University of Sheffield, Sheffield, UK; Porterbrook Clinic, Sheffield, UK.
Department of Psychiatry, University of British Columbia, BC, Canada.
Lancet. 2016 Jul 23;388(10042):401-411. doi: 10.1016/S0140-6736(16)00682-6. Epub 2016 Jun 17.
The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.
世界跨性别健康专业协会（WPATH）的跨性别、变性和性别不一致者护理标准（第 7 版）代表了这些人群临床护理的国际规范标准。虽然提供给跨性别群体的服务的实施将取决于卫生系统基础设施和社会文化背景，但世界各地最佳的个体临床护理标准是一致的。一些跨性别者的临床服务，包括性别肯定手术，最好在更专业的设施中提供；然而，大多数医疗保健需求可以由初级保健医生提供。在高收入和低收入环境中，医疗保健专业人员在跨性别健康方面的教育计划往往仍然不足，尽管最佳证据支持在临床医生和相关健康专业人员的临床教育早期引入关于跨性别健康的模块。虽然这些挑战仍然存在，但我们回顾了越来越多的证据和例子，这些证据和例子说明了心理健康专业人员在跨性别者医疗保健决策中的明确作用、有效的卫生服务提供模式以及为跨性别者提供的可用手术干预措施。
