變性人的健康需求

1、Health Needs of Transgender People RemainUnmetFran LowryJune 17, 2016Despite the recent flurry of media attention that has been directed toward transgender people, they and their health needs remain poorly understood, ex

2、perts say.專家們說，盡管最近一系列的媒體關(guān)注已經(jīng)指向了變?nèi)巳?，他們和他們的健康需求仍難以被 理解。In a series of articles published online June 17 in the Lancet, experts on the transgender community outline some of the social and legal conditions in which transgen

3、der people live, as well as some of the medical perspectives that frame the provision of healthcare for these individuals.在6月17號的《柳葉刀》的網(wǎng)上發(fā)表了一系列的文章，專家們在變性人團體中描述了變性 人生活中面臨的一些社會的和法律的情況，同樣這些個體的一些構(gòu)建醫(yī)療保健的醫(yī)學觀點。 The series was p

4、ublished to coincide with the World Professional Association for Transgender Health 24th Biennial Scientific Symposium, in Amsterdam, the Netherlands.這一系列文章的發(fā)布附合了在荷蘭阿姆斯特丹舉行的24屜兩年一次的世界專業(yè)協(xié)會科學研 究會關(guān)于變性人的健康的主題。“Many transgend

5、er people live on the margins of society, facing stigma, discrimination, exclusion, violence, and poor health,“ write Sam Winter, PhD, Curtin University, Perth, Australia, and colleagues in the first of three articles in

6、 the series.許多變性人生活在社會的邊緣，面對侮辱，歧視，孤立，暴力和疾病。“Many of the health challenges faced by transgender people are exacerbated by laws and policies that deny them gender recognition,“ Dr Winter said in a statement.變性人因法律和政策否識對他們性

7、別的認知導致他們面對的許多健康挑戰(zhàn)更加惡化。“In no other community is the link between rights and health so clearly visible as in the transgender community. Faced with stigma, discrimination and abuse, transgender people are pushed to the mar

8、gins of society, excluded from the workplace, their families and health care. Many are drawn into risky situations or behaviors, such as unsafe sex or substance abuse, which leave them at risk of further ill health,“ he

9、said.沒有其他團體像變性人團體那樣權(quán)利和健康的聯(lián)系是那么的顯而可見。面對侮辱、歧視和虐 待，變性人被迫到社會的邊緣，被工作場所、他們的家庭和衛(wèi)生保健排除在外。許多人進被 拉進危險的場所或行為，像是不安全的性行為或濫用藥物，這會導致將來不健康的風險加重。In the second article in the series, Kevan Wylie, MD, Porterbrook Clinic, Sheffield, United

10、Kingdom, and colleagues note that although some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialized facilities, most healthcare needs can be

11、 delivered by a primary care physician.在系列里的第二篇文章，P和他的同事提到盡管一些變性人的醫(yī)療組織，包括變性手術(shù)，最 好是在具備專業(yè)設(shè)備的地方進行，其余大部分健康需求只需要找初級醫(yī)生。醫(yī)生應(yīng)該培訓去明白變性人的健康需求。政府應(yīng)該被阻止為兒童，青年和成人設(shè)立性別修復 治療。這些方法受到廣泛的遣責因為不道德?！癆 comprehensive public health approach to add

12、ress the health of transgender people requires access to gender affirmation services, evidence-based health-care delivery systems, and effective partnerships with local transgender communities,“ write Sari L. Reisner, Sc

13、D, Boston Children's Hospital, Harvard Medical School, and colleagues in the third article in the series一個全面的公眾的健康方法去處理變性人的健康需要獲得性別確認服務(wù)，以證據(jù)為基礎(chǔ)的健 康傳送系統(tǒng)，和與當?shù)刈冃匀藞F體有效的關(guān)系。Although there are substantial gaps in empirical r

14、esearch on transgender issues, “there are sufficient actionable data highlighting unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people

15、 that need interventions,“ Dr Reisner and colleagues write.盡管在變性人經(jīng)驗主義的調(diào)查中有大量的差異。有足夠的行動證據(jù)去強調(diào)獨特的生物學的， 行為學的和上下文結(jié)構(gòu)的因素圍繞著需要干預的變性人的健康風險和彈性?！癟here are huge gaps in our understanding of transgender health stemming from a fundame

16、ntal challenge of defining this diverse group and a failure to recognize gender diversity,“ Dr Reisner said in a statement.在理解變性人健康存大巨大差異源于一個根本性的挑戰(zhàn)去定義這個不同的團體和不能識別 性別的多樣性。“Nevertheless, we know enough to act. High rates o

17、f depression and HIV are all linked to the context in which transgender people are forced to live. In the past 15 years, there has been a dramatic shift from viewing transgender people as having a disorder towards a bett

18、er understanding of gender diversity, but much more needs to be done,“ she said.然而，我們知道足夠去行動。抑郁和艾滋的高發(fā)生率與變性人被迫生存的環(huán)境密切聯(lián)系。在 過去15年里，人們的觀點從認為變性人是一種病到更好地理解性別多樣化發(fā)生了巨大的改 變，但更多的是需要行動。“Visibility of transgender people and support

19、for transgender rights have increased dramatically in recent years,“ Dr Reisner, Mark A. Schuster, MD, PhD, and Sarah E. Onorato, from Boston Children's Hospital, write.變性人的透明度和對變性人權(quán)利的支持已經(jīng)明顯增加在近見年?！癐n 2015, a total o

20、f 375 Fortune 500 companies prohibited discrimination on the basis of gender identity, up from 15 in 2002. Nineteen states and the District of Columbia include gender identity in employment nondiscrimination laws,“ they

21、write.在2015年，總共有375個福利500間公司阻止性別認同的基礎(chǔ)上的歧視，超過2002年的 15間。19個州和哥倫比亞區(qū)將性別認同納入就業(yè)非歧視法。Nevertheless, transgender people still face substantial discrimination, they note.“Beyond bathroom accessibility, discrimination is associate

22、d with increased stress, anxiety, depressive symptoms, post-traumatic stress disorder, substance abuse, and suicide. It is also associated with increased risk of bullying, verbal harassment, sexual assault, and nonsexual