Saewyc Elizabeth M
School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Nurs Inq. 2017 Jan;24(1). doi: 10.1111/nin.12184.
Although societies and health care systems are increasingly recognizing gender outside traditional binary categories, the notion persists of two, and only two sexes, 'naturally' aligned between chromosomes and phenotypic body. Yet there are more than a dozen documented genetic or phenotypic variations that do not completely fit the two simplistic categories, and together, they may comprise 1%-2% of the population worldwide. In this commentary, I consider how adherence to binary notions of sex has created and maintained social and health care structures that perpetuate health care inequities, and may well violate our nursing codes of ethics. I provide some current examples in law and health care systems that create difficulties for people with variations in sex development. I describe our responsibility to challenge the societally promoted but scientifically inaccurate perspective of sex as a binary. I conclude by briefly suggesting a few implications for action within nursing research, nursing education, nursing practice, and in advocacy as a profession.
尽管社会和医疗保健系统越来越认识到性别超出了传统的二元范畴，但关于只有两种且仅两种性别“自然”地与染色体和表型身体相对应的观念仍然存在。然而，有超过十几种已记录在案的基因或表型变异并不完全符合这两种简单的类别，而且它们加起来可能占全球人口的1%-2%。在这篇评论中，我思考了坚持性别二元观念是如何创造并维持了社会和医疗保健结构，这些结构使医疗保健不平等长期存在，而且很可能违反我们的护理伦理准则。我提供了一些法律和医疗保健系统中的当前例子，这些例子给性发育变异者带来了困难。我描述了我们有责任挑战社会所宣扬但科学上不准确的性别二元观点。最后，我简要提出了一些对护理研究、护理教育、护理实践以及作为一个职业的倡导行动的启示。
