變性

性轉換症; Transsexualism
同義詞	易性症
分類和外部資源
ICD-10	F64.0
ICD-9-CM	302.50
	[編輯此條目的維基數據]

變性（英語：Transsexual）是跨性別的子分類，^[2]^[3]^[4]但是一些變性人拒絕跨性別的標籤^[5]^[6]^[7]^[8]。變性者經歷性別認同與其出生時的指定性別不一致，並希望生理性別和社會性別永久轉變為符合他們的性別認同，通常尋求醫療援助進行性別重置療法，例如性別肯定激素治療（GAHT）和性別重置手術，以幫助他們使自己的生理性別與其性別認同接近或相同。如果一個人表達了渴望在生活中被接納為另一個生理性別的一員，^[9]並且由於其性別認同而遭受功能障礙或困擾，他們就可以在醫學上診斷為性別不安。^[10]^{[頁碼請求]}

在過去，完成了性別重置手術，從一性別過渡到另一種性別以符合自身性別認同，早期以「變性人」稱之。而在醫學上，無論變性與否，想改變自己生理性別的人，都稱之為性別不一致者（這類人在變更性別的行為被去疾病化之前，會被診斷為「易性症」）。

醫學診斷[編輯]

在國際疾病與相關健康問題統計分類（ICD）中，易性症不再被列為精神障礙。在ICD-10中，將易性症、雙重角色異裝癖、兒童性別認同障礙納入其性別認同障礙的範疇。它將易性症定義為「渴望在生活中被接納為異性的一員，通常伴隨著對自己解剖學性別的不適或不恰當的感覺，以及希望進行手術和激素治療，使自己的身體儘可能與自己喜歡的性別一致。」

性別重置過程[編輯]

性別重置的過程，通常包括了實際生活體驗、荷爾蒙更換治療，以及旨在改造身體第一性徵的性別重置手術。在制度嚴謹的國家和地區，欲進行荷爾蒙或手術治療的換性者往往需要持久並反覆地向醫師表達強烈的治療慾望，他（她）們才會獲得合適的診斷。為了使身體與心理認同性別保持一致，很多換性的女性(MtF)亦會選擇進行除毛、隆胸和磨平喉結等整容手術，而很多換性的男性(FtM)亦會選擇儘早進行縮胸手術。

在英語中有時會用transsexual，以用來減少它和精神病以及醫學上的關聯性。

另外也有部分的"非手術的訴求" 跨性別者，在英語中會用 Non-Op TS (Non-Operative Transexual)稱呼之。這類人會改採用其他軟性美容建設等其他途徑與方式來達成心理與生理之平衡。

歧視[編輯]

「人妖」是中文中常用的一種蔑稱，原意指女扮男、男扮女、行為怪異、不守常法的人。《南史·卷四十五·崔慧景傳》：「東陽女子偵闛變服詐為丈夫，粗知圍棋，解文義，遍游公卿，仕至揚州議曹從事。……此人妖也。」。

各地[編輯]

泰國[編輯]

泰國換性女性（泰文：กะเทย，羅馬拼音：Kathoey或Katoey，IPA：[kaʔtʰɤːj]）是泰國男性換女性換性人，又名ladyboy。許多華人常將其稱之為「泰國人妖」。

在古代，กะเทย是指雌雄同體，與現代所指的異裝者、變性者或男同性戀者不同。^[1]現代幾乎所有的กะเทย都有接荷爾蒙補充療法，大部分有作過隆胸手術，有些已接受變性手術以及其他整形手術。通常กะเทย很年輕就開始異裝、注射荷爾蒙、整形等等。กะเทย的異裝形象與身材通常非常女性化。กะเทย通常在娛樂業與旅遊業作舞者，歌舞秀，以及性工作。也常有聽說kathoey在觀光區行竊。從事娛樂業與旅遊業之外的並不多，有些則是知名美容理髮師。在泰國，多數家庭如果有個成為กะเทย的兒子會很失望。法律則完全不承認變性女人。即使在變性手術之後，換性的女人也不能變更其法定性別^[2]。กะเทย很久以前通常來自社會低層，很久很久以前一部分幼年時期因生活所迫被販賣後被改造成กะเทย，自殺率顯著高出一般人，平均壽命一般不超過五十歲。^{[來源請求]}

換性者研究員、活動家普蘭普里達·巴莫·娜·阿育塔雅（Prempreeda Pramoj Na Ayutthaya）指出，泰國存在對換性人教育與就業機會方面的性別歧視。^[11]。2013年的多篇報導也指出，泰國尚未發現換性人從事高層官員、醫生、律師、科學家以及公辦學校教師等職位，在商業機構也不存在任職管理人員的換性人。簡言之，對換性的女性來說，政府機構和大型企業的大門依舊緊閉。而這也是他們成為自僱人士或自由職業者的原因^[12]。無論是否為政府職員，泰國法律都不給予進行手術後的男性換女性的人在工作場合中穿著女性制服的權利^[13]。

1996年，一個大半由男同性戀與กะเทย組成的排球隊（外號「鐵娘子」）贏得全國排球大賽冠軍。但是泰國政府以國家形象為由禁止其中兩個kathoey參加國手隊作國際比賽。กะเทย排球隊的事件在2000年改編成賣座電影《人妖打排球》，並於2003年推出續集。

根據東森新聞2004年6月與7月的報導，已常常見到娛樂業與旅遊業之外的換性女人，一所技術學校也設立了換性女人專用廁所，同志和換性女人並且於此時成立「泰國同性戀政治群」，目的是向政府在同志權利議題施壓。帕莉亞是一位參加泰拳比賽的知名換性別的女性。

伊朗[編輯]

伊朗是第一個認可換性別權利的伊斯蘭國家。在1979年伊朗革命前，政府從未正式關注變性議題。從1980年代中期開始，伊朗伊斯蘭共和國政府正式認可跨性別人士並且准許進行換性手術，惟與同性戀者一樣，跨性別人士受到極大的歧視。

參見[編輯]

注釋[編輯]

^ 中華醫學會精神病學分會. 中国精神障碍分类与诊断标准第三版(精神障碍分类) 34 (3). 中華精神科雜誌. 2011. doi:10.3760/j:issn:1006-7884.2001.03.028 （中文（簡體））.
^ Transgender Rights (2006, ISBN 0816643121), edited by Paisley Currah, Richard M. Juang, Shannon Minter
^ Thomas E. Bevan, The Psychobiology of Transsexualism and Transgenderism (2014, ISBN 1440831270), page 42: "The term transsexual was introduced by Cauldwell (1949) and popularized by Harry Benjamin (1966) [...]. The term transgender was coined by John Oliven (1965) and popularized by various transgender people who pioneered the concept and practice of transgenderism. It is sometimes said that Virginia Prince (1976) popularized the term, but history shows that many transgender people advocated the use of this term much more than Prince. The adjective transgendered should not be used [...]. Transsexuals constitute a subset of transgender people."
^ A. C. Alegria, Transgender identity and health care: Implications for psychosocial and physical evaluation, in the Journal of the American Academy of Nurse Practitioners, volume 23, issue 4 (2011), pages 175–182: "Transgender, Umbrella term for persons who do not conform to gender norms in their identity and/or behavior (Meyerowitz, 2002). Transsexual, Subset of transgenderism; persons who feel discordance between natal sex and identity (Meyerowitz, 2002)."
^ Valentine, David. Imagining Transgender: An Ethnography of a Category, Duke University, 2007
^ Stryker, Susan. Introduction. In Stryker and S. Whittle (Eds.), The Transgender Studies Reader, New York: Routledge, 2006. 1–17
^ Kelley Winters, "Gender Madness in American Psychiatry, essays from the struggle for dignity, 2008, p. 198. "Some Transsexual individuals also identify with the broader transgender community; others do not."
^ Transsexualism. Gender Centre. March 2014 [2016-07-05]. （原始內容存檔於2016-03-04）. Transsexualism is often included within the broader term 'transgender', which is generally considered an umbrella term for people who do not conform to typically accepted gender roles for the sex they were assigned at birth. The term 'transgender' is a word employed by activists to encompass as many groups of gender diverse people as possible. However, many of these groups individually don't identify with the term. Many health clinics and services set up to serve gender variant communities employ the term, however most of the people using these services again don't identify with this term. The rejection of this political category by those that it is designed to cover clearly illustrates the difference between self-identification and categories that are imposed by observers to understand other people.
^ ICD-10. [2008-09-28]. （原始內容存檔於2008-09-21）.
^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Text Revision). American Psychiatric Publishing. 2000. ISBN 978-0-89042-025-6.
^ http://www.bangkokpost.com/news/local/303850/sex-drugs-stigma-put-thai-transsexuals-at-hiv-risk
^ Katoey face closed doors
^ http://www.bangkokpost.com/news/local/301113/transgender-official-right-to-wear-dress
^ "A Trans Timeline - Trans Media Watch". Trans Media Watch. Archived from the original on 26 December 2018. Retrieved 3 February 2016.
^ Worthen, Meredith. Lili Elbe Biography. The Biography.com website. A&E Television Networks. 2019-04-12 [2015-09-08] [2022-08-02]. （原始內容存檔於2019-04-08）.

外部連結[編輯]

^ Peter Jackson, Performative Genders, Perverse Desires: A Bio-History of Thailand's Same-Sex and Transgender Cultures（頁面存檔備份，存於網際網路檔案館）.（"The Homosexualisation of Cross-Dressing"那段）
^ Andrew Matzner: In Legal Limbo: Thailand, Transgendered Men, and the Law, 1999.描述1999年時kathoey的一般社會與法律狀況。（英文）
貝月清：泰國人妖探秘／變男變女變變變！　人妖處處在身邊以及其他相關報導，《東森新聞》，2004年6月與7月（頁面存檔備份，存於網際網路檔案館）

[1] 中華醫學會精神病學分會. 中国精神障碍分类与诊断标准第三版(精神障碍分类) 34 (3). 中華精神科雜誌. 2011. doi:10.3760/j:issn:1006-7884.2001.03.028 （中文（簡體））.

[TR2006-2] Transgender Rights (2006, ISBN 0816643121), edited by Paisley Currah, Richard M. Juang, Shannon Minter

[Bevan-3] Thomas E. Bevan, The Psychobiology of Transsexualism and Transgenderism (2014, ISBN 1440831270), page 42: "The term transsexual was introduced by Cauldwell (1949) and popularized by Harry Benjamin (1966) [...]. The term transgender was coined by John Oliven (1965) and popularized by various transgender people who pioneered the concept and practice of transgenderism. It is sometimes said that Virginia Prince (1976) popularized the term, but history shows that many transgender people advocated the use of this term much more than Prince. The adjective transgendered should not be used [...]. Transsexuals constitute a subset of transgender people."

[Alegria-4] A. C. Alegria, Transgender identity and health care: Implications for psychosocial and physical evaluation, in the Journal of the American Academy of Nurse Practitioners, volume 23, issue 4 (2011), pages 175–182: "Transgender, Umbrella term for persons who do not conform to gender norms in their identity and/or behavior (Meyerowitz, 2002). Transsexual, Subset of transgenderism; persons who feel discordance between natal sex and identity (Meyerowitz, 2002)."

[Valentine-5] Valentine, David. Imagining Transgender: An Ethnography of a Category, Duke University, 2007

[Stryker-6] Stryker, Susan. Introduction. In Stryker and S. Whittle (Eds.), The Transgender Studies Reader, New York: Routledge, 2006. 1–17

[7] Kelley Winters, "Gender Madness in American Psychiatry, essays from the struggle for dignity, 2008, p. 198. "Some Transsexual individuals also identify with the broader transgender community; others do not."

[8] Transsexualism. Gender Centre. March 2014 [2016-07-05]. （原始內容存檔於2016-03-04）. Transsexualism is often included within the broader term 'transgender', which is generally considered an umbrella term for people who do not conform to typically accepted gender roles for the sex they were assigned at birth. The term 'transgender' is a word employed by activists to encompass as many groups of gender diverse people as possible. However, many of these groups individually don't identify with the term. Many health clinics and services set up to serve gender variant communities employ the term, however most of the people using these services again don't identify with this term. The rejection of this political category by those that it is designed to cover clearly illustrates the difference between self-identification and categories that are imposed by observers to understand other people.

[icd-10-9] ICD-10. [2008-09-28]. （原始內容存檔於2008-09-21）.

[DSM-IV-TR-10] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Text Revision). American Psychiatric Publishing. 2000. ISBN 978-0-89042-025-6.

[11] ttp://www.bangkokpost.com/news/local/303850/sex-drugs-stigma-put-thai-transsexuals-at-hiv-risk

[12] Katoey face closed doors

[13] ttp://www.bangkokpost.com/news/local/301113/transgender-official-right-to-wear-dress

[14] "A Trans Timeline - Trans Media Watch". Trans Media Watch. Archived from the original on 26 December 2018. Retrieved 3 February 2016.

[15] Worthen, Meredith. Lili Elbe Biography. The Biography.com website. A&E Television Networks. 2019-04-12 [2015-09-08] [2022-08-02]. （原始內容存檔於2019-04-08）.

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