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“要是我早知道你是个异装者,我就不会碰你了”:土耳其的医源性暴力与跨性别死亡政治

"If I knew you were a travesti, I wouldn't have touched you":Iatrogenic violence and trans necropolitics in Turkey.

作者信息

Atuk Tankut

机构信息

Rensselaer Polytechnic Institute, Science and Technology Studies Department, United States.

出版信息

Soc Sci Med. 2024 Mar;345:116693. doi: 10.1016/j.socscimed.2024.116693. Epub 2024 Feb 13.

DOI:10.1016/j.socscimed.2024.116693
PMID:38367339
Abstract

Since 2007, the number of HIV diagnoses in Turkey has increased more than 600% and the AIDS-related deaths have more than doubled. Despite trans community being severely impacted by the growing epidemic, there exists a conspicuous absence of epidemiological data regarding the HIV burden of trans people. This paper examines the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of health providers. The paper emphasizes the urgent need for comprehensive interventions to address the intersecting issues of HIV risk, structural violence, and discrimination faced by HIV-positive trans sex workers, one of the most marginalized communities worldwide. To interpret better how transphobia and HIVphobia become deeply entangled in Turkish medical settings, the paper draws from the concepts of iatrogenesis, necropolitics, and immunity. By bringing together these conceptual tools with long-term ethnographic data and in-depth interviews, this paper demonstrates that trans women are treated by healthcare providers as though they are always-already infectious. The paper contends that aggressive immunitarian boundaries, erected between healthcare personnel and individuals deemed "contagious others," are central to doctors' denial of medical care and reluctance to touch, examine, or even admit trans patients, particularly when they are HIV-positive.

摘要

自2007年以来,土耳其的艾滋病毒诊断病例数增加了600%以上,与艾滋病相关的死亡人数增加了一倍多。尽管跨性别群体受到这一日益严重的流行病的严重影响,但关于跨性别者艾滋病毒负担的流行病学数据却明显缺失。本文考察了从事性工作的艾滋病毒呈阳性的跨性别女性的就医经历以及她们在医疗服务提供者手中遭遇的有害暴力。本文强调迫切需要采取全面干预措施,以解决艾滋病毒呈阳性的跨性别性工作者所面临的艾滋病毒风险、结构性暴力和歧视等相互交织的问题,她们是全球最边缘化的群体之一。为了更好地解读在土耳其的医疗环境中,恐跨症和恐艾症是如何深度交织的,本文借鉴了医源性、死亡政治和免疫的概念。通过将这些概念工具与长期的人种志数据和深入访谈相结合,本文表明医疗服务提供者对待跨性别女性的方式就好像她们一直都是具有传染性的。本文认为,在医护人员与被视为“传染性他人”的个体之间建立的激进免疫边界,是医生拒绝提供医疗服务以及不愿接触、检查甚至收治跨性别患者的核心原因,尤其是当她们艾滋病毒呈阳性时。

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