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性别认同障碍:当前的医学与社会范式及《国际疾病分类第11版》的创新

Gender Identity Disorders: Current Medical and Social Paradigm and the ICD-11 Innovations.

作者信息

Dyachenko Anton V, Perekhov Alexey Y, Soldatkin Victor A, Bukhanovskaya Olga A

出版信息

Consort Psychiatr. 2021 May 25;2(2):54-61. doi: 10.17816/CP68. eCollection 2021.

Abstract

INTRODUCTION

This article presents a review of current concepts of gender identity under normal and pathological conditions.

AIM

To analyse the impact of the medical and social paradigm shift for clinical practice.

RESULTS AND DISCUSSION

The modern academic literature devoted to gender identity disorders is characterized by a variety of terminology, a shift in emphasis from clinical judgement to a socially beneficial normocentric approach and a relatively few advanced, evidence-based research. There is also a lack of evidence for the gender theory underlying the new approach, which raises serious doubts about the validity of the medical and social paradigm revision. In the same time, the position of Russian psychiatrists remains to be more clinically oriented.

CONCLUSION

Patients who declare the desire to reassign their gender have to be assessed by psychiatrists for differential diagnosis to exclude a mental disorder. In such cases, the destigmatization of mental disorders is more critical than the depathologization of gender identity disorders.

摘要

引言

本文对正常和病理状态下的性别认同的当前概念进行综述。

目的

分析医学和社会范式转变对临床实践的影响。

结果与讨论

致力于性别认同障碍的现代学术文献具有多种术语特点,重点从临床判断转向以社会有益的正常为中心的方法,且先进的循证研究相对较少。新方法所依据的性别理论也缺乏证据,这对医学和社会范式修订的有效性提出了严重质疑。同时,俄罗斯精神科医生的立场仍更倾向于临床导向。

结论

宣称希望重新分配性别的患者必须由精神科医生进行评估以进行鉴别诊断,排除精神障碍。在这种情况下,消除精神障碍的污名化比性别认同障碍的去病理化更为关键。

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