变性者的临床管理。
Clinical management of transsexual subjects.
作者信息
Costa Elaine Maria Frade, Mendonca Berenice Bilharinho
机构信息
Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo.
FM, USP, São Paulo, SP, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2014 Mar;58(2):188-96. doi: 10.1590/0004-2730000003091.
Transsexual subjects are individuals who have a desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex. They seek to develop the physical characteristics of the desired gender, and should undergo an effective and safe treatment regimen. The goal of treatment is to rehabilitate the individual as a member of society in the gender he or she identifies with. Sex reassignment procedures necessary for the treatment of transsexual patients are allowed in our country, at Medical Services that have a multidisciplinary team composed of a psychologist, a social worker, a psychiatrist, an endocrinologist and surgeons (gynecologists, plastic surgeons, and urologists). Patients must be between 21 to 75 years old and in psychological and hormonal treatment for at least 2 years. Testosterone is the principal agent used to induce male characteristics in female transsexual patients, and the estrogen is the chosen hormone used to induce the female sexual characteristics in male transsexual patients. Based on our 15 years of experience, we can conclude that testosterone and estradiol treatment in physiological doses are effective and safe in female and male transsexual patients, respectively.
易性症患者是指渴望以异性成员的身份生活并被接纳,通常伴有对自身解剖学性别感到不适或认为其不合适,且希望通过手术和激素治疗使身体尽可能与自己偏好的性别相符的个体。他们试图发展出期望性别的身体特征,并且应该接受有效且安全的治疗方案。治疗的目标是使个体作为其认同性别的社会成员得到康复。我国允许在由心理学家、社会工作者、精神科医生、内分泌学家和外科医生(妇科医生、整形外科医生和泌尿科医生)组成的多学科团队的医疗服务机构中,为易性症患者进行必要的性别重置手术。患者年龄必须在21至75岁之间,并且至少接受2年的心理和激素治疗。睾酮是用于诱导女性易性症患者出现男性特征的主要药物,而雌激素是用于诱导男性易性症患者出现女性特征的首选激素。根据我们15年的经验,我们可以得出结论,生理剂量的睾酮和雌二醇治疗分别对女性和男性易性症患者是有效且安全的。