Yes and yes again: are standards of care which require two referrals for genital reconstructive surgery ethical?

被引：25

作者：

Bouman, W. P. ^{[1
]}

Richards, C. ^{[1
,2
]}

Addinall, R. M. ^{[3
]}

Arango de Montis, I. ^{[4
]}

Arcelus, J. ^{[1
]}

Duisin, D. ^{[5
]}

Esteva, I. ^{[6
]}

Fisher, A. ^{[7
]}

Harte, F. ^{[8
]}

Khoury, B. ^{[9
]}

Lu, Z. ^{[10
]}

Marais, A. ^{[3
]}

Mattila, A. ^{[11
]}

Reddy, D. Nayarana ^{[12
]}

Nieder, T. O. ^{[13
]}

Robles Garcia, R. ^{[4
]}

Rodrigues, O. M., Jr. ^{[14
]}

Roque Guerra, A. ^{[15
]}

Tereshkevich, D. ^{[16
]}

T'Sjoen, G. ^{[17
]}

Wilson, D. ^{[3
]}

机构：

[1] Nottingham Gender Clin, Nottingham, England

[2] West London Mental Hlth Trust Gender Ident Clin, London, England

[3] Univ Cape Town, Groote Schuur Hosp, Dept Psychiat & Mental Hlth, ZA-7925 Cape Town, South Africa

[4] Inst Nacl Psiquiatria Ramon de la Fuente Muniz, Mexico City, DF, Mexico

[5] Clin Psychiat Clin Ctr Serbia, Cabinet Transgender States, Belgrade, Serbia

[6] Reg Univ Hosp, Andalusian Gender Team, Malaga, Spain

[7] Univ Florence, Sexual Med & Androl Unit, Interdept Ctr Gender Dysphoria Assistance, Florence, Italy

[8] Gender Dysphoria Clin, Melbourne, Vic, Australia

[9] Amer Univ Beirut Med Ctr, Beirut, Lebanon

[10] Shanghai Jiao Tong Univ Med Sch, Shanghai Mental Hlth Ctr, Shanghai, Peoples R China

[11] Tampere Univ Hosp, Gen Hosp Psychiat Unit, Tampere, Finland

[12] Tamil Nadu Dr MGR Med Univ, Madras, Tamil Nadu, India

[13] Univ Med Ctr Hamburg Eppendorf UKE, Inst & Outpatient Clin Sex Res & Forens Psychiat, Hamburg, Germany

[14] Clin Psicol Sexualidade, Inst Paulista Sexualidade, Sao Paulo, Brazil

[15] SOCUMES, Havana, Cuba

[16] Human Hlth Inst, Astana, Kazakhstan

[17] Univ Hosp Ghent, Ctr Sexol & Gender Problems, Ghent, Belgium

来源：

SEXUAL AND RELATIONSHIP THERAPY | 2014年 / 29卷 / 04期

关键词：

medical ethics; transgender; trans-sexualism; Standards of Care; genital reconstructive surgery; gender dysphoria; MALE-TO-FEMALE; SEX REASSIGNMENT; GENDER DYSPHORIA; PSYCHIATRIC COMORBIDITY; HEALTH; PATIENT; SATISFACTION; 2ND-OPINION; PREDICTORS; MANAGEMENT;

D O I：

10.1080/14681994.2014.954993

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

The commonly used Standards of Care for people with gender dysphoria, including those of the World Professional Association for Transgender Health and The Royal College of Psychiatrists in the United Kingdom, as well as those standards used in many other countries, usually require that two signatures of approval from qualified mental health professionals be provided before genital reconstructive surgery (GRS) - sometimes called sexual reassignment surgery or gender confirmation surgery - is undertaken. This is different from surgeries which are similarly irreversible and remove reproductive capacity carried out on cisgender people. This paper explores the trans-specific issues from a standpoint of medical ethics and argues that, provided sufficient safeguards are in place, including assessment within a multidisciplinary team, a nuanced approach utilising a single signature may instead be appropriate.

引用

页码：377 / 389

页数：13

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