[4] Farina was supported by a team from Hospital das Clínicas da Universidade de São Paulo, who pushed for surgical intervention as a therapeutic solution for the patient.
In 1969, Waldirene Nogueira, a transgender manicurist and hairstylist, left Lins and went to Hospital das Clínicas da Universidade de São Paulo to seek treatment for her gender dysphoria.
[6] She was initially seen by Dorina Epps, and went on to attend weekly therapy sessions, where she was diagnosed with gender dysphoria and told that gender-affirming surgery might be a viable treatment for her.
Nogueira's surgery was done free of charge, and she expressed satisfaction with the procedure, saying:"My life before the operation was an unbearable martyrdom because I had to deal with genitalia that were never mine.
[11][7] During this time, Nogueira was made to submit to many invasive procedures, including a nude photo shoot and gynecological exam that measured the size of her vaginal canal to determine whether she had been born a woman.
[1] The Conselho Federal de Medicina brought the case, accusing Farina of grave bodily harm, and the presiding judge was Adalberto Spagnuolo.
"[5]Robert Rubin, of the David Geffen School of Medicine at UCLA, wrote:"In no other country in the world where this type of treatment is done has the state ever accused a doctor of criminal conduct.
"[5] on 17 October 1978, Heleno Fragoso issued an opinion on the case, saying that Dr. Farina acted strictly within the limits of the law, doing no harm, even if he had committed an error in recommending surgery.
On 25 May 1995, for instance, plastic surgeon Antonio Lino de Araújo performed a gender-affirming surgery on 22-year-old Valéria José dos Santos at the regional hospital of Asa Norte in Brasília.
[16][1] Upon learning that the procedure had been performed, Emy Rezende, the director of the hospital, called the police and the Regional Counsel of Medicine of the Federal District and notified them.
The first trans woman to undergo gender-affirming surgery after the resolution legalizing the procedure was Bianca Magro at the Hospital das Clínicas da Unicamp in Campinas on 8 April 1998.
[21] On 10 February 2021, José Carlos Martins e Claudio Eduardo Pereira de Souza at the Santo Antônio Hospital in Blumenau performed near-simultaneous surgeries on two identical twin sisters, Sofia Albuquerck and Mayla Phoebe.