The article examines health itineraries followed by Brazilian travestis, trans men and trans women in the affirmation of their gender, based on the survey Trans Uerj: Health and Citizenship of Trans People in Brazil. The survey's main objectives were to gauge the trans/travesti population's diversity and sociodemographic profile; and to map the various ways they access their rights as citizens, especially to healthcare services and body modification technologies. Interviewers, mainly trans people and travestis, applied 391 questionnaires in the city of Rio de Janeiro and its metropolitan region to interviewees of different social classes, schooling levels and gender identity configurations, contacted through the interviewers' social networks. For defining respondents' gender identities the survey used an original method based on self-definitions, which were then aggregated into 6 categories for data analysis purposes. This article discusses the multiple strategies used by this trans population in gender affirmation processes to gain access to regulated and/or unregulated use of hormones and surgical procedures.