Division of Plastic Surgery, Department of General Surgery, Oregon Health & Science University, Portland.
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
JAMA Surg. 2017 Apr 1;152(4):394-400. doi: 10.1001/jamasurg.2016.5549.
IMPORTANCE: In 2014, the US Department of Health and Human Services decided that its 1981 exclusion of transsexual surgical treatments from Medicare coverage was based on outdated, incomplete, and biased science and did not reflect current evidence or standards of care, and the exclusion was therefore lifted. As a direct result of this decision, surgeons nationwide are seeing an increase in consultations for surgical therapy to help transgender and gender-nonconforming individuals. Although some clinicians may have the technical training for such surgical procedures, in many cases, they may not have a full understanding of the complex and comprehensive care required to provide optimal health care for transgender individuals. OBSERVATIONS: Gender confirmation surgery is a developing field in the United States and other areas of the world. The World Professional Association for Transgender Health started a global education initiative intended to provide surgeons and other health care professionals with the necessary background knowledge to understand and treat this patient population. This article provides an overview of best practices as set forth in the seventh edition of the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People by the World Professional Association for Transgender Health, including mental health, endocrinology, and surgery for trans women and trans men. CONCLUSIONS AND RELEVANCE: Experts in each aspect of transgender health have summarized the content of the global education initiative in this article. It provides valuable information to surgeons of all disciplines and other health care professionals to help guide the treatment and management of transgender individuals.
重要性:2014 年,美国卫生与公众服务部决定,其 1981 年将跨性别者的外科治疗排除在医疗保险范围之外的决定是基于过时、不完整和有偏见的科学,并且没有反映当前的证据或护理标准,因此该决定被推翻。作为这一决定的直接结果,全美各地的外科医生都看到了寻求手术治疗的咨询人数有所增加,以帮助跨性别者和性别不一致者。尽管一些临床医生可能具备进行此类手术的技术培训,但在许多情况下,他们可能并不完全了解为跨性别者提供最佳医疗保健所需的复杂和全面的护理。
观察:性别确认手术是美国和世界其他地区一个不断发展的领域。世界跨性别健康专业协会发起了一项全球教育倡议,旨在为外科医生和其他医疗保健专业人员提供必要的背景知识,以了解和治疗这一患者群体。本文概述了世界跨性别健康专业协会第七版《跨性别、跨性别和性别不一致者健康护理标准》中规定的最佳实践,包括跨性别女性和跨性别男性的心理健康、内分泌学和手术。
结论和相关性:跨性别健康各个方面的专家在本文中总结了全球教育倡议的内容。它为所有学科的外科医生和其他医疗保健专业人员提供了有价值的信息,以帮助指导跨性别者的治疗和管理。
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