Koh Jun
Department of Neuropsychiatry, Osaka Medecal College.
Seishin Shinkeigaku Zasshi. 2012;114(6):673-80.
The Metamorphoses Greek myth includes a story about a woman raised as a male falling in love with another woman, and being transformed into a man prior to a wedding ceremony and staying with her. It is therefore considered that people who desire to live as though they have the opposite gender have existed since ancient times. People who express a sense of discomfort with their anatomical sex and related roles have been reported in the medical literature since the middle of the 19th century. However, homosexual, fetishism, gender identity disorder, and associated conditions were mixed together and regarded as types of sexual perversion that were considered ethically objectionable until the 1950s. The first performance of sex-reassignment surgery in 1952 attracted considerable attention, and the sexologist Harry Benjamin reported a case of 'a woman kept in the body of a man', which was called transsexualism. John William Money studied the sexual consciousness about disorders of sex development and advocated the concept of gender in 1957. Thereafter the disparity between anatomical sex and gender identity was referred to as the psychopathological condition of gender identity disorder, and this was used for its diagnostic name when it was introduced into DSM-III in 1980. However, gender identity disorder encompasses a spectrum of conditions, and DSM-III -R categorized it into three types: transsexualism, nontranssexualism, and not otherwise specified. The first two types were subsequently combined and standardized into the official diagnostic name of 'gender identity disorder' in DSM-IV. In contrast, gender identity disorder was categorized into four groups (including transsexualism and dual-role transvestism) in ICD-10. A draft proposal of DSM-5 has been submitted, in which the diagnostic name of gender identity disorder has been changed to gender dysphoria. Also, it refers to 'assigned gender' rather than to 'sex', and includes disorders of sexual development. Moreover, the subclassifications regarding sexual orientation have been deleted. The proposed DSM-5 reflects an attempt to include only a medical designation of people who have suffered due to the gender disparity, thereby respecting the concept of transgender in accepting the diversity of the role of gender. This indicates that transgender issues are now at a turning point.
希腊神话《变形记》中有一个故事,讲述了一个从小被当作男性抚养长大的女子爱上了另一名女子,并在婚礼前被变成了男子,之后与她在一起。因此,人们认为渴望以异性身份生活的人自古就有。自19世纪中叶以来,医学文献中就有报道称有些人对自己的生理性别及相关角色感到不适。然而,同性恋、恋物癖、性别认同障碍及相关病症在20世纪50年代之前一直被混为一谈,并被视为在伦理上令人反感的性变态类型。1952年首例性别重置手术引起了广泛关注,性学家哈里·本杰明报告了一例“被困在男性身体里的女性”病例,这被称为易性癖。约翰·威廉·莫尼研究了性发育障碍方面的性意识,并在1957年提出了性别概念。此后,生理性别与性别认同之间的差异被称为性别认同障碍这一精神病理状况,并在1980年被引入《精神疾病诊断与统计手册》第三版(DSM-III)时用作其诊断名称。然而,性别认同障碍涵盖一系列状况,《精神疾病诊断与统计手册》第三版修订本(DSM-III-R)将其分为三种类型:易性癖、非易性癖以及未另行说明的类型。前两种类型后来合并并标准化为《精神疾病诊断与统计手册》第四版(DSM-IV)中的官方诊断名称“性别认同障碍”。相比之下,在《国际疾病分类》第十版(ICD-10)中,性别认同障碍被分为四组(包括易性癖和双性恋异装癖)。《精神疾病诊断与统计手册》第五版(DSM-5)的提案草案已提交,其中性别认同障碍的诊断名称已改为性别烦躁不安。此外,它提及“指定性别”而非“性别”,并包括性发育障碍。而且,关于性取向的子分类已被删除。提议的《精神疾病诊断与统计手册》第五版试图仅纳入因性别差异而受苦的人的医学诊断名称,从而在接受性别角色多样性方面尊重跨性别者的概念。这表明跨性别问题如今正处于一个转折点。