Brazil

Brazil has had a complicated history with transgender rights throughout history, and opinions still vary both in the general population (src [1]) and on a state-by-state basis (src [2]). However, federal protections have been strengthening in recent years, including laws against discrimination in schools (src [3]) and support for trans identities within the federal government (src [4]). With this, and the generally high acceptance for transgender people within some states such as São Paulo, Brazil can be a safe and welcoming home for transgender individuals, with ready access to gender affirming care in the public health system, including surgeries.

Why Brazil?

Brazil is known for its vibrant and diverse cultures, with a standard of living that matches many countries within Europe and North America in its most developed areas, and cost of living that is accessible for people earning even mediocre wages within those countries. Transgender and LGBTQ+ people in general have enjoyed many advancements in care and support here, including:

Legal gender recognition: Binary and non-binary identities have both been recognized by the country, including an X marker on passports.

Anti-discrimination laws: The Brazilian court ruled in 2019 that homophobia and transphobia are a violation of the broader anti-racism laws.

Public healthcare: The public healthcare system (Sistema Único de Saúde) provides counseling, hormones, and bottom surgery to anyone who requests it.

LGBTQ+ rights and community: Large cities within states such as São Paulo and Rio de Janeiro have well-established queer communities.

Immigration pathways: Brazil offers numerous points of entry for residents and ways to acquire citizenship, including student visas, marriage, parentage, association with specific countries, and digital work.

Why not Brazil?

Despite major advances, Brazil has still been economically and socially disadvantaged by exploitative forces, and many residents hold regressive views.

High violent transphobic crime rates in poor areas: Brazil has an alarmingly high murder rate for trans women, approximating 40% of all deaths in the world, with most of the victims being sex workers or Black in poor living conditions (src [5]). While most people will be safe, this is still deeply concerning.

Massive inequality: Brazil is a country with deep economic disparity, meaning multiple parts of the country are not safe to relocate to, and anyone choosing to move should vet the city they intend to move to for safety. The safest parts of the country are as safe as any major city in the US.

Monolinguality: Portuguese is the lingua franca in the country, and it can be difficult to find people who speak English outside of the most major (and expensive) city centres.

Bureaucracy: Brazil is infamous for its complicated legal and civil processes, including in immigration. Some people may find the amount of work necessary to obtain a visa overwhelming.

Political situation for trans people

Brazil has quickly become one of the most progressive countries in South America with regards to LGBTQ+ rights, with free transgender health care, legal protections for LGBTQ+ people, same sex marriage, anti-censorship laws, right to legal gender change without restriction, anti-discrimination laws, same sex adoption, blood donations, and conversion therapy bans. While parts of the country, such as the North, are more prone to holding bigoted views, other parts such as São Paulo and Rio de Janeiro have openly celebrated LGBTQ+ culture and lively queer night life. Additionally, foreigners are mostly welcomed in Brazil, as the highly mixed racial and geographical background of the countries population have led to people becoming used to seeing people from diverse cultures. White people are, broadly, still treated the best, but people display greater friendliness in general.

Access to trans health care

Brazil has a universal healthcare system which is available to everybody, including foreigners in times of need. Though accessing long-term care requires residency, it is very easy to enroll. Additionally, (most) gender affirming medications DO NOT require a perscription, making DIY accessible to anybody who can purchase from a pharmacy.

HRT is available in multiple forms over-the-counter for both transmasc and transfem care, and can be covered by the healthcare system.
Gender-affirming surgery is available under the healthcare system with a long wait time, and the country has numerous private surgeons of high talent.
Many cities have local LGBTQ+ groups, though access will often require speaking Portuguese.

It is highly recommended to know somebody who is a Brazilian citizen before arriving, as access to purchase from a pharmacy requires a CPF (tax ID number). While foreigners can readily obtain these through e-mail, it still requires Portuguese knowledge to do so.

Trans medication overview

There are multiple options for hormonal medicine, many of which will be familiar to US trans people and many of which may not.

Estrogen:

Natifa is a brand-name Estradiol-b17 pill usable in oral or sublingual applications. It is extremely similar to Estrace with only a few different filler ingredients. Only available as 1mg.
Estradiol valerate (valerato de estradiol) pills are readily available here, with or without a synthetic progesterone added in.
Estradiol enanthate (enantato de estradiol) injections are readily available in the form of Perlutal, which is EEn + DHPA, a synthetic progestin known to be safe.

Anti-androgens:

Spironolactone (espironolactona) is highly affordable and very common in many formulations.
Cyproterone (acetato de ciproterona) is also highly affordable and very common.
Bicalutamide has VERY poor availability and extremely high costs.

Testosterone:

Gel is available as Androgel, 16,2 mg/g @ 88g per package.
Injections are available but REQUIRE a prescription (receita).

Immigration policy

U.S. citizens can enter Brazil visa-free for 90 days until April 2025, when an e-Visa will be required. After 60 days, it is possible to request a 90 day renewal from the immigration agencies. Key immigration routes include:

Worker visa: VITEM V is a visa given to anyone sent to the country for long-term employment (more than 90 days). This most prominently includes tech and financial institutions sending skilled workers to their Brazilian offices, as well as students in a work exchange program.
Student visa: VITEM IV is a visa given to students who study abroad in Brazil. Brazilian universities are always looking for talented overseas students, and many are located in highly desirable areas.
Digital nomad: VITEM XIV is a visa given to people who meet the requirements for digital work abroad, including earning USD$1,500 a month. Requirements vary depending on which consulate governs your area of the US, but in general it is not too difficult to obtain. It lasts one year and can be renewed for a second year.
Family residency: VITEM XI and the Autorização de Residência por Reunião Familiar program are for people who are married to a Brazilian, or have Brazilian family. VITEM XI provides a one-year visa to give time to file paperwork in the US and Brazil for obtaining residency, while the Autorização de Residência por Reunião Familiar grants permanant residency upon completion.
All visa options must be done in the home country, WITH EXCEPTION to the Autorização de Residência por Reunião Familiar, which is a direct filing with the immigration authorities to grant permanant residency within the country.
Asylum options: Brazil does not offer asylum for LGBTQ+ peoples, and asylum is restricted only to certain humanitarian situations.

Permanent Residence Permit

Permanant, indefinite residency, is only provided in a select few cases:

Have obtained a permit by marriage or other immediate familial ties.
Have invested in real estate.
Have a retirement visa.

Citizenship Pathway

Naturalization in Brazil is provided in many different ways:

Ordinary A: 1 year of residence with family, no criminal conviction, and a petition to naturalize.
Ordinary B: 2 years of residence and the potential to provide professional, scientific, or artistic benefit relevant to Brazil.
Ordinary C: 4 years of residence under almost any other circumstance.
Extraordinary: 15 years of residence with no criminal convictions.
Special: Spouse of a person or a person in certain diplomatic or governmental positions.
Provisional: An adolescent under the age of 10 who has been petitioned to obtain citizenship by their guardian.

General document requirements

The documents required for residency and visas are highly dependent on which residency or visa you are applying for. However, there are a few which very regularly show up:

Proof of income: The digital nomad visa at the least requires 3 months of bank statements, showing you earn USD$1,500 or greater. Paystubs may also serve this function.

Apostilled birth certificate: If your visa provides you a residence card (CRNM), you generally must provide a copy of your birth certificate which has been certified for use within Brazil, and translated by a legal translator within the country.

Background check: Some visas from out of the country and any residency application within the country will request you provide a background check performed in the last 90 days by the federal government. If you are applying from within the country, then this background check must be apostilled for use in Brazil and legally translated.

Health insurance: Many applications require proof you have health insurance valid in Brazil, such as GeoBlue. This is different from your US private insurance, and tends to be significantly cheaper.

CPF: For applications within the country and for obtaining your residence card, you MUST have a CPF. This is a tax ID number which can be acquired by email when you are within the country.

Community & Social Support

Languages Spoken

Portuguese is the primary spoken language, with English profiency ranging from near non-existent in most states, to minorly present in others (such as São Paulo). Other languages such as Chinese, Japanese, and Arabic are minorly present in areas with major immigration from relevant reasons, such as Liberdade and its East Asian population.
Portuguese is necessary for all legal and civil procedures, but a fluent and trusted person can help on your behalf, and sworn translators are allowed (often required) to represent you in matters such as the signage of major documents.

Portuguese is not a particularly difficult language to learn due to the massive amount of Latin-derived vocabulary in English, and learning it is absolutely essential for adjusting to life here.

General life in Brazil

The friendliness towards LGBTQ+ populations will vary from area to area. People living in the North may face more bigotry, but in areas such as much of São Paulo and Rio de Janeiro, people are incredibly accepting. People will gender you based on how you mostly pass, and people in general are extremely friendly and vibrant.

LGBTQ+ Friendly Cities

São Paulo: São Paulo is the most important city in Brazil from a financial perspective, and is home to a diverse group of people. It is, however, very expensive to live in, with many cities on the outskirts of it offering equal quality of life at a significantly lowered cost.
Rio de Janeiro: Rio de Janeiro is another important city in Brazil, with a vibrant and accepting culture. Safety in it however is generally worse than the city of São Paulo, and it is infamously expensive.
Florianópolis: Florianópolis is a famous city near the beaches in Brazil, situated in the state of Santa Catarina. Like Rio and São Paulo, it is expensive, but has a flourishing night life.

Support Groups

Alian (Alian) - LGBTQ+ advocacy group.
ANTRA (ANTRA) – Transgender advocacy group.

Many cities also have local advocacy groups.

Cost of Living

While cities such as the cities of São Paulo, Rio de Janeiro, and Florianópolis are expensive, prices go down significantly around the outskirts without any compromise to safety or quality of life.
Healthcare costs are generally low, with the universal healthcare covering many needs if you are able to navigate it.
Taxes vary heavily, and all foreign income is subject to the Carnê-Leão, which has bracketed tax rates going up to 27.5%. These taxes are eligible to deduct against US income tax via the Foreign Tax Credit.

Housing Access & Cost

Renting as a foreigner without residency is near impossible. While you can sign contracts directly with landlords, you will need Portuguese profiency to do so, and popular rental sites such as QuintoAndar will not accept any rental attempt without an ID card.
Long-term AirBnBs are readily available, with price increases that are not completely absurd. A 1-bedroom apartment can cost around USD$550/mo in a good but not rich area.

Internet Access & Cost

Brazil has readily available internet with high speeds and low costs.
Mobile plans are often incredibly cheap, but require a CPF to obtain.

Law Enforcement

Brazilian law enforcement is broken up into multiple branches, most key of which are the Polícia Federal, Polícia Civil, and Polícia Militar. The PF manages immigration and federal matters, the PC manages investigations and forensics, and the PM is the closest to US LEO.
Quality of law enforcement varies heavily from region to region, but in decent areas they are usually non-invasive to people who are not poor.

Censorship Concerns

It is strictly forbidden by the constitution to censor any sort of speech which does not violate other laws (such as the anti-racism law which also applies to discrimination of LGBTQ+ people). Thus, speech about and by LGBTQ+ people is forbidden to be censored. (source)

Ease of Travel to Other Countries

Brazil has an incredibly powerful passport with many visa options, only hampered by stricter visa requirements for some countries such as the US and Canada.
Brazil benefits from the MERCOSUR trade bloc, and has easy transit between other countries in the bloc.

Animal Policies

Brazil allows pet importation but has some requirements for health certificates.
It is easy to find places which allow pets in renting.