Arịrịọ maka nyocha ndị omebe iwu na Transgenderism: Prọfesọ John Whitehall.

Arịrịọ maka nyocha ndị omeiwu n'ime ntụgharị nke Ọha na Ọrịa na Ahụike nke withmụaka na Denderphoys

Dr John Whitehall MB BS, BA, DCH, MPH na TM, MRCP (UK), FRACP.

Prọfesọ nke Paediatrics na Ahụike Childmụaka.

The Honono Greg Hunt MP

Minister maka Ahụike

Parliamentlọ Omeiwu

Canberra.

Ezigbo Onye Ozi Hunt,

Ana m ede, ị kelee gị maka nchegbu gị banyere ọnụ ọgụgụ na-arị elu nke ụmụaka Australia na-akọ na-ata ahụhụ site na dysphoria okike na igosipụta nchegbu m na enweghị ntọala sayensị maka ọgwụgwọ ahụike nke ọgwụgwọ dysphoria nwata.

Ama m na i nyefere ndịnchụnta arịrịọ maka Royal Australasian College of Likita (RACP), nke m bụ, enwerekwa uru na nnabata a maka mkpa nyocha. Agbanyeghị, RACP adịghị mma, maka m, maka nyocha dị otú ahụ. E kwuwerị, nzukọ bụ isi nye mmụta nke ndị dibịa. Ntughari nke ihe banyere omume nke karia ihe ndi dibia ma tinye ndi oru ndi mmadu, ndi okacha amara, ndi dibia na ndi dibia.

Okwu a bụ n'ezie maka ngalaba na-ahụ maka ahụike na ndị na-achịkwa ụlọ ọgwụ ụmụaka. E kwuwerị, ndị nke ikpeazụ nyere nkwenye usoro maka usoro ahụ, wee gaa n'ihu na-akwado ndị ọrụ ahụ na ndị ọrụ nchịkwa, oghere ụlọ na ụgwọ ọnwa nke ndị sonyere. A na-etolite ihe gbasara nchekwa ụmụaka na nchedo nke bụ ihe dị mkpa maka gọọmentị etiti. Ọrụ mbụ nke gọọmentị bụ nchekwa nke ụmụaka na-adịghị ike.

Eji m nkwanye ugwu na-atụ aro na Nnyocha Ndị Ome Iwu ga-abụ nnọkọ kachasị mma maka ntụle kwesịrị ekwesị nke ihe omume mmekọrịta bilitere na ngwa ngwa dị otú ahụ ma kpatara ọgba aghara dị otú ahụ. Ọ dị ka a na-ekwuwapụta na usoro iwu ọha na eze na 'ahụmịhe kachasị mma' na ngwa ngwa na-enweghị ntọala zuru oke nke eziokwu na ntụgharị uche, yana nyocha irylọ Ome Iwu nwere ike inye ntọala ahụ.

Aghọtara m nke ọma na nnabata nke okwu a. Ama m ihe mgbu na nhụjuanya nke ndị ọrịa, na ntinye onwe nke ndị ọrụ nke ụlọ ọgwụ ụmụaka maka 'ọdịmma kachasị mma' nke ụmụaka. Enweghị m nkatọ na ntinye akwụkwọ nke ndị ọrụ na ụlọọgwụ ụmụ nwoke.

Mgbe m tụlechara nchegbu abụọ ahụ gbasara ịrị elu ọrịa dysphoria nwata na Australia na enweghị usoro sayensị maka ọgwụgwọ ahụ ugbu a, aga m atụpụta ụfọdụ usoro ntụnye maka nyocha ndị omebe iwu. Ana m ekele gị maka nnabata a sitere nkwanye ùgwù.

Ọ bụrụ n ’ịchọrọ inwetakwu nkọwa nke isi okwu n’akwụkwọ ozi a, a ga m agwa gị gaa n’otu isiokwu m dere gbasara isiokwu a Anọ ebe ma nye m isi nke akwụkwọ ahụ Transgender Otu Shade nke Grey (2018), nke nwere ndepụta ntụaka zuru oke.

 

UBUPU IWU RAPID NKE OBURU Gender DYSPHORIA.

1.) Nọmba ndị bịara njem na Australia.

Ana m eleghachi anya azụ na ahụmịhe Dr Robert Kosky mgbe ọ bụ onye ntụzi nke Ọrụ Ọrịa Uche na Hospitallọ Ọgwụ Perth Princess maka Childrenmụaka na WA State Director nke andmụaka na Ndị Ọrụ Nkà Mmụta Ọrịa, ma kọọ akụkọ banyere ụmụ 8 ụmụ nwoke nwere mgbagwoju anya n'ime afọ ise. afọ site na 1979 ruo 1984[I]. Ugbu a, a na-ekunye ụmụaka ụmụaka ihe atụ nke 2-3 n'ụlọ ọgwụ ụmụaka Perth kwa izu.

Ana m atụgharị aka na mkparịta ụka nke m na 2016 na 28 nke ndị ọrụ ibe m na-arụ ọrụ ụmụaka na Australia na afọ mmechi 931, yana site na nke enwere ike icheta ikpe 12: 10 na nsogbu uche metụtara ya na ndị metụtara 2 nke mmetọ mmekọahụ. N’ezie, mgbe m bụ nwata n’ụlọ ọgwụ, nọ na mbụ n’iji mmetọ ụmụaka na Western Sydney, maka nwatakịrị na-egosi na onye na-abụghị nwoke ma ọ bụ nwanyị ka a na-ele anya ịbụ onye e metọrọ. Ka o sina dị, na ngafe 50 afọ nke m ji arụ ọrụ paediatrics, ọ dịbeghị nwatakịrị a kpọtara m na-enwe nchegbu nke ndagwurugwu na njirimara nwoke. Ọ bụghịkwa nke nne ma ọ bụ nna na-elekọta ma ọ bụ nwe nlebara anya na-akpalite mkparịta ụka gbasara mmekọahụ gbasara ụmụ ha.

Ugbu a, ọnụ ọgụgụ ụmụaka a na-ebute n'ụlọ ọgwụ ụmụaka nwere mgbagwoju anya okike na-abawanye nke ukwuu. Dịka ọmụmaatụ, na Royal Children'slọ Ọgwụ Royal, Melbourne, ntụgharị maka dysphoria okike amụbawo site na otu nwa afọ abụọ na 2003 ruo ụmụaka 104 na 2014[Ii] na umuaka 253 na 2017.[iii] Gburugburu Australia, ngụkọta ụmụaka 2415 na ndị nọ n'oge uto nwere ike ịnọ na-anata ọgwụgwọ. Iji nye echiche anya, ihe dị ka ụmụaka na ụmụ ntorobịa 960 na-ebute kansa n’afọ n’Ọstrelia.[iv]

Na ahụmịhe ugbu a, mgbagwoju anya okike bụ ihe a na-ahụkarị ebe ụmụ agbọghọ na-eto eto nọ mgbe ha nwere mmalite ngwa ngwa, na-efe efe, yana njikọta mgbasa ozi.[v] Iji maa atụ, amụtara m na ntiwapụ na ụlọ akwụkwọ sekọndrị dị na Western Sydney ebe ụmụ agbọghọ nọ n'otu afọ 'gbanwere' na mberede gbasara njirimara nwoke na nwanyị.

Na UK, a na-akọ na 'ntiwapụ na ọnụ ọgụgụ ụmụaka na-achọ ịgbanwe mmekọahụ emeela ka ndị ozi' Penny Mordaunt, Mịnịsta na-ahụ maka andmụ nwanyị na Nhata, jụọ ajụjụ na ọ chọrọ 'ịghọta ihe kpatara 4,400 kwa mmụba pasent na ụmụ agbọghọ a na-ezo aka maka ọgwụgwọ mgbanwe n'ime afọ iri gara aga '. Ekwuputara na Mịnịsta ahụ kwupụtara na ndị isi ga-eleba anya na ọrụ nke mgbasa ozi mmekọrịta na nkuzi nke okwu transgender n'ụlọ akwụkwọ dịka akụkụ nke ajụjụ ha '.[vi]

Nyere n’enweghi ihe ndi ozo di ndu banyere ihe apuru ịkọwa dika oria ojoo, o kwesiri ndi isi ike ka ha nyochaa nsogbu a.

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1 na-atụ aro

 A na-arịọ Minista Health maka Ahụike gbakọọ mgbaru aka nke nwata okike dysphoria na Australia, ma lelee etu o siri nwee ihe ndu ma ọ bụ ọ dị ka ọ na-eso usoro 'mmekọrịta na-efe efe'.

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2.) UGWU iwu steeti na akwụkwọ gbasara usoro ịmela nọmba

Ngalaba agụmakwụkwọ steeti nke NSW, Victoria, Queensland na South Australia na-ekwu na a na-amanye ha ịkwado ụmụaka (ụmụntakịrị) n'obodo na usoro ahụike na-aga n'ihi iwu gọọmentị etiti, steeti na ókèala.[vii],[viii].

Nke a nwere ike bụrụ ihe ịma aka akọnuche nke ndị isi na ndị ọrụ. A na-agwa ha ka ha sonye na usoro nnwale ga-eduga na nwatakịrị ịgbanye aka na-enweghị mgbagha ebe a na-akọwara ya na ọtụtụ ụmụaka nwere mmachi ga-alaghachi na okike nwoke enweghị ọgwụ.

Nkwupụta mmekọrịta nke nwatakịrị ma ọ bụ nwa agbọghọ na onye na-abụghị nwoke ma ọ bụ nwanyị nwere nsogbu dị ize ndụ n'ihi na ọ nwere ike ịbụ nzọụkwụ mbụ n'ụzọ nke mmụba ahụike nke na-aga n'ọbara homonụ na ikekwe ịwa ahụ, n'okpuru oge nlekọta ahụike. A na-ewerekarị ịzere oge nlekọta ahụike dịka ihe kachasị mkpa.

Nyere na ụmụ nwoke nwere mgbagwoju anya nke ụmụ nwoke nwere ike na-arịa ọrịa uche metụtara nsogbu gụnyere autism, ịda mbà n'obi na nchekasị (dị ka a tụlere n'okpuru ebe a) ha ga-enwekarị ike ịdabere na nlebara anya nke ndị isi, na-eme ka ha nwee ike ịnụ ọkụ n'obi. nke ndị okenye maka mgbanwe ha na njirimara nwoke na nwanyị.

Ndi umuaka ndi a nwere ikike ichota ikike nke ndi ikike, dika ndi nkuzi, na ikwuputa 'mba, achoputaram n'ezie na m bu nwata nwoke na nwanyi'? N'iburu adịghị ike ha, ọ bụghị ihe mgbagwoju anya na ọtụtụ ụmụaka ndị e gosipụtara mmekọrịta ọha na eze na-enwe ọganihu na nzọụkwụ ọzọ na usoro ọgwụgwọ, nke ga-abụkarị nchịkwa nke homonụ 'igbochi' mmepe nke oge uto n'oge na-adịghị anya ọ pụtara. Nwatakịrị nke kacha nta na-eto eto na Australia abụrụla nwata nwoke dị afọ 10½, dịka ndekọ nke Courtlọikpe Ezinụlọ.

O kwesịrị ekwesị ka ndị isi ahụike nyochawa etu iwu anyị na ụkpụrụ ngalaba agụmakwụkwọ si enye aka na ọgbụgba akụrụngwa a na-enwetabeghị nke nwatakịrị.

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2 na-atụ aro

A na-arịọ Minista ka ọ nyochaa:

i.) Ruo ókè iwu Federal, Steeti na Territory chọrọ ụlọ akwụkwọ na ndị ọchịchị ndị ọzọ iji gosi ma kwalite ntụgharị nke nwatakịrị nke kwuru na okike nwoke dị iche na mmekọahụ ha;

ii.) Ruo ókè mmụba nke dysphoria okike kwekọrọ na iwebata ihe nkuzi n'ụlọ akwụkwọ Australia na-akwalite echiche nke 'ịdị n'etiti nwoke na nwanyị'.

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Enweghi omimi ihe omimi

3.) ABhapụ 'Uche na-eche'.

A na - akọ ebe niile na ihe ka ọtụtụ ụmụaka nwere dysphoria okike ga - ebute ụdị nwoke na nwoke site n'oge uto.[ix]

Ajụjụ a ga-aza Minista a bụ, 'Gini mere eji agbakwunyere umuaka ugbua n’okporo uzo nke dibia ogwu mgbe ahutara na a na-akwado “Chere ma hụ” abịaru nso ezuru? '

Nyocha na Ristori na Steensma chịkọtara ihe aka nyocha nyocha:[X]

Onye Prọfesọ ọkachamara n'ọpụrụiche na Mahadum Johns Hopkins, Paul McHugh, na-ekwu, sị, 'Mgbe a na-enyocha ụmụaka ndị kọọrọ mmetụta transgender na-enweghị ọgwụgwọ ma ọ bụ ọgwụgwọ na Mahadum Vanderbilt na London's Portman Clinic, 70% -80% n'ime ha tụfuru mmetụta ndị ahụ ozugbo.[xi]

Na Nyocha Pụrụ Iche na Journal nke nwoke idina nwoke banyere 'Ọgwụ nke ụmụaka dysphoric / okike ụmụaka na ụmụ ntorobịa' David Schwartz (2012),[xii] onye dibia bekee site na New York, kwusiri ike na enweghi ihe omuma sayensi banyere ihe gbasara ogwu ma mechie mmesi obi ike na otutu umuaka emetụtara ga-anwu. O kwupụtara

Ogologo oge nke uche na usoro ahụike nke… (ụzọ ahụike)… amaghi, yana, dịka ọ dị na ndị niile ahọpụtara n'onwe ha, ọ na-esiri ike ịlele n'ihi nsogbu nke (enweghị nnwale) njikwa na ọnụọgụ ọnụọgụ ole.

Schwartz gosipụtara nchegbu, gụnyere ịdabere na 'echiche ụlọ ọgwụ', 'ojiji nke data anecdotal', nkwusioru nke "obi abụọ" na 'ihu ọma nke eziokwu' nke ụmụaka na ndị ntorobịa 'na-ekwu, na - ekwenyeghị' nkwupụta ', na enweghị echiche nke' ikike ọghọm '.

Mụ onwe m anụla ka ndị nne na nna juputara na nne na nna na-agbachi ụmụ ha agbagha agbagha na ajụjụ dị mkpirikpi sochiri, mgbe emechara nyocha nke ‘ịmụ n’ajọ aru’. A dụrụ ndị nne na nna ọdụ ka ha 'gọzie nwa ha nwoke mbụ ma nabata nwa ha nwanyị / nwa ha nwoke mbụ. N'ihe niile zuru ụwa ọnụ, ọnwụnwa ndị nne na nna nwere maka nkasi obi sitere na arụmụka ahụ 'ọ ka mma inwe nwa nwanyị / nwa ndụ karịa nwa nwụrụ anwụ / nwa nwanyị'. Ihe fọrọ obere ka ọ bụrụ na mba niile, a na-enyeziri nne ma ọ bụ nna ndụmọdụ ịnabata ihe ọhụrụ ahụ, ọ bụghị maka nwa ahụ idozi ọgba aghara ha.

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3 na-atụ aro

A na-arịọ Minista ahụ ka o chee echiche dị mkpa nke Medicalzọ Ahụike Ahụike, ya bụ, 'Gịnị kpatara ụmụaka ji abanye ugbu a n'okporo ụzọ ọgwụ, mgbe a nwapụtaworo na imirikiti ụmụaka nwere dysphoria okike ga-ebute ụdị okike nke nwoke site na oge ntozu ya na nke a na-akwado 'chere na hụ' usoro, yana ị nweta ọrịa mmụọ, na-echekarị ezuru? '

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4.) NJIKWU EKPERE PSYCHOLOGICAL AND FAMILY THERAPY ModEL.

Ekwesighi ighapu umuaka ndi nwere oria nke ihe mgbagwoju anya nke nwoke na ndi ndi mmadu, ndi isi mgbaka na oria ezumike ha. Echefula na usoro ọgwụgwọ a maara na ọ dịla mma n'oge gara aga maka ụmụaka nwere nghọta na-adịghị mma maka njirimara nwoke na nwanyị[xiii],[xiv],[xv],[xvi],[xvii],[xviii].

Achọpụtala mmekọrịta dị n'etiti aghara aghara nwoke na nwanyị na nsogbu mgbaka uche na-akpata ogologo oge.[xix],[xx],[xxi],[xxii],[xxiii] Ndị na-akwado ọgwụ na-ekwupụta dysphoria nwere ike akpata nsogbu ụbụrụ, mana enwere nkwenye nke dysphoria na-eweta mgbe mmalite nke ọrịa uche, dịka akụkụ nke ngosipụta ya.[xxiv] Ọkpụkpụ ụdịdị ahụrụ anya, na-eweta oge nwata, ka amata na e nwere nwoke na nwanyị na-esote mmụọ nke dysphoria, ikekwe metụtara mmepe nke mmezi echiche.[xxv]

A nabatara ya na ụmụaka na-ekwupụta ọgba aghara maka okike ha bụ ụmụaka nwere nsogbu, na-ata ahụhụ nke ukwuu, bụ ndị kwesịrị ka echebara echiche nyocha na ọgwụgwọ. Udiri oria ekwesighi ibu ụzọ gosipụta kama ọ ga-abụ ihe nnọchianya dị mgbagwoju anya. Iji nye ntụnyere ahụike, naanị n'ihi na ụmụaka nwere oyi baa na-agbọ, ha ekwesịghị ibute ọrịa nke eriri afọ kama ịmị ngụgụ.

Yana mkpakọrịta nke ọrịa uche, mmekọrịta dị n'etiti ihe mgbagwoju anya nke nwoke na nwanyị na mgbagha ezinaụlọ a amaara ogologo oge. Nyochaa ụlọ ikpe ezinaụlọ nke Australia ebe ndị isi ụlọ ọgwụ na-achọ ikike ịbanye nwa ahụ n'ụzọ ahụike na-ekpughe njupụta nke ọgba aghara ezinụlọ. A mara ọgba aghara dị otú ahụ na-emetụta ahụike uche nke ụmụaka metụtara.

Na oge nke 1970 na nke 80, ọtụtụ ihe mgbagwoju anya nke nwoke, dị ka Robert Kosky si kọọ, ụmụ nwoke na-eto eto nwere mmasị na-ahụ ka ha na nne ha nwere mmekọrịta nje. Dị ka ọ na-adị, nwoke nke naanị otu nwa nwoke gbahapụrụ nwanyị ahụ, ma mee ka o mee ka obi nwatakịrị nwoke ahụ nwuo karịa ka ọ na-ewere nwanyị. Ndị ọzọ ekwuola na ọnụ ọgụgụ dị elu karịa atụmanya nke nsogbu ndị nne.[xxvi],[xxvii],[xxviii] Na ahụmịhe Kosky, mgbe kewapụrụ ya na nne, nwa ahụ laghachiri na njirimara nke ọmụmụ. Agbanyeghị, nlọghachi azụ banyere njirimara nke nwa dị na nwata na-ejikọtakarị na ọdịda nke nsogbu uche nke nne. Mmeghachi omume a na nne na-egosi ụdị ihe omume Munchausen site na nnọchi anya, nke mkpa mmụọ dị na otu onye na-akwado site na iwepu mgbaàmà na onye ọzọ. Enwere akụkọ banyere nne na nna na-arịwanye elu nke ndị nne na nna na-arịọ ndị ọchịchị ka ha tinye ụmụ ha na-eto eto n'ụzọ ahụike nke mgbanwe. Ahụmahụ Kosky ka bara uru.

N'okwu ndị a niile, enwere mkpa maka nyocha ọdịnala, nke sara mbara banyere nsogbu ọgụgụ isi na nwatakịrị na ezinụlọ, yana ịnye nkwado ọdịnala gụnyere ọgwụ-ọgwụ ọgwụ.

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4 na-atụ aro

A na-arịọ Minista ka o mee nyocha:

             i.) echiche nke, na ihe akaebe maka, akparamaagwa nke ọdịnala, ọrịa mmụọ na ọgwụgwọ ezinaụlọ n’ime dysphoria okike nwata..

            ii.) oke omumu ihe banyere uche, uche na nnabata ezin’ulo nke enyerela umuntakiri na umuaka nọ n’Australia ndi no n’ thezọ Ọgwụ Ahụike maka ọgwụgwọ dysphoria okike.

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5.) Mkpesa banyere oke ihe omume PSYCHOLOGICAL OF Gender DYSPHORIA.

A na-ezo aka na minista ahụ n'ọnọdụ ọjọọ Finch vs Southern Health nke nwa-nwoke nke mechara mmerụ-ahụ mgbanwe nwoke na nwanyị na Monash Medical Centre mechara mesịa kwuo na ọnọdụ akparamaagwa na-apụtabeghị na ụlọ ọgwụ ahụ, yana na -elezi ya nke ọma.[xxix]

Akwụkwọ akụkọ Fairfax kọrọ, 'A kpọchiela naanị ụlọ ọgwụ na-ahụ maka mgbanwe mmekọahụ na Australia nwa oge na onye isi ya na-ese okwu manye ya ịhapụ n ’ọnụ ọgụgụ na-arịwanye elu na-ekwu na a chọpụtawo ndị ọrịa nwere ọrịa isi dị ka transsexuals ma gbaa ha ume ịwa ahụ ụdị mmekọahụ.[xxx]

Ọzọkwa, 'Agebọchị Sọnde agwarala opekata mpe ndị ọrịa asatọ mbụ nke Gender Dysphoria Clinic na Melbourne's Monash Medical Center kwenyere na enwere ike ịkọwahie ha. Fọdụ anwawo igbu onwe ha ka ha na-achọ ibi ndụ dị ka onye na-abụghị nwoke ma ọ bụ nwanyị ibe ha mgbe arụ ọrụ a na-enweghị ike ịgbagha agbagha '.

Ọnọdụ isi mgbaka na-ebikọ ma na-enwekarị dysphoria okike n'ime ụmụaka. Na ngosi izizi a n'ụlọ ọgwụ US okike ụmụ iri itoolu na asaa nwere afọ nke afọ 14.8, pasent 44.3 nwere akụkọ banyere ọrịa uche, pasent 37.1 adịworị na ọgwụ psychotropic na pasent 21.6 nwere akụkọ mmerụ ahụ. omume.[xxxi] Achọpụtara Autism na 7.8 pasent nke ụmụaka transgender n'ụlọ ọgwụ Dutch[xxxii] na gburugburu 13 pasent na London[xxxiii]. N'ime ọmụmụ Australia banyere ụmụ dysphoric iri atọ na itoolu dị afọ iri, a chọpụtara nsogbu omume na otu ụzọ n'ụzọ anọ, yana ọrịa Asperger na otu n'ime asaa.[xxxiv]

Nkwenye n’echiche n’echiche bụ́ na a pụrụ ‘ịmụ nwa n’adịghị mma’ nwere ike ime ka ndị ụlọ ọgwụ ghara ilebara onwe ha anya n’ọnọdụ ọrịa ụbụrụ ndị dị mkpa dị ka autism ma ọ bụ nkụda mmụọ na-eme ka nsogbu nwatakịrị nwoke nwee. Emegaghị ịchọpụta nke ọma ga-ebute nsonaazụ ogologo ndụ nwatakịrị nke butere ụzọ Ahụike nke Mmekọ Mmechi, nwoke na nwanyị nwere mmekọahụ na ịwa ahụ.

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5 na-atụ aro

A na-arịọ Minista ahụ ka ọ nyochaa ụgwọ ọrụ iwu dịịrị ndị na-eme ahụike na ụlọ ọgwụ ọha maka mmerụ ahụ na-esite na ụmụaka na-atụgharị uche na ahụike nwere ike metụtara okwu uche na nsogbu ahụike ndị ọzọ na-ebute ọnya ọnya ọnya na-ahụghị n'oge ọgwụgwọ..

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6.) ANYANWU ANYI NA-EGO NA-EGO NA-AH SU ANYA.

Na ọkwa a, a ga-eleba anya n'okwu banyere ohere igbu onwe ya. N’ezie, enwere ntakịrị ihe akaebe banyere njikọ dị n’etiti dysphoria okike kwa se na igbu onwe nwata[xxxv]. A na-akọkarị mmerụ ahụ n’ọtụtụ ụmụaka na ndị ntorobịa[xxxvi],[xxxvii] tinyere egbe na dysphoria okike. Nnukwu nnyocha UK na-eche ma ọnụọgụ ndị na-eyi onwe ha egwu na mkpokọta ụmụaka nke dysphoric 'na-egosipụta nnọọ ọnọdụ dị iche iche'[xxxviii]. Otu edemede na Journal nke nwoke idina nwoke kwubiri 'ndi mmadu ndi mmadu choro igbu onwe ha' bu ndi achoputara dika inwe 'ngbaputa nke oma' na omumu na North America: 3 nke ndi ntorobia 120 gburu onwe na New York, na 4 nke 55 na Quebec; ma dọọ aka ná ntị maka nkwubi okwu dabere na 'obere ọnụọgụ… a ga-ewere ya dị ka nke kachasị'[xxxix].

Okwesiri ime ka o doo anya na dysphoria nwoke na nwanyi na nmekorita uche nke uche nke anakpotara ihe ojoo maka onwe ya.[xl]. Childrenmụaka, n'ozuzu ha, nọ n'ihe ize ndụ, yana usoro ọgwụgwọ ọrịa ọdịnala na-akwado ha.

Gmụaka ụmụ nwoke dysphoric nke nwoke anaghị enwe nsogbu n'ihi oke nsogbu ọgbaghara ezinaụlọ ha, bụ ndị amaara mara nrụgide a na-emetụta ụmụaka niile.[xli].

Okwesiri iburu n'uche na nwatakiri ma ọ bụ onye na-eto eto na-aza 'Ee' otu ajụjụ ma ọ dị mgbe ha nwere mmerụ ahụ ha, ọ bụ ezie na ha nwere nnukwu nchegbu, abụghịcha ngosipụta nke ebumnuche. Onye Minista ahụ kwesịrị ịma banyere ngwaọrụ dị ike maka ịmegharị aghụghọ nke dị na iyi egwu nke igbu onwe ya, ma ọ bụ na-ekwupụta ya site na nwatakịrị ahụ dị mgbagwoju anya, ma ọ bụ site n'aka ndị ọrụ ọgwụ.

Ekwesịrị ime ka ọ pụta ìhè na enwere ike itinye mmechi nke igbu onwe ya n'ụzọ dị irè site n'inyere nwata ahụ aka inwe ahụ iru ala 'nke a mụrụ ya. Ọnụ ọgụgụ igbu onwe onye n'ime ndị okenye ebubigara ibufe kọọrọ ihe dị ka ugboro 20 karịa nke ndị nkịtị.[xlii],[xliii],[xliv]

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6 na-atụ aro

A na-arịọ Minista ka o nyochaa mmekọrịta ahụ, ọ bụrụ na ọ dị, n'etiti dysphoria okike na igbu onwe na ụmụntakịrị Australia na ndị na-eto eto, na ma ndị sitere n'aka ndị na-ekwupụta eziokwu banyere ajụjụ a dị mkpa.

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7.) PUBERTY BLOCKERS: UNSUBSTANCIATATEDTA NA IGKPỌ EGO NA-AGBA ỌD H ỌMARAKA.

N'iso ‘nkwuputa mmekọrịta’ nke ngagharị iwe nke nwatakịrị na a mụrụ ya n’arụghị arụ, ihe na-esote bụ iwebata ‘puberty blockers’. Ndị a bụ analogues nke homonụ eke nke topụtara na 70 ma gosiputara na ha nwere ike igbochi akpati homonụ nke malitere n'ime ụbụrụ na ọganiru na gonads, na-eme ka ha hapụ testosterone na estrogen. Homonụ mmekọahụ ndị a na-akpali uto nke njiri mara nke abụọ, gụnyere inwe mmekọahụ n'ụdị.

E nyere ha ọgwụ maka ọrịa, mmalite nke mmepe nwoke na agbọghọbịa nke ha gbochiri, yana ndị okenye na-arịa ọrịa na-akawanye njọ site na ịba n’ihu homonụ inwe mmekọahụ, dịka ọmụmaatụ, kansa nwere ọrịa nwoke na nwanyị na endometriosis.

Ha malitere ka ewee ha n'ọrụ na nlekọta ahụike nke dysphoria okike nwata na 80, n'usoro, ebubo, iji belata ahụhụ kpatara site n'ọdịdị nke njirimara nwoke na nwanyị na-achọghị, na inye nwa ahụ oge ịtụgharị uche na njirimara mmekọahụ ya na ọdịnihu. Ugboro ugboro, na ị underụ iyi n'okwu ikpe ezinaụlọ nke Australia, ndị na - ekwu okwu ekwuputala mmetụta ha dị ka 'ọ nweghị ihe ọ bụla ga - agbanwe.'

Agbanyeghị, nyocha banyere atụrụ gosipụtara nkwupụta a dị n'elu adịghị mma. Ndị ọrụ nyocha na mahadum dị na Glasgow na Oslo egosila na nchịkwa nke ndị na-egbochi ndị mmadụ arụpụtala ihe ngosipụta na-emetụta usoro limbic nke atụrụ. Na ndị na-egbochi ihe, akụkụ ahụ dị mkpa nke ụbụrụ nwere ọbara mgbali elu (ịmụbawanye), na emebiwo ọtụtụ n'ime mkpụrụ ndụ ihe nketa ya. N’ihi nke a, a na-ebelata ihe omimi n’aturu, ya na inwe obi ike nke ukwuu[xlv],[xlvi],[xlvii],[xlviii],[xlix],[l],[li].

Ihe omumu banyere oru ndi mmadu n’iru ndi mmadu n’onye egbochila amatala ihe omimi na omumu ihe obula n’agbanyeghi na enwere ike iwepu ihe ndi ozo dika onwa, oria na oria.[lii],[liii],[liv],[lv]. Ọzọkwa, nyocha banyere nsogbu nke eriri afọ na ụmụ nwanyị na-anata ihe mgbochi iji belata mmetụta estrogen na endometriosis, na-ekpughe otu mkpakọrịta na mbelata ọnụọgụ nke akwara ozi akwara.[lvi], na-ebulite ohere nke oke ọrụ maka homonụ a machibidoro kpọmkwem na ụbụrụ[lvii],[lviii].

Ya mere, nkwuputa nchekwa maka iji ihe mgbochi na ụmụaka ejighi nyocha nke mba ụwa. Ekwesighi ileghara anya na uto na-emetụta oke mmepe nke akụkụ ụbụrụ, site na nzukọ, na myelination, ruo apoptosis. Nchịkwa ọgwụ ọ bụla egosiri na-emetụta akwara anụ ahụ kwesịrị naanị na ntọala sayensị.

Onye ozi ahụ rụtụrụ aka na mmechi nke Rogers vs Whittaker okwu ikpe[isii], nke gosipụtara ọrụ dịịrị onye dọkịta iji kpughee otu n'ime iri puku ohere nke ọgwụgwọ. Nyere ụlọ ọgwụ ọha na eze na-etinye aka na nchịkwa nke ọgwụ nwere mmetụta a na-akọwaghị mana egosipụtara dị ka ekpughere na ọmụmụ na ụmụ anụmanụ, ma na-atụsi ike site na mmetụta na ụmụ mmadụ, ndị ga-ahụ maka ịkwụ ụgwọ mgbe ụmụaka ndị a na-adịghị ike na-ekwu na nkwarụ ga-abụ nsonaazụ nke ọgwụgwọ na-emeghi ka o doo anya?

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7 na-atụ aro

A na-arịọ Minista ka o mee nyocha:

            i.) ma a na-eleghara nnyocha anya ma na-egbochi ndị na-eto eto na-egbochi ụmụaka n'enweghị nkwado sayensị;

           ii.) ma ihe a na-ejighi n'aka na o bu ihe ogho ndi umuaka eme bu umuaka.

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8.) Ọha akwụkwọ igbochi na ebubo nke 'CONTEMPLATING' nwoke mara.

A na - ekwu na nchịkwa nke ndị na - egbochi ụmụ nwoke na nwanyị n'oge mmalite nke ntozu (nke nwere ike ịdị ka afọ 9- 10 afọ), ga - enye ohere maka 'ịtụgharị uche' nke okike / njirimara mmekọahụ na ọdịnihu, bụ ihe na-egosi na homonụ buru ibu na-arụ ọrụ dị mkpa na mmekọahụ, yana ọrụ nke abụọ na-akpali mmepụta nke homonụ mmekọahụ, testosterone na estrogen, site na nnwale na ụmụ nwanyị.

Hormone ahụ a machibidoro ọrụ nwere oke ọrụ na ụbụrụ limbic dị na ụbụrụ, nke na-ejikọta ebe nchekwa, mmetụta na cognition n'ọrụ ọrụ. Nke ahụ bụ, usoro limbic na-ahazi 'echiche ụwa' nke ụbụrụ n'ime ngosipụta nke 'mpụga' nke ọchịchọ, njirimara na mkpebi.

Na ọnụnọ nke ndị na-anabata ya pụrụ iche na cerebrum na eriri azụ na-atụ aro na homonụ ahụ akpọchiri nwere ọrụ ka-agbasawanye na ụbụrụ.[lx]. Egosiputara ya na nmekorita ya na 'etiti nmekorita nwoke na nwanyi' nke di na etiti nke achoputara na 1970. Ọ bụrụ na etinyere homonụ ahụ n’ime akụkụ ahụ nke agbụrụ dị n’anụmanụ, ọ na-akpasu mmụọ mmekọahụ dị mma: ụmụ anụmanụ na-eto eto na-akwadebe maka ịrịgo na ụmụ nwoke ịmanye ha[lxi],[lxii],[lxiii],[lxiv],[lxv]. A na - egbochi ndị mmekọahụ na - egbochi mmetụta nwoke na nwanyị[lxvi].

Enweela mmetụta mmekọahụ nke ụbụrụ ụbụrụ ọtụtụ izu mgbe a tụụrụ ime ya site na mmetụta nke mkpụrụ ndụ ihe nketa na Y chromosome, nke ọ bụghị naanị kpaliri nguzobe nke akụkụ nwoke na nwanyị site na anụ ahụ na-enweghị iche, kamakwa mepụtara akụkụ nwoke kpọmkwem na ụbụrụ nke ụbụrụ. Mmetụta ụbụrụ a yiri ka a na-arụ ọrụ ọzọ n'oge uto site na mgbakwunye mmetụta nke homonụ mmekọahụ, testosterone na estrogen, dịka akụkụ nke mmetụta ha niile na njirimara nwoke na nwanyị[lxvii],[lxviii],[lxix],[lxx].

Amaghị ihe dị ukwuu gbasara usoro ọmụmụ mkpụrụ ndụ na -alụ na mmekọahụ nke nwoke na nwanyị, mana amachaghị nke a na-agbagha maka nkwupụta nke ndị na-egbochi ndị mmadụ na-ahapụ oge ịtụgharị uche banyere mmekọahụ na ọdịnihu. Kedu ka a ga-esi chee echiche banyere ọdịnihu ahụ n'ụzọ dabara adaba na nwatakịrị ọgwụ ọjọọ na-eme ka ọ ghara inwe mmekọahụ. Kedụ ka a ga-esi tụọ nwatakịrị ịzụlite 'ụwa si ele ihe anya' gụnyere njirimara ya mgbe ọ metụtara usoro limbic ya? Kedụ ka ndị na - ekwuchitere ndị na - eme ihe eji eme ihe n'oge nwude nwoke na nwanyị na --eme ka nnwere onwe na mmetụta ha bụ 'adịghị mma ma nwekwaa ọzọ' mgbe nchịkwa ha maka ọnwa 28 rue nwa nwoke 11 afọ kpughere nkwụsị na ikike nkịtị nke okwu ọcha, jikọtara ya na 'a ibelata na… ngụkọta ọgụgụ isi arụmọrụ mgbe mmalite nke pubertal ngọngọ '[lxxi].

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8 na-atụ aro

A na-arịọ Minista ahụ ka o nyochaa nkwupụta ahụ na igbochi ndị na-eto eto ga-eme ka 'ịtụle njirimara nwoke na nwanyị' dabara adaba na ụmụaka.

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9.) Nchọpụta MAKA EGO gụnyere CROSS-SEX HORMONES NWAANYI N’IWU.

Nyere nrụgide nke nkwupụta mmekọrịta ọha na eze na mmetụta mmetụta nke ihe mgbochi, ọ bụghị ihe ijuanya na akụkọ na-ekwu na ihe ka ọtụtụ ụmụaka na-egbochi ọganihu na-aga ọkwa nke ọzọ: nchịkwa nke homonụ na-akpali agụụ mmekọahụ iji kpalie ọdịdị mpụga chọrọ.

Ntuziaka mba dị iche iche na-atụ aro ka enyeghị ndị nọ n'afọ iri na ụma nsogbu mmekọahụ nwoke na nwanyị. Ntụziaka nke bourlọ Ọgwụ Royal Children's nke Royal Melbourne enweghị oke afọ.

Nchọpụta nke Hulshoff Pol et al na-ekpughe ọnụego nke ụbụrụ ụmụ nwoke tozuru etozu na oke oestrogens bụ oge 10 karịrị nke ịka nká, mgbe naanị ọnwa anọ ọgwụgwọ gasịrị.[lxxii]. Ndị ọzọ egosikwala mgbanwe anụ ahụ na ụbụrụ ndị toro eto[lxxiii],[lxxiv]. Enweghị akụkọ ọ bụla dị na mmetụta nke homonụ nwoke na nwanyị na ụbụrụ na-eto eto nke ụmụaka na ndị toro eto. Agbanyeghị, onye ozi ahụ kwesịrị ịmara na homonụ ndị na-abụghị nwoke ma ọ bụ nwanyị ibe ha nwere mmetụta pụtara ìhè na ụbụrụ okenye mgbe naanị ọnwa 4 gwọchara ya. Likelymụaka nwere ike ịnabata ha maka ndụ na oge niile nke ụbụrụ tozuru etozu, nke na-esite na nwata ruo oge ntorobịa.

Enweghi m ike ịchọta ntinye aka na ụbụrụ ụbụrụ nke homonụ mmekọahụ nwoke na nwanyị na Ntuziaka ọ bụla akpọrọ maka njikwa nke dysphoria okike, ma ọ bụ na usoro ikpe ikpe ezinụlọ. A kọwapụtara ihe ndị metabolic zuru ezu, mana a na-eleghara mmetụta ndị a na-akọ na ụbụrụ.

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9 na-atụ aro

A na-arịọ Minista ka o nyochaa ma homonụ na-enwe mmekọahụ na- Inye ụmụaka na ndị ntorobịa ihe megidere ụkpụrụ mba ụwa, ma ọ bụ enyeghị ya nkọwa ọ bụla nke nsonaazụ mmerụ ahụ.

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10.) Mkpesa iji kpughee nsogbu dị egwu NA-arịa ọrịa na ngwa agha.

Nchịkwa nke homonụ na-enwe mmekọahụ na-enwe mmetụta na-ebelata ihe ndị dị mmadụ n'ọbara. Ogologo oge ole ọ na-ewe maka iwepu ka ọ bụrụ nke na-adịgide adịgide amabeghị, mana mgbanye kemịkal bụ nsonazụ ya. Ndị na-akwado ịkọgharị nwatakịrị na-akwado nke a site na ịtụ aro ka enwere ike ibute àkwá ụmụ nwanyị na biopsies nke ụmụ nwanyị tupu ha na-eme ka homonụ nwoke na nwanyị nwee mmekọahụ iji wee nweta echiche ọdịnala n'ọdịnihu.

Australiankpụrụ Iwu nke Nlekọta na Ọgwụ nke Australia maka ụmụaka na ụmụ na-eto eto, nke Children'slọ Ọmụmụ Royal Royal dị na Melbourne kwusara, pg.14.

Maka ụmụ nwoke trans, ọgwụgwọ na testosterone adịchaghị akpata amụghị amụ… Otú ọ dị, ogo nke testosterone nwere ike belata ikike ịmụ nwa mgbe iwere oge uto na ntorobịa… Maka ụmụ nwanyị trans, enwere ihe akaebe na estrogen na-egbochi imepụta spam, ọ bụ ezie na ma Mmetụta ndị a na-adịgide adịgide ka amabeghị.

Nkwupụta dị otú ahụ na-akpata arụmụka. Ọ dị mma ka onye Minista ahụ jụọ ajụjụ ma ndụmọdụ a na-enye n'okpuru ụkpụrụ nduzi a kọwara na Australia na-eme ka ndị na-eto eto nwee nghọta ziri ezi banyere ọnwụ nke ọmụmụ ha.

Site na ịwa ahụ usoro ọzọ na mmemme ahụike nke transgendering therapy, ndụmọdụ mba ụwa bụ na ekwesighi ịgwọta ọgwụgwọ na-erubeghị afọ 18 mana, ugbua n'Australia, opekata mpe ụmụ nwanyị ise enwebeghị mastectomies n'okpuru afọ ahụ. Abụọ dị afọ iri na ise, otu isii na iri na abụọ.

Ndị na-akwado mgbanwe na-arụ ụka mastectomies ziri ezi site na nkwupụta na ha 'atụgharịrị'. Site na nke a ha na-egosi na ara bụ naanị ihe ịchọ mma nke ọdịdị ya nwere ike weghachite site na ịkụnye sacsọn sacs, dị ka a ga-asị na inye ara adịghị mkpa.

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10 na-atụ aro:

A na-arịọ Minista ahụ ka ọ nyochaa ndụmọdụ arụmụka nyere banyere nlọghachi nke amụghị nwa n'ihi homonụ na-enwe mmekọahụ na nkwupụta na mastectomies abụọ 'na-agbanwegharị' site na iji ihe sịlịkọn sac implants.

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11.) NKWUKWU EGO NA-EKWURU N'ANAR H NA ANARA MARA TMEDAKA MAKA GMILDAKA Gender DYSPHORIA.

Ka aghara imecha ya abum onye dibia bekee na-ekwusi ike na enweghi sayensi maka nkwuputa ihe banyere nnwale nke nnyonye anya n ’umu aka dysphoria umuaka, m n’edeputa ihe n’edere n’akwukwo ogwu nke umuaka na-eme mkpesa‘ enweghi nkwekorita banyere itinye aka ma obu ihe kwesiri ekwesi. ebumnuche nke ntinye '[lxxv], 'obere oge data',[lxxvi] ọnụ ọgụgụ dị nta si naanị otu ụlọ ọgwụ '[lxxvii], 'ondabere n'echiche nke ụlọ ọgwụ'[lxxviii].

M na-atụzị aka n’otu ederede e bipụtara na akwụkwọ akụkọ, Paediatrics, nke ndị ụlọọgwụ nọ n’ụlọ ọgwụ Royal Children dị na Melbourne gosipụtara, ụlọ ọgwụ amapụtara maka ntinye aka ya n’ịkwalite ụzọ ahụike nke dysphoria.

Ndị ode akwụkwọ ahụ nyochara akwụkwọ banyere ọgwụgwọ homonụ nke ndị na-eto eto site na 1946 ruo 2017, na-achọta naanị akwụkwọ 13 dị mkpa. Ha kwupụtara na ụkọ a 'nwere nsogbu', na-ekwubi n'ọmụmụ 'leghaara ọtụtụ nsonaazụ ndị gbara ọkpụrụkpụ' gụnyere 'mgbaàmà akparamaagwa', mmetụta ọmụmụ, ohere nke uto na uto na akụrụngwa, yana ụzọ esi ewepu ọgwụgwọ, ọkachasị na akwa ụta[lxxix]. Ndị edemede Melbourne kọrọ akụkọ dị oke egwu 'agbụrụ nke agbụrụ na ọmụmụ ihe niile, enweghị mmetụta dị ukwuu nke ndị na-egbochi ọnụnọ nke dysphoria nwoke na nwanyị n'ọmụmụ ihe ọ bụla, mana ọnụ ọgụgụ na-enweghị mmụba na dysphoria okike na ihe isi ike nke otu.[lxxx]

Yabụ, enwere ọmụmụ ọmụmụ na-achịkwa nke na-enye ntuziaka doro anya maka nhọrọ ọgwụgwọ. Yabụ, dị ka onye edemede ọzọ si kwuo, ihe kacha mma dịnụ bụ nke a ka akọwapụtara dịka 'echiche ndị ọkachamara', nke na-emetụta usoro nkwenye ọdịnala na usoro mgbakwasị nke usoro ọmụmụ.[lxxxi]

Nyocha nke nyocha nke Fuss et. al. (2015) kwubiri nke ahụ

achọrọ nyocha ọzọ ogologo oge iji tụlee usoro dị iche iche nke nlekọta ma hụ nsonaazụ ogologo oge ọkachasị ụmụaka ndị nwere ọrịa psychiatric. Enweghi ihe akaebe di nkpa karia considering otutu onu ogugu ndi mmadu na-ekwu banyere ulo ogwu nwoke na nwanyi…[lxxxii].

Echiche m bụ na enweghị ihe akaebe maka mmetụta na ịgọnahụ nsonaazụ na-edugharị Pzọ Ahụike Ahụike nke nyocha nke nyocha nke nwoke na nwanyị nke nwanyi.

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11 na-atụ aro

A choro Minister iji tụọ ihe akaebe n'ozuzu maka abamuru na maka ihe ọjọọ nke Pzọ Ahụike maka ụmụaka nwere dysphoria okike.

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AKW REMKWỌ UKWU:.

N'ikpeazụ, ana m agwa arịrịọ m na Federal na State Minister maka Ahụike, na nchịkwa nke Hosplọ ọgwụ Children'smụaka n'ihi na amataghị m usoro mba maka ụdị ahụike a na-ezighi ezi.

N'uche m, a kọbara ide echiche, ọmụmụ ihe nke nwoke na ngalaba nke ọgwụ na obodo ka nwee nnukwu iwu. Omume nnwale dị otú ahụ na-emegide koodu ụwa niile nke usoro nyocha ahụike na nyocha nke mmadụ gụnyere, Hippocratic Oath, Belmont Report (1978), Nkwupụta nke Geneva (1948), Nkwupụta nke Helsinki (1964) na Nuremberg Principles (1949) ).

Ya mere, a na m arịọ Minista ka o tinye usoro ndị a na-atụ aro maka nyocha ndị omebe iwu gọọmentị.

Usoro Okwu Okwu

Kọmitii Ahọpụtara Ndị Omeiwu Achọpụta Usoro Ọchịchị na Ahụike Maka Childrenmụaka Maka Dysphoria.

1. Ka ịgbanye nbawanye njọ nke dysphoria okike nwata nwoke na Australia, ma tughari uche na o nwere nsogbu ndu ndu ma obu gosiputa uzo 'nmekorita nke mmadu.

2.) Inyocha:

i.) Ruo ókè ha, ma ọ bụrụ na ọ bụla, Federal, State na Territory iwu chọrọ ka ụlọ akwụkwọ na ndị isi ndị ọzọ kwado ma kwado mgbanwe mmekọrịta nke nwatakịrị bụ onye kwuru na okike ya dị iche na mmekọrịta nwoke na nwanyị ha nwere;

ii.) Ruo ókè ha, ọ bụrụ na ọ dị, mmụba nke dysphoria okike kwekọrọ na iwebata ihe nkuzi n'ụlọ akwụkwọ Australia na-akwalite echiche nke 'ịdị n'etiti nwoke na nwanyị'.

3.) considertụle ihe mgbochi dị na ụzọ nke Ahụike Ahụike:

'Gini mere eji agbakwunyere umuaka ugbua n'uzo nke ogwu mgbe achoputara na otutu umuaka nwere dysphoria nwoke na nwanyi ga - edunye ya na nmekorita nwoke na nwanyi site na nmekorita nwoke na nwanyi, ya mere ihe nlere anya ‘ichere ma hu’, ya na ihe ndi mmadu gha eme ya. ? '

4.) Inyocha:

i.) echiche nke, na ihe akaebe maka, akparamaagwa nke ọdịnala, ọrịa mmụọ na ọgwụgwọ ezinaụlọ n’ime dysphoria okike nwata.

ii.) oke omumu ihe banyere uche, uche na nnabata ezin’ulo nke enyerela umuntakiri Australia ndi no ugbua n’okporo uzo ogwu maka ọgwụgwọ dysphoria okike.

5.) Nyochaa oke nwere ike bụrụ ihe iwu dịịrị ndị na-eme ahụike na ụlọ ọgwụ ọha maka mmebi nke ọrịa na-ebugharị ụmụaka nwere ike ibute nsogbu gbasara ahụike na nsogbu ahụike ndị ọzọ na-ebute ọnya ọnya ọnya na-ahụghị n'oge ọgwụgwọ.

6.) Nyochaa mmekọrịta ahụ, ọ bụrụ na ọ dị, n'etiti dysphoria okike na igbu onwe ya na ụmụntakịrị Australia, yana ma ndị na-ekwu okwu ha gosipụtara eziokwu banyere ajụjụ a dị mkpa.

7.) Inyocha:

i.) ma a na-eleghara nnyocha anya ma na-egbochi ndị na-eto eto na-egbochi ụmụaka n'enweghị nkwado sayensị;

ii.) ma ihe a na-ejighi ekwenye ekwenye na umu ihe

8.) Iji nyochaa nkwupụta nke igbochi ntorobịa ga-enye ohere 'ịtụle njirimara okike' kwesịrị ekwesị n'ime ụmụaka.

9.) Inyocha ma à na-enye ụmụaka ụmụaka homonụ nwoke na nwanyị na nwanyị megidere ụkpụrụ nduzi mba ụwa, ma ọ bụ na-enyeghị nkọwa zuru ezu nke nsonaazụ mmerụ ahụ.

10.) ichoputa ndụmọdụ na-ese okwu nyere banyere nlọghachi nke amụ nwa n'ihi homonụ na-enwe mmekọahụ na nkwupụta nke abụọ mastectomies bụ 'agbanaghari' site na iji ihe sịlịkọn sac implants.

11.) Nyochaa ihe akaebe n'ozuzu maka abamuru na maka imerụ ahụike forzọ Ahụike maka ụmụaka nwere dysphoria okike.

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References

 

[I] Osmụaka Kosky RJ Ogbenye ụmụ nwanyị: ọgwụgwọ inpatient na-enyere aka? MJA.1987: 146; June 1: 565-569.

[Ii] M. Telfer, M. Tollit, & D. Feldman, 'Mgbanwe nke nlekọta ahụike na usoro iwu maka Transgender Population: Mkpa maka Mgbanwe' (2015) 51 Akwụkwọ nke Paediatrics na Ahụhụ Ụmụaka 1051.

[iii] 'Demandmụaka chọrọ maka ọgwụgwọ ntụgharị nke okike dị elu iji dekọọ elu', ABC News. 4 October, 2018, https://www.abc.net.au/news/2018-09-20/childhood-demand-for-biological-sex-change-surges-to-record/10240480

[iv] Ọrịa kansa nwata. Eziokwu. https://ccia.org.au/home/our-purpose/childhood-cancer-information/

[v] Littman L. Rapid bidoro dysphoria okike ntorobịa na ndị ntorobịa: Nnyocha gbasara akụkọ nne na nna. PLoS ONE 13 (8): e0202330. https://doi.org/10.1371/journal.pone.0202330.

[vi] Penny Mordaunt. https://www.telegraph.co.uk/politics/2018/09/16/minister-orders-inquiry-4000-per-cent-rise-children-wanting/

[vii] Studentsmụ akwụkwọ transgender na ụlọ akwụkwọ - ikike na ikike dịịrị iwu ', Okwu gbasara iwu ngbasa ozi adịghị 55, Disemba 2014, Mmụta na obodo, gọọmentị NSW. https://education.nsw.gov.au/about-us/rights-and-accountability/media/documents/public-legal-issues-bulletins/LIB-55-Transgender-students-in-schools-legal-rights-and-responsibilities.pdf

'Di iche iche na ụlọ akwụkwọ Queensland - ozi maka ndị isi', Ngalaba Mmụta na Ọzụzụ Queensland, agbanwebeghị ma ọ dị ugbu a dị ka nke 30 June 2017.http://education.qld.gov.au/schools/inclusive/docs/diversity-in-qld-schools-information-for-principals.pdf

'Ihe njirimara nwoke na nwanyị', Mmụta na Ọzụzụ, Gọọmentị Victoria, enweghị oge ọ dị ugbu a dịka nke 15 March 2018. http://www.education.vic.gov.au/school/principals/spag/health/Pages/genderidentity.aspx

'Transgender na onye na - akwado ụmụ akwụkwọ na - agbakwunye', SA Ngalaba Mmụta na Nzụlite ụmụaka.https://www.decd.sa.gov.au/sites/g/files/net691/f/transgender-and-intersex-support-procedure.pdf

[viii] Ms Hennessy, Health Comintints Bill Nke abụọ. Ndị omeiwu Victoria. Hansard. Feb 10, 2016.

[ix] Diagnostic na Statistical Manual of Disental Disndrome (DSM-5), American Psychiatric Association, 2013, Op. cit., pg. 452.

[X] J. Ristori na T. Steensma, 'Gender Dysphoria in the Childhood' (2016) 28 Nnyocha gbasara mmụọ nke mba ụwa 13 na 15.

[xi] McHugh, 'Surwa Ahụ Transgender abụghị Ngwọta,' Wall Street Journal, Emelitere 13 Mee 2016. https://www.wsj.com/articles/paul-mchugh-transgender-surgery-isnt-the-solution-1402615120

[xii] Schwartz D. 'tonụ ntị na 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

[xiii] Rekers GA, Kilgus M, Rosen A. Ogologo oge mmetụta nke ọgwụgwọ maka nsogbu njirimara nwoke na nwanyị. Journal nke akparamaagwa na amp: nwoke na nwanyi. 1991; 3 (2): 121-153.

[xiv] Pauly I. Nwanyi transsexualism: Nkeji 2. Ebe a na-edebe akwụkwọ gbasara mmekọahụ. 1974. 3 (6): 509-524

[xvi] Omume Zuger B. Kpamkpam dị ugbu a n'ụmụaka nwoke site na nwata: afọ iri ọzọ sochirinụ. Comprehensive Psychiatry. 1978; 19 (4) (July-August): 363-369.

[xvii] Lothstein L, onye ọrịa dysphoric na-eto eto nke nwoke: ụzọ a ga-esi gwọọ ya na njikwa ya. Journal of Pediatric Psychology. 1980; 3 (1): 93-109.

[xviii] Zucker KJ, Wood H, Singh MA, Bradley SJ. Oge mmepe, usoro biopsychosocial maka ọgwụgwọ ụmụaka nwere nsogbu njirimara nwoke na nwanyị. J nwoke idina nwoke. 2012. 59 (3): 369-397.

[xix] Wallien MS, Swaab H, Cohen-Kettenis PT. Ihe akparamaagwa nke ọrịa uche n'etiti ụmụaka nwere nsogbu njiri mara nwoke. J Am Acad Adomụaka Maka Ọrịa Uche. 2007; 46 (10): 1307-1314. Doi 10.1097 / chi.0b013e3181373848

[xx] Steensma TD, Zucker KJ, Kreukels BP et al. Nsogbu na akparamaagwa na Mkpesa Onye Nkuzi Nke Onye Ozizi: nyocha nke mba, nyocha ụlọ nyocha gbasara ụmụaka ụmụaka na-eto eto. J Abnorm Child Psychol. 2014; 42 (4): 635-647. Doi: 10.1007/s10802-013-9804-2

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

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

[xxiii] Hewitt JK, Paul C, Kasiannan P et al. Ormgwọ ọrịa obi dị n’etiti amamịghe agwa dị n’otu n’ime ụmụaka na ndị ntorobịa. Med J Aust. 2012; 196 (9): 578-581. Doi 10.5694 / mja12.10222

[xxiv] 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

[xxv] De Vries AL, Nọmba IL, Cohen-Kettenis PT et al. Ọrịa Autism dị iche iche na ụmụaka dysphoric okike na ụmụ ntorobịa. J Autism Dev Disord. 2010; 40 (8): 930-936. Doi 10.1007/s10803-010-0935-9

[xxvi] Zucker KJ. Withmụaka nwere nsogbu njirimara nwoke na nwanyị. Enwere omume kacha mma? Neuropsychiatrie de l'enfance et de l'adolescence. 2008; 56 (6): 358-364. Doi 10.1016 / j.neurenf.2008.06.003

[xxvii] Zucker KJ, Lambert S, Bradley SJ et al. Ihe ndị dị egwu maka nsogbu akparamagwa ụmụ nwoke niile nwere nsogbu njiri mara nwoke. Ekepụtara ya na 19th Symposium nke Harry Benjamin International Gender Dysphoria Association. 2005. Bologna Italy.

[xxviii] Marantz S, Coates S. Ndị nne ụmụ nwoke nwere nsogbu njirimara nwoke na nwanyị: ntụnyere njikwa mmekọrịta. J Am Acad. Psymụaka na ndị na-eto eto isi mgbaka. 1991; 30 (2): 310-315. Doi 10.1097 / 00004583-199103000-00022

[xxix] Finch v Southern Health & Ors [2004] VCC 44 (12 Nọvemba 2004)

[xxx] 'Cliniclọ ọgwụ mgbanwe mmekọahụ mehiere,' Jill Stark, Melbourne Age, Mee 31, 2009. https://www.theage.com.au/national/sexchange-clinic-got-it-wrong-20090530-br3u.html

[xxxi] Spack NP, Edwards-Leeper L, Feldman HA et al. Childrenmụaka na ndị nọ n'afọ iri na ụma nwere nsogbu njirimara nwoke na nwanyị na-ezo aka na ngalaba nlekọta ahụike ụmụaka. Ọrịa ụmụaka. 2012; 129 (3): 418-425.

[xxxii] De Vries AL, Nọmba IL, Cohen-Kettenis et al. Ọrịa Autism dị iche iche na ụmụaka dysphoric okike na ụmụ ntorobịa. J Autnanism Dev Dis. 2010; 40: 930-936.

[xxxiii] Holt V, Skagerberg E, Dunsford M. Ndị na-eto eto nwere njiri mara nke dyshoria okike: ọgụgụ mmadụ na ihe isi ike metụtara Clin Child Psychil Psychiatry. 2016; 164: 108-118.

[xxxiv] Hewitt Jk, Paul C, Kassiannan P et al. Ormgwọ ọrịa obi dị n’etiti amamịghe agwa dị n’otu n’ime ụmụaka na ndị ntorobịa. MJA. 2012; 196 (9): 578-581.

[xxxv] Aitken M, VanderLaan DP, Wasserman L, Stojanovski S, Zucker KJ. Imerụ onwe na igbu onwe onye ụmụaka zoro aka na dysphoria okike. J Am Acad Adomụaka Maka Ọrịa Uche. 2016; 55 (6): 513-520. Doi 10.1016 / j.jaac.2016.04.001

[xxxvi] 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.

[xxxvii] Faulkner AH, Cranston K. Correlates nke otu nwoke na nwanyị inwe mmekọahụ na ụdị ụmụ akwụkwọ sekọndrị na Massachusetts. Am J Ọhaneze. 1998 Feb; 88 (2): 262 – 266. Doi 10.2105 / AJPH.88.2.262

[xxxviii] 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

[xxxix] Haas A et al, Igbu mmadu na igbu onwe ya na nwoke ma obu nwanyi, nwoke nwere mmasị nwoke, nwoke na nwoke ma obu ndi nwoke na ndi nwanyi na ndi transgender: nyochaa na ntuziaka J Homosex. 2011; 58 (1): 10-51. doi: 10.1080 / 00918369.2011.534038.

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

[xli] 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

[xlii] Murad MH, Elamin MB, Garcia MZ, Mullan RJ, Murad A et al. Okpukpo aru na imekorita nwoke na nwanyi: nyocha nke oma na inyocha ihe omumu banyere ndu ndu ya na ihe ndi ozo. Clin Endocrinol (Oxf) 2010; 72 (10): 214 – 231. Doi 10.1111 / j.1365-2265.2009.03625.

[xliii] De Cuypere, Elaut E, Heylens G, et al. Ruo ogologo oge: nsonaazụ psychosexual nke ndị Belgium transpexuals mgbe a na-emegharị ahụ gbasara mmekọahụ. Sexologies. 2006; 15: 126-133.

[xliv] 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

[xlv] Nuruddin S, Bruchhage M, Ropstad E et al. Mmetụta nke agonist na-ahapụ mkpụrụ ndụ gonadotropin na ụbụrụ ụbụrụ atụrụ - ọmụmụ ihe onyonyo magnetik. Psychoneuroendocrinology. Ọrịa. 2013; 38 (10): 1994-2002. Doi 10.1016 / j.psyneuen.2013.03.009

[xlvi] Nuruddin S, Wojniusz S, Ropstad E et al. Peri-pubertal gonadotropin na-ewepụta afọ analog ọgwụgwọ analog na-emetụta usoro mkpụrụokwu hippocampus n'egbanweghị ntụzi aka gbasara ụmụ atụrụ. Behav Brain Res. 2013; 242 (1): 9-16. Doi 10.1016 / j.bbr.2012.12.027 ·

[xlvii] Nuruddin S, Krogenaes A, Brynildsrud OB et al. Ọkpụkpọ Peri-pubertal gonadotropin na-ewepụta agonist hormone na-emetụta mmekọahụ sitere na usoro amygdala na atụrụ. Psychoneuroendocrinology. 2013; 38 (12) .3115-3127. Doi 10.1016 / j.psyneuen.2013.09.011

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

[xlix] Hough D, Bellingham M, Haraldsen IRH et al., 2017 Ncheta oghere gbasara nsogbu site na ọgwụgwọ agonist GnRH peripubertal na nrụrụ testosterone na atụrụ. Psychoneuroendocrinology. Ọrịa. 2017; 75 (1): 173-182. Doi 10.1016 / j.psyneuen.2016.10.016

[l] 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

[li] 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

[lii] 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

[liii] Craig MC et al. Mgbatị homonụ Gonadotropin na-ewepụta agonist hormone 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

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

[lv] Ohlsson B. Gonadotrophin_releasing homonụ na ọrụ physiological ya na ọrịa pathophysiological na mmekọrita ot nhazi na ọrụ nke eriri afọ. Nnyocha ịwa ahụ na Europe. 2016: 57: 22-33.

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

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

[lviii] Hulshoff Pol HE, Cohen-Kettenis PT, Van Haren NE, et al. Inggbanwe nmekorita nwoke na nwoke na - agbanwe ụbụrụ gị: Mmetụta nke testosterone na estrogen n'usoro ụbụrụ mmadụ. Eur J Endocrinol. 2006; 155 (1): S107 – S111. Doi 10.1530 / eje.1.02248

[isii] Rogers v. Whitaker, Courtlọikpe dị elu nke Australia, Iwu Aust. 1993 Jan;67(1):47-55. https://www.ncbi.nlm.nih.gov/pubmed/11648609

[lx] Caraty A, Skinner DC. Gonadotrophin na - ewepụta homonụ nke mmiri ụbụrụ nke atọ: end na - ebute oke na mmụba.

[lxi] Pfaff D, Lewis C, Diakow C et al. Nyocha Neurophysiological nke mmeghachi omume nke mating dị ka ihe dị mma dị n’ahụ. Prog Physiol Psychol. 1973; 5: 253-297

[lxii] 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

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

[lxiv] 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

[lxv] Riskind 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

[lxvi] 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

[lxvii] Knoedler JR, Shah NM. Mozọ eji arụ ọrụ dị iche iche na-apụ iche na mmekọahụ. Echiche ugbu a na neurobiology. 2018.53; 192-197.

[lxviii] Hyer MM, Phillips LL, Neigh GN. Mmekorita nke nwoke na nwanyi na plastik synaptik: homonụ na karịa. Frontiers na Molecular Neuroscience. 2018; 11: 266. Doi: 10.3389 / fnmol.2018.00266.

[lxix] Menzies L, Goddings A, Kirstie J et al. Mmetụta nke oge ntorobịa na mmepe ọcha na ụmụ nwoke. Dev Cog Neurosc.2015; 11: 116-128.

[lxx] Pangelinan MM, Leonard G, Perron M et al. Mkpụrụ obi na testosterone na-akpụzi akụkụ ahụ corticospinal n’oge uto nke nwoke. Brain Struct Funct. 2016; 221: 1083-1094.

[lxxi] Schneider MA, Spritzer PM, Soll BM et al. Mkpokọta ụbụrụ, nghọta na usoro olu n'ụdị dysphoria okike n'okpuru nnabata. N'ihu Hum Neurosci. 2017; 11: 528. Doi: 10.3389 / fnhum.2017.00528.

[lxxii] Hulshoff Pol HE, Cohen-Kettenis PT, Van Haren NE, et al. Inggbanwe nmekorita nwoke na nwoke na - agbanwe ụbụrụ gị: Mmetụta nke testosterone na estrogen n'usoro ụbụrụ mmadụ. Eur J Endocrinol. 2006; 155 (1): S107 – S111. Doi 10.1530 / eje.1.02248

[lxxiii] Zubiaurre-Elorza L, Junque C, Gomez-Gil E, & 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

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

[lxxv] 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

[lxxvi] 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

[lxxvii] 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

[lxxviii] Schwartz D. Na-ege ntị na ụmụ na-eche echiche okike: na-elele onu oriri nke echiche. Op. cit.

[lxxix] 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

[lxxx] 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

[lxxxi] Milrod C. Kedu ka nwata si dị obere: Nchekasị metụtara agbụrụ dị na ịwa ahụ nwa agbọghọ MTF na-agafe agafe. J Mmekọahụ Med. 2014; 11 (2): 338-346. Doi 10.1111 / jsm.12387

[lxxxii] Fuss J, Auer MK, Briken P. Gys driaphoria na ụmụ na ndị na-eto eto: nyocha nke akwụkwọ na - adịbeghị anya. Isi mgbaka Curr. 2015; 28 (6): 431-434.

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