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Kula da lafiyar transgender

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Kula da lafiyar transgender
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Kula da lafiyar masu canza jinsi ya haɗa da rigakafi, ganowa da kuma magance matsalolin lafiyar jiki da ta hankali waɗanda ke shafar mutanen da ke canza jinsi . Babban ɓangaren kula da lafiyar masu canza jinsi shine kula da tabbatar da jinsi, ɓangaren lafiya na sauyin jinsi . Tambayoyin da ke tattare da kula da lafiyar masu canza jinsi sun haɗa da bambancin jinsi, maganin sake sanya jinsi, haɗarin lafiya (dangane da tashin hankali da lafiyar kwakwalwa), da kuma samun damar samun kulawar lafiya ga mutanen da ke canza jinsi a ƙasashe daban-daban na duniya. Kula da lafiya mai tabbatar da jinsi na iya haɗawa da kula da halayyar hankali, likita, jiki, da zamantakewa. Manufar kula da tabbatar da jinsi shine don taimaka wa mutumin da ke canza jinsi ya dace da asalin jinsi da yake so. [1]

A shekarun 1920, likita Magnus Hirschfeld ya gudanar da bincike na hukuma don fahimtar rashin daidaiton jinsi da kuma jima'i na ɗan adam kuma ya yi kira ga al'ummomin da aka ware. [2] Bincikensa da aikinsa sun samar da sabon hangen nesa kan asalin jinsi, bayyanar jinsi, da kuma jima'i. Wannan shi ne karo na farko da aka fuskanci ƙalubale a kan ƙa'idodin zamantakewa . Baya ga bincikensa, Hirschfeld ya kuma ƙirƙiro kalmar transvestite, wadda a zamanin yau ake kira "transgender". [2] Aikin Hirschfeld ya ƙare a lokacin mulkin Nazi na Jamus lokacin da aka kama mutane da yawa masu transgender aka tura su sansanonin tsarewa. [2]

A shekarar 1966, aka buɗe asibitin Johns Hopkins Identity Identity ; yana ɗaya daga cikin na farko a Amurka da ke ba da kulawa ga mutanen da suka canza jinsi, ciki har da maganin maye gurbin hormones, tiyata, shawarwari kan halayyar ɗan adam, da sauran kiwon lafiya masu inganci ga jinsi. [2] Asibitin ya buƙaci marasa lafiya kafin a yi musu tiyatar tabbatar da jinsi su shiga wani shiri mai suna "Gwajin Rayuwa ta Gaske". [2] [3] Jarrabawar Rayuwa ta Gaske shiri ne inda kafin a yi musu tiyatar tabbatar da jinsi, ana buƙatar majiyyaci ya rayu da rawar da yake takawa a fannin jinsi. [3] A shekarar 1979, sabon darektan ilimin tabin hankali Paul R. McHugh ya rufe asibitin. [2]

Bayanin likitanci game da bambancin jinsi

[gyara sashe | gyara masomin]

An bayyana bambancin jinsi a cikin littattafan likitanci a matsayin "asali, bayyanawa, ko ɗabi'a da ta bambanta da al'adun da aka ayyana da ke da alaƙa da takamaiman jinsi". [4] Tsawon ƙarni, ana ɗaukar bambancin jinsi a matsayin cuta. [5] Hukumar Lafiya ta Duniya ta gano rashin daidaiton jinsi a matsayin matsalar kwakwalwa a cikin Rarraba Cututtuka ta Duniya (ICD) har zuwa 2018. [6] An kuma lissafa rashin daidaiton jinsi a cikin Littafin Bincike da Ƙididdiga na Cututtukan Hankali ( DSM-5 ) na Ƙungiyar Halayyar Dan Adam ta Amurka, inda a da ake kiransa "masu canza jinsi " da "rashin daidaiton jinsi". [7] [8]

A cikin 2018, ICD-11 ta haɗa da kalmar "rashin daidaiton jinsi" a matsayin "rashin daidaito mai alama da dorewa tsakanin jinsin da mutum ya ƙware da kuma jinsin da aka ba shi", inda ɗabi'un bambancin jinsi da abubuwan da ake so ba lallai bane su nuna ganewar asali ta likita. [9] Duk da haka, bambancin da ke tsakanin "rashin daidaiton jinsi" da "rashin daidaiton jinsi" ba koyaushe yake bayyana a cikin littattafan likitanci ba. [10]

Wasu nazarce-nazarce sun nuna cewa ɗaukar bambancin jinsi a matsayin wata cuta ta lafiya yana da mummunan tasiri ga lafiyar mutanen da suka canza jinsi kuma suna da'awar cewa ya kamata a guji zato game da alamun tabin hankali da ke tare. [5] [11] [12] Wasu nazarce-nazarce sun yi jayayya cewa gano rashin daidaiton jinsi na iya zama da mahimmanci har ma da kyau ga mutanen da suka canza jinsi a matakin mutum ɗaya da na zamantakewa. [13]

Ganin cewa akwai hanyoyi daban-daban na rarrabawa ko siffanta waɗanda aka gano ko kuma suka tabbatar da kansu a matsayin mutanen da suka canza jinsi, wallafe-wallafen ba za su iya kimanta yadda waɗannan abubuwan suka yaɗu a cikin jimlar yawan jama'a ba. Sakamakon wani bita na tsari na baya-bayan nan ya nuna buƙatar daidaita girman da hanyar da ta shafi tattara bayanai na waɗanda ke gabatar da kansu a matsayin masu canza jinsi. [14]

Taimakon lafiyar kwakwalwa

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Saboda wariyar da suke fuskanta, mutanen da ke canza jinsi sau da yawa suna nuna babban bambanci a lafiyar kwakwalwa . Daga cikinsu, an kiyasta cewa kashi 32-50% na mutanen da ke canza jinsi a ƙasashe daban-daban sun yi ƙoƙarin kashe kansu, tare da wannan yawan da ake samu sakamakon abubuwa kamar cin zarafi, cin zarafi, tashin hankali, ƙin amincewa da zamantakewa da iyali, da kuma wariya a sassa daban-daban na gwamnati. [15] Banda rashin lafiyar jinsi, mutanen da ke canza jinsi suma suna fuskantar alamun cutar kwakwalwa, kamar babban baƙin ciki da damuwa gabaɗaya, a mafi yawan lokuta fiye da mutanen da ba sa canza jinsi. [16] Duk da cewa kulawar da ke tabbatar da jinsi tana da tasiri mai kyau ga lafiyar kwakwalwar mutanen da ke canza jinsi kuma tana iya rage alamomi da yawa, ci gaban tunanin irin wannan kulawa galibi yana iyakance ta hanyar damuwa marasa rinjaye da ke shafar yawan masu canza jinsi. [17]

Saboda waɗannan dalilai, taimakon lafiyar kwakwalwa ta hanyoyi kamar ilimin halayyar ɗan adam na iya taka muhimmiyar rawa wajen magance lafiyar kwakwalwar marasa lafiya masu canza jinsi. Ana iya gudanar da kimanta lafiyar kwakwalwa da magani kafin fara kula da tabbatar da jinsi a matsayin hanyar tabbatar da yardar majiyyaci da kuma ƙara wa canjin likita. Ana hana yin amfani da maganin rage radadi a matsayin buƙatar fara kula da lafiya mai inganci a yau ta hanyar ka'idojin kula da lafiyar masu canza jinsi, kamar yadda hanyoyin da ake ƙoƙarin canza asalin majiyyaci ko karkatar da binciken kai zuwa wani takamaiman alkibla. [3]

Binciken asali

[gyara sashe | gyara masomin]

Saboda ci gaba da haɗa asalin jinsi wani tsari ne daban-daban tsakanin matasa masu canza jinsi, ana ba da shawarar cewa ƙwararrun ma'aikatan kiwon lafiya su ba da yanayi mai daraja ga abokan ciniki - musamman matasa - don bincika da bayyana fannoni daban-daban na asalin su, gami da buƙatar kulawa mai tabbatar da jinsi. [3] Yana da mahimmanci kada a yi amfani da binciken jinsi don jinkirta kulawa mai tabbatar da jinsi ko ƙoƙarin gano asalin jinsi zuwa cututtuka, saboda irin waɗannan hanyoyin za su yi daidai da ayyukan canzawa, waɗanda aka san su da haifar da mummunar illa. [18] [19] [20]

Kulawa mai tabbatar da jinsi

[gyara sashe | gyara masomin]

Akwai zaɓuɓɓuka daban-daban ga mutanen da suka canza jinsi don neman sauyi a jiki. Akwai zaɓuɓɓuka don sauyi a jiki ga mutanen da suka canza jinsi tun daga 1917. Kulawa mai tabbatar da jinsi yana taimaka wa mutane su canza kamanninsu da/ko halayen jima'i don dacewa da asalin jinsinsu; ya haɗa da maganin hormone mai tabbatar da jinsi da tiyata mai tabbatar da jinsi . Duk da cewa mutane da yawa masu canza jinsi suna zaɓar su canza jiki, kowane mutum mai canza jinsi yana da buƙatu daban-daban, kuma saboda haka, babu wani shirin sauyi da ake buƙata. [21] Kula da lafiya mai kariya muhimmin ɓangare ne na sauyi kuma ana ba da shawarar likita na farko ga mutanen da suka canza jinsi waɗanda ke canzawa. [21]

Cancanta

[gyara sashe | gyara masomin]

A cikin sigar 11 ta Tsarin Rarraba Cututtuka na Duniya ( ICD-11 ), an san ganewar cutar da rashin daidaiton jinsi . ICD-11 ta bayyana cewa "Halayya da fifikon jinsi kaɗai ba su ne tushen sanya ganewar asali ba." [9]

Littafin Bincike da Ƙididdiga na Cututtukan Hankali na Amurka (DSM) ya sanya masa suna dysphoria na jinsi (a sigar 5 [22] ). Wasu mutanen da aka gano sunansu daidai ba su da sha'awar duk ko wasu sassan maganin maye gurbin hormone, ko tiyatar tabbatar da jinsi, kuma/ko kuma ba su dace da irin wannan maganin ba.

An bayyana ƙa'idodi na gabaɗaya don gano cutar, da kuma magance damuwa da rashin daidaiton jinsi ko rashin lafiyar jinsi ke haifarwa a cikin Ma'aunin Kulawa na WPATH don Lafiyar Masu Canza Jinsi da Mutane Masu Bambancin Jinsi . Tun daga watan Fabrairun 2023, sigar da ta gabata ta ƙa'idodin ita ce Sigar 8, wacce ake kira SOC8 a takaice. [23] [24] Dangane da ƙa'idodin kulawa, "Rashin lafiyar Jinsi yana bayyana yanayin damuwa ko rashin jin daɗi wanda za a iya fuskanta saboda asalin jinsi na mutum ya bambanta da wanda aka danganta shi da jiki da/ko zamantakewa ga jinsi da aka sanya masa a lokacin haihuwa... Ba duk mutanen da ke canza jinsi da jinsi daban-daban ke fuskantar rashin lafiyar jinsi ba." Rashin daidaiton jinsi ba iri ɗaya bane da rashin lafiyar jinsi; rashin daidaito, bisa ga ƙa'idodin kulawa, ba cuta ba ce kuma baya buƙatar magani. [23]

Ka'idojin Kulawa na WPATH a cikin sabon sigar 8 daga Fabrairu 2023, suna bin tsarin amincewa mai cikakken bayani, wanda shine tsarin da yawancin ƙwararrun likitoci ke bi a yau. [24] Hanyoyin amincewa mai cikakken bayani sun haɗa da tattaunawa tsakanin mai ba da lafiya da mutumin da ke neman kulawa kan cikakkun bayanai game da haɗari da sakamako, fahimtar binciken kimiyya na yanzu, da kuma yadda mai bada sabis zai iya taimaka wa mutumin wajen yanke shawara. [25]

Akwai ƙa'idodin kulawa na gida a ƙasashe da yawa, inda yawancin ƙa'idodin gida suka dogara ne akan ƙa'idodin WPATH, tare da wasu ƙananan keɓancewa. [24]

Cancanta ga matakai daban-daban na magani

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Duk da cewa ana ba da shawarar yin kimanta lafiyar kwakwalwa a matsayin aikin da aka saba yi ta hanyar WPATH Standards of Care (SoC), ilimin halayyar ɗan adam ba cikakken buƙata ba ne amma ana ba da shawarar sosai. [23]

Za a fara maganin maye gurbin hormone daga ƙwararren likita. Bukatun gabaɗaya, bisa ga ƙa'idodin WPATH, sun haɗa da:

  1. Dysphoria na jinsi mai ɗorewa, wanda aka rubuta da kyau;
  2. Ikon yanke shawara mai cikakken bayani da kuma amincewa da magani;
  3. Shekarun da suka fi yawa a wata ƙasa (duk da haka, ƙa'idodin kulawa na WPATH suna ba da tattaunawa daban-daban game da yara da matasa);
  4. Idan akwai wata matsala ta lafiya ko ta hankali, dole ne a kula da su sosai.

Sau da yawa, aƙalla wani lokaci na ba da shawara kan ilimin halayyar ɗan adam kafin fara maganin maye gurbin hormones, kamar yadda kuma ake buƙatar lokacin rayuwa a cikin rawar da ake so ta jinsi, idan zai yiwu, don tabbatar da cewa za su iya yin aiki a cikin wannan rawar ta rayuwa. A gefe guda kuma, wasu asibitoci suna ba da maganin hormones bisa ga yarda da aka bayar kawai. [23]

Cancanta ga ƙananan yara

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Duk da cewa ƙa'idodin kulawa na WPATH gabaɗaya suna buƙatar majiyyaci ya kai shekarun girma, sun haɗa da wani sashe daban da aka keɓe ga yara da matasa. Yara masu zuwa ba su da damar shiga cikin aikin likita don maganin tabbatar da jinsi. Bayan balaga, akwai wasu hanyoyin magani ga matasa dangane da takamaiman sharuɗɗa don gano rashin daidaiton jinsi, ikon samun izini mai tushe, da lafiyar kwakwalwa da ta jiki. [23] A cewar wani bincike da JAMA Pediatrics ta buga a watan Janairun 2025, ƙasa da kashi 0.1% na matasa da inshorar lafiya mai zaman kansa ke rufewa a Amurka suna shan magungunan tabbatar da jinsi don magance rashin daidaiton jinsi. [26]

Maganin maye gurbin hormone (maganin hormone mai tabbatar da jinsi)

[gyara sashe | gyara masomin]
Mace mai canjin jinsi kafin da kuma bayan shekaru biyu na maganin maye gurbin hormone

Maganin maye gurbin hormone (HRT) ya fi mayar da hankali ne kan rage matsalar rashin daidaiton jinsi a cikin mutanen da suka canza jinsi. [21] Maganin hormone yana mai da hankali kan halayen jima'i na biyu. Matan da suka canza jinsi yawanci suna amfani da maganin mata, wanda burinsa shine haɓaka halayen mata yayin da yake danne halayen maza. Mazan da suka canza jinsi yawanci suna amfani da maganin maza, wanda ke da akasin haka - don haɓaka halayen maza yayin da yake danne halayen mata. [27]

Mata masu canza jinsi yawanci ana yi musu magani da estrogen da kuma maganin hana androgenic. A cewar UCSF Transgender Care, "Aji na farko na estrogen da ake amfani da shi don maganin mata shine 17-beta estradiol, wanda shine hormone 'bioidentical' saboda yana kama da na kwai na ɗan adam." [27] Magungunan hana androgenic sun haɗa da spironolactone da masu hana 5-alpha reductase, finasteride da dutasteride. Wannan maganin yana haifar da samuwar nono, yana rage girman gashin maza, kuma yana canza rarraba kitse, wanda hakan ke haifar da raguwar girman ƙwai da aikin miji. [28]

Ana yi wa mazan trans maza magani da sinadarin testosterone na waje. Akwai nau'ikan testosterone da dama, kuma a Amurka, duk nau'ikan suna "haidentical" ga testosterone na ciki wanda asalin ƙwayoyin halitta ne. [29] Ana sa ran maganin maza zai dakatar da haila, ya ƙara gashin fuska da jiki, ya haifar da canje-canje a fata da rarraba kitse, da kuma ƙara yawan tsoka da sha'awa. [28] Bayan akalla watanni uku, ana sa ran wasu tasirin, kamar zurfafa murya da canje-canje a cikin gabobin jima'i (kamar su ƙaiƙayi na kyallen farji, da ƙara girman clitoral). [28] Kulawa akai-akai ta likitan zuciya shawara ce mai ƙarfi don tabbatar da amincin mutane yayin da suke canzawa. [30]

An nuna cewa samun damar yin amfani da maganin maye gurbin hormone yana inganta rayuwar mutane a cikin al'ummar mata zuwa maza idan aka kwatanta da mata zuwa maza waɗanda ba su da damar yin amfani da maganin maye gurbin hormone. [31] An kuma gano cewa maganin mata yana inganta walwala. Abin sha'awa, wani bita na tsari ya gano cewa "Gabaɗaya, wallafe-wallafen inganci sun nuna goyon bayan canje-canje masu kyau a cikin walwala tsakanin mutane bayan fara maganin hormone na mata, kodayake sau da yawa tare da cancantar cewa an danganta ci gaban walwala da gamsuwa da canje-canje a cikin bayyanar maimakon tasirin hormones kai tsaye akan yanayin psychosocial." [32]

An nuna cewa maganin hormone ga mutanen da ke canza jinsi a cikin littattafan likitanci yana da aminci, idan ƙwararren likita ya kula da shi. [33] Kula da abubuwan da ke tattare da haɗarin maganin maye gurbin hormone, kamar matakan prolactin a cikin mata masu canza jinsi da matakan polycythemia a cikin maza masu canza jinsi, suna da mahimmanci don kula da lafiyar masu canza jinsi waɗanda ke ɗaukar waɗannan magungunan. [21]

Mutane da yawa da suka canza jinsi ba su da damar samun tsarin kula da lafiya mai inganci, mai tallafi, kuma ba tare da nuna bambanci ba. Saboda haka, zaɓi ɗaya tilo ga GAHT shine magunguna da kansu (testosterone, estrogen, anti-androgens, da sauransu), ba tare da jagorancin ƙwararru ba. [34] Binciken amfani da magunguna da kansu ya gano cewa mutanen da suka yi maganin kansu sun fi fuskantar mummunan tasirin lafiya daga cututtuka da suka riga suka kasance kamar hawan jini da kuma ci gaban halayen jima'i na biyu da ake so a hankali.

Ana iya sanar da mutanen da ke canza jinsi zuwa jinsi masu jinsi ɗaya waɗanda ke neman tiyata cewa za su buƙaci shan hormones har tsawon rayuwarsu idan suna son ci gaba da tasirin estrogen ko tasirin testosterone na maza. Yawan hormones ɗinsu yawanci zai ragu, amma ya kamata ya isa ya samar da tasirin da suke buƙata da kuma kiyaye su lafiya, da kuma kare su daga osteoporosis (rage ƙashi) yayin da suke tsufa. Idan har yanzu suna shan hormones, za su daina shan su gaba ɗaya. [35]

Kula da lafiyar haihuwa

[gyara sashe | gyara masomin]

Akwai ra'ayoyi marasa tushe da yawa a tsakanin marasa lafiya da likitoci game da yadda maganin maye gurbin hormones ke shafar haihuwa. Wani kuskuren fahimta da aka saba gani shi ne cewa fara shi yana haifar da rashin haihuwa ta atomatik. Duk da cewa yana iya shafar ikon yin haihuwa, ba yana nufin yana haifar da kashi 100 cikin 100 na rashin haihuwa ba. [36] Akwai lokuta da yawa na mazan da suka canza jinsi suna fuskantar ciki da zubar da ciki. [37] Ganin cewa mazan da suka canza jinsi da likitoci na iya fuskantar wannan kuskuren fahimta game da maganin maye gurbin hormone da ke shafar haihuwa da kuma yin aiki a matsayin nau'in hana haihuwa, sanar da mutane game da zaɓuɓɓukan haihuwa yana da mahimmanci.

Ga matan da suka canza jinsi, yana yiwuwa su yi cryopreservation kafin su fara maganin maye gurbin hormones. Kamar yadda shaida ta nuna cewa matan da suka canza jinsi suna da ƙarancin maniyyi idan aka kwatanta da takwarorinsu na maza da mata, [38] kiyaye haihuwa na iya zama da mahimmanci ga mutanen da ke tsammanin samun 'ya'ya na halitta a nan gaba. Duk da cewa kiyaye haihuwa yana da mahimmanci a yi la'akari da shi kafin fara HRT, a wasu lokuta yana yiwuwa a sake samun haihuwa bayan dakatar da HRT na ɗan lokaci. [39]

Haka kuma yana da mahimmanci a ilmantar da matasan transgender kan hanyoyin kiyaye haihuwa. Wannan saboda matasa kaɗan ne ke yin hakan, tare da matasan transgender suna ba da rahoton damuwa game da yiwuwar zama marasa haihuwa saboda yanayin lafiya da magani da ya shafi asalin transgender ɗinsu. [40]

Gender-affirming surgery

[gyara sashe | gyara masomin]

Manufar tiyatar tabbatar da jinsi ita ce daidaita halayen jima'i na biyu na mutanen da suka canza jinsi tare da asalin jinsinsu . A matsayin maganin maye gurbin hormones, ana kuma amfani da tiyatar tabbatar da jinsi a matsayin martani ga ganewar cutar dysphoria ta jinsi [21] [41]

Ma'aunin Kulawa na Ƙungiyar Ƙwararru ta Duniya don Lafiyar Jinsi Mai Canji (WPATH) ya ba da shawarar ƙarin buƙatu don tiyatar tabbatar da jinsi idan aka kwatanta da maganin maye gurbin hormones. Yayin da za a iya samun maganin maye gurbin hormones ta hanyar wani abu mai sauƙi kamar fom ɗin yarda mai cikakken bayani, tiyatar tabbatar da jinsi na iya buƙatar wasiƙar tallafi daga mai ilimin hanyoyin kwantar da hankali mai lasisi (wasiƙu biyu don tiyatar al'aura kamar farji ko phalloplasty ), maganin hormones, da kuma (don tiyatar al'aura) kammala tsawon watanni 12 wanda mutumin ke rayuwa cikakken lokaci kamar jinsinsa. Ka'idojin WPATH, kodayake ana amfani da su akai-akai a asibitocin jinsi, ba su da wani tasiri; yawancin marasa lafiya masu canza jinsi da ake yi wa tiyata ba su cika dukkan sharuɗɗan cancanta ba.

Inganci

[gyara sashe | gyara masomin]

Mutanen da ba a yi wa magani ba waɗanda suka yi transgender suna fuskantar yawan baƙin ciki, damuwa, jaraba, da kashe kansu idan aka kwatanta da sauran jama'a. A cikin bita na yau da kullun, maganin hormones da tiyata mai tabbatar da jinsi suna da alaƙa da ingantattun sakamakon lafiyar kwakwalwa. [42] [43] A cikin nazarin da aka yi, yawancin mutanen da suka yi transgender suna fuskantar ingantaccen aikin tunani, zamantakewa, da jima'i, [44] inganta aiki a duniya, [45] da raguwar tunanin kashe kansu sosai. [46] Kasa da kashi 1% na marasa lafiya da suka yi transgender bayan tiyata sun yi nadamar tiyata. [47] Tiyatar da ke tabbatar da jinsi kaɗai ba za ta iya kawar da dysphoria ko kisan kai ba, kuma wasu mutanen da suka yi transgender na iya buƙatar ƙarin kulawar lafiyar kwakwalwa ban da tiyata. [48]

Wasu masu bincike sun bayyana buƙatar ƙarin bincike mai inganci kan sakamakon lafiyar kwakwalwa bayan jiyya masu tabbatar da jinsi. [43] [32] Wasu tsare-tsare na bincike masu ƙarfi a ƙididdiga, kamar gwaje-gwajen da aka sarrafa bazuwar, ba su dace ba wajen nazarin wasu fannoni na kula da lafiyar transgender saboda damuwa ta ɗabi'a (misali, zai zama rashin da'a sosai a gwada ingancin maganin hormone na dogon lokaci ta hanyar kula da wasu marasa lafiya da ke da yiwuwar shan placebo ) da kuma matsalolin hanyoyin (galibi saboda magungunan tabbatarwa suna da tasirin da ke bayyane akan ilimin halittar jiki, don haka suna lalata makanta ). [49] [50] [51]

Shawarwari ga lafiyar masu canza jinsi

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Cibiyar Shari'ar Masu Canza Jinsi

[gyara sashe | gyara masomin]

Cibiyar Shari'ar Transgender ƙungiya ce ta ƙasa da aka kafa a shekarar 2002, wadda ta sadaukar da kanta don kare haƙƙoƙi da walwalar mutanen da ba sa bin ƙa'idodin jinsi da na jinsi, tare da ba da shawara kan doka, manufofi, da kuma ƙarfafa al'umma. Cibiyar Shari'ar Transgender ta faɗaɗa ayyukansu zuwa muhimman fannoni da dama, ciki har da amma ba'a iyakance ga samun damar kiwon lafiya ba, ilimi, aiki da gidaje. [52]

Suna ba da shawara kan samun ingantacciyar hanyar kula da lafiya ga mutanen da suka canza jinsi tare da ƙoƙari da yawa. Tare da fafutukar kare haƙƙin mata da kuma shari'o'i, Cibiyar Shari'ar Mata ta Transgender tana ba da shawara kan dokoki da ƙa'idoji don buƙatar kamfanonin inshora su rufe kulawar da ta tabbatar da jinsi kuma suna shiga cikin matakan shari'a don yaƙi da ƙa'idodi da manufofi waɗanda ke nuna wariya ga mutanen da suka canza jinsi. Cibiyar Shari'ar Mata ta Transgender kuma tana shiga cikin kamfen na wayar da kan jama'a da ayyukan al'umma don tabbatar da mahimmancin lafiyar mata masu canza jinsi tare da shingayen da buƙatun da ba a cika ba waɗanda ake gabatarwa suna nuna abubuwan da suka faru a zahiri, suna fatan canza fahimtar jama'a da samun tallafi don canje-canjen da ake buƙata. Ga ƙwararru, Cibiyar Shari'ar Mata Masu Canji tana ba da ilimi da horo ga masu samar da kiwon lafiya da sauran ƙwararru don yin ƙoƙari don ƙara wayar da kan jama'a da haɓaka kulawa daidai gwargwado ga mutanen da suka canza jinsi. A ƙoƙarin samar da ƙarin albarkatu, suna magance ƙalubalen tsari kuma suna shirya jagorori da rahotanni kan mafi kyawun ayyuka don kula da lafiyar mata masu canza jinsi. A ƙarshe, Cibiyar Shari'ar Mata Masu Canji tana ba da tallafi kai tsaye kuma tana ba da tallafin shari'a ga waɗanda ke fuskantar wariyar kiwon lafiya, waɗanda ke buƙatar albarkatu ko tura su, da ƙari. [53]

Matsalolin da ke shafar masu cutar transgender

[gyara sashe | gyara masomin]

Bayanan da ba su dace ba game da lafiyar mata masu canza jinsi

[gyara sashe | gyara masomin]

Wani taron masu fafutukar kare haƙƙin mata a matsayin wani ɓangare na yunƙurin yaɗa labaran ƙarya game da lafiyar mata masu canza jinsi, ƙoƙarin rinjayar gwamnatoci da jama'a da kuma hana amincewa da mutane masu canza jinsi da jinsi bisa doka da kuma samun damar kula da lafiya mai tabbatar da jinsi. [54] [24]

Ƙwararren Masani na Majalisar Ɗinkin Duniya kan yanayin jima'i da kuma asalin jinsi ya buga Rahoton IESOGI kan Jinsi: Dokar Haɗawa da Ayyukan Keɓewa a shekarar 2021 wanda aka gabatar a Majalisar Kare Hakkin Dan Adam ta 47 da Babban Taron Majalisar Ɗinkin Duniya na 76 wanda ya nuna dokokin da suka karya Dokar Haƙƙin Dan Adam ta Duniya kuma ya yi kira da a yi jerin barazanar da masu adawa da canjin jinsi ke ci gaba da yi wajen yaɗa labaran ƙarya game da haƙƙin mutanen da suka canza jinsi da kuma kula da lafiya da suka shafi hakan. Wannan labarin ƙarya ya haifar da wasu ƙasashe da suka zartar da dokoki da ke karya haƙƙin ɗan adam na asali na mutane kamar hana amincewa da jinsi bisa doka da kuma ƙuntatawa kan samun magungunan da ke tabbatar da jinsi, musamman ga matasan da suka canza jinsi waɗanda ake hana su samun magungunan hormone kamar hana balaga . [54] [24]

Masu fafutukar kare haƙƙin ɗan adam suna amfani da dabaru daban-daban wajen yaɗa labaran ƙarya game da lafiyar masu canza jinsi ta hanyar ƙirƙirar ra'ayoyi na kimiyya na ƙarya da kuma kai hari ga ƙwararru da ƙungiyoyi waɗanda ke ba da kulawar tabbatar da jinsi, suna ƙoƙarin bayyana kulawar tabbatar da jinsi a matsayin "mai haɗari" ko "gwaji" ko kuma iƙirarin cewa yawancin matasan masu canza jinsi za su canza jinsi, wani abu da masana kimiyya suka musanta kuma suka sanya wa suna tatsuniyar dainawa, ko kuma za a iya warkar da su ta amfani da maganin juyawa . [24]

Canja wurin

[gyara sashe | gyara masomin]

Wasu mutanen da suka canza jinsi za a iya tilasta musu su daina canza jinsi ta hanyar likitanci kuma su daina yin maganin da ke tabbatar da jinsi saboda dokokin da ake zartar a ƙasarsu ko jiharsu waɗanda ke hana samun kulawar lafiya mai tabbatar da jinsi. [55] A lokuta da ba kasafai ba, mutane na iya yanke shawarar daina ko kuma mayar da maganin da ke tabbatar da jinsi da son rai. Dalilan na iya haɗawa da illolin jiki, canza ra'ayi game da asalin jinsi, da ƙin yarda/wariya ta zamantakewa. Bincike ya takaita sosai a cikin tsarin hana canjin jinsi. A cewar Mujallar Lafiya ta Duniya ta Masu Canjin Jinsi, shawarar ita ce a tuntuɓi ƙungiyar masu ba da sabis a fannoni daban-daban kan yadda za a ci gaba da tsarin hana canjin jinsi. [3]

HIV a cikin mutanen da suka canza jinsi

[gyara sashe | gyara masomin]

Mutane masu canza jinsi suna kamuwa da cutar HIV a yawan da ba a saba gani ba a duk duniya. A cewar Cibiyar Kula da Cututtuka da Rigakafi ta Amurka (CDC), a Amurka a shekarar 2019, kashi 2% na marasa lafiya da aka gano suna dauke da kwayar cutar HIV sun canza jinsinsu, wanda ya fi kashi 0.3% na al'ummar Amurka wadanda suka bayyana kansu a matsayin masu canza jinsinsu. [56] Yaduwar kwayar cutar HIV ta fi yawa a cikin mata masu canza jinsinsu idan aka kwatanta da maza masu canza jinsinsu. Wani bita da nazari mai tsari da kuma nazari mai zurfi ya gano cewa yawan kwayar cutar HIV a duniya ya kai kashi 19.9% a cikin mata masu canza jinsinsu da kuma kashi 2.56% a cikin maza masu canza jinsinsu. Aikin jima'i na mata masu canza jinsinsu yana kara fuskantar barazanar kamuwa da cutar HIV, kuma yawan masu canza jinsinsu a yankunan Afirka da Latin Amurka yana da karuwar yawan kwayar cutar HIV. [57]

Bisa ga jagororin CDC da USPSTF, UCSF ta ba da shawarar a yi gwajin HIV ga duk mutanen da suka canza jinsi aƙalla sau ɗaya. Ana iya maimaita gwajin a kowane hali, ya danganta da haɗarin kamuwa da cutar HIV. Ya kamata a tantance haɗarin bisa ga halayen jima'i na mutum. Binciken kimanta haɗarin HIV ya kamata ya yi la'akari da takamaiman yanayin jikin mutum da kuma irin ayyukan jima'i da ɗabi'un da mutum ke shiga. [58] Misali, yawan kamuwa da cutar HIV a cikin mata masu canza jinsi yana da yawa, kuma abin da ke haifar da haɗari shine cewa ana yawan lura da cewa mata masu canza jinsi suna shiga cikin jima'i ta dubura tare da abokan hulɗa na maza na halitta. [59] Akwai yiwuwar a haɗa waɗannan mutane da "MSM" a cikin bincike kan abubuwan da ke haifar da haɗarin HIV, saboda wata hanyar da ake ɗauka ta haɗakar raunin halitta ga yaduwar HIV. Wannan matsala ce saboda wasu dalilai. Wannan haɗuwa ta kasa bambance tsakanin yanayin jikin waje da jinsi. Bugu da ƙari, wannan haɗuwa na iya haifar da rikicewar rahotannin bayanai game da yawan masu canza jinsi. [57]

Ga marasa lafiya masu canza jinsi da ake yi wa maganin HIV ta hanyar maganin hana haihuwa (ART), akwai haɗarin hulɗar miyagun ƙwayoyi da magunguna tsakanin ART da magungunan hormonal da majiyyacin zai iya amfani da su, musamman maganin hormone na mata. Akwai ƙarancin bayanai kan hulɗar da ke tsakanin ART da maganin hana haihuwa na mata. Duk da haka, bincike ya gano hulɗar da ke tsakanin ART da magungunan hana haihuwa na mata, waɗanda mutanen da ke canza jinsi da mata za su iya sha idan ba za su iya samun damar yin amfani da maganin mata da aka yi niyya ba. [60] A cewar wani bita da Wansom et al. suka yi, "Muhimman hulɗar magunguna da magunguna suna wanzu tsakanin ethinyl oestradiol da manyan nau'ikan magungunan hana haihuwa guda biyu: magungunan hana haihuwa marasa nucleoside (NNRTIs) da magungunan hana haihuwa masu ƙarfafawa na ritonavir (PIs)." [60] Ana amfani da Ethinyl estradiol a cikin magungunan hana haihuwa ta baki, kuma ba a ba da shawarar yin amfani da shi don maganin mata ba saboda ƙaruwar haɗarin abubuwan da suka shafi thromboembolism . [27]

Tashin hankali

[gyara sashe | gyara masomin]

Yawan tashin hankali da cin zarafi da mutanen da suka canza jinsi ke fuskanta yana haifar da mummunan tasiri ga lafiyar jiki da ta kwakwalwa . [61] Musamman, a cikin wurare masu ƙarancin albarkatu inda manufofin rashin nuna wariya za a iya iyakance su ko ba a aiwatar da su ba, mutanen da suka canza jinsi na iya fuskantar yawan kyama da tashin hankali waɗanda ke da alaƙa da mummunan sakamako na lafiya. [62] [63] Nazarin da aka yi a ƙasashen Arewa ta Duniya ya nuna manyan matakan wariya da cin zarafi a makaranta, wurin aiki, ayyukan kiwon lafiya da iyali idan aka kwatanta da yawan mutanen da suka canza jinsi, yana mai cewa tsoron transgender a matsayin babban abin da ke haifar da haɗarin lafiya ga lafiyar jiki da ta hankali na mutanen da suka canza jinsi.

Cin zarafi galibi yana faruwa ne sakamakon fallasa ga mutanen da suka canza jinsi. [64] Ana matsa wa mutanen da suka canza jinsi su bi ƙa'idodin jinsi wanda ke sa su zama masu rauni ga waɗanda takwarorinsu da iyaye ke cin zarafi. Wani bincike da Grossman da D'Augelli suka gudanar ya nuna cewa matasan da suka canza jinsi suna jin tsoron fuskantar cin zarafi ta jiki da ta jima'i saboda gogewarsu da cin zarafi da wariya. Matasan kuma suna bayyana yadda mutane ke ganinsu kawai saboda jinsi da jima'i maimakon halayensu na kashin kansu. Yawancin matasan ma sun daina ko kuma sun fuskanci koma baya a fannin ilimi saboda cin zarafi akai-akai. Cin zarafi ya fara ne a matsakaici ga masu canza jinsi tun suna ɗan shekara 13, yayin da cin zarafi ta jiki ya fara ne a matsakaicin shekaru 14. [65]

Peitzmeier da abokan aikinsa sun gudanar da wani bincike kan cin zarafin abokin tarayya; sun gano cewa mutanen da suka canza jinsi sun fi takwarorinsu fuskantar cin zarafin abokin tarayya sau uku fiye da takwarorinsu. Cin zarafin abokin tarayya abu ne mai haɗari ga sakamako da yawa na lafiya kamar raguwar lafiyar kwakwalwa, rashin lafiyar jima'i, da sauransu. [66]

Akwai ƙarancin bayanai game da tasirin da masu yanke shawara kan lafiya ke yi wa masu canza jinsi da kuma waɗanda ba sa bin ƙa'idodin jinsi. Duk da haka, duk da ƙarancin bayanai da ake da su, an gano cewa mutanen da ba sa canza jinsi da waɗanda ba sa bin ƙa'idodin jinsi suna cikin haɗarin fuskantar mummunan sakamako na lafiya da kuma ƙuntatawa ga samun kulawar lafiya saboda ƙaruwar haɗarin tashin hankali, warewa, da sauran nau'ikan wariya a ciki da wajen wurin kiwon lafiya. [67]

Duk da muhimmancinsa, samun damar yin rigakafi yana da iyaka da dalilai da dama, ciki har da wariya da gogewa. Wani bincike kan yadda mata masu canza jinsi ke samun damar yin maganin HIV ya gano cewa ɗaya daga cikin manyan abubuwan da suka taimaka wajen rashin samun kulawa shine amfani da suna da karin magana mara kyau. [68] Wani bincike na binciken nuna wariya ga mata masu canza jinsi na kasa ya binciki wadanda suka yi amfani da zabin "jinsi da ba a lissafa a nan ba" a binciken da kuma gogewarsu da samun kulawar lafiya. Sama da kashi daya bisa uku na mutanen da suka zabi wannan zabin sun ce sun guji samun kulawa ta gaba daya saboda son zuciya da fargabar tasirin zamantakewa. [69]

Lafiyar kwakwalwa

[gyara sashe | gyara masomin]

Mutane masu canza jinsi na iya fuskantar damuwa da baƙin ciki sakamakon rashin daidaiton jinsi da jinsinsu na halitta. Wannan damuwa ana kiranta da rashin daidaiton jinsi . [70] Rashin daidaiton jinsi yawanci yana damun mutum kafin ya canza, kuma da zarar mutum ya fara canzawa zuwa jinsin da yake so, ko dai canjin ya kasance na zamantakewa, ko na likitanci, ko duka biyun, damuwar kan ragu akai-akai. [71] [72] [73]

Ana iya cin zarafin mutane masu jinsi daban-daban sakamakon al'adar jinsi. [74] Nazarin da aka yi kan tasirin cin zarafi ya nuna cewa cin zarafi yana da alaƙa da raguwar lafiyar kwakwalwa. Abubuwan da suka faru a baya sun annabta ƙarin alamun damuwa da ƙarancin darajar kai. Wani bincike ya kuma nuna cewa waɗanda suka fito zuwa ga abokan makaranta ko ma'aikata suna da ƙoshin lafiya a hankali duk da cewa ana cin zarafi. Illolin cin zarafi sun haɗa da haɗarin shan muggan kwayoyi, halaye masu haɗari kamar tukin mota cikin maye, da kuma yawan shiga cikin halayen haɗarin jima'i. Cin zarafi kuma yana ƙara rashin zuwa makaranta da rashin maki a tsakanin mutanen LGTBQ. Alamomin jiki na iya bayyana sakamakon haka, ciki har da ciwon ciki, rashin cin abinci mai kyau, matsalolin barci, ƙaruwar hawan jini, da sauransu. Waɗannan abubuwan da suka faru a lokacin ƙuruciya na iya haifar da mummunan sakamako a lokacin girma. Waɗannan sakamakon sun haɗa da baƙin ciki, ƙoƙarin kashe kai, ƙarancin gamsuwar rayuwa, da sauransu. [75] [76] [77] [78] [79] [80] [81] [82] [83]

Waɗanda suka yi transgender sun fi fuskantar yiwuwar kamuwa da cututtukan damuwa ko baƙin ciki fiye da sauran jama'a. [71] [72] [73] [84] Wasu bincike sun nuna cewa ƙaruwar baƙin ciki da damuwa a cikin mutanen da suka yi transgender na iya zama saboda wariya ta tsari ko rashin tallafi. [85] [86] Shaida ta nuna cewa waɗannan ƙaruwar yawan mutanen da suka yi transgender sun fara daidaita lokacin da aka karɓi mutanen da suka yi transgender a matsayin jinsi da aka gano da kuma lokacin da suke zaune a cikin gida mai tallafi. [85] [86] [87]

Nazarce-nazarce da dama sun nuna cewa adadin kashe kai ya yi yawa a cikin al'ummar transgender. [71] [84] Wani bincike da aka yi a Amurka kan mutane 6,450 masu transgender ya gano cewa kashi 41% daga cikinsu sun yi yunkurin kashe kansu, kamar yadda ya bambanta da matsakaicin kasa na 4.6%. Wannan binciken ya gano cewa wadannan adadin sun fi yawa ga wasu al'umma, inda matasa masu transgender tsakanin shekaru 18 zuwa 24 ke da mafi girman kaso. [88] Mutanen da ke cikin binciken wadanda suka kasance kabilu daban-daban, suna da karancin ilimi, kuma wadanda ke da karancin kudin shiga na shekara-shekara duk sun fi yin yunkurin. [88] Musamman, maza masu transgender a matsayin rukuni su ne suka fi yin yunkurin kashe kansu, fiye da mata masu transgender. [88] [89] Binciken da aka yi daga baya ya nuna cewa adadin yunkurin kashe kai ga mutanen da ba su transgender ba yana tsakanin su biyun. [89] Manyan masu transgender wadanda suka "rage canjin jinsi", ma'ana sun koma rayuwa kamar yadda aka sanya musu jinsi a lokacin haihuwa, sun fi yin yunkurin kashe kansu fiye da manya masu transgender wadanda ba su taba "rage canjin jinsi" ba. [90]

Nazarce-nazarce da dama sun nuna alaƙar da ke tsakanin damuwa tsakanin tsiraru da kuma ƙaruwar baƙin ciki da sauran cututtukan kwakwalwa tsakanin maza da mata masu canza jinsi. [91] Tsammanin fuskantar ƙin yarda na iya zama babban abin damuwa ga mutanen da ba sa bin ƙa'idodin jinsi da jinsi. [92] Matsalolin lafiyar kwakwalwa tsakanin mutanen da ke canza jinsi suna da alaƙa da yawan cutar da kansu, amfani da miyagun ƙwayoyi, da kuma ra'ayoyin kashe kai da yunƙurin kashe kansu.

Ga matasan transgender

[gyara sashe | gyara masomin]

Zaɓuɓɓukan sauyawa ga matasa masu canza jinsi da matasa suna da iyaka sosai idan aka kwatanta da na manya masu canza jinsi. Matasa masu canza jinsi kafin su fara girma za su iya fuskantar canje-canje daban-daban na zamantakewa, kamar gabatar da jinsinsu da kuma neman a kira su da suna daban ko sunaye daban-daban. [93] Zaɓuɓɓukan magani don sauyawa za su kasance samuwa da zarar yaron ya fara balaga. A ƙarƙashin kulawar ƙwararrun likitoci, ana iya amfani da masu toshe balaga don iyakance tasirin balaga. [93]

Wariya tana da tasiri sosai ga lafiyar kwakwalwar matasa masu canza jinsi. Rashin karɓar iyali, ƙin amincewa a makarantu da cin zarafi daga takwarorinsu na iya zama babban abin damuwa, wanda ke haifar da mummunan lafiyar kwakwalwa da shan muggan kwayoyi. [94] Wani bincike da aka yi kan matasan masu canza jinsi a San Francisco ya gano cewa yawan nuna wariya ga masu canza jinsi da kuma bambancin launin fata yana da alaƙa da ƙaruwar baƙin ciki, matsalar damuwa bayan tashin hankali, da kuma tunanin kashe kai. [95] Hukumar Ba da Shawara ta Ƙasa ta Switzerland kan Ɗabi'un Halittu (NCE) ta ba da shawarar cewa bincike kan magunguna ga matasa masu bambancin jinsi da bambancin jinsi ya kamata a yi la'akari da tasirin abubuwan zamantakewa, gami da wariya da tallafin zamantakewa, lokacin nazarin sakamakonsu. [96]

A cikin wani bita na 2018, shaidu sun nuna cewa magungunan hormonal ga matasa masu canza jinsi na iya cimma tasirinsu na jiki da aka nufa. Tasirin kwakwalwa na masu gyaran GnRH suna da kyau tare da maganin da ke da alaƙa da ci gaba mai mahimmanci a cikin ma'auni da yawa na tunani, gami da aiki a duniya, baƙin ciki, da matsalolin ɗabi'a da/ko motsin rai gabaɗaya. [97] A cikin wani bincike na shekaru biyu da aka buga a watan Janairun 2023, Chen et al. sun gano cewa hormones masu tabbatar da jinsi ga matasa masu canza jinsi da waɗanda ba su da alaƙa da jinsi "sun inganta daidaiton kamanni da aikin zamantakewa". [98] Wani bincike da ke nazarin matasan masu canza jinsi na Dutch wanda Catharina van der Loos et al. suka kammala ya gano cewa kashi 98% na mahalarta waɗanda suka fara maganin hormone mai tabbatar da jinsi a cikin matasa sun ci gaba da amfani da wannan maganin har zuwa lokacin girma. [99]

A watan Fabrairun 2024, Ƙungiyar Ilimin Halayyar Dan Adam ta Amurka ta amince da wata sanarwa ta manufofi da ke goyon bayan samun damar kula da lafiya ba tare da wani cikas ba da kuma kulawar asibiti bisa shaida ga yara masu canza jinsi, masu bambancin jinsi, da waɗanda ba su da bambancin jinsi, matasa, da manya, da kuma haramcin da gwamnati ta yi da manufofi da nufin takaita samun irin wannan kulawa. [100]

A watan Mayu na 2025, wani bita na tsawon shekaru biyu da jihar Utah ta bayar a matsayin wani ɓangare na hana kula da lafiyar matasa masu canza jinsi ya kammala da cewa "Iyakancewar shaidun sun nuna cewa magungunan suna da tasiri dangane da lafiyar kwakwalwa, sakamakon zamantakewa, da kuma haifar da canje-canje a jiki daidai da jinsi da aka tabbatar a cikin marasa lafiya da ke fama da rashin lafiyar jinsi na yara. Shaidar kuma ta tabbatar da cewa magungunan suna da aminci dangane da canje-canje ga yawan ƙashi, abubuwan da ke haifar da haɗarin zuciya da jijiyoyin jini, canje-canje a cikin metabolism, da ciwon daji". Daga baya majalisar dokokin jihar Utah ta yi watsi da binciken da aka yi, wanda ya ci gaba da hana. [101] [102]

Ga tsofaffi masu canza jinsi

[gyara sashe | gyara masomin]

Tsofaffin 'yan transgender na iya fuskantar ƙalubale a fannin samun damar kulawa da ingancin da ake samu a tsarin kiwon lafiya da gidajen kula da tsofaffi, inda masu ba da sabis ba za su iya shirya sosai don samar da kulawa mai mahimmanci ga al'adu ga mutanen transgender ba. [103] Mutanen transgender suna fuskantar haɗarin tsufa tare da ƙarancin tallafi da kuma a cikin yanayi mai banƙyama fiye da mutanen da ke da bambancin ra'ayi. [104] Duk da mummunan hoto da aka nuna ta wallafe-wallafen likitanci dangane da baƙin ciki da kaɗaici da yawancin mutanen transgender ke fuskanta a farkon rayuwa, wasu bincike sun gano shaidar tsofaffin LGBT da ke da alaƙa da jin daɗin haɗa kai, jin daɗi da tallafin al'umma. [105]

Ga tsofaffi masu canza jinsi waɗanda ke neman maganin hormones masu tabbatar da jinsi, bayanai kan tasirin lafiyar maza da mata a cikin tsofaffi suna da iyaka. Matakan testosterone da estrogen suna raguwa da shekaru, kuma an gano matakan hormones na jima'i da tsufa a matsayin abubuwan da ke haifar da cutar kansa, cututtukan zuciya da jijiyoyin jini, da sauran yanayin cututtuka. Ana buƙatar ƙarin bincike don tantance haɗari da fa'idodin GAHT a cikin tsofaffi. [106]

Manazarta

[gyara sashe | gyara masomin]
  1. ↑ "Gender incongruence and transgender health in the ICD". www.who.int (in Turanci). Archived from the original on April 16, 2023. Retrieved 2024-07-26.
  2. 1 2 3 4 5 6 Caraballo, Alejandra; Delaware, Mary (2023-06-21). "To protect gender-affirming care, we must learn from trans history". Harvard Public Health Magazine (in Turanci). Retrieved 2024-07-26.
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  4. ↑ Simons, Lisa K.; Leibowitz, Scott F.; Hidalgo, Marco A. (2014-06-01). "Understanding Gender Variance in Children and Adolescents". Pediatric Annals (in Turanci). 43 (6): e126–e131. doi:10.3928/00904481-20140522-07. ISSN 0090-4481. PMID 24972420.
  5. 1 2 Byne, William; Karasic, Dan H.; Coleman, Eli; Eyler, A. Evan; Kidd, Jeremy D.; Meyer-Bahlburg, Heino F.L.; Pleak, Richard R.; Pula, Jack (May 2018). "Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists". Transgender Health. 3 (1): 57–A3. doi:10.1089/trgh.2017.0053. ISSN 2380-193X. PMC 5944396. PMID 29756044.
  6. ↑ Reed, Geoffrey M.; Drescher, Jack; Krueger, Richard B.; Atalla, Elham; Cochran, Susan D.; First, Michael B.; Cohen-Kettenis, Peggy T.; Arango-de Montis, Iván; Parish, Sharon J. (October 2016). "Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations". World Psychiatry. 15 (3): 205–221. doi:10.1002/wps.20354. PMC 5032510. PMID 27717275.
  7. ↑ Reed, Geoffrey M.; Drescher, Jack; Krueger, Richard B.; Atalla, Elham; Cochran, Susan D.; First, Michael B.; Cohen-Kettenis, Peggy T.; Arango-de Montis, Iván; Parish, Sharon J. (October 2016). "Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations". World Psychiatry. 15 (3): 205–221. doi:10.1002/wps.20354. PMC 5032510. PMID 27717275.
  8. ↑ Cohen-Kettenis, Peggy T.; Pfäfflin, Friedemann (2009-10-17). "The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults". Archives of Sexual Behavior. 39 (2): 499–513. doi:10.1007/s10508-009-9562-y. ISSN 0004-0002. PMID 19838784. S2CID 16336939. |hdl-access= requires |hdl= (help)
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  11. ↑ Castro-Peraza, Maria Elisa; García-Acosta, Jesús Manuel; Delgado, Naira; Perdomo-Hernández, Ana María; Sosa-Alvarez, Maria Inmaculada; Llabrés-Solé, Rosa; Lorenzo-Rocha, Nieves Doria (2019-03-18). "Gender Identity: The Human Right of Depathologization". International Journal of Environmental Research and Public Health. 16 (6): 978. doi:10.3390/ijerph16060978. ISSN 1660-4601. PMC 6466167. PMID 30889934.
  12. ↑ Latham, J.R. (2017). "Making and Treating Trans Problems The Ontological Politics of Clinical Practices". Studies in Gender and Sexuality. 18 (1): 40–61. doi:10.1080/15240657.2016.1238682. S2CID 152123850.
  13. ↑ Vargas-Huicochea, Ingrid; Robles, Rebeca; Real, Tania; Fresán, Ana; Cruz-Islas, Jeremy; Vega-Ramírez, Hamid; Medina-Mora, María Elena (November 2018). "A Qualitative Study of the Acceptability of the Proposed ICD-11 Gender Incongruence of Childhood Diagnosis Among Transgender Adults Who Were Labeled Due to Their Gender Identity Since Childhood". Archives of Sexual Behavior. 47 (8): 2363–2374. doi:10.1007/s10508-018-1241-4. ISSN 0004-0002. PMID 29971651. S2CID 49681691.
  14. ↑ Collin, Lindsay; Reisner, Sari L.; Tangpricha, Vin; Goodman, Michael (2016). "Prevalence of Transgender Depends on the "Case" Definition: A Systematic Review". The Journal of Sexual Medicine (in Turanci). 13 (4): 613–626. doi:10.1016/j.jsxm.2016.02.001. PMC 4823815. PMID 27045261.
  15. ↑ Virupaksha, H. G.; Muralidhar, Daliboyina; Ramakrishna, Jayashree (2016-11-01). "Suicide and Suicidal Behavior among Transgender Persons". Indian Journal of Psychological Medicine (in Turanci). 38 (6): 505–509. doi:10.4103/0253-7176.194908. ISSN 0253-7176. PMC 5178031. PMID 28031583.
  16. ↑ Wanta, Jonathon W.; Niforatos, Joshua D.; Durbak, Emily; Viguera, Adele; Altinay, Murat (November 2019). "Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study". Transgender Health. 4 (1): 313–315. doi:10.1089/trgh.2019.0029. ISSN 2688-4887. PMC 6830528. PMID 31701012.
  17. ↑ Swan, Jaime; Phillips, Tania M.; Sanders, Tait; Mullens, Amy B.; Debattista, Joseph; Brömdal, Annette (2023-01-02). "Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review". Journal of Gay & Lesbian Mental Health. 27 (1): 2–45. doi:10.1080/19359705.2021.2016537. ISSN 1935-9705.
  18. ↑ Bharat, Bharat; Dopp, Alex; Last, Briana; Howell, Gary; Nadeem, Erum; Johnson, Clara; Stirman, Shannon Wiltsey (October 2023). "Deimplementation Strategies to End Sexual Orientation and Gender Identity and Expression Change Efforts: Undoing a Harmful Legacy of Behavior Therapy". The Behavior Therapist. 46 (7): 261–270. ISSN 0278-8403. PMC 11661860 Check |pmc= value (help). PMID 39713211 Check |pmid= value (help).
  19. ↑ Alempijevic, Djordje; Beriashvili, Rusudan; Beynon, Jonathan; Alempijevic Petersen, Djordje; Birmanns, Bettina; Brasholt, Marie; Cohen, Juliet; Alempijevic Petersen, Djordje; Duque, Maximo; Duterte, Pierre; Van Es, Adriaan; Fernando, Ravindra; Korur Fincanci, Sebnem; Holger Hansen, Steen; Hamzeh, Sana (2020). "Statement of the Independent Forensic Expert Group on Conversion Therapy". Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture. 30 (1): 66–78. doi:10.7146/torture.v30i1.119654. ISSN 1997-3322. PMID 32657772.
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  30. ↑ Moore, Eva; Wisniewski, Amy; Dobs, Adrian (2003-08-01). "Endocrine Treatment of Transsexual People: A Review of Treatment Regimens, Outcomes, and Adverse Effects". The Journal of Clinical Endocrinology & Metabolism. 88 (8): 3467–3473. doi:10.1210/jc.2002-021967. ISSN 0021-972X. PMID 12915619.
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  82. ↑ Gini, Gianluca; Pozzoli, Tiziana (2009-03-01). "Association Between Bullying and Psychosomatic Problems: A Meta-analysis". Pediatrics. 123 (3): 1059–1065. doi:10.1542/peds.2008-1215. ISSN 0031-4005. PMID 19255040. S2CID 32470703.
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  95. ↑ Wilson, Erin C.; Chen, Yea-Hung; Arayasirikul, Sean; Raymond, H. Fisher; McFarland, Willi (2016-04-26). "The Impact of Discrimination on the Mental Health of Trans*Female Youth and the Protective Effect of Parental Support". AIDS and Behavior. 20 (10): 2203–2211. doi:10.1007/s10461-016-1409-7. ISSN 1090-7165. PMC 5025345. PMID 27115401.
  96. ↑ "New CNE opinion paper on the medical treatment for minors with gender dysphoria". National Advisory Commission on Biomedical Ethics (NCE). 16 December 2024. pp. 18–9, 25. Retrieved 2025-03-04. differences in social support and discrimination experiences should be systematically included in the analysis" (p. 18) "The prospects of success of medical treatment for a minor with gender dysphoria demonstrably depend not only on the treatment protocol itself, but also on the social support received by the person treated. Because of this close interaction, it is therefore recommended that, in the context of gender dysphoria, differences in social support and discrimination experiences should be systematically included in the analysis when the effectiveness of particular treatment methods is studied.
  97. ↑ Chew, Denise; Anderson, Jemma; Williams, Katrina; May, Tamara; Pang, Kenneth (2018-04-01). "Hormonal Treatment in Young People With Gender Dysphoria: A Systematic Review". Pediatrics. 141 (4): e20173742. doi:10.1542/peds.2017-3742. PMID 29514975.
  98. ↑ Chen, Diane; Berona, Johnny; Chan, Yee-Ming; Ehrensaft, Diane; Garofalo, Robert; Hidalgo, Marco; Rosenthal, Stephen; Tishelman, Amy; Olson-Kennedy, Johanna (19 January 2023). "Psychosocial Functioning in Transgender Youth after 2 Years of Hormones". The New England Journal of Medicine. 388 (3): 240–250. doi:10.1056/NEJMoa2206297. PMC 10081536 Check |pmc= value (help). PMID 36652355 Check |pmid= value (help). S2CID 255969323 Check |s2cid= value (help).
  99. ↑ Catharina van der Loos, Maria Anna Theodora (October 20, 2022). "Continuation of gender-affirming hormones in transgender people starting puberty suppression in adolescence: a cohort study in the Netherlands". The Lancet. 6 (12): 869–875. doi:10.1016/S2352-4642(22)00254-1. PMID 36273487 Check |pmid= value (help). Archived from the original on June 3, 2023. Retrieved May 1, 2023.
  100. ↑ "APA Policy Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation, and the Role of Psychological Practice and Science". American Psychological Association. February 2024. Archived from the original on March 11, 2024. Retrieved 2024-02-29.
  101. ↑ Pauly, Madison. "Utah study on trans youth care extremely inconvenient for politicians who ordered it". Mother Jones (in Turanci). Retrieved 2025-05-28.
  102. ↑ "Utah lawmakers' own study found gender-affirming care benefits trans youth. Will they lift the treatment ban?". The Salt Lake Tribune (in Turanci). Retrieved 2025-05-28.
  103. ↑ "Aging". National Center for Transgender Equality. Archived from the original on January 10, 2024. Retrieved 2019-03-24.
  104. ↑ de Vries, Brian; Gutman, Gloria; Humble, Áine; Gahagan, Jacqueline; Chamberland, Line; Aubert, Patrick; Fast, Janet; Mock, Steven (2019-03-14). "End-of-Life Preparations Among LGBT Older Canadian Adults: The Missing Conversations" (PDF). The International Journal of Aging and Human Development. 88 (4): 358–379. doi:10.1177/0091415019836738. ISSN 0091-4150. PMID 30871331. S2CID 78094482. Archived (PDF) from the original on July 8, 2023. Retrieved October 24, 2019.
  105. ↑ Reygan, Finn; Henderson, Neil (2019-03-21). "All Bad? Experiences of Aging Among LGBT Elders in South Africa". The International Journal of Aging and Human Development. 88 (4): 405–421. doi:10.1177/0091415019836929. ISSN 0091-4150. PMID 30897921. S2CID 85446146. |hdl-access= requires |hdl= (help)
  106. ↑ Iwamoto, Sean J.; Defreyne, Justine; Kaoutzanis, Christodoulos; Davies, Robert D.; Moreau, Kerrie L.; Rothman, Micol S. (2023-04-19). "Gender-affirming hormone therapy, mental health, and surgical considerations for aging transgender and gender diverse adults". Therapeutic Advances in Endocrinology and Metabolism. 14. doi:10.1177/20420188231166494. ISSN 2042-0188. PMC 10126651 Check |pmc= value (help). PMID 37113210 Check |pmid= value (help).
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