare personnel and patients, and recognized. From the SWOT Matrix, it is noted that the main strengths of the Protocol include the dialog between professionals and the trans community, and the openness of the professional team in learning about improving health care for trans people. The main weaknesses include a passive discrimination toward trans people from some health professionals, the lack of certain specific services in the Protocol, and the few hours available for professionals from the Program. Conclusions: The Attention Protocol implemented by the Talcahuano's Health Service experience is acknowledged as pioneering work in Chile, and it is both valued positively and validated by the national trans community. Hence, the search for a means to replicate this work in other health services is necessary.

Resumo Introdução: no Chile, a legislação existente assegura a atenção médica no sistema de saúde público para as pessoas trans. Entretanto, isso não está sendo cumprido em todos os serviços de saúde. O objetivo deste trabalho é descrever as características e relevância do Protocolo de Atenção de pessoas trans implementado pelo Serviço de Saúde Talcahuano. Realizou-se uma investigação qualitativa, com coleta de dados através de entrevistas semiestruturadas e grupo focal. A informação foi analisada através da Teoria Fundamentada e uma matriz FODA. Desenvolvimento: a partir da Teoria Fundamentada obtivemos duas categorias principais, correspondentes à "Necessidade de despatologização e bom tratamento" e o "Protocolo" como tal, que se articulam com a comunidade trans e a institucionalidade. O Protocolo se caracteriza por ser pioneiro, participativo, vinculador, e reconhecido. A partir da matriz FODA observa-se que os principais pontos fortes correspondem ao diálogo entre a comunidade e os profissionais, e a abertura da equipe profissional em atualizar seus conhecimentos no que diz respeito a atenção à saúde de pessoas trans. As principais debilidades se referem a discriminação passiva com as pessoas trans por parte de alguns profissionais, a falta de alguns serviços específicos no Protocolo, e as poucas horas disponíveis para os especialistas que fazem parte do programa. Conclusões: o Protocolo de Atenção de pessoas trans implementado pelo Serviço de Saúde Talcahuano é considerado pioneiro no país, e é positivamente valorizado pela comunidade trans nacional, fato que o torna válido. Por esse motivo, deve-se buscar formas de reproduzir este trabalho em outros serviços de saúde.