|
中间性
-
怎样对待中间性
|
|
坚持不懈的变革
-
现今的指南
|
|
几年前，美国生物学家米尔顿•戴尔蒙德(Milton Diamond)和加拿大精神病学家基思•西格蒙德逊(Keith Sigmundson)为中间性病患管理拟定了一个指南，它涵盖了从出生到青春期及成年的诊疗管理规则。这个指南是生物学家、内科医生、心理学家、律师和各个中间性援助社团深入研讨的成果。以下则是对医生的指南要点： |
- 对每一例反常的性器官，尽一切可能确切弄清楚病因。
- 从发现病例起，就要通知病患父母和与其商议，并为他们保守秘密。
- 一旦弄清楚病因与预后，尽早做出合适的性别指派(sex assignment
)。
- 对不易确诊的病例，性别指派(sex assignment
)不是基于出生时的生理外观，而是基于青春期之后最可能的最终发育状况而定。
- 对一些疑难病例，当时就要制定出尽可能的最佳治疗方案，但是要向病患家属解释清楚，这个孩子随后可能会“转换性别”(switch genders)，也就是说可能发展成另一个性别自认(即性别认同会和指派的性别相反——译者注)。
- 只要有不能最后确诊性别的情况发生，就要延迟填写出生证上的性别一览。可以适用模糊的短语来处理出生证等法律文件，像“琼斯婴儿”或“布郎宝宝”之类的描述，也可使用中性词给孩子起名，像“特里”、“珂姆”“弗朗西斯”诸如此类的名字。(在中国的实际运用中，中国人的中性名字，倒也值得我们仔细地研究研究——译者注。)
- 不要仅为美容的理由而实施大型的性器官改造手术；而只为孩子将来健康着眼对症状实施手术。要向孩子的父母解释这种治疗方案，因为他们可能想让孩子“看起来正常”。即使孩子的外部性器官仍然明显地异常，他们到了成年也可能会有满意的生活。事实也是这样，大多数的中间性症状根本就不需要任何的外科手术。
- 为病患父母和患者本人开放长期的咨询途径。因为随着年复一年的时间过去，他们可能需要偶尔或经常性的专业咨询。
- 要做专业权威，但要避免充当专业的专横独断者。要为病患家庭提供有用的知识，但是要切记：只有客户能够就她或他的性别认同做出最后的性别选择决断。
- 让病患家庭与有关援助社团保持联系。
|
|
欲查阅完整的指南，请点击此处。（中国大陆尚没有此类指南可供使用，需要有关专业指导部门重视。——译者注）
欲查阅“性器官矫正的外科手术”方面的法律文件，请点击此处。（中国大陆尚无相应的法律规定，需要有关立法部门重视。——译者注）
|
|
|
|
Intersexuality - Dealing with Intersexuality
|
|
Continuing Changes - Current Guidelines
|
|
A few years ago, the American biologist
Milton Diamond and the Canadian psychiatrist
Keith Sigmundson proposed new guidelines for the medical management of intersexes, from birth through adolescence into adulthood. These guidelines were the result of intensive discussions among biologists, physicians, psychologists, lawyers and various intersex support groups. For doctors, this is a brief summary of the main points: |
- In each case of atypical sex organs, make every effort to establish the probable cause.
- From the very beginning, inform and counsel the parents, and protect their confidentiality.
- Where cause and prognosis are clear, make the appropriate sex assignment as early as possible.
- In less obvious cases, base the sex assignment not on the physical appearance at birth, but on the most likely eventual outcome for the child after puberty.
- In very difficult cases, make the best decision possible at the time, but explain to the family that the child may later “switch genders”, i.e. develop another sexual self-identification.
- As long as there is no final diagnosis, delay entering the child’s sex in official records. Some indeterminate phrase like “Infant Jones” or “Baby Brown” may be used as well as gender-neutral first names like “Terry”, “Kim”, “Francis”, etc.
- Perform no major surgery for cosmetic reasons alone; only for conditions related to the child’s future health. Explain this decision to the parents who may want their baby to "look normal." Even if the external sex organs remain obviously atypical, a satisfying life in adulthood may very well be possible. Indeed, most intersex conditions do not need any surgery at all.
- Keep the door open for future consultation. Both parents and child may need occasional or regular counseling as the years go by.
- Be an authority, but avoid being authoritarian. Provide the best available information, but remember: Only the client can make the final decision about her or his sexual identity.
- Put the family in touch with a support group.
|
|
For the full text of the guidelines, click
here.
For some legal aspects of “normalizing surgery”, click
here.
|
