Štrkalj Goran, Pather Nalini
Department of Anatomy, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
Anat Sci Educ. 2021 Jul;14(4):513-518. doi: 10.1002/ase.2002. Epub 2020 Sep 4.
Developments in biology and genetics in recent decades have caused significant shifts in the understanding and conceptualization of human biological variation. Humans vary biologically in different ways, including individually, due to age, ancestry, and sex. An understanding of the complexities of all levels of biological variation is necessary for efficient health care delivery. Important steps in teaching medical students about human variation could be carried out in anatomy classes, and thus, it is important that anatomical education absorbs new developments in how biological variation is comprehended. Since the early 1990s biological sex in humans has been vigorously investigated by scientists, social scientists, and interest groups. Consequently, the binary division in male and female sex has been called into question and a more fluid understanding of sex has been proposed. Some of the major textbooks teach anatomy, particularly of the urogenital system, as a male-female binary. Anatomical sciences curricula need to adopt a more current approach to sex including the introduction of the category of "intersex"/"differences in sexual development" and present sex as a continuum rather than two sharply divided sets of characteristics. This approach offers a better understanding of the complexity of sex differences and, at the same time, provides students with an improved theoretical framework for understanding human variation in general, transcending the limitations of biological typology. When well delivered, the non-binary approach could play a significant contribution to the formation of competent and responsible medical practitioners and avoidance of problematic practices such as non-consensual "normalizing" surgeries.
近几十年来，生物学和遗传学的发展使人们对人类生物变异的理解和概念化发生了重大转变。人类在生物学上以不同方式存在差异，包括个体差异、因年龄、血统和性别的差异。了解生物变异各个层面的复杂性对于高效提供医疗保健至关重要。在解剖学课程中可以采取重要步骤来教导医学生关于人类变异的知识，因此，解剖学教育吸收关于生物变异理解方面的新进展非常重要。自20世纪90年代初以来，科学家、社会科学家和利益集团对人类的生物性别进行了深入研究。因此，男性和女性的二元划分受到了质疑，人们提出了对性别的更灵活理解。一些主要教科书将解剖学，尤其是泌尿生殖系统的解剖学，讲授为男女性别二元模式。解剖学科学课程需要采用更现代的性别研究方法，包括引入“间性人”/“性发育差异”类别，并将性别呈现为一个连续体，而不是两组截然不同的特征。这种方法能更好地理解性别差异的复杂性，同时为学生提供一个改进的理论框架，以更全面地理解人类变异，超越生物类型学的局限性。如果实施得当，非二元方法可以对培养有能力和有责任感的医学从业者以及避免诸如未经同意的“正常化”手术等有问题的做法做出重大贡献。
