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[变性患者:心理医学与外科医学合作面临的挑战]

[The transsexual patient: a challenge for cooperation between psychological and surgical medicine].

作者信息

Langer D

出版信息

Fortschr Neurol Psychiatr. 1985 Mar;53(3):67-84. doi: 10.1055/s-2007-1001954.

DOI:10.1055/s-2007-1001954
PMID:3997032
Abstract

Transsexuality is not seen as a disorder by itself but rather as a common final stage of different dispositions and developments, with the common core of disordered, conflicting gender identity, and the common transsexual desire for "gender reassignment". Proceeding on the ascertainable increase in frequency in the past 15 years we wonder whether some sort of collaboration between psychological and surgical medicine and persons with identity disorders may not have been conducive to the transsexual desire at the expense of a thorough study of the phenomenon as well as psychotherapeutic possibilities. Under this aspect it is analyzed and depicted which the dimensions of transsexual experience are, what constitutes the personality of transsexuals, and how the development toward transsexuality takes its course. Subsequently there is a critical analysis of the "fulfillment" of the transsexual desire under the transsexuality-law and by means of physical-medical measures. A study of case histories and follow-ups at hand reveals whether the desire for gender reassignment has indeed been fulfilled. In conclusion the recent critical re-orientation toward psychotherapy for transsexuals as a method to control psychic disorders by psychic means is corroborated, albeit its chances may be viewed rather skeptically in the light of the present boom of gender reassignment operations.

摘要

变性本身并不被视为一种疾病,而是被看作是不同性格和发展阶段的一个常见最终阶段,其共同核心是紊乱、冲突的性别认同,以及变性者对“性别重置”的共同渴望。鉴于在过去15年中可确定的发病率有所上升,我们不禁要问,心理医学和外科医学与身份障碍患者之间的某种合作是否不利于对这一现象以及心理治疗可能性进行深入研究,反而助长了变性欲望。从这方面分析并描述了变性经历的维度、变性者的性格构成以及向变性发展的过程。随后,对变性欲望在变性法下以及通过物理医学措施得到“满足”的情况进行了批判性分析。对现有病例史和随访的研究揭示了性别重置的欲望是否真的得到了满足。最后得出结论,尽管鉴于目前性别重置手术的盛行,人们可能对其效果持相当怀疑的态度,但最近将针对变性者的心理治疗重新定位为一种通过心理手段控制精神障碍的方法的做法得到了证实。

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