Transitionmụaka na-agagharị: ILDdọ aka ná ntị ụmụaka na-adọ ịdọ aka ná ntị na New Zealand

Transitionmụaka na-akpụgharị:
YM GAKA Gender DYSPHORIA
Warningdọ aka na ntị gbasara paediatric New Zealand
Site n'aka Dr John Whitehall


October 2018
Nke a bụ akụkọ sitere na akwụkwọ TRANSGENDER: otu ndò nke isi awọ - Nsonaazụ iwu maka nwoke na nwanyị, ụlọ akwụkwọ, egwuregwu, ndọrọ ndọrọ ọchịchị, ọchịchị onye kwuo uche ya site n'aka Patrick J Byrne - ya na Prọfesọ John Whitehall na Lane Anderson (onye na-akpọ ya), Nkwuputa Wilkinson, 2018.


Ọ dị na https://shop.newsweekly.com.au/product/transgender-one-shade-of-grey/ NOUT N'AUWA AUTHOR Prọfesọ John Whitehall bụ Onye isi oche na Prọfesọ nke Paediatrics na Ahụike Childmụaka na Mahadum nke Western Sydney. Dr Whitehall gụsịrị akwụkwọ na Mahadum Sydney na 1966 wee mezuo ọnụnọ ya na Hospitallọ Ọgwụ Sydney tupu ya arụ ọrụ na mba ndị na-emepe emepe. Ọ gara ọzụzụ ọzụzụ banyere ụmụaka na England na Australia, ya na ọzụzụ azụ na neonatology. Dr Whitehall enweela ọkwa dị ka Onye Ọkachamara Ọkachamara na ngalaba nlekọta kpụ ọkụ n'ọnụ na pelọ Ọgwụ Nepean, Director nke Neonatal Intensive Care Unit na Townsville na onye otu Kọmitii nke Women'smụ nwanyị na Children'smụaka nke North nke lekọtara mmepe nke ọrụ na mmezi nke ụkpụrụ niile na mpaghara ahụ. . Dị ka Prọfesọ Prọfesọ na oflọ Akwụkwọ Ahụike Ọha na Ahụike Ọgwụ na Mahadum James Cook, Dr Whitehall mepụtara ma nyefee ihe ọmụmụ na Tropical Paediatrics ma keere òkè na ịzụlite oflọ Akwụkwọ Ọgwụ.

Ahụmịhe Prọfesọ Whitehall na-arụ ọrụ na mba ndị ka na-emepe emepe gụnyere mmemme enyemaka ndị gbara ọsọ ndụ na Vietnam, ụlọ ọgwụ ndị ozi ala ọzọ dị na South Africa, yana ụlọ ọgwụ mahadum dị na Zimbabwe (mgbe ahụ Rhodesia). O tinyela aka na otu ndị enyemaka na Guam (maka ndị gbara ọsọ ndụ Vietnamese), East Timor, Lebanon na Mexico. Na 2005, o duru mmemme enyemaka na Sri Lanka mgbe mbufịt tsunami nke Asia, wee bụrụ onye ikpeazụ maka Senior Australian of the Year na 2006 maka ọrụ enyemaka a. Ruo ọnwa abụọ karịa ekeresimesi 2014, ọ rụrụ ọrụ dị ka dibịa bekee n'otu ụlọ ọgwụ dịpụrụ adịpụ na Madagascar. Dr Whitehall na-enwe mmasị pụrụ iche na ahụike mba ụwa, wee bipụtara n'ọtụtụ isiokwu sitere na neonatology na ahụike ọha. Dị ka ọkà mmụta banyere neonatologist, Dr Whitehall nwere mmasị karịsịa na embrayology nke ụbụrụ na mmetụta nke ọgwụ, dị ka mmanya. Ọ bụ nchegbu banyere nkwụsị nke ụbụrụ na-etolite site na ọgwụ ndị gbochiri oge uto ma kpalite omume mmekọahụ nke nwoke na nwanyị nke kpalitere itinye aka na arụmụka dysphoria okike. Ntinye aka ahụ etinyela isiokwu anọ dị ogologo na Magazin Quadrant (Disemba 2016, Mee & Disemba 2017, Julaị 2018), ajụjụ ọnụ redio na ikwu okwu n'ihu ọha. Dr Whitehall kwuru okwu na Nzukọ Ezumike nke Ezinụlọ na Ezinụlọ na 2017. Enwere ike ilele ihe ngosi ya na www. mmmmmmmmmmmmm.nz


N ’EZIN FLỌ NZIZI NZ Family First NZ bụ ọgbakọ ọrụ ebere hiwere na 2006, wee deba aha ya dịka ndị ọrụ enyemaka na ndị ọrụ enyemaka.
Ebumnuche ya na ebumnuche ya:
• ịkwalite na iwelie nyocha na iwu gbasara ezinụlọ na alụm di na nwunye
• isonye na nyocha mmekọrịta na arụmụka metụtara nsogbu metụtara yana emetụta ezinụlọ
• imepụta ma bipụta ihe dị mkpa ma na-akpali akpali na akwụkwọ akụkọ, akwụkwọ akụkọ, na usoro mgbasa ozi ndị ọzọ metụtara okwu metụtara ezinụlọ
• ikwuputa nsogbu gbasara ezinaụlọ ndị dị na ngalaba ọhaneze.

Maka ozi ndị ọzọ na mbipụta nke akụkọ a, gaa na www.familyfirst.nz
tel: 09 261 2426
faksị: 09 261 2520
ozi-e-mail: admin@familyfirst.org.nz
weebụ: www.familyfirst.nz
post: PO Box 276-133, Manukau City 2241, New Zealand
Copyright - Nkwupụta a na ozi niile dị na ya bụ © Family First NZ 2018.

NCHỊKỌTA ONYE ISI
Ọrịa gbasara 'dysphoria okike nwata' na-egbu Ọdịda Anyanwụ .wa. N'inwe nsogbu site ụkọ ihe na-erughi afọ iri gara aga, enwere mmụba dị ugbu a na ọnụ ọgụgụ nke ụmụaka a na-ewetara ụlọ ọrụ ndị mepụtara nke ọma na ụlọ ọgwụ ụmụaka dị ukwuu na mkpesa 'a mụrụ ha na ahụ adịghị mma' na 'so' na nke ahụ nke nwoke na nwanyị. Nsogbu dị otú ahụ na njirimara anaghị eju anya na oke ihe mgbu ya, ma ụmụaka ma, na-abụkarị, ndị nne na nna.

Ozi ọma nke ọrịa na-efe efe bụ na ọtụtụ ụmụaka nwere mgbagwoju anya banyere okike ha ga-ebute isi site na nwata ruo na nke nwoke a mụrụ ya. N'ọtụtụ, enwere ike ịdabere na mmiri sitere n'okike na usoro homonụ ịrụ ọrụ ha.

Ihe mmesi obi ike a bu ihe anaghi achi site n’aka ndi okachasi ndi nwere mmetuta iwebata nwatakiri emetutara n’uzo ogwu nke bidoro site na akparamaagwa nke nkwuputa mmadu na ibe ya: aha, nkwuputa, na edozi isi, uwe na ulo mposi. Ndị nwe ikike na ndụ nwatakịrị ahụ na-akwado ihe (ma ọ bụrụ na akwadoghị ya): nwatakịrị (nne na nna), ndị nkuzi na ndị ọgbọ.

Mmemme dị otú a nwere ike iduga n'ọgwụgwụ nke usoro ọgwụgwọ ọzọ: nchịkwa ọgwụ iji gbochie usoro eke nke agbọghọ na ebumnuche ya na ebumnuche nke inye nwata ahụ oge iji lelee okike ya na ọdịnihu.

Imirikiti ụmụaka nke 'akpọchiri' ga-aga n’ihu na usoro ọgwụgwọ ọzọ, nchịkwa nke homonụ na-enwe mmekọahụ iji kpalite agwa anụ ahụ na-abụghị nwoke na nwanyị. Mmụba a nwere ike ịga n'ihu na ịwa ahụ iji nwude njirimara ndị ọzọ. Na ogbo a, dịka ọmụmaatụ, ụmụ nwanyị ndị na-amụ nwa nwere ike ịga akwụkwọ mastectomy.

Agba ikpeazụ nke ụzọ ahụike bụ oge ndụ nke nlebara anya na nsonaazụ nke homonụ na-ekwekọghị n’ahụ, agbanyeghị ịwa ahụ urogenital na nsogbu ọ bụla nke uche na-adịgide. N'ime usoro 'mgbanwe' nke onye na-abụghị nwoke na nwanyị, castration bụ ihe ekere eke.

Nnukwu nnabata a na uche na ahụ ụmụaka ka a ga-atụ anya ga-esite na nyocha nke sayensị mana, n'ụzọ dị ịtụnanya, nke ahụ abụghị ikpe.

O nweghi ihe ndabere sitere na nduhie banyere okike: o nwere njiri mara nke echiche uche, nke ndi mgbasa akuko na-akwadoghi, nke webatara site na webusaiti nzuzo na nke mmemme ochichi nke ego nke ‘muta’ a mara nke oma na Australia dika ‘Schoolslọ akwụkwọ nchekwa. Ihe omume ', na nrụgide ndị ọgbọ na-agbakwa ume.

O di nwute, ndi umuaka ndi n’enweghi ihe omuma ka ha di otutu: otutu nyocha na-ekpughere otutu umuaka ndi mmadu gha enwe mgbagwoju anya banyere okike ha nwekwara nsogbu oria, dika obi uto na nchekari. Ọzọkwa, enwere nnọchiteanya pụrụ iche nke ụmụaka nwere Ọrịa Autism Spectrum Disorder onye amarala banyere eziokwu adịla mbụ mara na-agbagha.

Ọ bụghị ihe ijuanya, akụkọ na-ekpughe na ọtụtụ n'ime ụmụaka si n'ụlọ etisasịwo. Na ihe kwesiri ịbụ ịdọ aka na ntị agbakwunyere: akụkọ na-ekpughe nnukwu mkpakọrịta na nsogbu omume na nne na nna, ọkachasị ndị nne.

Ndị na-akwado ụzọ nke ahụike kwupụtara na ọ dị mkpa iji gbochie igbu onwe ya mana, ọzọkwa, enweghị ihe akaebe ọ bụla na dysphoria okike na ụmụaka, kwa se, nwere ihe egwu dị elu nke igbu onwe ya. Ọgba aghara ndị metụtara uche na ezinaụlọ a, ka amaara na imerụ onwe ya, yabụ, nwatakịrị emetụtara (na ezinụlọ) kwesịrị ka akpachara anya na ọmịiko.

Dika a na-akuko onu ogugu ndi na-egbu onwe ha kariri oge 20 nke onu ogugu ndi mmadu, enwere ike igbochi igbu onwe site na obi ebere 'na-eche' maka ihe okike nke oge uto iji mee ka nwatakiri kwenye na chromosomes ya, ma itinye ọgwụgwọ dị ka ihe metụtara ọrịa uche metụtara.

Ndị na-akwado ụzọ a na-ekwupụta igbochi agbọghọbịa bụ 'ihe nchekwa ma nweghachigharị kpamkpam', mana nyocha nke ndị okenye jisiri ike 'blockers' iji belata mmepụta homonụ nwoke na nwanyị na-ele anya na-akpali uto mkpụrụ ndụ (dịka ọrịa kansa prostate na ụmụ nwoke na endometriosis na Ndi umu nwanyi), atuputala nnyonye anya na oru ndi ụbụrụ, nke ekwenyesiri na omumu. Usoro aka nke ụmụ atụrụ ‘egbochi’ na-ekpughere mmebi na arụ ọrụ: a chọpụtala na agbanwere ihe omume nke ọtụtụ narị mkpụrụ ndụ ihe nketa, na-eduga ná nkwụsi ike na ebe nchekwa na mmetụta.

Ndị na-akwado echiche na-ekwu na igbochi mgbe a na-eto eto na-ekwupụta mmetụta ndị a na-emetụta nwatakịrị ahụ ịtụle njirimara ya na mmekọahụ mana olee otú nke a ga-esi mee mgbe usoro mmekọahụ sitere na ụbụrụ na ahụ na-egbochi.

Ndị na-akwado nkwado na-ekwenye ọtụtụ mmetụta metabolic nke ọgwụgwọ nwoke na nwanyị na-eme ka nwoke na nwanyị nwee mmekọahụ, si otú a na-akwado mkpa ọ dị ịdị na-ahụ maka nlekọta ahụike mana ekwetaghị mmetụta na ụbụrụ. Iji maa atụ, ọmụmụ MRI achọpụtala na ụbụrụ nwoke toworo eto ekpughere estrogen shrinks na nrịgo ugboro iri karịa ịka nká, mgbe ekpughechara ọnwa anọ. Gịnị ga-eme ụbụrụ na-eto eto ekpughere homonụ mmekọahụ na-eduga ná ndụ?

Ndị na-akwado akwụkwọ na-arụ ụka na enwere ike ịme mastectomy ụmụ nwanyị nwere mgbagwoju anya iji nyere ha aka kọwaa akụkụ nke nwoke, ma ọ dịkarịa ala ụmụ nwanyị ise nwere usoro a na Australia: abụọ dị na 15, otu na 16, na abụọ na afọ 17. Ndị na-akwado akwụkwọ na-enye usoro na mmetụta ndị a 'agbanweela', dị ka a ga-asị na inye nwa ara adịghị mkpa yana ihe ndị niile atụnyere bụ ihe siliconised.

Onweghi ihe omuma sayensi na akwukwo banyere ogwu iji kwado oke uzo nke aru ike. Kama nke ahụ, enwere otutu ngosipụta nke mkpa ihe akaebe, yana akwa arịrị banyere enweghị ya. A na-eduzi ọha na ndị gọọmentị site na ndị a na-akpọ 'echiche ọkachamara'.

Ihe omumu nke uzo transgendering gbara gha arua nke Western Western nwere echiche nke ndi ozo: 'agbanyeghi nwoke na nwanyi' nke na adighi ejighari ihe ndi nwoke na nwoke ka ndi nwoke: nke onye obula di na onodu a na nkwenye ime. Ọzọkwa, ụmụafọ a amabeghị nke ọma, na njirimara nwoke na nwanyị nwere ike gbanwee dabere na mmetụta dị n'ime.

Echiche a na-egosi na nwoke na nwanyị na-enyocha ike na-enwe ike ọfụma. Naanị afọ ole na ole gara aga, nkwupụta ahụ na enweghị ndị dị ka ụmụ agbọghọ na ụmụ nwoke nwere ike ịnwere nnwere onwe kwesịrị ịtụnanya nke ụwa dị larịị. Ma ihe dị iche ugbu a na, n'ọtụtụ mba, enwere ọtụtụ ndị kwere ekwe n'ezie. Ikekwe na-egosipụta oke nkwenye, ma ọ bụ ikekwe enweghị ntụkwasị obi, ndị kwere ekwe enwegola ọfụma n'ime ka ndị omebe iwu kwenye (na ndị isi ndị ọzọ) ịmanye nnabata na echiche ha. A na-amanye mmadụ izisa ozi ọma.

Edemede a bu ederede edeputara ma tulee oria ojoo a, udi umuntakiri ndi agbagwo agbaghari, uzo ihe nlere anya di na ogwu, ndi eweputara na ya na ufodu iwu di nkpa. Ọ na - agbagha ndị na - akwado ụzọ maka ịdakwasị akwụkwọ sayensị na eleghara nyocha ya. Ọ na - enye 'arụmụka sayensi' ma jụ iwepu ebubo nke 'transphobia' ma ọ bụ 'nku nku ụjọ ziri ezi'.

 

Thedọ aka na ntị a na New Zealand bụ na nnabata dị ukwuu na uche na ahụ ụmụaka nke ụzọ ahụike nke transgending butere enweghị isi sayensị. Site na United States ruo Europe enweghị ihe nchọpụta sayensị nke izi ezi. Kama nke ahụ, enwere nchọpụta sayensị na-emetụta nsonaazụ na-adịgide adịgide. Thezọ ahụike dabere na naanị echiche, yana nkwuputa nke 'ịga nke ọma' na-egosi nkwenye, ọ bụghị sayensị. Nke ka njọ bụ na nkwenkwe ndị a anaghị enwe mkparita ụka: ha na - amanye mmanye.
Isiokwu a na-enye 'arụmụka sayensị' na-ajụ ịgbachi nkịtị byaccusations nke 'transphobia' ma ọ bụ 'nku nku ụjọ'. N'ụzọ megidere nke a, ọ na-ekweta ma na-achọ iwelata oke nhụjuanya nke ụmụaka gbara gharịrị, mana ọ dabere na ụkpụrụ nke Hippocratic: 'Nke mbụ, emekpala ihe ọ bụla'.

TEBULU ỌDỊNAYA
Okwu Mmalite
Kedu otu a na-ahụkarị dysphoria okike nwata?
Onwere nsogbu ndi ozo di na dysphoria okike?
Risk nwere ihe dị njọ nke imerụ onwe ya na igbu onwe ya?
Gini bu akparamagwa nke ndi nne na nna na-eweta umuaka na ulo ogwu dysphoria okike?
Kedu nhọrọ ndị dịnụ maka ọgwụgwọ ụmụaka nwere dysphoria okike?
Kedu ihe Ndị Nhazi Dutch na-agụnye?
Olee nsogbu nwatakịrị zutere n'okporo ụzọ Dutch?
Na-adọ 1: ngbanwe ọhaneze
Oge nke 2: igbochi agba
Usoro nke ato: nlekọta nke homonụ nwoke na nwanyị
Usoro 4: ogwugwo
Enwere ihe akaebe na Protocol Dutch bara uru?
Mmetụta anụ ahụ
Mmetụta uche mmadụ
Mmetụta iche echiche
Ọ nwere ihe ọzọ dị n'ihe ize ndụ?
Kedu ihe iwu nwere ikwu na North America?
Kedu ihe iwu nwere ikwu na Australia?
Gịnị ga-eme n'ọdịnihu?
Njedebe


OKWU
A kọwara dysphoria okike dị ka “nnukwute nsogbu dị egwu ma ọ bụ mmekpa ahụ na mmekọrịta mmadụ na ibe ya, ụlọ akwụkwọ, ma ọ bụ ihe ndị ọzọ dị mkpa na-arụ ọrụ” n'ihi “nnabata pụtara ìhè n'etiti nwoke ma ọ bụ nwanyị agwala ya na okike ekenyela ya” (1). N'oge gara aga, n'oge na-adịbeghị anya, enwere mmụba dị egwu na ọnụ ọgụgụ ụmụaka a na-eweta n'ụlọ ọgwụ ụmụaka e mere maka ọrịa nwoke na nwanyị na-arịa ọrịa dysphoria na Western Western dum, gụnyere Australia. Mmụba a jikọtara ya na ọtụtụ mgbasa ozi nhọrọ transgender na mgbasa ozi, web wee na mmemme izizi gbasara mmekọahụ na ụlọ akwụkwọ. Onweghi onye ma ihe kpatara oria a ma o bu njiri mara nke akparamagwa. Ka o sina dị, ọ dị ize ndụ n'ihi na ọgwụgwọ ọgwụ nwere ike ịgụnye homonụ na-egbochi ụbụrụ yana ahụ, ọ nwere ike inwe ọganihu na ịwa ahụ a na-atụgharịghị agbanwe na ịnwapụta ụdị mpụga nke nwoke na nwanyị. Ihe fad bụ echiche a maara dị ka transgenderism. N'afọ ndị na-adịbeghị anya ahụla uto nke ihe nkiri ụmụaka na-ebo ebubo na-agbagha okike ha. Ọnọdụ ha na-apụta site na azụ nke mgbasa ozi na-akpali akpali na nke enweghị ike, ito ọnụ maka ndị na-aga na websaịtị transgender, na mmemme ụlọ akwụkwọ transgender dịka nke Njikọ Schoolslọ Akwụkwọ Ahụike Victoria na Rainbow Youth and planning na New Zealand. A na-emezi ihe nkiri a n'etiti ọha mmadụ: ihe ndị chọrọ maka asụsụ na-anọpụ iche, asambodo ịmụ nwa gbanwere, ihe mgbochi ịkpa oke megidere iwu, yana ụlọọgwụ pụrụ iche mepere n'ụlọ ọgwụ ụmụaka iji nyere ụmụaka aka ịkwaga na mmekọahụ nke ọmụmụ ha. A na-elebu ya anya na nwatakịrị na-ekwu na ọ bụghị ya na nwoke na nwanyị na-ekwupụta na ọ bụ nwoke nwere mmekọahụ na-egosi na a na-eleta nwatakịrị ahụ na-arịa Ọrịa Njirimara Ọrịa, na ọ bụghị nkewapụrụ na Nchọpụta Ahụhụ Ahụ, nke ụfọdụ ndị chọrọ. ka iwepu akụkụ ahụ dị mma; ma ọ bụ Anorexia Nervosa, nke na-echegbu ndị na-arịa ya na ha buru oke ibu. N’afọ 2013, ka ndị na-akwado echiche echiche transgender nwere ike mee ka ndị otu kwenye ekwenye na kọmitii nchịkọta akụkọ dị iche iche ha kwenyere na ọ nweghị ihe dị ka njirimara okike nwoke na, yabụ na nkwupụta a mụrụ na anụ ahụ adịghị egosi. nsogbu uche. Ọrịa, ọ bụrụ na ejikọtara ya na echiche a, bụ naanị n'ihi nsogbu nke ọdịda obodo na-akpata iji gosipụta ụdị okike nwoke.

Na 1980, ederede psychiatric chọpụtara ọnọdụ a dị ka Gender Identity Disorder (GID). Na 2013, e degharịrị GID dị ka ihe nkịtị ọ gwụla ma enwere nsogbu, metụtara nke a ga-akpọ nsogbu ahụ dị ka Gender Dysphoria. (2) Dika ekwuputaghi na ndi mmadu anabataghi ihe a bu ihe kpatara nsogbu di otua, usoro ihe omumu nke igbochi ga adi nkpa. N'otu oge ahụ, a na-agbanwe iwu iji chebe njirimara nwoke na nwanyị na ịta ndị mmadụ ahụhụ dị ka ndị na-akpa ókè megide ndị chọrọ ka a mata ha site na njirimara nwoke, ọ bụghị mmekọahụ ha. Dịka ụwa tara ahụhụ site n'echiche ndọrọ ndọrọ ọchịchị nke utopian na narị afọ nke 20, ndị ọrịa ata ahụhụla site na ụfọdụ ịnụ ọkụ n'obi nke ọrụ ahụike bụ ndị, na eleghachi anya azụ, ekpughere dị ka ndị nwere mmasị. Otu ihe atụ dị otú ahụ bụ omume zuru ebe nile nke ịkpụpụ ihu ihu n'akụkụ ụbụrụ ndị ọzọ n'atụmanya na ịwa ahụ ga-ebelata nsogbu uche. Ọtụtụ iri puku 'lobotomised' na ebumnuche kachasị mma na ụlọ ọrụ kachasị mma, n'agbanyeghị enweghị usoro sayensị. Hormonal na ọgwụgwọ ịwa ahụ maka dysphoria nwoke na nwanyị abụghị nke a: ọ bụ intrusion na ụbụrụ na ahụ na-atụ anya imeziwanye 'obi ụtọ' nke enweghị ntọala sayensị.


N'afọ ndị na-adịbeghị anya hụrụ uto nke ihe nkiri ụmụaka na-ebo ebubo na-agbagha okike ha. Ọnọdụ ha na-esite n'azụ mgbasa ozi na-akpali akpali na nke enweghị isi, na-eto maka ndị na-ebugharị na weebụsaịtị ndị transgender na mmemme ụlọ akwụkwọ transgender. Ọgwụ ịba ọcha n'anya na ịwa ahụ maka dysphoria okike abụghị nke a na - akọwaghị: ọ bụ nnabata na ụbụrụ na ahụ na olile anya imeziwanye 'obi ụtọ' nke enweghị ntọala sayensị. (6)


OLEE G COMMN IS B ISR IS GBỌTA IGBO Nwa na-eto eto?
Onweghi onye matara azịza ajụjụ a n'ihi na enweghi ọmụmụ ihe gbasara (3), (4) na atụmatụ dị iche iche na-ebubata ọnụ ọgụgụ ụmụaka na-aga na ụlọ nyocha nwoke na nwanyị na afọ ọ bụla (5). Onye ndu nke Transgender Youth Clinic na forlọ Ọgwụ maka Ọrịa Ọrịa, Dr Joey Bonifacio, kwupụtara na atụmatụ ahụ dabere na ịga ụlọ ọgwụ ndị okenye dysphoria sitere na 0.005-0.014 pasent nke ụmụ nwoke toro eto na-atụle onwe ha dị ka ụmụ nwanyị, na 0.002-0.003 pasent nke ụmụ nwanyị na-egosipụta dị ka ụmụ nwoke (nkwukọrịta onwe onye). Ngụkọta Bonifacio bụ otu ndị ekwuputara na akwụkwọ nchọpụta nke Diagnostic and Scientific of Mental Health –Fifth Edition (DSM-5) (6), nke Psytù Ọrịa Ọrịa Ndị Amerịka kwuru na “akwụkwọ ntuziaka ndị ọrụ ụlọ ọgwụ na ndị nyocha ji wee chọpụta ma wepụta nsogbu ụbụrụ. ”(7). Bonifacio (2015), kwughachiri nkwenye ya na onu ogugu a na-eleda ihe zuru oke (8). Na mkparịta ụka onwe onye nke 2016, Bonifacio kwughachiri nkwenye ya na ọnụ ọgụgụ ahụ na-eleda ihe dị adị n'ezie.

N’Australia, e nyela akwụkwọ nyocha a na-ekenye ndị ntorobịa 8,166 na New Zealand (Youth’12) nke kwuru na pacenti 1.2 zara “Ee” n’ajụjụ a, “I chere na ị bụ transgender? Nkọwa a na-ezo aka na nwa agbọghọ chere na ọ gaara abụ nwoke, ma ọ bụ nwa nwoke chere na ọ gaara abụ nwanyị. ” N'ime ndị ọzọ, pasent 94.7 kwenyere na ọ bụ transgender, pasent 2.5 zara na ha "ejighị n'aka", pasent 1.7 kwupụtara na ha "aghọtaghị" ajụjụ ahụ (9), (10). A na-akwalite atụmatụ nke 1.2 pasent site na ndị isi nke ọrụ dysphoria okike na Melbourne'slọ Ọgwụ themụaka (11), mana njupụta a yiri ka ekwenyela na pasent 4 site na mgbakwunye nke pasent 2.5 na-ejighị n'aka site n'aka ndị na-akwalite Ntorobịa Nwata. na New Zealand na Mmemme Schoolslọ Akwụkwọ Na-ahụ Maka Schoolslọ Akwụkwọ Na-ahụ Maka Safelọ Ọrụ. Akọrọ na igbe dị na ajụjụ nke “ọ dị gị ka ị bụ transgender” enweghị ike iji ya tụnyere nhọta ziri ezi yana ọkọlọtọ nkọwa e bipụtara na DSM-12 dabere na nke dysphoria nke nwata na-adabere na “nsogbu adịghị mma” n'etiti ọmụmụ nwa na ụmụ nwoke na-adịgide adịgide “ma ọ dịkarịa ala ọnwa isii”; "Gosipụtara ma ọ dịkarịa ala atụmatụ isii", gụnyere "ọchịchọ siri ike na nkwụsi ike" na, yana "nhọrọ siri ike" maka, ụlọ ọrụ, uwe na ihe egwuregwu ụmụaka na-abụghị nwoke ma ọ bụ nwanyị ibe ya yana ọrụ ya na egwuregwu efu; ma jikọtara ya na ịjụ nkwenye nke mmekọahụ okike, gụnyere mmewere. Ọzọkwa, iji rube isi na "dysphoria", a ga-enwe "oke nsogbu ma ọ bụ ọrụ impairmenin". (5) Enweghi ntụkwasị obi nke akara dị otú ahụ na igbe ajụjụ a na-emesi ike na Akwụkwọ akụkọ banyere Mmekọahụ (13) na-atụle njupụta nke igbu onwe onye na ụmụ obere mmekọahụ. Akwụkwọ akụkọ ahụ na-adọ aka ná ntị na nkwubi okwu dabere na ajụjụ ndị dị otú ahụ ga-ejedebe n'ihi na ha dabere na data "nlọghachi azụ"; “Ekwela ka a chọpụta ihe kpatara ya na mmekọrịta ọ bụla”, gụnyere “nsogbu ọgbako na-emekọ ọnụ”; “amachibidoro” ọnụ ọgụgụ ha pụrụ ịjụ iji kọwaa ihe ndị bụ́ eziokwu, na-emekwa ka ike gwụ ha site n’echiche ịghọta ajụjụ. (2011)

O juru ya anya na ajuwo ịdabere na nzizi sitere n’aka ndị na-eto eto? Na nyocha nke NZ, nke ụfọdụ ndị Australia na New Zealand nyere ikike, pasent 36.5 nke ndị ntorobịa kwupụtara n'ezie na ha aghọtaghị ajụjụ ahụ ma '' onye ọzọ tiri ihe ma ọ bụ merụọ ya ahụ '(15). Nzaghachi a siri ike ikwere na-esite na ala sitere na ntorobịa isonye na egwuregwu asọmpi nke Rugby Union na Ego enyerela ndị mmadụ ajụjụ ọnụ a kesara ụmụaka 8,166 na New Zealand (Ndị ntorobịa12). Nsonaazụ nke ajụjụ-igbe dị na igbe a bụ ihe ekwenyeghi ntụkwasị obi. Akara n’ime igbe dị na ajụjụ a “ị chere na ị bụ transgender” enweghị ike ịtụle ya n’ụzọ ziri ezi na nkọwa ọkọlọtọ edepụtara na DSM-5. Na nyocha nke NZ, nke ụfọdụ ndị Australia na New Zealand nyere ikike, pasent 36.5 nke ndị ntorobịa kwuru n'ezie na ha aghọtaghị ajụjụ ahụ maka ma 'onye ọzọ tiri ha ihe ma ọ bụ merụọ ha ahụ.' (7) Njikọ! Ọzọkwa, ọ gaghị ekwe omume ikwere na otu ụzọ n'ụzọ atọ nke ndị ntorobịa New Zealand bụ ndị na - agụghị akwụkwọ na ha enweghị ike ịghọta ederede ede! Ọ dị mfe ikwere na ha enweghị ike inye nsogbu ịza ajụjụ ndị ahụ nke ọma.

N'iburu n'uche ezighi ezi nke data nyocha dị otú a, olee otu a ga-esi kwuo na pasent 1.2 nke ndị bi na transgender, dabere na nyocha NZ? Nke a ga - eme ka mmeso nke dysphoria di na nwata dika nke 1-3 nke puru iche nwere ọgụgụ isi. Ọ bụ nzukọ iji kọọ ọnụ ọgụgụ ahụ 4 pasent, dị ka Mmemme Schoolslọ Akwụkwọ Nchedo Victoria (na Ndị Ntorobịa Rainbow na NZ) si kwuo, mana ọtụtụ nkwupụta nke ndị na-ekwu okwu na -eme ka mmụba nwoke na nwanyị esiteghị na usoro nyocha mmekọrịta ọha na eze guzobere. Ihe karịrị pasent 4 ga-apụta na otu ụmụaka n'ime ụmụaka 25 nke ndị ọrịa ụmụaka na-ahụ ahụ ga-abụ ihe transgender. N’aka nke ọzọ, nghoputa ahịhịa nke ndị na-ahụ maka ụmụ nwanyị 28 jenerato nke onye edemede a mere kpughere naanị ikpe iri na abụọ ka enwere ike icheta site na ahụmịhe nke afọ 12. Ejikọtara ikpe iri na nnukwu ọrịa uche, mmadụ abụọ nwegidesiri ike n'ụzọ mmekọahụ.

N’ezie, dysphoria okike nke umu aka bu ihe di obere nke amaghi ama rue mgbe n’abali ole na ole gara aga, mgbe onu ogugu umuaka na ndi umuaka noo n’ulo ogwu dysphoria na Western Western abawanyela nke ukwuu kwa afo.

Akpachapu anya ikpeazu n’ime ihe ndi mmadu na ekwu na ihe ruru pesenti 4 n’ime umuaka bu transgender (ma, site na innuendo, nwere ike choo enyemaka ahuike di iche) ekpughere ya na onu ogugu onu ogugu isi nke e biputara na DSM-5. Ọ bụrụ na ihe dị pasent 4 na ụmụaka na-adaba na 0.002 pasent na ndị toro eto, ọ pụtara, na mgbakọ na mwepụ, na ihe karịrị pasent 99 ga-akwụsị site na ịgagharị na ịlaghachi na mmekọahụ nwoke na nwanyị tupu ịbụ okenye ebilite. Ọ bụ naanị obere pere mpe ga-anọgidesi ike na ọnyụgụ nwoke na nwanyị ha. Ọ dị mkpa ịmara na ọ bụghị ndị ụkọ nrọ niile na-apụta na ntụgharị uche nwoke na nwanyị: ndị pere mpe ga-apụta na ntụzi-edina ụdị onwe na nwanyị nwere mmasị nwanyị. Nkwupụta na ndụ dịka nwoke nwere mmekọ nwoke na nwanyị dịkarịsịrị mgbagwoju anya karịa nke dibia bekee, nke a waziiri ma bụrụ nke echigharịrị pụtara ihe kpatara Prọfesọ Kenneth Zucker, onye ama ama ama na onye bụbu Isi nke Center nke riri ahụ na Ahụike Uche, a chụrụ ya na nso nso a. . N'ara dị ka onye ọkachamara mba ụwa na dysphoria okike na onye na - akwado usoro a "na - eche nche" na - echere ka nwughari nwatakịrị nwere mmekọ nwoke na nwoke, ọ bụrụ na ọ bụghị nwoke na nwanyị, Zucker kwụsịrị ma akụkụ ya mechie. (6) Zucker kwuru na nyocha na ahụmịhe na-egosi na imirikiti ụmụaka gbasoro anya n ’ịchefu nchoputa nke nwanyị (dysphoria) mgbe a hụrụ n’oge uto ma ọ bụ ntorobịa, ma gosipụta na ọ dịla iche na njiri mara okike nke dabara n’ihe ha bu pụta ụwa. nwoke na nwanyị (17).


TH nwere ndị nwere ụdị ọghọm ndị ọzọ na-emetuta n'etiti ndị na-elekọta mmadụ?
Ọrịa ụbụrụ na-akpakọrịta n’ụzọ doro anya na dysphoria okike, na-ewelite ajụjụ nke buru ụzọ bịa: ma ọnyụkpa nwoke na nwanyị na-akpata ọrịa ọgụgụ isi ma ọ bụ na ọ bụ ihe mgbaàmà nke oria, ọrịa na-apụtachaghị ìhè. Ndị na - akwado echiche nke transgender na - akwalite echiche na dysphoria okike bụ isi ihe kpatara nsogbu uche, ihe kpatara dysphoria bụ ọdịda nke ndị nne na nna na ọha mmadụ ịnabata enweghị mmekọ dịka ihe a na - ahụkarị. Nke a bụ n'agbanyeghị mkpesa doro anya banyere nsogbu uche nke bu ọdịmma nke dysphoria okike. Agbanyeghị, nsogbu akparamaagwa bụ ihe zuru ebe niile, ọ bụrụ na e nweghị njirimara.

Nnyocha nke ụmụaka Dutch nwere dysphoria. Ọ bụrụ na ihe dị pasent 4 na ụmụaka na-adaba na 0.002 pasent na ndị toro eto, ọ pụtara, na mgbakọ na mwepụ, na ihe karịrị pasentị 99 ga-akwụsị site na ịgagharị na ịlaghachi na mmekọahụ nwoke na nwanyị tupu mmadụ tokwaa dịka usoro ndụ. Naanị obere pere mpe ka ga-anọgidesi ike na nwoke na nwanyị nke nwanyị dị afọ anọ ruo afọ iri na otu kpughere ọnọdụ uche na-emetụta otu ụdị n'ime pasentị iri abụọ na ise, yana ọrịa gụnyere nchekasị, iyi ụjọ, ọgba aghara, obi erughị ala, nlebara anya na akparamagwa ọgụ. (11) Nnyocha nke ndị nkuzi ụlọ akwụkwọ kọrọ na akparamaagwa akparamaagwa na oke mmetụta na ihe dị ka otu ụzọ n'ụzọ atọ nke ụmụaka Dutch dysphoric Dutch na Canada na-erubeghị afọ iri na abụọ (52). Na ngosi izizi a na ụlọ ọgwụ ndị nwoke na United States nke ụmụaka 18 nwere afọ 554 afọ, 12 pasent nwere akụkọ banyere ọrịa psychiatric, 19 pasent anọworị na ọgwụ psychotropic na 97 pasent nwere akụkọ banyere mmerụ onwe ya (14.8 ). N'ime nnyocha Australia banyere ụmụ dysphoric 44.3 dị afọ iri na ise, “a hụrụ nsogbu akparamàgwà na otu ụzọ n'ụzọ anọ nke ụmụaka, na-arịa ọrịa Asperger syndrome n'ime otu asaa n'ime asaa” (37.1).

Ọmụmụ Becerra-Culqui et al (2018) mere n'oge na-adịbeghị anya, nke e bipụtara n'okpuru aha "Ahụike Uche nke Transgender na Gender Nonconforming Ntorobịa Tụnyere Ndị Ọgbọ Ha", tụlere ụmụaka ndị America sitere na afọ atọ ruo afọ 17 bụ ndị a chọpụtara dị ka “Transgender and Gender Ndị na - adịghị akwado ”(TGNC) nke ndị na - ahụ maka ọgwụgwọ na onye na - ahụ maka nlekọta ahụike, Kaiser Permanente (22). E nyochara ihe ndekọ nke ụmụaka 1,333, ndị 251 dị afọ atọ ruo itoolu, na 1,082 sitere na 10 ruo 17.
Ekwenyesiri ike na ọnọdụ uche dịkarịsịrị ebe. Nchọpụta ndị a na-ahụkarị maka ụmụaka na ndị nọ n'oge uto bụ nsogbu nlebara anya (transfeminine, pasent 15; transmasculine, pasent 16) na nsogbu ịda mba (transfeminine, pasent 49; transmasculine, pasent 62). N'ime ụmụaka ahụ site na afọ atọ ruo iteghete, pasent 31.7 enwetawo ọrịa nyocha dị ka akwụkwọ nhazi nke mba si kwuo, usoro nke itoolu (ICD-9). Ọtụtụ mgbe, ha nwere nsogbu nrụrụ aka (ihe dị ka pasent 15), nchekasị (pasent 14), na omume na / ma ọ bụ ọgba aghara. Pasent ise nke ụmụaka transfeminine nwere autistic na pasent 11 nke transmasculine nwere ịda mba. N'ime ụmụ okenye 1,082 mere okenye, achọpụtara ọrịa dị ukwuu pasent 73 na ọrịa uche nke sitere na nchekasị (ihe dị ka pasent 38), nlebara anya (pasent 19.6), nsogbu ndị na-akụda mmụọ (pasent 56), na Autism (5 pasent). Achọpụtara Frank psychoses na 4.7 pasent na ụdị schizophrenia na 1.6 pasent.

Na ngụkọta, ụmụaka 14.5 n'ime ụmụaka ahụ nwere isi mgbaka na-emetụta ya, ọ dị mkpa ka e nye ha ụlọ ọgwụ. Agbanyeghị, Becerra-Culqui et al zere ajụjụ bụ isi nke buru ụzọ bịa: nsogbu uche ma ọ bụ dysphoria okike? N’ezie enwere ike ideta mmekọrịta nwa oge na ihe ndekọ ha? Dị ka a ga - asị na ị na - ezere ajụjụ nke ihe kpatara ya, ndị dere ya gbara aka, na - ekwupụta "ụmụaka ndị natara nkwado njirimara nwoke na nwanyị apụtachaghị oke ịda mbà n'obi na nchegbu". Ha akọwapụtaghị ụdị ihe ahụ, ma ha na-agba mbọ hụ na ihe “ga-esochi” ga-eme ka ha nyochaa mmetụta ya. Ka ọ dị ugbu a, ndị ode akwụkwọ ahụ nọ n'ọnọdụ “nnukwu ọnọdụ edoghị anya”. (23) Họpụtara họọrọ ejighị n'aka kama ịjụ ajụjụ doro anya nke bu ụzọ pụta?

Onwere odi, enwere otutu akuko banyere dysphoria okike nke na - eso, kari oge gara aga, mmalite nke nsogbu uche. Iji maa atụ, Kaltiala-Heino et al (2015) tụleghachiri ikpe na-ewegara ụlọ ọgwụ Finnish site na 2011 ruo 2013 wee chọpụta na pasent 75 “anọwo ma ọ bụ na-anata ọgwụgwọ na-eto eto na ụmụaka na-eto eto n'ihi ihe ndị na-abụghị ọnya ọnya ọnya nwoke na nwanyị mgbe ha na-achọ ntụgharị." . Pasent iri isii na anọ nwere ọgwụgwọ maka nkụda mmụọ; Pasent 55 maka nsogbu ụjọ; Pasent 53 maka omume igbu onwe ya na omume imerụ onwe ya ahụ; Pasent 13 maka mgbaàmà psychotic; Pasent 9 maka ụkpụrụ omume; Pasent 4 maka ị substanceụ ọgwụ ọjọọ; Pasent 26 maka nsogbu ụdị akpịrị autism, na 11 pasent maka ADHD. N'ime ụmụaka a, pasent 68 “nwere mmekọrịta mbụ ha na ọrụ mmụọ n'ihi ihe ndị ọzọ sitere na njirimara nwoke na nwanyị" (24).

Site na nyocha nke akwụkwọ ahụ, Kaltiala-Heino et al (2018) 25 hụrụ ọnụ ọgụgụ na-arịwanye elu nke nsogbu ụdị akpaaka autism (ASDs), nke dị iche site na pasent isii ruo ihe karịrị pasent 20, ka a kọọrọ n'etiti ndị ntorobịa zoro aka na okike nwoke. ọrụ (26), (27), (28), (29). Ọnụ ọgụgụ a buru ibu karịa 0.6 pasent ruo 0.7 pasent (30) na mkpokọta mmadụ. N’etiti umuaka na ndi umuaka ndi nwere oria ndi ASD, udiri nwoke na nwanyi kariri okpukpu asaa karia n’etiti ndi n’abughi ezi ihe (31), (32) oria oria n’emekorita ya na dysphoria nke nwoke, na ewelite ajuju nke buru uzo: ma o bu dysphoria okike. na-ebute oria uche ma ọ bụ naanị ihe mgbaàmà nke oria dị, ọrịa na-apụtachaghị ìhè.


Ọ DARA Nsogbu dị njọ nke onwe ya na igbu onwe ya?
A kọọla ihe egwu nke imerụ onwe ya na ụmụ nwoke na - echigharị ma bụrụkwa arụmụka maka “ọgwụgwọ”, yana iyi egwu megide enweghị arụ. Onwe mmadu imerụ onwe ya bụ ihe ọzọ na - egosi nsogbu na-apụtachaghị ìhè, ka ọ bụ nkụda mmụọ site na dysphoria nke nwoke na nwanyị naanị, ka ọ bụ n'ihi nkwarụ ostracism?
Ndị na-akwado mmeso ọjọọ kwusara nke ikpeazụ ma kwupụta “oke oke njo” nke imerụ onwe ya na ịnwa igbu onwe, nke ihe ngosipụta na oke ntorobịa igbu onwe onye gosipụtara na US (33). Dị ka ọ dị na ọtụtụ data metụtara dysphoria okike na ụmụaka, ọmụmụ na-amachibidoro site na enweghị ọnụọgụ na ntanetị usoro, na a maghị ezi mmerụ onwe onye n'ihi mpụga nke mpụga.

Ihe ndi ozo bu ndi ozo buru ibu ma di nkpa ma yie ihe eleghaara anya na esemokwu a. Yabụ, n'agbanyeghị nkwupụta nke “oke oke oke” nke imerụ onwe ya na igbu onwe ya, atụpụtara site na mgbasa ozi na ọnwụ nke nwatakịrị nwoke dysphoria dị na US gosipụtara na 34 gburu onwe ya, n'eziokwu, Aitken et al (2016) kwuru data maka ndị igbu onwe ha zuru ezu n'etiti ndị nọ n'afọ iri na ụma nwere ọrịa GD [amaghị dysphoria okike), na-emesi ike na "data ole na ole dị maka mmerụ ahụ na -echegbu onwe ha na ụmụaka nwere dysphoria okike" 35. Otu nnyocha London mere site na Holt et al (2016) tụgharịrị na nyochaghachi nke akwụkwọ ozi sitere na ndị dọkịta na-ekwu okwu ya na ndetu nke ya banyere ụmụaka 218 ụmụ nwoke na ụmụ nwanyị nwere afọ 14 dị afọ iri na anọ. igbu onwe onye na pasent 41 na ọnwụ igbu onwe ya na pasent 11. N'ime ụmụaka 14.6 nọ n'afọ iri na abụọ ruo iri na asatọ, ka ndị mmadụ kwuru na ha chọrọ igbu onwe ha na 14.6 pasent, mmadụ imerụ onwe ya ahụ n'ime pasent 2.4 na mmadụ igbu onwe ya na pasent 177. Di omumu ahu, o nweghi otutu ihe di iche ma tugharighi uche na nkpuru nke bu nke puru iche site n’ile anya na icho onwu. N'ikpeazụ, ndị dere akwụkwọ ahụ chere ma ọnụego ndị ahụ “na-egosipụta ihe na-ewu ewu na ọha mmadụ n'ole”. (12) Ọzọkwa, n’agbanyeghi nkọwapụta nke ndụ ụmụaka ahụ, ụmụ edemede edeghị nkọwa banyere mmetụta ha, ọ bụ ezie na ama ama mmetụta nsonye ezinaụlọ na ọnọdụ nke ụmụ ya. Ọmụmụ ahụ chọpụtara na naanị pasent 18 ka ha na nne na nna mụrụ ha biri. Iri ise na asatọ na narị atọ “nwere nne na nna kewapụrụ”. “E gosipụtara ime ihe ike n'ime ezinụlọ na 39.5 pasent… ịda mba nne na 44.1 pasent… ịda mba nna na pasent ise [na] ị parentụ mmanya / ọgwụ ọjọọ nke ndị nne na nna na pasent 15.8”. (36) Ọmụmụ ihe ahụ adịghịkwa atụle uru Autism ọ hụrụ na 36.7-9.2 pasent nke ụmụ ya.

N’ebe ozo, ndi Mayers et al (2013) choputara na pacenti iri n’abuo umuaka ndi nwere ezi omumu na ano rue afo iri na isii ka ha na achochu igbu onwe ha ma obu igbali, ha na-egosi na onu ogugu abuo di elu karia ndi umuaka (14 n’ime ihe). (16) Nnyocha nyocha nke NZ banyere ndị na-eto eto, nke a tụlere n’elu ma lere anya na ụfọdụ ndị Australia (na New Zealand) jụrụ, banyere “imerụ onwe ya ahụ” n’afọ gara aga. Iri abụọ na atọ na anọ pasent anọ nke ndị na-abụghị transgenders zara “Ee”, dịka 28 pasent nke transgenders, mana pasent 0.5 chere na ha aghọtaghị ajụjụ ahụ. Mgbe a jụrụ ajụjụ banyere igbu onwe, pasent 38 nke ndị na-abụghị transgenders zara “Ee”, dị ka pasent 45.5 nke “transgenders”, mana pasent 23.7 kwupụtara na ha enweghị nghọta. (4.1) Aitken et al (19.8) chọtara ọnụego yiri nke ahụ na Canada, n'agbanyeghị agụnyere na mmerụ ahụ dị ala nke mmadụ imerụ onwe ya ma ọ bụ nwara igbu onwe ya (ihe dị ka 13.3 pasent 39). Ha kwubiri "ime agadi, na nsogbu akparamagwa ndị ọzọ, mana ọ bụghị mmekọrịta ndị ọgbọ na-adịghị mma, ejikọtara n'ụzọ dị ukwuu n'ihe ize ndụ… mana enweghị ike ịgbagha na mmekpa mmekọrịta ọha na eze… bụ mmekọrịta pụrụ iche". Ọmụmụ ihe ahụ ekpughikwa ihe dị iche iche nke onwe-onwe na ịnwa igbu onwe ya. (2016)

Nyochaa nke omume ndị a na-ekpughe nnukwu nsogbu dị na ịnweta data a pụrụ ịdabere na ya site na ajụjụ ọnụ ụmụaka na ndị na-eto eto. Muehlenkamp (2012) chọpụtara na ọnụọgụ nke mmerụ ahụ na-abụghị nke igbu onwe ya dịgasị iche site na 12.5 pasent ruo 23.6 pasent, na ụma na-emerụ onwe ya site na 12.2 pasent ruo 31.4 pasent, dabere n'ụdị nyocha. (41) Ọmụmụ ihe ndị ọzọ akwadoro n'etiti 19 pasent (42) na 29 pasent (43) nke ndị niile nọ n'afọ iri na ụma ekwuputala akụkọ banyere echiche igbu onwe ha, na n'agbata pasent asaa na 13 ịnwa "igbu onwe", n'agbanyeghị na ihe bụ nnwale akọwaghị na ọmụmụ ihe ndị a ma ọ bụ ndị sitere na London na NZ.

Nagide mkparịta ụka niile nke igbu onwe ụmụaka na nke dysphoria okike bụ ụdị ejikọtara ọnụ nke ọrịa uche na ụmụaka. Na nyocha a sitere na London site na Holt et al (2016) nke a kpọtụrụ aha n’elu, maka ụmụaka na-erubeghị afọ iri na isii, a chọpụtara nsogbu akpatipụtara site na 11 ruo 12.2 pasent, nlebara anya na-ebelata ịdị elu na 17.1 pasent, nchegbu na 14.6 pasent, ịda mbà n'obi na 17.1 pasent na psychosis na 7.3 pasent na, na ngụkọta, ọnụego na-abawanye na afọ. Ọ na-akọ banyere iji ike emegbu mmadụ na mmekpa ahụ n'ihe fọrọ nke nta ka ọ bụrụ ọkara ụzọ abụọ n'ime ụzọ abụọ nke ụmụaka mana ọ naghị atụle ma njimara transgender ma ọ bụ ndị metụtara autism, hyperactivity na psychosis kpasuru ha iwe. (2.4)

Ajụjụ bụzi, mbugharị ụmụaka transgender ga-emecha belata mmerụ ahụ? Ọ bụ ezie na De Vries et al (2012) na-ekwu na ahụmịhe Dutch kwubiri "ịmalite homonụ nwoke na nwanyị ka ọ gafere site na ịwa ahụ na-esote nwoke ma ọ bụ nwanyị na-arụ ọrụ," (45) ebe ndị ọzọ na-akọ oke ọnụego igbu onwe na afọ echigharịrị (46), (47). Iji bụrụ eziokwu, ndị ekenyegharịrị n'ọmụmụ ihe ndị a enweghị “ụzọ” atụpụta maka nkwenye a, dị ka enwere na Holland. Ka o sina dị, ịnwale igbu onwe egbuola na-abụkarị ihe a na-ahụkarị mgbe a wasịrị ya ahụ karịa ọnụọgụ mmadụ niile na Belgium (pasent 5.1 karịa 0.15 pasent) (48) na Sweden (49).

N'aka ozo, banyere igbu onwe nke ndi toro eto nke ndi mmadu nwere mmekorita nwoke na nwanyi, akwukwo akuko nke nwoke idina nwoke na nwanyi ndi mmadu kwuru na ha nwere “oria pere mpe” n’ime akwukwo emere na North America: ato n’ime mmadu iri n’onye oria nwayi na New York, na anọ n'ime 120 na Quebec ”; ma dọọkwa aka na ntị na nkwubi okwu dabere na “obere ọnụọgụ… ga-ahụrịrị na elele”. Mmechi akwụkwọ akụkọ banyere nwoke idina nwoke a dị mma. Onu ogugu di obere ma ihe omuma bu. (55) Onweghi onye ma oge esi egbu onwe onye ma ọ bụ mmekọrịta ha na ihe dị n'ime na mpụga dysphoria okike. Mgbe m welitere okwu ahụ na otu onye na - ahụ maka ọrịa, ọ na - ekwupụta dị ka "ihe mkpofu", ọ bụ naanị "ngwa agha ndị isi agha ji." Ka o sina dị, maka ihe ọ bụla kpatara ya, ụmụaka nwere dysphoria okike nọ n'ihe ize ndụ ma nwee ọmịiko, nkwado na nlebara anya maka ohere imerụ onwe ya ahụ. Ọ bụrụgodi na egosighi nsogbu nke nwoke na nwanyị, kwa se, ewepụtaghị ọnụ iji gbuo onwe ya na ụmụaka emetụtara, nsogbu uche ha niile na ọgba aghara ezinụlọ bụ ihe amaara na-etinye ha n'ihe egwu.

Gini bu ihe omume ndi nne na nna ghaputara umuaka na ndi umu nwoke na ndi umu nwanyi?
Ọmụmụ ihe ole na ole dị na njirimara ndị nne na nna na-ewetara ụmụaka n'ụlọ ọgwụ dysphoria okike n'agbanyeghị ọtụtụ ọmụmụ na ụmụ ha. Ọ bụ ihe mgbagwoju anya okike dị na nwatakịrị ga-enwe mmetụta miri emi n’ebe ndị mụrụ ya nọ, ahịrịokwu a na-ahụkarị ndị a na-ahụ ajụjụ ọnụ na televishọn, “gut wrenching”, dị mfe ịnabata. Ma, ụfọdụ ndị nne na nna adịghị eyi iwe iwe maka njirimara nwa ha na nwoke na nwanyị na - enwe oke ịnụ ọkụ n'obi maka mgbanwe na - agbasa na mgbasa ozi. Mgbe ụfọdụ, nne na nna, na-abụkarị nne, na - apụta dị ka onye na - agbagha maka ịkwalite nwatakịrị ahụ dịka nwa nwoke na - eziga ya nwanyị ma ọ bụ nwa nwanyị maka ụlọ akwụkwọ.

N’afọ 2016, m gbara ajụjụ ọnụ Kenneth Zucker, onye bụ onye isi ndị kọmiti American Psychiatric Association nke debara ọnọdụ DSM-5 gbasara nchọpụta na ọgwụgwọ nke dysphoria okike. Ajụrụ m Zucker ma enwere ndịiche dị na nne na nna nke ụmụaka nwere dysphoria okike. Echiche ya bipụtara kwesịrị ka atụlee ya n'ụzọ zuru ezu n'ihe gbasara "psychopathology na nne na nna" (51). O dere, sị: Ọ bụrụgodi na nsogbu nwoke na nwanyị, kwa se, egosighi iji mepụta ọnụego igbu onwe ya na ụmụaka emetụtara, a maara ihe na-emetụta uche na nsogbu ndị ọzọ niile na-emebi ezinụlọ.

Dị ka ọ dị n’ezie maka ọtụtụ ọrịa ndị ọzọ na-emetụta akparamàgwà ụmụaka, ịdị ukwuu nke akparamaagwa nne na nna na-arịa ọrịa uche bụ ihe dị ize ndụ n'ihe gbasara usoro ọgwụgwọ. Ya mere, a na-ege m ntị nke ọma kemgbe ọtụtụ afọ iji nyochaa ọrụ ndị nne na nna ma nwee nnukwu data gbasara ọnọdụ na nke a. Dịka otu ọmụma, iji usoro nyocha Achọpụta Diagnostic, usoro ahaziri oke nke iji nyochaa etu ọrịa uche na ndị okenye nọ… Achọpụtala m na ihe dịka pasent 50 nke ndị nne ụmụ nwoke GID nwere ọrịa abụọ ma ọ bụ karịa na ihe dịka pasent 25 nwere ọrịa atọ ma ọ bụ karịa. ọrịa nyocha. A
otutu ihe banyere nne na nna umu aka bu ihe bu ezigbo nnabata nke umuaka (52).

Na mbu, Zucker akọputala: etiology nke nsogbu njirimara nwoke na nwanyị ka bụ ihe arụmụka… Otu n'ime ihe ndị metụtara psychosocial e lebara anya dị mkpa n'àgwà nne na nna na omume gbasara mmekọrịta mmadụ na ibe ya. Ngbanye aka na ahụike a na-ahụkarị bụ na ndị nne na nna nwere ike ịnabata ma ọ bụ gbaa agwa nwoke ma ọ bụ nwanyị ume ka ọ pụta ìhè, nke na-egosi na ọ ga-eso mee ka mmekorita nwoke na nwanyị mara na nwata. Ihe kpatara nnabata ma ọ bụ mgbamume dị otú ahụ dị iche iche. N'ụfọdụ, ọ na - egosi na ọ nwere oke agụụ maka nne ma ọ bụ nna, ọkachasị nne mụrụ nwa nwoke… (53).

Ọmụmụ ihe ọzọ nke Marantz (1991) rụtụrụ aka na nnukwu ihe banyere Borderline Personality Disorder na nkụda mmụọ na nne nke ụmụ dsyphoric. N'iji ndi nne umu nwoke ndi nwoke umu nwoke nke umu nwoke na umu nwanyi ndi nwoke nwuru anwu, umu nwanyi 53% nke umu nwoke na nwa ha nwoke hutara oria a ma obu nke ndi nne. Ọzọkwa, n'ihe banyere ịzụ ụmụ na omume ụmụ nwanyị, ndị nne nke ụmụaka ụmụaka na-anwụde “nwere omume na omume ndị na-akwalite symbiosis na nkụda mmụọ” (6). N'ihe gbasara “withmụaka nwere nsogbu njirimara nwoke na nwanyị: practice nwere omume kacha mma?”, Zucker (54) dere, sị: Maka… ndị nne na nna… ebe a na-etinye ihe isi ike na njiri mara ụmụ nwanyị na oke ọmụmụ, ihe a ga-elekwasị anya na nnọkọ nwere ike ịbụ ichoputa ihe omimi. Ọtụtụ mgbe, ihe a na-eme na nke a bụ usoro dị obosara nke usoro ezinaụlọ, mmekọrịta nne na nna, na nsogbu onye ọ bụla na nne na nna. N'ọnọdụ ndị a, ọrụ ọgwụgwọ ahụ dị ọtụtụ gbagwojuru anya, na-ama aka na ogologo oge. (2008)

Nnabata ndị nne na nna banyere njirimara nwatakịrị na nwoke na nwanyị na - abụghị nwoke na - eduga n'ọdịdị mbido mmekọrịta mbụ. Dọkịta Toronto Bonifacio kwuru na ọtụtụ enweela ọganihu n'ụzọ dị ukwuu tupu ha aga ụlọ ọgwụ: ndị nne na nna na-eyi uwe na-atọ nwa ahụ ụtọ dị ka nwoke na nwanyị na-abụghị nwoke ma ọ bụ nwanyị, na-etinye aha na aha ọhụrụ. Ọ na-akọwa mkpebi dị otú ahụ, na-emeghe ụzọ maka ọgwụgwọ ọzọ. Zucker (2018) bụ ihe doro anya karịa: ọ ga-arụ ụka na ndị nne na nna na-akwado, mejuputa ma ọ bụ na-agba ume na mgbanwe nwoke na nwanyị (yana ndị ọrụ ụlọ ọgwụ na-atụ aro otu) na-emejupụta usoro ọgwụgwọ psychosocial nke ga-eme ka ọdịiche nke nnọgidesi ike ogologo oge pụta. (56) Ọ na-ebu amụma na, “na ụmụaka ndị na-emekọrịta ihe tupu ha eru ntozu… nkwụsi ike ga-adị nnukwu elu” (57). Dịka a tụlere n'okpuru, nsogbu dịgidere na o yikarịrị ịbanye n'okporo ụzọ ọgwụgwọ ọgwụgwọ a maara dị ka Dutch Protocol, yana nsogbu niile. Ngbanye aka na ahụike a na-ahụkarị bụ na ndị nne na nna nwere ike ịnabata ma ọ bụ gbaa agwa nwoke ma ọ bụ nwanyị ume ka ọ pụta ìhè, nke na-egosi na ọ ga-eso mee ka mmekorita nwoke na nwanyị mara na nwata.

O lee nhọrọ ndị a na -eme ka enwee umuaka na ụmụ nwoke na nwanyi ndi na-enwe nwoke na nwanyi.
N'ụzọ bụ isi, enwere nhọrọ atọ. Nke mbu, nke anakpo dika “ogwu mgbanwe” ma obu “reparative treatment”, bu nnwale na-eme ka nwa ahu nwekwuo nkasi obi na nmekorita nwoke na nwanyi ya na ime ka nwa ya ghara idi ire. Enwere ike ịkpọ nke abụọ “ichere ma na-elele”, ebe a na-eme ka nwatakịrị nwee ahụmị nwoke na nwoke na nwa na atụmanya nke ọnụọgụ nyere na ọ ga-eto site na dysphoria okike site na ntozu nwoke. N'ime nhọrọ nke abụọ na nke abụọ, Zucker (2008, 2012) kwuru na a na-enyocha ihe mere dysphoria okike na nwatakịrị na nne na nna ha na ebumnuche iji belata ike nke dysphoria. (58), (59) Ristori and Steensma (2016) kwuru na a na-akpọ nhọrọ ọgwụgwọ atọ "'ọgwụgwọ nkwanye ugwu', nke gụnyere ịkwado ntụgharị na onye na-abụghị nwoke na nwanyị (60).

Nhọrọ izizi, “ntụgharị” ma ọ bụ ọgwụgwọ “eji emeghachi omume”, ebe a na-agba ụmụaka ume ka ha nwee mmekọahụ na mmekọrịta nwoke na nwanyị ha, bụ mmekorita nke ndị na-agagharị agagharị. N'akụkụ ụfọdụ nke North America, iwu gbochiri ọgwụgwọ “ntụgharị” ma ọ bụ ọgwụgwọ “ịkwụghachi ụgwọ”. Ihe ngosi otu mba nke Australian Labour Party bụ ime ka ụdị ọgwụgwọ a bụrụ ihe iwu megidere, mgbe ọ bụla n’ọchịchị. N'ịhapụ ndị na-ekiri ụzọ ọjọọ obi ọjọọ nke ndị na-eme transgender na ụmụ nwoke na-edina ụdị onwe ha, ndị na-eme ihe nkiri kwusara na ihe ọ bụla na-erughị nkwupụta na ụmụaka transgender bụ ihe ọjọọ, enweghị isi ma nwee ike ịkpalite igbu onwe ya. Arụmụka ha bụ na transgender bụ nke edozi tupu, ma gbanwee ịgbanwe mgbe amụchara nwa. Childrenmụaka ndị emetụtara 'ka a mụrụ n'anụ arụ', ihe ndị nne na nna ga-anara dịka nke nkịtị na nke na-agaghị agbanwe agbanwe: yabụ na ịnwa iguzogide ntụgharị a bụ mmegbu ụmụaka. Ya mere, okwu a bu “ncheghari ogwu” nwere ihe di egwu na ndota ndoro-ndoro ochichi ya. N’ezie, a na-eji okwu ahụ dị ka ngwa agha nke echiche karịa ịkọwa ụdị ọgwụgwọ ọgwụ nwere ike, n’ezie, enweghị ike imesi obi ike dịka mmesi obi ike na-emesi obi ike.

Nhọrọ nke ọgwụgwọ nke abụọ gụnyere idobe nwatakịrị ahụ ụdị obi ụtọ ọ bụla o kwere omume na “anụ ahụ” ya na mmekọahụ nwoke, na nchekwube na ọ “ga-esi na ya pụta”. Ọ na-enyere nwatakịrị aka iji ejiji ma ọ bụ ihe egwuregwu ụmụaka ma ọ bụ egwuri egwu ma ọ na-enweghị agbamume na-enweghị ike na itinye oge na oge. Ọ na-enye ohere ka onye ole na ole 'nọgide' na nwoke idina nwoke ma na-ele ndụ dịka nwoke nwere mmekọ nwoke na nwanyị dị ka ihe na-esighị ike na nke transgender transgender transgender.

Nhọrọ nke ọgwụgwọ nke atọ, “nkwuputa,” wezuga abụọ nke mbụ ma nwekwaa '' ụzọ 'usoro ọgwụgwọ maka imega ahụ nwoke na nwanyị ma ọ bụ nwanyị nwere ike ịhụ ka ọ na-aga n'ihu n'ụzọ ise. A maara ụzọ a dịka Protocol Dutch. O sitere na ọgwụgwọ nke ụmụaka dysphoric na ụlọ ọgwụ okike na Holland mana ọ bụ ugbu a dịka ọkọlọtọ nke ụkpụrụ nwapụta ahụike nke nwatakịrị na-abụghị nwoke ma ọ bụ nwanyị (De Vries na Cohen-Kettenis, 2016). (61)

Cheta na: Asụsụ nke “ntụgharị ọgwụgwọ” na “nkwuputa ọgwụgwọ” na-agbaghakarị n'ihi na ihe okwu pụtara dabere n'echiche ụwa transgender, ọ bụghị na sayensị nke ihe omumu ihe banyere ndu. N ’ụwa transgender,“ ntụgharị ”pụtara ilekwasị nwatakịrị anya na nwoke na nwanyị a mụrụ ya. “Nkwupụta” pụtara na ọ ga-eme ka nwatakịrị ahụ mata na nwoke ọ bụ nwoke ahọpụtara. Emezighi ịkwalite “nkwuputa ọgwụgwọ” bụ “ọgwụgwọ ntụgharị” na ndabara na, yabụ kwesiri ekwugide ụdị iwu ahụ n'okpuru iwu. N'ezie, ndị na - akwado echiche echiche transgender anaghị anabata etiti ọ bụla. Ma otu dibia na-aru oru “Nchighari” ma obu “mmeghachi omume”, nke a gbara ụmụaka ume ka ha nwee mmekorita nwoke na nwoke, ha bu ezigbo ogwu nye ndi na-emegharia nwoke. Ndị na-eme ngagharị iwe na-ekwupụta na ihe ọ bụla na-erughi ihe na-ekwupụta na ụmụ transgender bụ nke obi ọjọọ, ọ nweghị ihe ọ bụla ma nwee ike ịkpalite igbu onwe ya. (13) na-enyere nwatakịrị ahụ aka na nke onye na-abụghị nwoke ma ọ bụ nwanyị na-agwọ ọrịa na-ata ụta maka "ọgwụgwọ ntụgharị" site na mwepu.
Yabụ, n'ihe mgbakwasị ụkwụ, “ụkpụrụ nlekọta” dị ugbu a (Coleman et al, 2011) na-ekwupụta: ọgwụgwọ agbadoro iji gbanwe njirimara mmadụ… ka ya na nwoke na nwanyị na-enwe mmekọrịta n'oge a mụrụ nwa, a nwaa ya n'oge gara aga n'enweghị ihe ịga nke ọma. … Ụdị ọgwụgwọ a adịghịzi ele ụkpụrụ omume anya. (62)

Zucker (2018) abụghị ihe ijuanya na ndị na-akwado ntụgharị na-ewere “ọnụ na ebumnuche nke ogwe aka ọgwụgwọ nke e mere iji belata dysphoria nwatakịrị site na usoro psychotherapeutic” .63 O kwupụtara mmasị maka nkwupụta nchịkọta nke Mahadum American nke Adomụaka na Ntorobịa. Isi mgbaka: a na-akwado ụzọ dị iche iche a na-adakarị dị iche iche maka nghọtahie okike dị na nwata ... enwebeghị ụdị ọnwụnwa ọ bụla a na-achịkwa na uru ọ bụla… a ga-akpachara anya na uru ọgwụgwọ dị na ya iji kpochapụ esemokwu nwoke na nwanyị… a ga-eji nlezianya chekwaa nsonaazụ o nwere ike ịkpata. (64)
Nsogbu a bu na ndi na akwadoro maka iweghari ohuru adabaghi ​​na ha ghotara otutu ihe oma.


G DONES KA DUTCH PROTOCOL KWES ?R??
Usoro nke 1 nke Dutch Protocol na-emetụta ntughari mmekọrịta nke nwatakịrị nwoke na-arịa ọrịa anya na aha, aha, akwa na ụdị nke nwoke na nwanyị.

Oge nke abụọ ga - esite na nchịkwa ọgwụ nke na - egbochi mwepụta homonụ site na gland pituitary nke kwesịrị ịga gonads iji mee ka mmepụta nwoke na nwanyị na ova, yana imepụta na izochi mmiri nke homonụ nwoke na nwanyị (testosterone na estrogen) na - eweta. banyere ma kwado aru nke aru na ezi uche nke nwoke, ma, mezie ndu okenye. A na - akpọ ọgwụ ndị a dị ka ihe na - egbochi ogo mmadụ, a na - enyekarị ya na mmalite nke agba. Nwatakịrị nke kasị okenye nyere ọkwa na ha natara ha n'Australia mere ya mgbe ọ dị afọ 2½.

Usoro nke ato metụtara nlekọta nke homonụ nke nwoke na nwanyị na ebumnuche ịchụpụ ihe dị mma ahụ nwoke ahụ. Ka oge na-aga, ikpughe ahịhịa dị na homonụ nke nwoke na nwanyị ịlụ nwanyị ga-eduga n'ịrụ ọrụ kemịkalụ. Ọ bụ ezie na ntuziaka mba ụwa na-atụ aro ịwa ahụ a na-atụgharị amị ga-egbu oge rue afọ 3, ọ dịkarịa ala ụmụ nwanyị ise nọ na Australia ejirila mastectomy tupu oge ahụ dị ka akụkụ nke usoro ọgwụgwọ 18A. (3) 'akwara ịwa ahụ', a na-anabata ikike abụọ ga - eme ka ụmụaka n'oge a dị obere site na nyocha na ha "agbanyụgharị ọzọ". Agbanyeghị, ikike ị breastụ ara bụ apụtachaghị nke ọma, ọbụlagodi na ụfọdụ n'ụdị ara nwere ike weghachi site na ntinye aka n'ụdị dị iche iche.

Usoro nke 4 gụnyere ịkọwapụta akụkụ ahụ nwoke na nwanyị na ihe ndị ọzọ metụtara mmekọahụ nke nwoke, dịka nwoke “apple apple” na nkesa ntutu. Ọ bụghị ụmụaka niile nwere dysphoria okike rubere ogo ịwa ahụ.

Usoro 5 anaghị apụta na akwụkwọ transgender. Ndị na-apụta na Oge A na-eche ihu oge ndụ na nlekọta nke usoro ọgwụgwọ homonụ, mmezi nke urogenital ịbelata nsogbu nke oghere na ngọngọ, na, ikekwe, nkwado mmụọ. Anabatabeghị nke dị n'ime ime mmụọ abụọ ka dị n'oge nwata ndị a n'okpuru arụmọrụ na ha "ga-emegharị ọzọ". Agbanyeghị, ikike ị breastụ ara bụ apụtachaghị nke ọma, ọbụlagodi na ụfọdụ n'ụdị ara nwere ike weghachi site na ntinye aka n'ụdị dị iche iche.
Ndị na - akwado echiche echiche transgender anaghị anabata etiti ọ bụla. Ma obu dibia n’adighi aka nyere nwa ahu aka n’ebe ndi ozo di ma obu ndi dibia n’onye ikpe mara “mgbanwe ntụgharị uche” site na iju.

G PRN PR KWESAYRAY AYBAYR A CHMAKA NIILE NA-AK ONKỌ CHBỌCH ON?
Na-adọ 1: Mgbanwe ọha. Enweghi ike ikwusi mmekorita ya na oria uche: otutu onu ogugu umuaka dysphoric ka enyere nnabata nke uche. Nkọwa nke “dysphoria” pụtara ihe ndị ọzọ na-ata ahụhụ. Ndị na-ekwu okwu ga-eme ka nsogbu uche nke abụọ dị na mgbagwoju anya nwoke na nwanyị. Nke a bụ agbanyeghi na ọtụtụ akụkọ na-ekpughe mmalite mmalite nke ọnọdụ mmụọ nke dysphoria okike bụ akara ga-emesịa, dịka ekwuru. N'ọnọdụ ọ bụla, ịta ahụhụ site na ọnọdụ uche na ọdịiche na nke anụ ahụ bụ nke a na-ewerekarị na ọ bụ ihe efu, na, dịka ọ dị, ọnụ ọgụgụ ndị isi na ndụ nwatakịrị anaghị achọ ịkwagide aghụghọ ahụ. Ha anaghị agba ume, itisa ma ọ bụ sonye na aghụghọ ahụ mana ha na-achọ iwelata ịdị ukwuu ya na ịgbatị ya maka mmerụ ahụ.
Dịka ọmụmaatụ, ọ nweghị onye na-ekere òkè na aghụghọ nke anorexia nervosa nke nwatakịrị na, ọ bụrụ na ndị isi ụlọ ọrụ emeela ka ngosipụta ya dị na ya site na imepụta ebe ndị pụrụ iche maka obere nri ma ọ bụ na-agbọ nke onwe nke afọ, a ga-ahụta omume ha dị ka omempụ. Onye omekome ga - abụ onye dọkịta na - awa ahụ ga - ekere òkè na nzuzu nke oke ibu site na itinye ọnya na - egbu nri iji belata oriri iji mee ka afọ ojuju mata onye ọ bụ.
Ma mkparịta ụka ahụ metụtara okwu aghụghọ nwatakịrị na-ekwu na ọ bụ ya nwe nwoke ma ọ bụ nwanyị. Ihe egwu di iche iche imebi aghugho nke uche bu ihe uzo mgbe gara aga, ma odighizi. Kedụ ka nwatakịrị ga-esi tụgharịa uche na ntuziaka nke chromosom na homonụ ya ma ọ bụrụ na ndị ọchịchị toro eto agbaala ozi iji mebie ozi nke ihe dị iche na ọnụọgụ abụọ na nwoke na nwanyị?
Ọ bụrụgodi na mmụọ nke nwatakịrị ga - enye echiche ụfọdụ ike, olee otu nwatakiri ga - esi gbanahụ nnabata a ma tinye ya ọzọ mgbe homonụ nke itolite etolite etolite mmekọahụ nke ụbụrụ ya. Ngagharị iwe na “ntụgharị nke abụọ” mgbe oge nọrọ dị ka nwoke na nwanyị abụghị ihe echere n'echiche (Steensma and Cohen-Kettenis, 2011) 66. Kedu ihe ga - eme ma ọ bụrụ na nwatakịrị gbanwere obi ya wee chọọ ịkwụsị ịgbagharị, dịka nyocha na-egosi na ọ na - eme n'ọtụtụ oge? Kedu ka nwatakịrị si guzogide ndị isi ikike ahụ sonyere na, ọ bụrụ na a gbaghị ya ume, aghụghọ ahụ?
Nke jọgburu onwe ya, ọ bụrụ na nwatakiri ahụ nwere oke egwu maka iwepụta ihe aghụghọ na nnabata nnabata nke ụzọ nke Dutch na - esote ya bụ naanị ihe ga - ekwe omume? Ma ọ bụ, gịnị ga - eme ma ọ bụrụ na o nweburu mmetụta nke uche nwatakịrị na - enweghị echiche ọ ga-ebi na mmekọahụ nkịtị ya, n'agbanyeghị na homonụ ya na-agba ume? Dịka Zucker kwupụtara n’elu, ozugbo nwatakịrị abanyela n’usoro mgbanwe ọha na eze, ọ ga-ebelata ohere nke ịnọpụ onwe ya.

Usoro nke 2: igbochi agba. Nmalite imu uto na - amalite omimi n'ime ụbụrụ ebe elekere sitere na ndu ya ma nwee ọtụtụ homonụ nwere nyocha na nguzozi dị iche iche. A maghị ebe na etu o si amalite, mana ndị ozi kemịkalụ n’ikpeazụ na-emetụta mkpụrụ ndụ akwara na hypothalamus ịhapụ homonụ na ejiji pulsatile iji bido ihe akpalite. Ha na - akpali mkpụrụ ndụ dị na gland dị nso na nzuzo iji mee ka homonụ ndị ọzọ na - eme njem iji kpalie gonads (testes na ovaries) ịhapụ homonụ ndị ọzọ na - eme njem iji kpalite agwa mmekọahụ nke anụ ahụ n'ime ahụ, ma gbalite ma nwee ume na - echere ebe a na - enwe mmekọahụ na ụbụrụ.
Homonụ nke ogwurugwu na -akụ ndụ ka ọ na-akpali akuku a na-akpọ “gonadotropins”. A na-esite na Grik ahụ ihe ndọta ahụ site '' tropins '' ọ pụtara n'ụzọ dị irè 'na-eme ka ogwe na-eto ma too.' A na-akpọ homonụ nke sel na -akpata na hypothalamus nke na-akpata ịhapụ gonadotropins site na pituitary akpọrọ "gonadotropin-na-ewepụta homonụ", nke akpọpụrụ GnRH. Ọ dịghị onye na-ekere òkè na aghụghọ nke anorexia nervosa nke nwatakịrị na, ọ bụrụ na ndị isi ụlọ akwụkwọ mere ka ngosipụta ya dị na ya site na imepụta ebe ndị pụrụ iche maka nri dị ntakịrị ma ọ bụ ọgbụgbọ nke onwe nke afọ, a ga-ahụta omume ha dị ka omempụ.

Homonụ nke GnRH nke hypothalamus na-arụ na-anabata ndị na-anabata ya n'elu sel nke dị na pituitary. Ihe nzuzo ha na - ewepụta oge (nkeji 60 ruo 90) na - enye ohere maka ndị na - anabata ọnya ahụ ịtọgharịrị mgbe ike gwụchara ha na - ezipụ ozi na njikọ nke sel ha. Ọ bụrụ na a na-akpalikarị ha, ndị na-anabata ya na-agwụ ike, ozi anaghịzi enwe njikọ akwara mkpụrụ ndụ nke pituitary, gonadotropins anaghịzi ewepu ya, na ọdụ agba.
Ekewapụtara kemịkal nke GnRH na mmalite 1970s wee chọpụta na enwere mkpụkọ 10 nke akpọrọ peptides. N’ezie, ndị ọkà mmụta sayensị mechara mụta otu esi agbanwe peptide ikpeazụ n’ime yinye maka ihe ọzọ, na nsonaazụ ahụ GnRH ọhụrụ ahụ ga-esonyere ndị na-anabata ya ma na-akpali gland, mana ọ gaghị ekwe ka eweghachi ndị nabatara ndị ahụ na arụ ọrụ ha na sel. mgbidi. N’aka ozo, ndi sayensi weputara uzo nke ghapu oke, ma si otua kwusi imeputa gonadotropins ma obula ana ebu otu.
A maara dị ka GnRH “agonists”, n'ihi na ha na-ebu ụzọ na-akpali mmepụta nke gonadotropins, a na-emepụta ndị agonists GnRH na ụdị ọgwụ ọkụ ga-agwụ ike mmepụta nke gonadotropins ruo ọtụtụ izu mgbe nchịkwa gasịrị. Ọ bụrụ na etinye ya kwa ọnwa ma ọ bụ karịa, opupu ike nwere ike ịkwụsị ime ya ruo ọtụtụ afọ na njedebe.

Kemgbe 1980s, ọgwụ ndị a ejirila na-egbochi oge uto mgbe ọ malitere ngwa ngwa. A maara ọnọdụ a dị ka oge ntozu nwoke mara mma ma jikọtara ya na nsogbu uche, nnyonye anya na itolite ma nwee oke mmetọ a. Ejirila ndị na - eme ihe ọfụma n'ụdị ọma ndị a dịkarịsịrị njọ yana ọ na - egosi na etolite etolite n'onwe ya nwere ike bulie ya mgbe ekpughere ya. Mmetụta ọ bụla nke ikpughe ọgwụ a na ụbụrụ na-etolite etolite, enweela ike siri ike ịchọpụta n'ihi nrụgide uche na mmekọrịta mmadụ na ibe ya na-emetụta n'oge iko nwoke na nwanyị nwere nsogbu na ụkọ nke ọnọdụ ahụ. Agbanyeghị, eziokwu ahụ bụ na mgbamgba nwere ike ịmaliteghachịgo emeela ka ndị na-akwado ya kwupụta mmetụta nke ndị na-egbochi ihe banyere nwoke na nwanyị na alụso nwanyị anya “dị mma ma na-atụgharị ya kpamkpam”. International Endocrine Society (Hembree et al, 2011) adịchaghị arụ ọrụ iji mesie ya obi ike, na-ekwupụta n'ụzọ na “mgbachi obi ogologo oge… anaghị egbochi iweghachi” mgbe a kwụsịrị ya (67). Karịsịa, Society na-adọ aka na ntị na enweghị data gbasara oge ọ ga-ewe ka spam na-agba ọsọ na ova wee pụta mgbe mgbochi ogologo oge gasịrị.
Mgbe ịchọpụtara, n'oge na-adịghị anya, ewepụrụ ndị ọrụ igbochi nzuzo nke homonụ nwoke na nwanyị site na gonads n'ọnọdụ ndị amaara na omume ha na-aka njọ, dịka mmetụta nke oestrogens na endometriosis na ụmụ nwanyị na testosterone na kansa nke prostate. Egosiwo na ihe eji emechi ihe na onodu ndia ka egosiputara na nmekorita nke uche ya na mbelata ya (Grigorova et al, 2006; Nelson et al, 2008; Craig et al, 2007) 68,69,70 mmetụta nke ịka nká, ọgwụ mgbasa na-echegbu onwe ya banyere ọrịa ahụ emeela ka o sie ike ịtụle ntinye aka nke ndị na-egbochi GnRH. N’atụghị anya, na mpụga mmetụta ha na sistemụ akwara Central, Ohlsson (2016) egosiputala na ojiji nke igbochi emetụta ụjọ ụjọ nke bowel n’ime ụmụ nwanyị na-ewere ha belata mmepụta nke gonadal estrogen nke akwara kwenyere na ọ ga-akpalite ọnọdụ ọrịa gynecological. endometriosis. Mmụba a na-atụghị anya ya na nsogbu nke eriri afọ na ụmụ nwanyị ndị a na biopsies gosipụtara mbelata nke ọma na mkpụrụ ndụ akwara ndị na-ebute ngaghari nke eriri afọ. (71)
Ekwenyewo mmetụta a na ọmụmụ anụmanụ (Sand et al, 2015) (72) (lee anya n'okpuru) ma kwenyere na ọ na-atụ aro ọrụ maka GnRH gafere ọrụ dịpụrụ adịpụ na ọrụ akọwapụtara mkpali nke pituitary ka ọ bụrụ ọrụ dị ukwuu maka mmezi nke mkpụrụ ndụ akwara. n’akụkụ ahụ dị iche iche. N’aka ozo, oru nke GnRH agagh enwe ike wedata n’otu nsogbu nke ikwuputa pituitary imeputa gonadotropins. GnRH yiri ka ọ nwere mmetụta zuru ebe niile na ndị a kwesịrị ịtụle mgbe a na-achịkwa ndị na-egbochi ndị na-egbochi ihe.
Gịnị ma ọ bụrụ na ụjọ jidere nwatakịrị ahụ megide aghụghọ ahụ na nnabata nnabata nke usoro nke Dutch na-eche na ọ bụ nanị ohere ga-ekwe omume? Ma ọ bụ, gịnị ga - eme ma ọ bụrụ na o nweburu mmetụta nke uche nwatakịrị na - enweghị echiche ọ ga-ebi na mmekọahụ nkịtị ya, n'agbanyeghị na homonụ ya na-agba ume?

Ọ bụ ezie na eleghara anya na nyocha ahụike na ụmụ mmadụ, enwere ọtụtụ ọrụ na ọmụmụ ihe nyocha ụlọ nyocha na ụmụ anụmanụ iji kọwaa mmetụta dị ukwuu nke GnRH, ma zaa ajụjụ nke ihe nwere ike ime mgbe akpọchiri ha. Ihe omumu banyere anumanu ekpughere na ngalaba nke ụbụrụ na-ejigide GnRH na-eme ka ọfụma na mpaghara ụbụrụ metụtara mmekọahụ, cognition, ebe nchekwa, mmetụta na ọrụ onye isi (Jennes et al, 2009; Casoni et al, 2016; Jennes et al, 1994; Kauffman 2004; Quintanar et al, 2007) 73,74,75,76,77. E gosipụtara ọrụ nke GnRH na mpaghara ndị ahụ site na ịchọta ọnụnọ nke ndị nnabata kwesịrị ekwesị (Stopa et al, 1991; Ban et al, 1990) (78), (79). Enwere ike ịchọta GnRH na mmiri cerebrospinal nke na-asa ụbụrụ tụrụ aro na mmiri nwere ike ịbụ usoro ọzọ maka nkesa zuru ebe niile, karịa ọnụnọ mkpụrụ ndụ ndị odeakwụkwọ GnRH (Caraty 2008) (80).
Mgbe nke a gachara, igba ogwu GnRH na saịtị nke ụbụrụ butere nsonaazụ ụfọdụ. Nke kachasị, enyocha n'ime mpaghara metụtara mmekọ nwoke na nwanyị ka a na-eme ka enwee mmekọ nwoke na nwoke na nwoke na nwanyị (Pfaff et al. 1973; Moss et al 1973; Pfaff 1973; Maney et et al 1997; Schimi et. Al. Al. 2000; Riskind et. Al. 1979; Argiolas et. Al. 2013) (81), (82), (83), (84), (85), (86), (8) 7. N'aka nke ọzọ, mmekọahụ belatara site na igbochi nsonaazụ GnRHnwith pụrụ iche, yana ọgwụ mgbochi pụrụ iche na-egbochi ịkpa agwa mmekọahụ n'oge ụmụ anụmanụ (Bentley 2006) 88. Ọ na - egosi na GnRH na - agbanye mmekọahụ, na mgbochi ya na - agbanyụ ya.

A rụpụtara mmetụta GnRH ka ukwuu na njirimara mmekọahụ na omume site na ịchọpụta na isi dị iche iche (pheromones) nke ndị na-abụghị nwoke ma ọ bụ nwanyị nwere ike ịkwalite ntọhapụ nke GnRH iji mee ihe na ebe a na-enwe mmekọahụ na ụbụrụ, yana pituitary, iji weta. gbasara nnwepụta nke abụọ nke homonụ nwoke na nwanyị gonadal tinyere mmetụta mmekọahụ ha (Martin et al, 1986; Ungerfeld 2007) (89), (90). N’oge na-adịghị anya, ka aghọrọ, achọpụtara ya na “mkpali mmekọrịta nwoke na nwanyị” maka njirimara nwoke na nwanyị dị na “gburugburu ebe obibi mmekọrịta bara ụba na nke jupụtara na nlele, ụda na isi nke ndị agbata obi ha, ndị di na ụmụ na ụmụ ụmụ ha (Hawken). et al, 2012) (91). Ya mere, n’atụrụ, a gara n’iru na-ekpughe na ọnụnọ nke nwoke na-enweghị isi na nwoke ma ọ bụ nwanyị na nwanyị na-adịghị mma nwere ike ime ka enwee ike ịhapụ nke GnRH ozugbo, dịka ọ nwere ike bụrụ onye na-enweghị isi. Ọbụna foto nke ebule nwere ike itinye mkpịsị aka na nwa atụrụ, dịkwa ka ihe nkpuchi ihu ebule n'anya nwanne ya.
Nchoputa ndi a banyere aturu rụtụrụ aka na mmezu nke mmekọrịta nwoke na nwanyị nke “sociosexual” nke metụtara uche, ncheta, mmetụta na mmetụta uche, na-emetụta oke homonụ, na-eme ka mmeghachi omume ha dị njọ site na mmezu chromosomes mbụ. N'agbanyeghi na aghotaghi ya, ike nke ihe mkpali ndia bu ihe doro anya. Nkọwa Eugene E Bruscho nke ịhụnanya dị ka “Ọmarịcha nrọ na ọrụ ọgbụgba” bụ ihe dabara adaba.

Dabere na nyochaa nnukwu ọrụ nke GnRH na mmepe na mmezi nke mmekọahụ, ụfọdụ ndị ọrụ nyocha na-elele nsonaazụ ụfọdụ na ụbụrụ atụrụ nke enyerela ndị na - egbochi ihe na - adịghị mma. N'ime ụlọ akwụkwọ ọgwụgwọ anụ ụlọ na mahadum dị na Glasgow na Oslo, ihe karịrị afọ 10 gara aga, a na-egosipụta mmetụta buru ibu na akparamagwa na atụrụ ahụ. Ndị ahụ a machibidoro iwu kpughere ihe mebiri emebi amygdala mebiri emebi nke mpaghara ahụ nke mkpụrụ ndụ ahụ mepụtara GnRH rutere na ya ruru. Usoro limbic na - ejikọta cognition, ebe nchekwa na mmetụta, ma na - eduga “arụmọrụ onye ọrụ” kwesịrị ekwesị. Na ndị na-egbochi, amygdala ji nwayọọ nwayọọ na-arụ ọrụ, na arụmọrụ nke ọtụtụ mkpụrụ ndụ ihe mejupụtara ya gosipụtara gbanwere. Atụrụ ahụ metụtara gosipụtara na ha nyeere ha aka
Mbelata na ncheta na mmụba nke mmetụta uche (Nuruddin et Al, 2013; Nuruddin et Al, 2013; Nuruddin et al, 2013; Evans 2 et Aa, 012; Hough et al, 2017; Wojniusz et al, 2011) (92) , (93), (94), (95), (96), (97) (, 98). N'iji nlezianya, ọmụmụ ihe ọmụmụ na ụlọ nyocha ndị ọzọ gosipụtara mmetụta na-emerụ emerụ nke ndị na-egbochi mgbochi na iguzosi ike n'ezi ihe nke mkpụrụ ndụ akwara site na hippocampus, akụkụ ọzọ nke sistemụ limbic. Ikekwe site na ị na-enwe mmetụta dị omimi nke enzymes n'ime sel ndị ahụ, ikpughe na ndị na-egbochi ya emebiela ọtụtụ, n'ezie ọtụtụ, amabeghị banyere ọrụ GnRH zuru ebe niile, mana enwere ihe akaebe zuru oke maka ọrụ mmezi na ọrụ neuronal zuru ebe niile, yana dị ka ọrụ a kapịrị ọnụ na njirimara mmekọahụ na ọrụ ịmụ nwa iji maa aka nnwale nnwale ya maka ụbụrụ ụmụntakịrị na-eto eto. (17) obere mgbatị site na nke mkpụrụ ndụ akwara na-ekwurịta okwu na ibe ha, n'ikpeazụ, na-enye aka na ụbụrụ nke ụbụrụ (Prange et al, 2008; Quintanar et al, 2016; Naftolin et al, 1971) (99), (100) , (101).

Ọtụtụ, n'ezie ọtụtụ, amaghị banyere ọrụ GnRH zuru ebe niile, mana enwere ihe akaebe zuru oke maka ọrụ mmezi na arụ ọrụ neuronal zuru oke, yana ọrụ dị mkpa na njirimara mmekọahụ na ọrụ ịmụ nwa iji maa ọchịchị nnwale ya echiche na-eto eto nke .mụaka. Yabụ, kedu ka a ga-esi atụ anya ụbụrụ na-eto eto egbochiri iji ghọta ọdịnihu inwe mmekọahụ? Clinlọọgwụ ụmụ nwoke na ụmụ nwanyị na-enye ndị na-eto eto nsogbu na-enye arụmụka oge iji tụlee njirimara nwoke na nwanyị na ịmụ nwa n'ọdịnihu, ma na-ebelata mkpasu iwe nke njirimara mmekọahụ achọghị. Ajuju a bu: kedu ka esi eme ka nwatakiri elebara anya na onodu di iche, site na mmalite nke 10½, ka aghota ka o ghota ihe ndi di otua mgbe agwara ya ihe omuma nke mmekorita nwoke na nwanyi? Na, olee otu a ga-esi atụ anya ka nwatakịrị ahụ “chee echiche” mgbe a na-agọnahụ mmetụta na-akwagide ya, ọkachasị, GnRH, n'akụkụ dị iche iche nke ụbụrụ nke na-etinye ihe nchekwa, ihe ọmụma, na mmetụta uche n'ime ọrụ ezi uche? Dabere na bench na akwụkwọ ọgwụgwọ ọrịa anụmanụ, nchịkwa nke ndị na-egbochi nwere ike ịtụ anya ọ bụghị naanị igbochi ihe ịrịba ama nke ntorobịa kamakwa:

  1) mmekorita nke nmekorita nke nwoke na nwanyi na ike ndi mmadu na ndi mmadu na-aru ike dika ihe omuma nke GnRH

  2) Nkwado nke omume a na-eduga na mmekọrịta nwoke na nwanyị site na arụmọrụ GnRH kpọmkwem na “ebe mmekọ nwoke na nwanyị” dị na ụbụrụ

  3) mmetụta nke abụọ nke testosterone na estrogen na nhọpụta ha na-ahọrọ nke ụbụrụ nke nọ na-echere ha nwayọ, dịka chromosomess nke ahụ na-ahazi ma na-eduzi kemgbe izu ndị mbụ nke ndụ nwa ebu n'afọ.

  4) ikpughe ụbụrụ n'oge homonụ gonadal ndị ahụ, dịka otu ihe eke mmụọ nke pubertal si kọọ. Egosiputara mbubreyo ka ha belata ihe ndi mmadu na eme

  5) ike nke usoro nke limbic iji mee ka nghazi zuru oke, ncheta na mmetụta ma rụọ ọrụ “onye isi” maka mgbasa nke ụdị ahụ. Ọ bụ ezie na a na-egbochi usoro ebumpụta ụwa nke imebi njirimara nwoke na nwanyị,
nwatakịrị ahụ dị ya nso ka na-ahụgide nrụgide dịgidere na ntughari nke ndị isi ya, nwatakịrị ahụ, ndị nkuzi, ndị dọkịta, ndị na-agwọ ọrịa, ndị na-enye ndụmọdụ, weebụsaịtị ntanetị na ịdị mkpa nke ahụmịhe ahụ site n'igosi na ibi dị ka onye otu nwoke na nwanyi. Gọnarịrị ntụgharị nke homonụ eke pụta ụwa ebe a na-ahụkarị mmetụta ndị dị ike, ọ bụghị ihe ijuanya na ọmụmụ na-ekpughe na, ozugbo malitere na mgbochi, mmụba ahụike na-aga n'ihu na mmekọahụ ọzọ.    

Usoro 3: Nlekọta nke homonụ nwoke na nwoke na nwanyị. Usoro ọgwụgwọ nwoke na nwanyị na - eme ka nwoke na nwoke nwee mmekọ nwoke na nwanyị na - enye nwoke homonụ zuru oke iji kpalite ma jigide njiri mara ya, dịka mmepe nke ara na nwoke, ma ọ bụ ajị agba nke nwanyị. A na-enye homonụ ndị ahụ maka ndụ, a ga-enyocha ya maka nsonaazụ ya. Dabere na World ọkachamara Association maka Transgender Health (WPATH), homonụ ụmụ nwanyị na-ebu ibu nwere ike ịba ụba nke gụnyere ọrịa thromboembolic venous, gallstones, enzymes dị elu, oke ibu, na hypertriglyceridemia. Enwere ohere dị elu maka ọrịa obi yana ọnụnọ nke a ga - esi atụ anya nwatakịrị a nọgide n'ọnọdụ dị anya, site na mgbe ọ dị afọ 10½, ka ọ ghọta ihe ndị dị otú ahụ mgbe agọnarị mmetụta mmekọahụ na-akpali akpali nke
homonụ nke eke? (18) ihe ndị ọzọ dị egwu. Enwere ike ịbawanye ụba nke hyperprolactinemia na hyperprolactinemia ma ọ bụ prolactinoma, yana Ọrịa shuga withdị nke Abụọ na ọnụnọ nke ihe ndị ọzọ dị ize ndụ.

WPATH na-ekwu na homonụ nke homonụ na-ebu ibu nwere ike ịbawanye ụba nke gụnyere polycythemia, ibu ibu, apnea ụra na ịtụda. Enwere ohere dịwanye ukwuu nke enzymes imeju na hyperlipidemia dị elu. Ihe nwere ike ime ya na ihe ndi ozo puru ime ya bu igbu mmadu nke oria obi mmadu, oria obi, obara mgbali na oria nke abuo. (2)
Site na mkpochapu nke gonads, enwere ihe ngbanye nke igba ogwu na ya, ya mere ochicho igba omumu gha etolite site na nnakọta na ihie ova na spam tupu a ghaa homonụ nwoke na nwanyi. Mgbe ahụ, ekwesịrị ịchekwa ova na spam n'ọnọdụ oyi ka ejiri ya mee ihe onye na-esote ya. Dabere na omume mba ụwa, homonụ nwoke na nwanyị nwere ike iso ma soro ma gbochie ọgwụ mgbochi, ma amalitekwa ihe dị ka afọ iri na isii. Fọdụ ụlọọgwụ, agbanyeghị, malitere ọgwụ dịka afọ 16 (Shumer 14) (2016). Uzo a “na mbu” na-agbaso uzo “nkwanye ugwu”: oburu na nwata ekpebie na o ga - agbanwe okike, ma oburu na ndi nne na nna na ndi isi a nakweere, gini kpatara o jiri mee nwa ahu ichere? A sị ka e kwuwe, ọ bụrụ na ọ na-etozu etozu, nwata ahụ ga-anọ etozu ebe ndị ọgbọ ya niile na-eto eto ma topụta agwa mmekọahụ. N'ezie, oge ịkpa oke a adịghị mkpa. Ọ gaghị abụ obi ebere karịa inye homonụ mmekọahụ nke ga-emepụta njirimara mpụga nke nwoke a họọrọ n'oge na-adịghị anya mgbe emesịrị? N'uche a, usoro nkwuputa ọrịa na-abanye na mmalite nke afọ n'agbanyeghị ndụmọdụ nke Endocrine Society: “Nyere oke mgbaghara… [nke dysphoria okike]… mgbe mmalite nke ntozu nwoke, anyị na-akwado megide mgbanwe mgbanwe mmekọrịta ọha na zuru oke na ọgwụgwọ hormone na umuaka prepubertal ”(Hembree 103) (2009).

Enwere mmetụta dị iche iche nke homonụ nwoke na nwanyị na-enwe mmekọahụ na ụbụrụ? Ọ bụ ezie na ndị na-akwado usoro ọgwụgwọ transgender na-emeghe maka mmetụta metabolic nke cross-sexhormones dị ka protein nke thrombosis, ọbara mgbali elu, na osteoporosis, ntụaka ole na ole na-ekwu banyere mmetụta nke homonụ na-enwe mmekọahụ na ụbụrụ na-eto eto na-eto eto (Chew et al, 2018) 105. Agbanyeghị, enwere ihe akaebe zuru oke site n'ọmụmụ mmadụ mmadụ na ọgwụgwọ anụ ụlọ iji dọọ aka na ntị na mmetụta ahụ ọ bara ụba, ọbụlagodi
Aghọtaghị ihe kpatara ya.
N’ụzọ dị ịtụnanya, ekpughere ya na mkpụrụ ndụ akwara nke ụmụ nwoke na ụmụ nwanyị na-emepụta homonụ nke nwanyị, estrogen, nke a na-ahụkarị ka ọ bụ nanị ụmụ nwanyị tozuru oke mepụtara (106), (107). Egosipụtawo na estrogen a na-emepụta mpaghara (nke a maara dị ka neurosteroid) bụ ihe dị mkpa maka ọrụ nke neurons, n'ụzọ a na-amaghị ama (Spencer et al, 2008) 108. Ihe ịtụnanya bụ na testosterone, nke sitere na testes buru oke ibu na ụbụrụ ụbụrụ n’ime ụmụ nwoke, na obere ọnụọgụ sitere na mkpụrụ ndụ adrenal dị na ụmụ nwanyị, na-agbanye mkpọrọgwụ n’ime sel ndị ahụ n’ime estrogen, na-atụnye ụtụ na mpaghara ya (Garcia-Segura 2008) ( 10) 9.
Ya mere, hormone nwanyi, estrogen, kwenyere na-ahazi ọdịiche dị na akwara ozi na sel ha na - akwado ya. Ọ "na - ebute esemokwu nwoke na nwanyị na ntanetị nke na-achịkwa… mmeputakwa" yana mmepe obodo nke mgbatị site na akwara ozi na ụzọ ha si ekwurịta okwu, n'ọtụtụ puku ha, na ibe ha (Terasawa et al, 2012) (11) 0.
Nkwụsị nke uche nke estrogen na-ebute mbibi nke ngalaba neurons, otu aka ahụ mmetụta mmetụta nke puberty blockers na neurons na ọmụmụ bench (Quintanar
2016) (111). Ikekwe, GnRH na-akwado mkpụrụ ndụ akwara site na ịnọgide na-enwe nguzozi nke testosterone na estrogen, mana a ka ga-enyocha ya. “Ebe ọ bụ na mgbaghara dị ukwuu of [nke dysphoria nke nwoke] pub mgbe mmalite nke oge uto, anyị na-akwado megide mgbanwe mgbanwe mmekọrịta ọha na eze yana ọgwụgwọ hormone na ụmụaka ịmụrụ nwa.” Society nke Endocrine ”(91)

Ajụjụ na-ebilite: kedu ihe ga - eme ọrụ nke onye neurons na mkpokọta ya n'ime ụbụrụ, ọ bụrụ na a ga - eme ya homonụ nke nwanyị nwere mmekọahụ ma ghara ịhapụ ọnụnọ nke ndị emebere ya? Ọzọ, ihe omuma bu ihe di oke nihi na enweghi ike nyocha di omimi. Ọ maara na nguzozi nke homonụ nwoke na nwanyị na-ahụ maka ọdịiche nke nwa ebu n'afọ n’ime nwoke ma ọ bụ nwanyị, yana maka nzukọ a na-ahụ nwoke na nwanyị na ụbụrụ nke bidoro n’oge ọ bụ nwa rue mgbe ahụ na-eche nzụlite ọzọ na mmeme ahụ nwoke na nwanyị a kaputere. oge uto. Brainbụrụ ụbụrụ na-eto eto nwere ike imeghari na homonụ nke mmekọrịta nwoke na nwanyị na-enwe mmekọahụ na-atụghị anya ya? Na mbu, a gwara homonụ nwoke na nwanyị ka ọ bụrụ ihe mgbochi ka ọ bụrụ afọ iri na isii mana ugbu a, na Australia, enweghị ogo ọ bụla ma ọ ga - apụta na ọ ga - ebute nchịkwa n'oge. Nchoputa nke ulo ikpe ezinulo nke Australia choro ka ochichi nke homonụ nwoke na nwoke na nwanyi inwe mmekorita nwoke na nwanyi n’abali iri-na-isii mana, na onwa November 16, thelọ ikpe a, na-agbaso nkwenye sitere na ụlọọgwụ ụmụaka gbasara okike, kpebiri na ọ gakwaghị etinye aka na ebe ụmụaka nwere ikike. nke ndị mụrụ ha na ndị dọkịta na-agwọ ha. (16) Ugbu a, nchịkwa ọgwụ ndị a na omume mastectomies ga-aza ajụjụ maka ndị na-edebanye aha ha na akụkọ ọ bụla nke nchịkwa ha adịchaghị maka nyocha ọha.

Yabụ, olee mmetụta enwere ike ịtụ anya site na nchịkwa homonụ nwoke na nwanyị na-abawanye na ụbụrụ na-arịwanye elu? Dịka m kwuru, enwere ọmụmụ ole ole dị mkpa mana imirikiti ụbụrụ nke transgenders ndị okenye ekpughere ọnọdụ nke ụbụrụ ụmụ nwoke n'ebe ekpughere ugboro iri karịa ịka nká, wee kpughee mmụba nke ụbụrụ ụmụ nwanyị na testosterone (Zubiaurre-Elorza et al, 2014; Rametti et al, 2 2012; Hulshoff et al, 2006) (113), (114), (115). Hulshoff et al (2006) nyochara ụbụrụ ụbụrụ ụmụ nwoke asatọ na ụmụ nwanyị isii bụ ndị nọ na homonụ na nwoke ma ọ bụ nwanyị na-achọ ịwa ahụ, ma bipụta nsonaazụ ha n'akwụkwọ nke akpọrọ “yourgbanwe mmekọahụ gị na-agbanwe ụbụrụ gị: mmetụta nke testosterone. na estrogen n'ihe banyere ụbụrụ mmadụ hiwere okenye ”. Afọ ha dị n'agbata afọ 16 ruo 45, na nkezi afọ 25. Mamụ nwoke natal natara estrogen na ọgwụ antiadrenergic, cyproterone. Femụ nwanyị natal natara testosterone. A na-enyocha ike ọgụgụ isi n'ụdị mkpebi ndọta dị elu nke enwetara “tupu oge ọgwụgwọ nwoke na nwanyị na-agafe agafe mgbe ọnwa anọ gachara” ma e jiri ya tụnyere ndị nke ntụnyere ahụike ahụike. Nnwale ahụ gosipụtara mbelata nke “hypothalamus na ngụkọta ụbụrụ zuru oke” na ụmụ nwoke na usoro ọgwụgwọ nwoke na nwanyị na-alụ ọgụ maka “ịdị ukwuu”.
(31ml karịa ọnwa anọ) nke “dị egwu, ebe ọ bụ na ọ na-egosi mbelata olu olu, nke dịkarịa ala okpukpu iri nke ndị okenye nwere ahụike dị afọ iri.

Ọzọkwa, ndị dere na-ekwusi ike na, na ndị okenye, ụmụaka imebi ihe metụtara afọ “na-adịkarị obere” ma e jiri ya tụnyere ndị okenye. Testosterone na-ahụ maka ụmụ nwanyị natal rụpụtara mmụba nke olu ụbụrụ dum. (116) Mgbanwe ndị a na mpịakọta jikọtara na (na ụmụ nwoke na nwoke) mbelata nha nke akụkụ nke ime na nke etiti, yana (na ụmụ nwanyị) yana mmụba na olu ha. Nke a tụrụ aro ka “na ngụkọta… mgbanwe dị opekata mpe n'ihi mgbanwe n'ọdịdị ụbụrụ (gụnyere gụnyere na ejedebeghị na hypothalamus… (gụnyere) mgbanwe abụọ ahụ na mkpụrụ akwara yana eriri akwara." na enwere “mgbanwe n'ogo ụbụrụ zuru oke” dịka mkpụrụ ndụ ihe estrogen na androgens na-emetụta ụbụrụ niile. (117)
Yabụ, homonụ nke nwoke na nwanyị nwere mmekọ na -eme mgbanwe n'ụba ụbụrụ na -echepụta ọdịiche ebilite dị n'etiti ụmụ nwoke na ụmụ nwanyị, mana enweghị ike ịkọwa mgbanwe ndị a "nke" n'ihi na mkpụrụ ndụ nwụrụ. N'ịtụgharị uche na nsonaazụ ụbụrụ, ndị edemede kwupụtara usoro kachasị mkpa nke steroid homonụ na-agbanwe ọnụ ọgụgụ neuron na mmekọahụ.
mpaghara dimorphic bụ site na ịkpa ike ọnwụ. Na mgbakwunye, ha na-etinye aka na mpụga neuronal, neurogenesis, na plasticity nke neurotransmitter. (118)
Homonụ nwoke na nwoke na nwanyị na-ebute oria na -eme mgbanwe n'ụdị ụbụrụ na ụmụ nwoke na ụmụ nwanyị, mana enweghị ike ịkọwa mgbanwe ndị a dị ka "eke" n'ihi na mkpụrụ ndụ nwụrụ.

A na-akwado ọrụ Hulshoff site na ntụaka maka mmetụta nke homonụ nwoke na nwanyị na nwoke na nwanyị inwe mmekọahụ (Raisman et al, 1971; Block et al, 1988; Nottebohm 1980) 119,120,121 a tụlere na ụfọdụ omimi n'ihi na e zoro aka na mmetụta ndị dị otú ahụ na ụbụrụ adịghị. n'akwụkwọ nkwado maka transgending. Ntụle onwe m nke gbasara akwụkwọ gbasara ebipụta banyere mkpesa nwoke na nwanyị nke Courtlọ ikpe ezinaụlọ nke Australia kpughere enweghị mmetụta na homonụ mmekọahụ na-emetụta ọnya na ụbụrụ akwara. Ọ dị ka a ga - asị na ha adịghị. Mkpa ha dị mkpa karịsịa maka ụmụaka na ndị nọ n'afọ iri na ụma na-aga site na homonụ na-enwe mmekọrịta nwoke na nwanyị n'ihi na ekwesịrị ịkọpụta nsonaazụ n'ọmụmụ Hulshoff ka ekpughere naanị ọnwa anọ nke ọgwụgwọ: ndị ntorobịa na-agafe agafe ga-achịkwa homonụ ndị a maka ndụ.

Usoro 4: ogwugwo. Dabere na ntuzi aka nke mba ụwa, enwere ike ịme “ịwa ahụ nwoke na nwanyị” afọ 18, agbanyeghị na enwere akụkọ banyere ya na - eme na mbụ n'ụlọọgwụ ndị mmadụ (Milrod 2014) 122. Enwere ike ịme Mastektomi n'oge ọ dị obere ma ọ bụrụ na ara na-eto eto na-abawanye dysphoria. Dika ihe ndi n’adighi ezi uche banyere ogwu gha ghuta ndi di nkpa banyere aru oru, odi ike itughari uche na nkowa banyere akara aka umu aka na ekwesi ike (Weissler et al, 2018) 123. Enwere ọtụtụ ihe dị iche iche na ọ bụghị ndị ọrịa niile na-enwe ọganihu na ngwugwu ikpeazụ, mana ọrụ ahụ ga-agụnyekarị usoro ịwa ahụ dị mfe nke castration, mwepu ma ọ bụ imeju anụ ahụ, mbelata nha nke apụl Adam, na mgbanwe nke ntutu anụ ahụ. Wa ahụ nke ụdị mkpụrụ ndụ ọzọ siri ike, ọ na-abụkarị nke ọtụtụ, nwere ọghọm, yana oke na nsonaazụ ya. Genmepụta akụkụ ahụ nwanyị nke ersatz bụ ihe kachasị mfe: a na-emepụta orifice na perineum, nke nwere akpụkpọ site na amụ etinyere ma, mgbe ụfọdụ, etinyere site na eriri afọ. Ọrịa scrotum na-akpụ akpụ. Mpempe ahụ na-agbaze n’elu orifice ma eriri ure na-eme mkpụmkpụ. Hardermepụta akụkụ ahụ nwoke siri ike. Otu dọkịta na-awa ahụ kwupụtara “ọrụ ahụ na-ebido ihe fọrọ nke nta ka ọ bụrụ akụkụ Herculean” (Rashid et al, 2013) 124, mana nke a na-eleda akọpụta na ebumnuche dị iche iche anya mgbe ọ na-ekwupụta nsonaazụ. Hercules nwere ihe ịga nke ọma mgbe niile: ịmepụta azịza abụghị. Patientsfọdụ ndị ọrịa na-edozi maka klọpis amụbawanye site na homonụ nwoke. Ndị ọzọ na-achọ akụkụ anụ ahụ, ma ọ bụ opekata mpe, nke nwere ike ibuga mmamịrị mgbe onye nwe ya guzo. N'ụdị ndị a, enwere ike ịnwale mkpụ ya site na anụ ahụ a gwakọtara ya na apata ụkwụ ma ọ bụ ọbụna aka aka yana ejiri ọkpụkpụ ogologo kwenye ya. Enwere ike idobe ya site na mpempe nke akpụkpọ ahụ dị n'ime yana tube nke na-ewepụta mmamịrị nwere ike idozi akpụkpọ ahụ mucous n'ọnụ. Enwere ike ịpụta ọdịdị nke scrotum site na ịmepụta sac site na abụọ ma tinye ya na ihe aka abụọ.
Ọ bụ ezie na usoro dị mma site na iji ya eme ihe, nsogbu dị ka protein. Ogwe aka nwere ike ịnwụ, oghere jupụtara, tubes na-egbochi, oghere na-apụta, ọkpụkpụ na-agbadata, na-emetụta ọrịre na nje na-abata, mana, na ngụkọta, usoro ndị a dị oke elu a na-eme na mbalụpụtara nsonaazụ 'mma na arụ ọrụ maka onye na-anabata ya. .

Ọ B EVR EV THEBỌCH D EGO NA-AK ISZI AHUT B IS BARA?
Agbanyeghi oke ngbanye uche na aru umuaka enwere na Oru Dutch, o nweghi ihe nleba anya na “usoro sayensi” nke kwesiri ijikota ogwu. Dị ka ọ na-adịkarị, usoro iji kwado usoro ọgwụgwọ ọ bụla na-amalite na oghere anụ ahụ, wee gaa na ụlọ nyocha na laborat laboati, wee mụọ maka ụmụ anụmanụ, emesịa iji mụọ gbasara ụmụ mmadụ; emesia, n’ikpeazu, omumu ihe omumu nke ndi nyocha ihe n’enweghi nsogbu nke nyochaputara na nyocha. N'oge niile ahụ, a na-achọ nkwupụta echiche ziri ezi ma nwee nguzozi megide uru nsogbu. Onye ji ezi uche na-ahụ ihe ga-eche n'echiche omume ndị dị otú ahụ ga-emetụta usoro ọgwụgwọ nke na-amalite site n'inye homonụ. Wa ahụ nke ụdị mkpụrụ ndụ ọzọ siri ike, ọ na - abụkarị nke ọtụtụ ọghọm, yana
ejedebe na nsonaazụ (21) nke nwere ike imetụta ụbụrụ yana ahụ, ga-emetụta nkedo kemịkal, ma nwee ike ibute nnukwu ọrụ ịwa ahụ nke nkedo anụ ahụ dị. Nte ededi, idịghe ntre. Edemede nso nso a nke Chew et al (2018) 125 na Pediatrics, akwụkwọ akụkọ ama ama nke American Academy of Pediatrics, na-ekwusi ike na enweghị nyocha sayensị kwesịrị ekwesị. Akpọrọ ya "Hormonal Treatment in Young People with Gender Dysphoria: a systemic review" na bụ nchikota nke akwụkwọ mba ofesi na "psychosocial, cognitive and / or physical effects". Ọ bụ isiokwu dị mkpa na gburugburu Australia n'ihi na ndị dere ya na ụlọ ọrụ ndị a ma ama dị ka Royal Children's Hospital dị na Melbourne, nke yiri ka ọ bụ mmalite nke Dutch Protocol na mba a.
Maka Chew et al kwuputara na mmeghe ha, na ụdị ọmụmụ a "dị ụkọ" bụ enweghị atụ: na afọ 70 site na Jenụwarị 1946 ruo June 2017, ha nwere ike ịchọta naanị akwụkwọ iri na atọ dị mkpa ọ bụla. Ha chọpụtara na ụkọ a “nwere nsogbu” n'ihi na “oge ntorobịa bụ oge mmepe ngwa ngwa gafere n'ọtụtụ ngalaba” nke usoro ọgwụgwọ homonụ na transgending nke okenye agaghị enwe ike “ịtụgharị”. Nsogbu a dị na enweghị akwụkwọ ọgụgụ sayensị nke metụtara nnabata ahụ nwere ike ibute ụbụrụ ụmụaka na-enwe uto mkpụrụ akwụkwọ na-eto eto.
oge uto. Ndị ode akwụkwọ edepụtara nchọpụta ha n'okpuru isi okwu.

Mmetụta ahụ: Ndị ode akwụkwọ na-ewebata ihe omume nwoke na agbọghọbịa na homonụ na-enwe mmekọahụ na nkọwapụta mmetụta ụfọdụ nke anụ ahụ, na-ekwubi, “n'ozuzu, ọgwụgwọ homonụ maka ndị ntorobịa transgender enweghị ihe nchebe”. Mgbe ahụ ha ga-emebi ntụkwasị obi ahụ site na ịnabata "oge nchụso ihe dịtụ obere". Ha tụlere mmetụta uto uto ya dị mkpa, ma na-adọkwa aka na ntị maka “metabolic na ọrịa dị iche iche” amaara na njikọta na homonụ nwoke na nwanyị na mmekọrịta nwoke na nwanyị. (126)

Mmetụta uche mmadụ: Nkwupụta nke ndị ode akwụkwọ a na-ekwu na usoro ọgwụgwọ transgendering bụ ndị "jikọtara ya na ndozi dị ukwuu n'ọtụtụ ụzọ nke mmụọ, gụnyere ọrụ zuru ụwa ọnụ, ịda mba… na nsogbu omume na / ma ọ bụ nsogbu mmetụta". Agbanyeghị, ha na-akọpụta nyocha ndị ahụ kpughere “mmetụta na-edoghị anya na iwe na ụjọ” yana “enweghị mmetụta pụtara ìhè na mgbaàmà nke GD (dysphoria okike)”. N'ezie, otu nnyocha tụrụ aro maka “mmụba nke GD na ihe isi ike nke anụ ahụ” (127). Agbanyeghị, ndị dere ekwughi maka adịghị ike na ọmụmụ ihe ndị a na-ekwu na o nwere uru mmụta uche, naanị ikweta na e nwere “oghere”. Adịghị ike ndị a gụnyere mmachi ụmụ aka amụrụ amụ, oge agụghị akwụkwọ, enweghị njikwa, na ị ga - elele ndị nlebara anya. Mgbe ndị na - achọpụta ọrịa, na - achọpụta ma na - atụpụta (na - enweghị ntụle) na obere mkpokọta ụmụaka na - ata ahụhụ ga-amacharịrị onye ọ bụla, enwere ike ịlele onye kwuru. Ọmịiko, naanị ya ga-eme ka mmadụ nwee nchekwube.

Ihe ozo di nkpa nke mmekorita nke uche nke uche bu onu ogugu nke umuaka na-ata ahụhụ site na nsogbu uche, dika Becerra-Culqui et al (2018) .128 Mmetụta nke uche, ọmịiko, nkwado nke ndị ọrụ, site na otu ndị okenye tozuru oke iji nwekwuo Obi ụtọ nwatakịrị nwere ike ịbụ, naanị, ka ọ bụrụ nke ziri ezi, ma si otu a pụta ihe. Ọzọkwa, ọgwụ ọ bụla a na-akọwaghị ọgwụ ndị ụmụaka nwere ike ị takingụ na ya ga-emetụta nsonaazụ.


Mmetụta iche echiche: Ndị edemede nwere ike ịchọta naanị ntụaka abụọ, nke metụtara ọmụmụ na-esighị ike, na nsonaazụ mmuta nke usoro mgbanwe; nke ahụ bụ, na ụbụrụ ụbụrụ na omume nke onye nnata. Otu nnyocha nyochare "ọrụ njikwa" n'ime ụmụaka asatọ na ndị na - egbochi ya, ọ bụ ezie na ọ chọtara "belata oke nzi ezi" na ndị na-eto eto na-ebufe transfemale, mkpa nke nchọpụta a na-adịghị mma site na ịrụ ụka Onye na - ekiri ihe nwere ezi uche ga - eche na omume ndị a siri ike ga - emetụta ọchịchị ọgwụgwọ nke na - amalite site na inye homonụ nke nwere ike ịmetụta ụbụrụ yana ahụ, ga - eweta mkpụkpụ kemịkal, ma nwee ike ibute nnukwu ọrụ ịwa ahụ nke nkedo anụ ahụ dị. Nte ededi, idịghe ntre. (22) Onu ogugu umuaka pere aka maka nkwado. Ọmụmụ ihe nke ọzọ nyochare ikike visio-spatial, nke a kwenyere na ọ dịkarịrị ukwuu karịa ụmụ nwoke, ma kọọrọ na enwekwukwa na ụmụ nwanyị natal natara testosterone maka ọnwa 10. Enweghị mmetụta ndị ọzọ nke steroid na ụbụrụ na-eto eto. A na-enyocha ogo na ihe ize ndụ nke enweghị mmasị nke ọmụmụ 13 onwe ha site n'aka ndị edemede abụọ nke Australia, bụ ndị kwubiri: "N'ime ọmụmụ ihe niile, enwere nnukwu ihe egwu dị n'etiti" n'ihi obere ọnụọgụ nke isiokwu, enweghị njikwa, ọnwụ nke ịgbasochi, nlọghachi azụ, enweghị usoro na "enweghị ikpu ìsì" nke ndị nchọpụta. (129)
N'ụzọ dabara adaba, ndị otu Australia kwusara mkpa ọ dị "iji nyochagharị ma gbasaa na nchoputa nke ọmụmụ ndị a dị." Ha kọwara enweghị ike ịkwụsịlata akara nke dysphoria okike dị ka “ọ bụghị ihe ijuanya”, na-ekwu na ọ ga-abụ ihe ezi uche na-atụ anya na ndị na-egbochi 'belata ihe na-enweghị isi' nke ihe ndị metụtara mmekọahụ na "imeju agụụ" maka ihe anụ ahụ nke nwoke na nwanyị. Ha ekwurita enweghi ike nke ihe igbochi ibelata nsogbu uche nke nke dysphoria nwere ike buru ma obu akara. (130)

Banyere mmetụta homonụ na-enwe mmekọahụ na cognition, ewezuga obere nkọwa testosterone, ndị na-enyocha enyocha ahụ enweghị akwụkwọ ọ bụla dị mkpa. N'ozuzu, ndị edemede Australia kwubiri na ọmụmụ ndị dị adị 'eleghaara ọtụtụ nsonaazụ igodo'. Ndị a gụnyere “akara ngosipụta akparamaagwa nke bụ ihe dị oke mkpa ịmata ihe”; mmetụta ọgwụgwọ na ọmụmụ; enwere ike ibute mmetụta anụ ahụ ndị ọzọ, gụnyere uto na ọrụ akwara; na ụzọ mwepu site na ọgwụgwọ, ọkachasị akwa ụta. (131)
Ekwesiri ikwusi ike na ihe edere n'isiokwu a banyere ịkọ ụkọ ọmụmụ abụghị ihe pụrụ iche. Akwụkwọ ndị ọzọ dị na akwụkwọ akwụkwọ pediatric bụ isi na-eme mkpesa banyere "enweghị nkwekọrita gbasara ntinye kwesịrị ekwesị ma ọ bụ ọbụlagodi ebumnuche kwesịrị ekwesị nke itinye aka" (Shumer et al, 2013) 132, "amachi obere oge" (Costa R et al, 2015) naanị otu ụlọ ọgwụ "(de Vries et al, 133) 2014," ịdabere na mmetụta ahụike "(Schwartz 134) 2012. N'ihi ya, enweghi usoro ọmụmụ a na-ejikọtaghị iche na-enye nkwenye zuru oke maka nhọrọ ọgwụgwọ. Ya mere, ihe akaebe kachasị mma dị ka "echiche ọkachamara", nke usoro nkwenkwe ọdịbendị na-agbaso na usoro ntụgharị uche (Milrod 135) (2013) 13 na-emetụta.


Na Nyocha Pụrụ Iche na Journal of ግብረ-nwoke na nwanyị “ọgwụgwọ nke ụmụ nwoke na ụmụ ntorobịa ịkpa agwa nwoke, David Schwartz (2012) 137, onye isi mgbaka ụmụaka si New York, kwusiri ike na enweghị sayensị nke gbasara ọgwụ gbasara ọgwụ ma mechie ya Okwu mmesi obi ike a metụtara ụmụaka ga-akwụsịrịrị. O kwupụtara: nsonaazụ ogologo oge nke uche na nke anụ ahụ nke (ụzọ ahụike) amabeghị na, dịkwa ka ọ dị na ndị niile ahọpụtara onwe ha, ọ siri ike ịtụle maka nsogbu nke (enweghị nnwale) njikwa na ọnụọgụ nlele mmachi. . Schwartz gosipụtara nchegbu, gụnyere ịdabere na “echiche ụlọ ọgwụ”, “ojiji nke data anecdotal”, nkwusioru nke “obi abụọ” sitere na “ihu ọma nke eziokwu” nke ụmụ na ụmụ na-eto eto, na-ekwenyeghi "nkwupụta", na enweghị echiche nke "ike ọghọm ”(138).
Ma nyocha ọzọ nke nyocha na nso nso a site na Fuss et al (2015) kwubiri na nyocha dị ogologo oge… dị mkpa iji tụnyere atụmatụ dị iche iche nke nlekọta na ịhụ nsonaazụ ogologo oge ọkachasị ụmụaka ndị nwere ọrịa psychiatric na-adịghị mma. Enweghị ihe akaebe na-adịwanye ike na-atụle ọnụ ọgụgụ na-arịwanye elu nke ndị na-ezo aka na ụlọ ọgwụ ụmụ nwoke. (139).

LHL ỌR AT ATD AT Nsogbu DARA?
Ewezuga ahụike ụmụaka, enwere ihe ọzọ dị n'ihe ize ndụ? Azịza ya bụ ee. Nkparịta ụka transgender na-agbagha ikike na nnwere onwe mmadụ bụ isi. Amalite na US na Canada, agafeelarị iwu nke na-eme ka dọkịta na-ahụ maka iduzi nwatakịrị na-arịa ọrịa uche na-agafe na ntughari. Kedu ihe iwu nwere ikwu na North America? Na California, na Septemba 2012, e tiri iwu “machibidoro onye na-ahụ maka ahụike uche itinye aka na ntụgharị mgbanwe mmekọrịta ya na onye ọrịa na-erubeghị afọ 18” nke gụnyere “ndị ntorobịa transgender, yana nwanyị na-eto eto nwanyị nwere mmasị nwanyị, nwoke nwere mmasị nwoke na nwoke na nwanyị inwe mmekọahụ. ”. Mgbalị ndị ahụ gụnyere "mbọ iji gbanwee omume ma ọ bụ ngosipụta nwoke na nwanyị" nke e lere anya na "omume enweghị ọrụ ma ga-enye onye na-enye ọzụzụ ọzụzụ". Billkpụrụ ahụ zoro aka na mba dị iche iche nke ụmụaka na-ahụ maka ụmụ nwanyị, ndị ọkà n'akparamàgwà mmadụ na ndị isi mgbaka nke kọwara ihe omume ndị dị ka ntụgharị ma ọ bụ usoro nnabata. (140) Enweela iwu ndị yiri ya na New Jersey, Illinois, Oregon na Washington. N’afọ 2015, steeti Ontario, Canada tiri iwu “mgbochi ịkwụ ụgwọ” na “ngbanwe mgbanwe”. Ọ na-emegide ọnwụnwa ọ bụla ịgbanye agụụ mmekọahụ ma ọ bụ na-ekwupụta nwatakịrị na nwoke na nwanyị ọmụmụ "iji zọpụta ndụ ụmụaka".
Nke a pụtara na Onye isi ala US Barack Obama sonyeere na otu nkwenye ahụ, na-aza arịrịọ nke machibidoro nwa nwoke dị afọ iri na ise nwuru igbu onwe ya, onye chọrọ ịchọpụta dị ka nwanyị ma bụrụ onye e kwuru na ọ ga-enweta ọgwụgwọ “ntụgharị”. n'ụlọ ụka nne na nna ya. Fada White House kwuru na “nchịkwa Obama na-akwado mbọ” iji machibido ọgwụgwọ ntụgharị maka ụmụaka "n'ihi na akaebe na-egosi na ọ" adịghị mma ma ọ bụ usoro iwu kwesịrị ekwesị "(15).

O siri ike ịnwale mmetụta nke iwu. Akwụbeghị ebubo ọ bụla mana ọtụtụ ndị na-agwọ ọrịa ekweghị na nkwenye siri ike na-akọzi na ha enweghị mmasị ilekọta ụmụaka transgender n'ihi na ha achọghị nchegbu nke ihe egwu medico-iwu (nkwukọrịta onwe onye). Nsonaazụ nke mbịarị ha mgbe ha na-abawanye n'ihe ọha na-eme bụ na ụmụaka na ndị mụrụ ha na-emegharịrị anya maka ndị dị njikere ịga n'ihu ma ọ bụ ịmalite usoro mgbanwe. Otu mkpakọrịta siri ike na mmepe nke iwu ahụ bụ nchụpụ nke onye isi ụwa na njikwa nke dysphoria okike, Dr. Kenneth Zucker, yana mmechi nke ụlọ ọgwụ guzobere ogologo oge na Toronto maka ebubo na-eme ọgwụgwọ ntụgharị. Nke a ewetawo iwu dị oke egwu. Edere iwu a na Ontario, Canada, dị ka Asambodo Nkọwa Mmekọ nwoke na Nweta Mmekọ nwoke na nwanyị, 2015142 n’otu n’otu n’ụzọ ọrụ ebube dịka onye na-akwalite ya, onye omeiwu, Reverend Cheri DiNovo kwuru. Mgbe m gbara Rev DiNovo ajụjụ ọnụ na 2016, ọ kọwara na “Ego a nwere ike were ihe ruru ọtụtụ afọ ma ọ gafere nke ọnwa abụọ”. Rev DiNovo, onye batara na nzuko omebe iwu na March 2006, bụ onye nkwado ama ama maka ọtụtụ okwu, gụnyere ịnakwere ụnwụ nri Stalin na Ukraine dị ka “mgbukpọ agbụrụ,” ma bụrụkwa onye ama ama maka “ịnyefe ọtụtụ iwu LGBTQ na Canada ”. Ọ duziere ihe omume redio kwa izu, nata enwetara akwụkwọ ọgụgụ, nweta akara ugo mmụta nke Master na divinity, doctorate na ministri si Mahadum Toronto, ma bụrụ onye ụkọ nke United Church of Canada kemgbe 1995143.
Ọ rụzuru ihe niile ọ kụziiri ya dabara na mkparịta ụka anyị kwur ita. N’ezizi, o kwuputara ihe ‘iwu’ okike ya abughi nke anabataghi kama o bu “nkuzi”: iji zoputa ndu umuaka, a gha ekwenye na okike nwoke. Ekwesịrị imeghari "mgbanwe ma ọ bụ ngbanwe" maka nke a, a gaghị akwụghachi ya ụgwọ n'okpuru Iwu mkpuchi Ahụike steeti 1990. Echiche nke transgender na-agbagha ikike na nnwere onwe mmadụ bụ isi. Amalite na US na Canada, agafeelarị iwu nke na-eme ka dọkịta na-ahụ maka iduzi nwatakịrị na-arịa ọrịa uche na-agafe na ntughari.

Ajụrụ m ajụjụ banyere usoro iwu ahụ na-ekwupụta na mmachibido iwu ọgwụgwọ mmeghachi iwu "anaghị emetụta ma ọ bụrụ na onye ahụ nwere ike na nkwanye ugwu na nkwenye nke inye ọgwụgwọ". Rev DiNovo edoghị anya na nzaghachi ya. Ajụrụ m afọ ole nwa ga-elere anya dị ka onye nwere ike ikwere ọgwụgwọ ga-emeghachi omume? Ruo n’afọ ole nwatakịrị ga - enweghị ike ikwenye, ya mere ọ dabere n’ikpe ndị nne na nna na ndị na - ahụ maka ọgwụgwọ? DiNovo agaghị agbakọọ, na-ekwughachi, ma ugbu a, ọtụtụ okwu, na iwu ahụ bụ "nkuzi". Ihe kacha enye nsogbu nsogbu bu nzaghachi nke onye ndọrọ ndọrọ ọchịchị gụrụ akwụkwọ a na-ajụ m ihe kpatara etinyere ọgwụ ike, nkwanye ugwu, na-agbanwe oge mgbe ọmụmụ gosiri na imirikiti ụmụaka nwere ọnyụ nwoke na nwanyị 'ga-esi na ya pụta' ma mata naanị ọnọdụ ha. inwe nwoke ma obu okenye? O kwuru, sị, “Amaghị m nke ahụ. Anọgidere m na-ewepụta akwụkwọ nke ndị isi Dutch dere n'ọhịa nke na-agba akaebe na ihe ka n'ọnụ ọgụgụ kwesịrị. O kwuru na ya anụbeghị banyere ha. Ahapụrụ m ụlọ ọrụ ya gbagwojuru anya. Otu onye a ma ama amaghị na ọtụtụ ụmụaka ga-ezere ọgba aghara transgender?

Kedu ihe iwu nwere ikwu na Australia? N’ọnwa Febụwarị 2017, Iwu Mkpesa Ahụike ghọrọ iwu na Victoria nke enwere ike iwelie mkpesa megide usoro aghụghọ na nlefuanya nke ga-agụnye, dị ka Minista Ahụike Jill Hennessy si kwuo, ntụgharị “ntụgharị”.

Ihe kariri ka Ngosipụta Mmekọahụ nke Nweta Mmekọahụ na Nkọwapụta Mmekọ nwoke na nwanyị 2015, nke na-elekwasị anya na ndị na-agwọ ọrịa na-anata ego mkpuchi mkpuchi nke National Insurance, Iwu Mkpesa Ahụike Victoria na 2017 ga-anabata mmadụ ọ bụla ma ọ bụ nzukọ karịa ndị na-ahụ maka ahụike oge gboo na-enye "ọrụ ahụike ahụike" (146) iji “lekọta ma ọ bụ melite ahụ ike nke onye ahịa” (147), gụnyere “ahụike ma ọ bụ ọnọdụ uche ma ọ bụ ọnọdụ” (148). Nyere anya na ntughari nke ndi n’emegharia transgender na ikwenye umu aka na nmekorita nwoke na nwanyi, n’oge na adighi anya, onye obula nye ndumodu “nchere n’ anya nke nwatakiri obula nwere ike juo “ihe ngwere”. Ọ bụghị naanị ndị dọkịta, ndị ọkà n'akparamàgwà mmadụ na ndị ndụmọdụ n'ihe ize ndụ, otú ahụkwa ka ndị nkụzi ụlọ akwụkwọ na ndị nne na nna nọ. Dabere na Ngalaba Nkụzi NSW, a na-echetara ndị nkuzi ọrụ dị mkpa ịkpesa mmetọ ụmụaka na-enyo isi na ndị isi ha, ma, n'aka nke ha, na-echetara ọrụ ha iji kọọrọ ndị isi na Ndị Ọrụ na Ọrụ Community. Dabere na ngalaba okwu Okwu Bulletin (149), Onye nkuzi kwesịrị inwe “enyo ezi uche dị na ya” na nwa akwụkwọ transgender nọ “n'ihe egwu a na-enyo enyo… na-ekwu ihe onye mụrụ nwa kwuru na nwa ha kwuru na ọ bụ transgender… [mgbe ahụ] ndị ọrụ ụlọ akwụkwọ kwesịrị ịgwa onye isi ha ihe ọ bụla gbasara nwatakịrị nwere ike ịnọ n'ihe egwu nwere ike ibute nsogbu ”(2014).

G DONES KA ỌN F?
Ekwesiri imesi ya ike na “usoro ọgwụgwọ mgbanwe” bụ Orwellian nke ugboro abụọ maka mbọ ọ bụla iji belata dysphoria okike site n'inyere nwa ahụ aka iru ntozu ya, na ịghara iwebata nwa ahụ n'ụzọ nke nkwenye. Childgba nwatakiri nwere nsogbu gharị na nwoke ka o chere ihe ga-eme ka o ruo uto ya bụ ihe a ga-ele anya dị ka ụdị mmetọ ụmụaka. N’ọdịnihu, ọ nwere ike ịbụ ihe egwu nye nwatakịrị igosipụta mgbagwoju anya nke okike: onweghị onye ga-enwe ike n’iwu chedo ya na usoro ọgbanwe sitere n’aka ụmụ nwoke. Ihe a puru iche bu na steeti a ga-amachibido okike o bula, dika oge onye azuma ahia siri choro, ma o buru na ntuziaka ahu aputaghi iwu chromosom. Onye nkuzi kwesiri inwe “inyo ezi uche” na onye transgender
nwata akwụkwọ nọ “n'ihe egwu a na-enyo enyo na ọ ga-emebi… metụtara nzaghachi nne na nna nne na nna nyere nwa ha ihe amata ya dị ka transgender… ya bụ, ndị ọrụ ụlọ akwụkwọ kwesịrị ịgwa onye isi ha maka nsogbu ọ bụla gbasara nwa akwụkwọ nwere ike ịnọ n'ihe egwu nke imerụ ahụ”.

International Endocrine Society kwetara na etiti dị n'etiti “mgbanwe mgbanwe mmekọrịta mmadụ na ọfụma ọfụma” na njedebe “nkwanye ugwu” nke ụdị na ntaramahụhụ a ga-agbagha. ọzọ. N'ịkọwapụta na maka "ọtụtụ ụmụaka", dysphoria okike "anaghị adịgide" ma ọ bụrụ na ndị nne na nna na-enwe ndidi, Society na-atụ aro ka a ghara 'agọnahụ kpam kpam igosipụta ụdị omume nwoke na nwanyị' na 'ekwesịghị inye ntaramahụhụ maka igosipụta ụdị omume ahụ'. (151)
Ọ bụ ezie na a pụghị ịtụ anya ndị ndọrọ ndọrọ ọchịchị Australia na New Zealand inwe nghọta zuru oke banyere ọgwụgwọ (ọbụlagodi Rev Cheri DiNovo na-ekwu na ọ nụtụbeghị na ọtụtụ ụmụaka dysphoric ụmụ nwoke na-amata mmekọrịta nwoke na nwanyị na okenye), ntinye nke ụfọdụ n'ime ụdị ntinye aka na ịgwọ ọrịa na-eju anya. Nraranye ha nye otu nhọrọ n'agbanyeghị echiche dịgasị iche iche ga-enwetara maka ihe ịga nke ọma na-aga nke transgender activism. N’ụzọ na-emegide onwe ya, ụfọdụ ndị na-edina ụdị onwe ha amalitewala ịghọta na ihe ga-adị mma n’ọdịnihu. Na mkparịta ụka ya na otu nne nke nwoke na nwoke nwere mgbagwoju anya, ọ kọọrọ m nkụda mmụọ nke otu nwoke na-edina ụdị onwe ya. Enyi nwoke ahụ kwuru, sị, "Obi dị m ụtọ na m tolitere n'oge gara aga, ma ọ bụghị ya, mmasị m maka uwe dị nro, agba na egwuregwu, yana ụmụ nwanyị ụmụ nwanyị, gaara eduga na mgbanwe m!" A sị na o tolitere na oge na-abịanụ, a gaara ebo ndị mụrụ ya ebubo mmetọ ụmụaka maka na ha etinyeghị ya na Protocols, na dọkịta ọ bụla na-eguzogide ọgwụ nwere ike debanye aha ya. Usoro ọgwụgwọ na usoro mgbanwe ahụike na-abụ nnwale nke yiri ka ọ dabere na Usoro ọgwụgwọ Dutch maka ọrịa dysphoria nke ụmụaka. Usoro iwu Dutch gosipụtara ileghara ụkpụrụ dị mkpa nke usoro nyocha nke ahụike na nnwale mmadụ anya, gụnyere Oath Hippocratic Oath, akụkọ Belmont (1978), Nkwupụta nke Geneva (1948), Nkwupụta nke Helsinki (1964) na Nuremberg Principles (1949). Usoro Nuremberg na Nkwupụta metụtara Helsinki bụ ihe ndabere maka Usoro Iwu Iwu US nke Ngalaba Ahụike na Ọrụ Ndị Ọrụ United States nyere maka ịgwọ omume nke ndị mmadụ. Na mgbakwunye, a nabatala echiche nke nnabata a mara nke ọma ma ugbu a bụ Nkeji edemede 7 nke ọgbụgba ndụ mba ụwa nke United Nations maka ikike obodo na nke ndọrọ ndọrọ ọchịchị. Ọ bụkwa ihe ndabere maka ụkpụrụ nduzi ụkpụrụ omume ụwa maka nchọpụta ọgwụ na-emetụta ihe gbasara mmadụ nke Humantù Ahụ Ike proposedwa tụpụtara.
Megide nchebe dị mkpa nke koodu ndị a, a ghaghị ịjụ ajụjụ gbasara ụmụaka na-agbanwe. Megide ihe a choro maka isi “ighota nkwenye”, kedu ka nwatakiri n’okorobia na-egbochi gi inwe nmeko nwoke na nwanyi? Kedu ka nwatakịrị nwere nsogbu mmụọ na-aghọta mgbanwe na mgbanwe na-adịgide adịgide maka ọdịnihu ha? N'ihe dị mkpa maka nsonaazụ na-enweghị ike ị nweta n'ụzọ ọ bụla ọzọ, gịnị kpatara na-agbasochi ike ịgbanwee ọgwụ mgbe ọtụtụ ụmụaka ga-alaghachi iji mara mmekọrịta nwoke na nwanyị ha na okenye? Nye nwere ike ịkọ na “ọmịiko, nkwado, ikiri na nchere” ruo mgbe nwatakịrị ahụ toro eto agaghị adị irè? Megide ihe a choro maka isi “ighota nkwenye”, kedu ka nwatakiri n’okorobia n’etu ndi n’emebi nghota ga-esi ghota odi n’iru ha? Kedu ka nwatakịrị nwere nsogbu mmụọ na-aghọta mgbanwe na mgbanwe na-adịgide adịgide maka ọdịnihu ha?

Childgba nwatakiri nwere nsogbu gharị na nwoke ka o chere ihe ga-eme ka o ruo uto ya bụ ihe a ga-ele anya dị ka ụdị mmetọ ụmụaka. Ihe a puru iche bu na steeti a ga-amachibido okike o bula, dika oge onye azuma ahia siri choro, ma o buru na ntuziaka ahu aputaghi iwu chromosom. Na agabiga ihe achọrọ nke nnwale sitere na ihe omuma mbu gara aga, tinyere ihe omumu banyere anumanu, enwere ihe omuma mbu gara aga, a na-eleghara ihe omumu nke kwesiri ekwenye anya. N'agbanyeghi ihe achọrọ na nnwale ekwesịghị ịbara uru ndị a tụrụ anya ya, ọmụmụ anụmanụ na-egosi ihe ize ndụ nke mbibi akụkụ ahụ. N'aka nke ọzọ, enweghi akaebe ogologo oge na ụmụaka dysphoric ga-erite uru site na ntughari ọgwụ, ebe enwere ogologo oge na-egosi na ndị tozuru oke nwere oke igbu onwe ha. Na agabiga ihe di nkpa, ndi oru kwesiri iruzu oke, tsunami nke dysphoria nke puru iche nke umuaka putara na ndi ogwugwo di pere mpe nwere. N'agbanyeghi ihe a chọrọ ka ndị ọrụ ahụike kwụsị kwụsị nnwale ahụ mgbe ha hụrụ nnwale ahụ dị ize ndụ, ma ọ bụrụ na enweghị ọdịdị ọmụmụ ihe ọdịnala, kedu etu ndị ọrụ ahụ ga-esi mata mgbe ihe adịla njọ? Ọ bụrụ na enweghị ụdị ule dị otú ahụ, a na-eji ịnụ ọkụ n'obi agbachitere oghere ihu n'ihu ogologo oge na ọnụ nke puku kwuru puku. N'agbanyeghi nkpa nke isi okwu kwesiri inwe ohere ịhapụ ihe omumu oge obula, kedu nwa ga - enwe ike isi n’ebe njuputa ohuru ya puta, ikwenye ogwu ike na ntinye ndi isi ikike? Kedu nwatakiri ga-enwe ike ịhapụ onye ọhụụ, ikwenye ọgwụ ọjọọ na ntinye ọnụ nke ndị ikike?

 

EGO

 

 

1 Diagnostic na Statistical Manual of Mental Disorders, Nke Ise. (DSM-5) American Psychiatric Association. Washington. DC 2013, pg. Ogbe 452.

2 Ibid.

3 Ristori J, Steensma TD. Dysphoria nke nwoke na nwata. Int Rev Uche. 2016; 28 (1): 13-20. Doi 10.3109 / 09540261.2015.1115754

4 Shumer D, Spack NP. Nlekọta ugbu a nke nsogbu njirimara nwoke na nwanyị na nwata: ntuziaka, ihe mgbochi na mpaghara nke esemokwu. Curr Opin Endocrinol, Ọrịa shuga na Obes. 2013; 20 (1): 69-73. Doi 10.1097 / m D.0b013e32835c711e

5 Eade DM, Telfer MM, Tollitt MA. Itinye otu nọọsụ otu nnọkọ duuru ụlọ nyocha nyocha n'ime ọrụ okike. Ahụ ike Transgender. 2018; 3 (1): 43-46. Doi 10.1089 / trgh.2017.0050

6 DSM-5. 2013, op. cit., pg. 454.

7 “Gys Dysphoria”, Ndị Ọrịa Ndị Ọrịa Ọrịa America. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_ DSM-5-Gender-Dysphoria.pdf Enwetara 12 July 2018.

8 Bonifacio HJ, Rosenthal SM. Enderkpa oke na Dysphoria na Childrenmụaka na Ntorobịa. Pediatr Clin North Am. 2015. 62 (4): 1001-1016. Doi 10.1016 / j. pcl.2015.04.013

9 Clark T, Lucassen M, Bullen P et al. Ahụike na ahụike nke ụmụ akwụkwọ ụlọ akwụkwọ sekọndrị transgender: Nsonaazụ sitere na Nnyocha Ahụike Ọhụrụ New Zealand (Ntorobịa'12). J Ike Isi. 2014; 55: 93-99.

10 Clark TC, Fleming T, Bullen P, et al. Tebụl okpokoro nke ndị ntorobịa: Ahụike na ahụike nke ụmụ akwụkwọ sekọndrị New Zealand na 12. Auckland, New Zealand: Mahadum nke Auckland; 2012. Nweta 2013 July 14.

11 Telfer M, Tollit M, Feldman D. Mgbanwe nke nlekọta ahụike yana usoro iwu maka ndị na - agafe agafe: Mkpa mgbanwe. JPCH.2015. 51; 1051-1053.

12 Anyị niile: Isi iyi Ahụike na Ahụike ingghọta Mgbakọ Dị Iche Iche Banyere Mmekọ nwoke na nwanyị, Di na nwanyị na Mkparịta ụka Intersex maka Afọ 7 na 8, Njikọ Schoolslọ Akwụkwọ Ọfụma Australia na Minus18, pg. 8. http://www.education.vic.gov.au/Documents/about/programs/health/AllOfUs_ UnitGuide.pdf Ejiri 14
Jenụwarị 2018. Ugbu a dị ugbu a na https://www.minus18.org.au/images/ALL_OF_US.pdf

13 DSM-5. 2013, op. cit., pg. 452.
14 Haas A, Eliason M, Mays V et al. Igwu igbu onwe ya na nsogbu nke ndi mmadu bi na Lesbian, nwoke na nwanyi ndi gay, ndi nke Bisexual na ndi nke transgender: Nyocha na Aro. J Homosex. 2011; 58: 10-51. Doi: 10.1080 / 00918369.2011.534038

15 Fan X et al. Nnyocha nyocha banyere ezighi ezi na adịghị ike na nyocha nyocha onwe onye na-eto eto. Zọ Ubi. Savon-Williams na Joyner. 2006; 18 (3): 223-244. Doi 10.1177 / 152822X06289161

16 "Mkparita ụka banyere ihe gbasara nwoke na nwoke gafere CAMH na-ahụ maka mmekọrịta nwoke na nwanyị, mmemme transgender", The Globe na Mail. 14 Febụwarị 2016. https://www.theglobeandmail.com/news/toronto/gender-identity-debate-swirls- over-camh-psychologist-transgender-program / edemede28758828 / Inweta 14 July 2018.

17 Zucker KJ, Wood H, Singh D, Bradley SJ. Ihe atụ nke biopsychosocial development maka ọgwụgwọ ụmụaka nwere nsogbu njirimara nwoke na nwanyị. J Homosex. 2012; 59 (3): 369-397. Doi 10.1080 / 00918369.2012.653309

18 Wallien MS, Swaab H, Cohen-Kettenis PT. Ọrịa akparamaagwa n’etiti ụmụaka nwere nsogbu njiri mara nwoke. J Am Acad Child Adolesc Psychiatry. 2007; 46 (10): 1307-1314. Doi 10.1097 / chi.0b013e3181373848

19 Steensma TD, Zucker KJ, Kreukels BP et al. Nsogbu na akparamaagwa na Mkpesa Onye Nkuzi Nke Onye Nkuzi: nyocha nke mba dị iche iche, nyochawa etu ọdịiche dị n'etiti ụmụaka na-eto eto. J Abnorm Child Psychol. 2014; 42 (4): 635-647. Doi: 10.1007 / s10802-013-9804-2

20 Spack NP, Edwards-Leeper L, Feldman HA, et al. Childrenmụaka na ndị nọ ntorobịa nwere njiri mara ụdị nwoke na-ezo aka na ngalaba nlekọta ahụike ụmụaka. Ọrịa ụmụaka. 2012; 129 (3): 418-425. Doi 10.1542 / peds.2011-0907

21 Hewitt JK, Paul C, Kasiannan P et al. Ormgwọ ọrịa homonụ maka nsogbu nwoke na nwanyị na-eto eto. Med J Aust. 2012; 196 (9): 578-581. Doi 10.5694 / mja12.10222

22 Becerra-Culqui TA, Liu Y, Nash R et al. Ahụike ụbụrụ nke transgender na okike n'agbanwe ndị ntorobịa tụnyere ndị ọgbọ ha. Ọrịa ụmụaka. 2018; 141 (5). Doi 10.1542 / peds. 2017-3845

23 Ibid.

24 Kaltiala-Heino R, Sumia M, Tyolajarvi M et al. Afọ abụọ nke njirimara nwoke na nwanyị maka ụmụ aka: oke iwebata ụmụ nwanyị natal nwere nnukwu nsogbu na mmepe nwa. Nwa Adol Psych Health Health. 2015.9 (9). Doi: 10.1186 / s13034-015-0042-y

25 Kaltiala-Heino R, Bergman H, Työläjärvi M, na Frisén L. Gender dysphoria n'oge ntorobịa: echiche ndị dị ugbu a. Adolesc Health Med Ther. 2018; 9: 31–41. Doi https://doi.org/10.2147/AHMT.S135432

26 Kaltiala-Heino R, Sumia M, Tyolajarvi M, Lindberg N. Afọ abụọ nke ọrụ njirimara nwoke na nwanyị maka ụmụaka: iwebata ụmụ nwanyị natal nwere nnukwu nsogbu na mmepe. Adomụaka Maka Ahụike Uche ụmụaka. 2015; 9: 9. Doi 10.1186 / s13034-015-0042-y

27 Chen M, Fuqua J, Eugster EA. Njirimara nke akwụkwọ ntụgharị maka dysphoria okike karịrị afọ 13. J Adolesc Health. 2016; 58 (3): 369–371. Doi 10.1016 / j. jadohealth.2015.11.010

28 Holt V, Skagerberg E, Dunsford M. Ndị na-eto eto nwere atụmatụ nke dysphoria okike: ihe gbasara mmadụ na ihe na-esiri ya ike. Clin Child Psychil Psychiatry. 2016; 21 (1): 108–118. Doi 10.1177 / 1359104514558431

29 Van Der Miesen AI, Hurley H, De Vries AL. Mmekpa ahụ nwoke na nwanyị ọrịa diski na akwara autism: nyocha nyocha. Int Rev Psychiatry. 2016; 28 (1): 70–80. Doi 10.3109 / 09540261.2015.1111199

30 Lai M, Lombardo MV, Baron-Cohen S. Autism. Lancet. 2014; 383 (9920): 896- 910. Doi 10.1016 / S0140-6736 (13) 61539-1

31 van Der Miesen AI, et al. 2016, op. cit.

32 Straw JF, Kenworthy L, Dominska A, et al. Increbawanye ihe di iche n'etiti nwoke na nwanyi na nsogbu aghara aghara aghara dị iche iche na nchebara echiche hyperactivity. Arch Sex Behav. 2014; 43 (8): 1525–1533. Doi 10.1007 / s10508-014-0285-3

33 Karasic D, Ehrensaft D. Anyị ga-akwụsị ọgwụgwọ ọgwụgwọ ụmụaka maka okike. Wired. 2015. Htp: //www.wired.com/2015/07/must-outan-end-gender- ntughari-ọgwụgwọ-ụmụaka / Enwetara 18 Ọktoba 2016.

34 Ibid.

35 Aitken M, VanderLaan DP, Wasserman L, Stojanovski S, Zucker KJ. Mmerụ ahụ na igbu onwe onye na ụmụaka zoro aka na dysphoria okike. J Am Acad Child Adolesc Psychiatry. 2016; 55 (6): 513-520. Doi 10.1016 / j.jaac.2016.04.001

36 Holt V, Skagerberg E, Dunsford M. Ndị na-eto eto nwere njiri mara nke dysphoria okike: ihe gbasara mmadụ na ihe na-esiri ya ike. Clin Child Psychil Psychiatry. 2016; 21 (1): 108-118. Doi 10.1177 / 1359104514558431

37 Ibid.28

38 Mayes SD, Gorman AA, Hillwig-Garcia J et al. Igbu onwe ya na itinye onwe ya na umuaka Res Autism Nkpọpụta Dis. 2013; 7 (1): 109-119. Doi 10.1016 / j. rasd.2012.07.009

39 Clark TC (2013) Op. cit.

40 Aitken M, VanderLaan DP, Wasserman L, Stojanovski S, Zucker KJ. Mmerụ ahụ na igbu onwe onye na ụmụaka zoro aka na dysphoria okike. J Am Acad Child Adolesc Psychiatry. 2016; 55 (6): 513-520. Doi 10.1016 / j.jaac.2016.04.001

41 Muehlenkamp JJ, Claes L, Hasrtape L, Plener PL. Ọnọdụ zuru ụwa ọnụ nke ndị na - eto onwe ha na - emerụ onwe ha ahụ ma jiri ụma na - emerụ onwe ya ahụ. Adomụaka Maka Ahụ Isi Uche. 2012; 6 (10). Doi 10.1186 / 1753-2000-6-10

42 Lewinsohn PM, Rohde P, Seeley JR. Igbu onwe onye na-achọ igbu onwe ya na ịnwale onwe ya Clin Psychol Sci eme. 1996; 3 (1): 25–46. Doi 10.1111 / j.1468-2850.1996.tb00056.x

43 Faulkner AH, Cranston K. Correlates nke nwoke na nwanyị inwe mmekọahụ na ịlele ụmụ akwụkwọ sekọndrị nke Massachusetts. Am J Ọhaneze. 1998 Febru 88 (2): 262–266. Doi 10.2105 / AJPH.88.2.262

44 Holt V et al (2016), Op. cit.

45 De Vries AL, Cohen-Kettenis PT. Nlekọta nke ogwu banyere dsyphoria okike na umuaka na umuaka: uzo Dutch. J Homosex. 2012; 59 (3): 301-320. DOI: 10.1080 / 00918369.2012.653300

46 Murad MH, Elamin MB, Garcia MZ, Mullan RJ, Murad A et al. Okpomoku nke mkpulite obi na inye mmeko nke nwoke: nyocha nke oma na inyocha ihe omimi banyere ndu ndu ya na ihe ndi ozo. Clin Endocrinol (Oxf) 2010; 72 (10): 214–231. Doi 10.1111 / j.1365-2265.2009.03625.x

47 Dhejne C, Lichtenstein P, Boman M et al. Ogologo Ntughari nke Ndi Transsexual Na-aga Ime Mgbaputa Mmezi Mmekọahụ: Ọmụmụ ihe na Sweden. PLOS 1. 2011; 6 (2): e16885. Doi 10.1371 / journal.pone.0016885

48 De Cuypere, Elaut E, Heylens G, et al. Ogologo oge sochirinụ: nsonaazụ psychosexual nke ndị Belgium na-ahụ maka ịwa ahụ gbasara ịkwa iko. Sexologies. 2006; 15: 126-133. Doi: 10.1016 / j.sexol.2006.04.002

49 Dhejene C, Lichtenstein P, Boman M et al. Ogologo Ntughari nke Ndi Transsexual Na-aga Ime Mgbaputa Mmezi Mmekọahụ: Ọmụmụ ihe na Sweden. PLOS 1. 2011; 6 (2): e16885. Doi 10.1371 / journal.pone.0016885

50 Haas A (2011), Op. cit.

51 Zucker KJ. Withmụaka nwere nsogbu njiri mara nwoke. Enwere omume kacha mma? Neuropsychiatrie de l'enfance et de l'adolescence. 2008; 56 (6): 358-1 Doi 10.1016 / j.neurenf.2008.06.003

52 Zucker KJ, Lambert S, Bradley SJ et al. Ihe ndị dị egwu maka nsogbu akparamagwa ụmụ nwoke niile nwere nsogbu njiri mara nwoke. Egosiputara ya na Nzuko okwu iri nke itolu nke Harry Benjamin International Gender Dysphoria Association. 19. Bologna Italy.

53 Zucker KJ, Bradley SJ, Moshe I. Ighaghi ịkpọ aha nwata nwoke. J nke Psychology: mmekọahụ nke mmadụ. 1990; 6 (1): 57-68. Doi: 10.1300 / J056v06n01_04

54 Marantz S, Coates S. Ndị nne ụmụ nwoke nwere nsogbu njirimara nwoke na nwanyị: ntụnyere njikwa mmekọrịta. J Am Acad. Nkuzi Uche na Ndi N’aka. 1991; 30 (2): 310-315. Doi 10.1097 / 00004583-199103000-00022

55 Zucker KJ. Withmụaka nwere nsogbu njiri mara nwoke. Enwere omume kacha mma? Neuropsychiatrie de l'enfance et de l'adolescence. 2008; 56 (6): 358-1 Doi 10.1016 / j.neurenf.2008.06.003

56 Zucker KJ. Echiche ụgha nke ịnọgidesi ike: nzaghachi na 'nkọwa dị oke egwu na nyocha ndị na-esochi na echiche' enweghị ike 'gbasara transgender na okike na-anaghị eme ihe kwekọrọ n'ụkpụrụ; site na Temple Newhook et al. Akwụkwọ bụ International Journal of Transgenderism. 2018; 19 (2): 231-245. Doi: 10.1080 / 15532739.2018.1468293

57 Ibid.

58 Zucker KJ, Osisi H, Singh D, Bradley SJ. Ihe omuma, usoro biopsychosocial maka ọgwụgwọ umuaka nwere nsogbu njiri mara nwoke. Journal Homosex. 2012; 59 (3); 369-397. Doi 10.1080 / 00918369.2012.65330959 Zucker KJ, 2008. Op. cit.
60 Ristori J, Steensma TD. Dysphoria nke nwoke na nwata. Int Rev Uche. 2016; 28 (1): 13-20. Doi 10.3109 / 09540261.2015.1115754

61 De Vries AL, Cohen-Kettenis PT. Nlekọta nke ogwu banyere dsyphoria okike na umuaka na umuaka: uzo Dutch. J Homosex. 2012; 59 (3): 301-320. DOI: 10.1080 / 00918369.2012.653300

62 Coleman E, Bockting W, Boltzer M et al. Ofkpụrụ nlekọta maka ahụike nke transsexual, transgender na ndị na - anaghị emekọ nwoke. 7.dị 2011. International Journal of Transgenderism 13; 165: 232-10.1080. Doi: 15532739 / 2011.700873. XNUMX.

63 Zucker, 2018. Op. cit.

64 Tụọ ihe gbasara nwoke ma ọ bụ nwanyị nwanyị, nwanyị nwere mmasị nwanyị, ma ọ bụ nke nwoke na nwanyị inwe mmekọahụ, na nwoke na nwanyị na-eto eto. American Academy of the Child and Adolescent Psychiatry. 2012; 51: 957-974. Doi: 10.1016 / j. jaac.2012.07.004

65 “gmụ transgender dị ụkọ, mana a na-agwa anyị…”, Daily Telegraph, 12 Septemba 2017. https://www.dailytelegraph.com.au/rendezview/what-madness-can-justify- mutilating-our-children / akụkọ-akụkọ / = 84c7426daf4c543d1074a08fd9bf3d41 ednweta 10 July 2018.

66 Steensma TD, Cohen-Kettenis PT. Mmegharị nwoke na nwanyị tupu nwoke na-eto eto. Arch Sex Behav. 2011; 40 (4): 649-650. Doi 10.1007 / s10508-011-9752-2

67 Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA et al. Ọgwụ endocrine nke ndị na - emeghari onwe ya: Ntụziaka omume nyocha nke Endocrine Society. J Clin Endocrinol Metab. 2009 Sep; 94 (9): 3132-3154. Doi 10.1210 / jc.2009-0345

68 Grigorova M, Sherwin BB, Tulandi T. Mmetụta ọgwụgwọ na leuprolide acetate depot na ebe nchekwa na ọrụ ndị isi na ụmụ nwanyị premenopausal. Psychneuroendocrinology. 2006; 31 (8): 935-947. Doi 10.1016 / j.psyneuen.2006.05.004

69 Nelson CJ, Lee JS, Gamboa MC et al. Mmetụta mmetụta nke usoro ọgwụgwọ hormone na ụmụ nwoke nwere ọrịa prostate: nyocha. Ọrịa kansa. 2008; 113 (5): 1097-1106.Doi 10.1002 / cncr.23658

70 Craig MC et al. Mgbatị homonụ Gonadotropin na-ewepụta agonists homonụ na-agbanwe ọrụ prefrontal n'oge nnabata okwu ọnụ na ụmụ agbọghọ. Psychoneuroendocrinology. 2007; 32 (8-10): 116-1127. Doi 10.1016 / j. psyneuen.2007.09.009

71 Ohlsson B. Gondadotrophin na - ewepụta homonụ na ọrụ physiological ya na ọrịa pathophysiological n'ihe gbasara nhazi na ọrụ nke eriri afọ. Nnyocha ịwa ahụ na Europe. 2016; 57: 22-33 https://doi.org/10.1159/000445717

72 Sand E, Linninge C, Lozinska L et al. Ọgwụ Buserelin na oke na-eme ka akwara neurodegeneration na-enwe mmetụta na-erughị ala na crfimmunoreactive neurons na enterobacteriaceae na colon, na acetylcholine na-agbasa echiche zuru oke na ileum. Ndetu nyocha nke BMC. 2015; 8: 824. https://doi.org/10.1186/s13104-015-1800-x

73 Jennes et al. Guzorotrophin na-ewepu homonụ nke na-anabata ya. Hormones, Brain na omume Nke abụọ edn. Pfaff DW (ed) Ọmụmụ Press/2 2009; pgs. 1645- 1668.

74 Casoni F, Malone SA, Belle M et al. Mmepe nke neurons nke na - achịkwa ọmụmụ nke mmadụ: nghọta ọhụrụ site na onyonyo 3D na ụbụrụ nwa ebu n'afọ na - enweghị atụ. Mmepe. 2016; 143 (21): 3969-3981. Doi 10.1242 / dev.139444

75 Jennes L, Conn P. Gonadotropin na-ewepụta homonụ na ndị nabatara ya na ụbụrụ ọnụego. Neuroendocrinol n'ihu. 1994; 15 (1): 51-77. Doi 10.1006 / frne.1994.1003

76 Kauffman AS. Ọrụ dị iche iche nke gonadotropin na-ewepụta homonụ nke II na physiology na akpara mammalian. J Neuroendocrinol. 2004; 16 (9): 794-806. Doi 10.1111 / j.1365-2826.2004.01229.

77 Quintanar JL, Salinas E, Gonzalez R. Mwepu nke gonadotropin na-ewepụta nnabata homonụ nke akụkụ ụbụrụ nke eriri afọ na oke oke. Leturo Neurosci. 2007; 411 (1): 22-25. Doi 10.1016 / j.neulet.2006.06.077

78 Stopa EG, Koh ET, Svendsen CN, Rogers WT, Schwaber JS, King JC. Nke enyere aka komputa nke mgbochi mammalian gonadotropin na-ewepụta homonụ nke ụmụ nwoke na ụmụ amaala basal na amygdala. Endocrinology. 1991; 128 (6): 3199–3207. Doi 10.1210 / endo-128-6-3199

79 Ban Ban E, Crumeyrolle-Arias M, Latouche J et al. Ndị na-anabata GnRH na ụbụrụ oke, pituitary na testis; mgbụsị akwụkwọ na-esochi ịwa ahụ na gonadotropin na-ewepụta homonụ nke agonist na-akpata. Mol Cell Endocrinol. 1990; 70 (1): 99-107. Doi 10.1016 / 0303-7207 (90) 90063-E

80 Caraty A, Skinner DC. Gonadotrophin na - ewepụta homonụ nke mmiri ụbụrụ nke atọ: distribution na - ebute oke na mmụba. Endocrinology. 2008; .149 (10): 5227-5234. Doi 10.1210 / en.2007-1636

 81 Pfaff D, Lewis C, Diakow C et al. Nyocha Neurophysiological nke mmeghachi omume nke mating dị ka mgbanwe dị nro nke homonụ. Prog Physiol Psychol. 1973; 5: 253-297.

82 Moss RL MCann SM. Induction nke mating omume na oke site na luteinizing hormone na-atọhapụ ihe. Sayensị. 1973; 181 (4095): 177-179. Doi 10.1126 / sayensị.181.4095.177

83 Pfaff DW, Luteinizing ihe na - atọhapụ ọgwụ nwere ike ịmịpụta akparamagwa oke arụ dị oke ala nke hypophysectomized nke ụmụ nwanyị. Sayensị. 1973; 182 (4117): 1148- 1149.

84 Maney DL, Richardson RD, Wingfield JC. Ọchịchị etiti nke gonadotropin ọkụkọ na-ewepụta hormone-11 na-akwalite omume mbedo na nza nwanyi. Horm Behav. 1997; 32 (1): 11-18. Doi 10.1006 / hbeh.1997.1399

85 Schimi PA, Rissmin EF. Mmetụta gonadotropin na-ewepụta homonụ, corticotrophin-na-ewepụta homonụ na vasopressin na omume mmekọahụ ụmụ nwanyị. Horm Behav. 2000; 37 (3): 212-220. Doi 10.1006 / hbeh.2000.1575

86 Ikike Ezigbo P, Moss RL. Midbrain Central Grey: Ngwakọta nke LHRH na-akwalite akparamaagwa nke agwa dị na oke oke estrogen-primed ovariectomized. Brain Res Bull. 1979; 4 (2): 203-205. Doi 10.1016 / 0361-9230 (79) 90282-X

87 Argiolas A, Melis MR. Neuropeptides na njikwa isi nke omume mmekọahụ site n'oge gara aga ruo ugbu a: nyocha. Prog neurobiol 2013; 108: 80-1 Doi: 10.1016 / j. pneurobio.2013.06.006

88 Bentley GE, Jensen JP, Kaur GJ et al. Mkpuchi ngwa ngwa mmeko nke nwanyi site na gonadotropin-inhibiting hormone (GnIH). Horm Behav. 2006; 49 (4): 550-555. Doi 10.1016 / j.yhbeh.2005.12.005

89 Martin GB, Oldham CM. Cognie Y et al. Nzaghachi physiological nke anovulatory ewes na ntinye nke ebule - Nyocha. Live Prod Sci. 1986; 15 (3): 219-47. Doi 10.1016 / 0301-6226 (86) 90031-X

90 Ungerfeld R. Ihe ngosi mmekọrịta nwoke na nwanyị na ọrụ gonadal: ohere maka njikwa omumu na anụ ụlọ. Soc Reprod Fertil Nye. 2007; 64 (1): 207-221. Doi: 0.5661 / RDR-VI-207

91 Hawken PA, Martin GB. Sociosexual na-akpali akpali na gonadotropin-na-ewepụta homonụ / luteinizing nzuzo nke mmiri na atụrụ. Domest Anim Endocrinol. 2012; 43 (2): 85-94. Doi 10.1016 / j.domaniend.2012.03.005

92 Nuruddin S, Bruchhage M, Ropstad E et al. Mmetụta nke peripubertal gonadotropin-na-ewepụta agonist hormone na ụbụrụ
mmepe na atụrụ… ihe omumu ihe omimi. Psychoneuroendocrinology. 2013; 38 (10): 1994-2002. Doi
10.1016 / j.psyneuen.2013.03.009

93 Nuruddin S, Wojniusz S, Ropstad E et al. Peri-pubertal gonadotropin na-ewepụta afọ analog ịgwọ ọrịa analog na-emetụta usoro mkpụrụ ndụ hippocampus na-enweghị ịgbanwe ntụzi aka gbasara ụmụ atụrụ. Behav Brain Res. 2013; 242 (1): 9-16. Doi 10.1016 / j.bbr.2012.12.027 ·

94 Nuruddin S, Krogenaes A, Brynildsrud OB et al. Peri-pubertal gonadotropin- ịtọhapụ ọgwụgwọ agonist nke homonụ na-emetụta nkwupụta sitere na usoro ọmụmụ nke amygdala na atụrụ. Psychoneuroendocrinology. 2013; 38 (12) .3115-3127. Doi 10.1016 / j.psyneuen.2013.09.011

95 Evans NP, Robinson JE, Erhard HW et al. A na - enwe mmetụta nke reactivity psycophysiological moto na - emetụta ihe mgbochi ọgwụ ọgwụ kpamkpam nke arụmọrụ GnRH nke ụdị ovine. Psychoneuroendocrinology. 2012; 37 (11): 1876-1884. Doi 10.1016 / j.psyneuen.2012.03.020

96 Hough D, Bellingham M, Haraldsen IRH et al. Ncheta Spatial 2017 na-emebi emebi site na ọgwụgwọ agonist peripubertal GnRH na nnọchi testosterone na atụrụ. Psychoneuroendocrinology. 2017; 75 (1): 173-182. Doi 10.1016 / j.psyneuen.2016.10.016

97 Hough D, Bellingham M, Haraldsen IRH et al. Mbelata nke ebe nchekwa ogologo oge na-adịgide mgbe ịkwụsịsịrị ọgwụgwọ agonist peripubertal GnRH na atụrụ. Psychoneuroendocrinology. 2017; 77 (1): 1–8. Doi 10.1016 / j.psyneuen.2016.11.029

98 Wojniusz S, Vogele C, Ropstad E et al. Prepubertal gonadotropin na-ewepụta hormone analog na-eduga na ikwu ụdị mmekọrịta nwoke na nwanyị na inwe mmetụta dị njọ na atụrụ. Hormones na Omume. 2011; 59 (1): 22-27. Doi 10.1016 / j.yhbeh.2010.09.010

99 Prange-Kiel J, Jarry H, Schoen M et al. Gonadotropin na-ewepụta homonụ na-achịkwa njupụta nke spain site na njikwa ya na njikọta hippocampal estrogen. J Cell Biol. 2008; 180 (2): 417-426. Doi 10.1083 / jcb.200707043

100 Quintanar JL, Calderón-Vallejo D, Hernández-Jasso I. Mmetụta nke GnRH na Neurite Outgrowth, Neurofilament na Spinophilin na-echebe Nkwupụta na Cialured Spinal Cord Neurons nke Rat Embryos. Neurochem Res. 2016; 41 (10): 2693-2698. Doi 10.1007 / s11064-016-1983-0

101 Naftolin F, Ryan KJ, Petro Z. Aromatization nke androstenedione site na diencephalon. J Clin Endocrinol Metab. 1971; 33 (2): 368-370. Doi 10.1210 / jcem- 33-2-368

102 Ndi otu ndi otu ndi otu ndi otu ndi otu na aru oru transgender health. Ofkpụrụ nke Nlekọta Ahụike nke Transsexual, Transgender, na Mmekọahụ na-abụghị nwoke na nwanyị. 7.dị 20. https://www.wpath.org/media/cms/Documents/SOC%7v20/SOC%7V14_ English.pdf Ewetara 2018 July XNUMX.

103 Shumer DE, Nokoff NJ, Spack NP. Ọganihu n’ilekọta ụmụaka transgender na umuaka. Adv Pediatr. 2016; 63 (1): 79-102. Doi 10.1016 / j.yapd.2016.04.018

104 Hembree WC et al. 2009. ibid.

105 Chew D, Anderson J, Williams K et al. Ọgwụ hormonal na ndị na-eto eto nwere dysphoria Gender: nyocha nke usoro. Pediatrics 2018; 141 (4) .Doi 10.1542 / peds.2017-3742

106 Neurosteroids. Esemokwu Pụrụ Iche. Ihe omumu ihe omimi J Steroid na ndu. 2012; 131. https://www.sciencedirect.com/journal/the-journal-ofsteroid-biochemistry- and-molekụla-bayoloji / vol / 131 / nke / 3

107 Fester L, Prange-kiel J, Jarry H, Rune GM. Nmekorita nke estrogen n’ime hippocampus. Cell Tissue Res. 2011; 345 (3): 285-294. Doi 10.1007 / s00441-011- 1221-7

108 Spencer JL, Waters EM, Romeo RD et al. Na-ekpughere usoro mmetụta estrogen na arụ ọrụ hippocampal. Neuroendocrinol n'ihu. 2008; 29 (2): 219-237. Doi 10.1016 / j.yfrne.2007.08.006

109 Garcia-Segura LM. Aromatase na ụbụrụ: ọ bụghị naanị maka ịmụ nwa ọzọ. J Neuroendocrinol. 2008; 20 (6): 705-712. Doi 10.1111 / j.1365-2826.2008.01713.x

110 Terasawa E, Kenealy BP. Neuroestrogen, ihe ngwa ngwa nke estradiol, na GnRH neurons. Neuroendocrinol n'ihu. 2012; 33 (4): 364-375. Doi10.1016 / j. yfrne.2012.08.001

111 Quintanar JL, Calderón-Vallejo D, Hernández-Jasso I. Mmetụta nke GnRH na Neurite Outgrowth, Neurofilament na Spinophilin na-echebe Nkwupụta na Cialured Spinal Cord Neurons nke Rat Embryos. Neurochem Res. 2016; 41 (10): 2693-2698. Doi 10.1007 / s11064-016-1983-0

112 "Ntorobịa trans achọghịzi nnwapụta nke onye ọka ikpe maka ọgwụgwọ hormone, iwu ụlọ ikpe", ABC News, 30 November 2017.
http://www.abc.net.au/news/2017-11-30/trans-teens-no-longer-need-court- approval-for-hormone-therapy/9212072 Accessed 14 July 2018.

113 Zubiaurre-Elorza L, Junque C, Gomez-Gil E, na Guillamon A. (2014). Mmetụta nke ọgwụgwọ hormone na-enwe mmekọahụ na ọkpụrụkpụ nke mmadụ na transsexual ndị mmadụ. J Mmekọahụ Med, 2014; 11 (5): 1248-1261. Doi https://doi.org/10.1111/jsm.12491

114 Rametti G, Carrillo, B, Gomez-Gil E, Junque C, Zubiaurre-Elorza L, Segovia S., Gomez A, Karadi K, Guillamon, A. Mmetụta nke androgenisation na okwu ọcha nke microstructure nke nwoke na-nwoke transsexuals. . Ihe omumu ihe omumu ihe omumu. Psychoneuroendocrinology, 2012; 37,1261–1269. Doi 10.1016 / j. psyneuen.2011.12.019

115 Hulshoff Pol HE, Cohen-Kettenis PT, Van Haren NE, et al. Changgbanwe nmekorita nwoke na nwoke na - agbanwe ụbụrụ gị: Mmetụta nke testosterone na estrogenon okenye ụbụrụ mmadụ. Eur J Endocrinol. 2006; 155 (1): S107 – S111. Doi 10.1530 / eje.1.02248

116 Ibid.

117 Ibid.

118 Ibid.

119 Raisman G, Field PM. Ikpa oke na nmeko oke bekee. Sayensị. 1971; 173 (3998): 731-733. Doi 10.1126 /
sayensi.173.3998.731

120 Gbochie GJ, Gorski RA. Usoro ọgwụgwọ estrogen / progesterone n'oge mmadụ tolitere na-emetụta oke nke ọtụtụ akụkụ mpaghara etiti ahụ na-ahụ maka ọgụgụ isi na oke nwoke. J Comp Neurol. 1988; 275 (4): 613-622. Doi 10.1002 / cne.902750409

121 Nottebohm F. Testosterone na-ebute uto nke ụbụrụ na-ejikwa ụbụrụ akụrụngwa ụmụ nwanyị toro eto. Resbụrụ Res. 1980; 189 (2): 429-436. Doi 10.1016 / 0006- 8993 (80) 90102-X

122 Milrod C. Lee ka o si dị obere: Ọ bụ nchegbu gbasara arụmụaka gbasara afọ nwanyị nke MTF na - eto eto. J Mmekọahụ Med. 2014; 11 (2): 338-1 Doi 10.1111 / jsm.12387

123 Weissler JM, Chang BL, Carney MJ et al. Okike na-ekwuputa usoro ịwa ahụ na nwoke nwere dysphoria okike. Plast regstr surg.
2018;141(3):388e-396e, Doi 10.1097/ PRS.0000000000004123

124 Rashid M, Tamimy MS. Phalloplasty: nrọ ahụ na eziokwu. Indian J Plast Surg. 2013; 46 (2): 283-293. Doi 10.4103 / 0970-0358.118606

125 Chew D, Anderson J, Williams K et al. Ọgwụ hormonal na ndị na-eto eto nwere dysphoria Gender: nyocha nke usoro. Pediatrics 2018; 141 (4). Doi 10.1542 / peds.2017-3742

126 Ibid.

127 Ibid.

128 Becerra-Culqui, et al. Ahụike ụbụrụ nke transgender na okike nwoke na - agbanweghị ntorobịa tụnyere ndị ọgbọ ha. 2018 Op. cit.

129 Chew D, et al. Ọgwụ Hormonal na ndị na-eto eto nwere Gender Dysphoria: nyocha nke usoro, 2018. Op. cit.

130 Ibid.

131 Ibid.

132 Shumer DE, Spack NP. Nlekọta ugbu a nke nsogbu njirimara nwoke na nwanyị na nwata: ntuziaka, ihe mgbochi na mpaghara nke esemokwu. Curr Opin Endocrinol Ọrịa Shuga. 2013; 20 (1): 69-73. Doi 10.1097 / MED.0b013e32835c711e

133 Costa R, Dunsford M, Skagerburg E et al. Nkwado akparamaagwa, mmechuihu, na ihe ndi mmadu na eme ya na ndi okenye. J Mmekọahụ Med. 2015; 12 (11): 2206-2214 Doi 10.1111 / jsm.13034

134 de Vries AL, McGuire JK, Steensma TD et al. Ihe umu agboghobia na - eto eto di na - ezughi oke mgbe ogba aghara ndi nwoke na ndi nwoke. Ọrịa ụmụaka. 2014; 134 (4): 696-704.Doi 10.1542 / peds.2013-2958

135 Schwartz D. eningnụ maka ụmụaka na-eche echiche okike: na-achọpụta onu oriri nke echiche. J nwoke idina nwoke. 2012; 59 (3): 460-479. Doi 10.1080 / 00918369.2012.653314

136 Milrod C. Lee ka o si dị obere: Ọ bụ nchegbu gbasara arụmụaka gbasara afọ nwanyị nke MTF na - eto eto. J Mmekọahụ Med. 2014; 11 (2): 338-346. Doi 10.1111 / jsm.12387

137 Schwartz D. eningnụ maka ụmụaka na-eche echiche okike: na-achọpụta onu oriri nke echiche. J nwoke idina nwoke. 2012; 59 (3): 460-479. Doi 10.1080 / 00918369.2012.653314

138 Ibid.

139 Fuss J, Auer MK, Briken P. Gys driaphoria na ụmụaka na ụmụaka: ntụle nke akwụkwọ na - adịbeghị anya. Isi mgbaka Curr. 2015; 28 (6): 431-1 Doi 10.1097 / YCO.0000000000000203

Californialọ omebe iwu nke California California 140, Isi nke 1172, 835 Septemba 30. http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=2012SB201120120 1172nweta 14 July 2018.

141 "Barack Obama na-akpọ ka a kwụsị omume 'dị ize ndụ' nke ntụgharị ọgwụgwọ maka ụmụ nwanyị nwere mmasị nwanyị", ABC News, 9 Eprel 2015. http://www.abc.net.au/news/2015-04-09/obama-calls -gbanwe-n’aghagharia- ọgwụgwọ-maka-lgbt-ntorobịa / 6380424 Enwetara 14 Julaị 2018.

142 Ontario siri gosiputa nmekorita nwoke na nwanyi na nmekorita nwoke na nwanyi, 2015 https://www.ontario.ca/laws/statute/S15018

143 Cheri DiNovo, Wikipedia. https://en.wikipedia.org/wiki/Cheri_DiNovo Enwetara 19 October 2016.

144 “Ogologo ihe mgbochi: Andrews mebiwanye usoro ọgwụgwọ nwoke‘ gay ’nwere,“ Afọ 24 Jenụwarị 2016. https://www.theage.com.au/national/victoria/zerotolerance-andrews-to- crack-down-on -gay-ntụgharị-ọgwụ-20160123-gmcimw.html Ewetara 20 October 2016.

Ndi omebe iwu 145, (Hansard) Ndị omebe iwu. Nzuko omeiwu nke 58, nnọkọ nke mbụ. Wenezde, 10 February 2016, pg. 97. https://www.parliament.vic.gov.au/images/stories/daily-hansard/Asxty_2016/As Loose_Daily_Extract_Wednesday_10_Febtember_2016_ si_Book_1.pdf

Iwu Mkpesa Ahụike 146 Ahụike 2017, Nkebi 3.

147 Ibid, Ngalaba12 (2) (a)

148 Ibid., Nkebi 3.

149 Ibid., Nkebi 39 (3).

Studentsmụ akwụkwọ 150 Transgender na ụlọ akwụkwọ - ikike na ikike dịịrị iwu ", Akwụkwọ Iwu Okwu Bulletin Mba 55, Disemba 2014, Mmụta na Ogbe, Gọọmentị NSW https://education.nsw.gov.au/about-us/rights-and-accountability/media/ akwụkwọ / ọha-legal-batunbulletins / LIB-55-Transgender-ụmụ-akwụkwọ-ụlọ akwụkwọ-ikike-ikike-na- rights.pdf Enwetara 18 Ọgọst 2017.

151 Hembree WC. et al. (2009), Op. cit.

Download isiokwu a -> Transmụaka na-atụgharị hoodmụaka: Dysphoria okike- Dr John Whitehall

Enwere ike ịnweta onye ntụgharị ntanetị ebe a: - https://www.onlinedoctranslator.com/

Hits: 73

Pịgharịa gaa na n'elu