Cohen-Kettenis P T, Gooren L J
Rudolf Magnus Institute of Neuroscience, Department of Child and Adolescent Psychiatry, Utrecht University, The Netherlands.
J Psychosom Res. 1999 Apr;46(4):315-33. doi: 10.1016/s0022-3999(98)00085-3.
Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery (SRS). The origins of transsexualism are still largely unclear. A first indication of anatomic brain differences between transsexuals and nontranssexuals has been found. Also, certain parental (rearing) factors seem to be associated with transsexualism. Some contradictory findings regarding etiology, psychopathology and success of SRS seem to be related to the fact that certain subtypes of transsexuals follow different developmental routes. The observations that psychotherapy is not helpful in altering a crystallized cross-gender identity and that certain transsexuals do not show severe psychopathology has led clinicians to adopt sex reassignment as a treatment option. In many countries, transsexuals are now treated according to the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, a professional organization in the field of transsexualism. Research on postoperative functioning of transsexuals does not allow for unequivocal conclusions, but there is little doubt that sex reassignment substantially alleviates the suffering of transsexuals. However, SRS is no panacea. Psychotherapy may be needed to help transsexuals in adapting to the new situation or in dealing with issues that could not be addressed before treatment.
易性癖被认为是性别认同障碍谱系的极端表现，其特征之一是追求性别重置手术（SRS）。易性癖的起源在很大程度上仍不明确。已发现易性癖者与非易性癖者在大脑解剖结构上存在差异的首个迹象。此外，某些父母（养育）因素似乎与易性癖有关。关于病因、精神病理学及性别重置手术成功率的一些相互矛盾的研究结果，似乎与某些易性癖亚型遵循不同发展路径这一事实有关。心理治疗无助于改变固化的跨性别身份这一观察结果，以及某些易性癖者未表现出严重精神病理学症状这一情况，促使临床医生将性别重置作为一种治疗选择。在许多国家，现在根据哈利·本杰明国际性别焦虑协会（易性癖领域的一个专业组织）的《护理标准》来治疗易性癖者。对易性癖者术后功能的研究无法得出明确结论，但毫无疑问，性别重置能极大地减轻易性癖者所遭受的痛苦。然而，性别重置手术并非万灵药。可能需要心理治疗来帮助易性癖者适应新情况或处理治疗前无法解决的问题。
