I-Intersex
I-Intersex iyiqoqo lezimo lapho kunokungafani phakathi kwezitho zangasese zangaphandle nezitho zangasese zangaphakathi (amasende kanye namaqanda).
Igama elidala lalesi simo yi-hermaphroditism. Yize amagama amadala asafakiwe kule ndatshana ukuze kubhekiswe kuwo, esikhundleni sawo kwathathwa ochwepheshe abaningi, iziguli nemindeni. Ngokwandayo, leli qembu lezimo libizwa ngokuthi ukuphazamiseka kokuthuthuka kwezocansi (ama-DSD).
I-Intersex ingahlukaniswa ngezigaba ezi-4:
- I-46, i-XX intersex
- I-46, i-XY intersex
- I-intersex yangempela ye-gonadal
- I-intersex eyinkimbinkimbi noma enganqunyelwe
Ngasinye sixoxwa ngokuningiliziwe ngezansi.
Qaphela: Ezinganeni eziningi, imbangela ye-intersex ingahlala inganqunywa, noma ngabe kunezindlela zesimanje zokuxilonga.
46, XX I-INTERSEX
Umuntu unama-chromosomes wowesifazane, amaqanda esifazane, kepha izitho zangasese zangaphandle (zangaphandle) ezibonakala zingowesilisa. Lokhu kuvame kakhulu ukuthi kube yimiphumela yokuthi umbungu wesifazane avezwe kuma-hormone abesilisa abeqile ngaphambi kokuzalwa. I-labia ("izindebe" noma amafolda esikhumba esitho sangasese sowesifazane sangaphandle) iyahlangana, futhi i-clitoris ikhulisa ukuze ivele njengepipi. Ezimweni eziningi, lo muntu unesibeletho esijwayelekile kanye namashubhu e-fallopian. Lesi simo sibizwa nangokuthi i-46, XX nge-virilization. Kwakuvame ukubizwa ngokuthi i-pseudohermaphroditism yabesifazane. Kunezimbangela eziningi ezingaba khona:
- I-congenital adrenal hyperplasia (imbangela ejwayelekile kakhulu).
- Ama-hormone abesilisa (njenge-testosterone) athathwe noma ahlangatshezwa ngumama ngesikhathi sokukhulelwa.
- Izicubu ezikhiqiza ama-hormone kumama: Lezi zivame ukuba izicubu zama-ovari. Omama abanezingane ezine-46, XX intersex kufanele bahlolwe ngaphandle uma kunesinye isizathu esicacile.
- Ukushoda kwe-Aromatase: Lokhu kungenzeka kungabonakali kuze kube seminyakeni yokuthomba. I-Aromatase iyi-enzyme evamise ukuguqula ama-hormone wesilisa aye kuma-hormone abesifazane. Umsebenzi omningi we-aromatase ungaholela ku-estrogen eyeqile (i-hormone yabesifazane); kuncane kakhulu ukuya ku-46, XX intersex. Ngesikhathi sokuthomba, lezi zingane ezingama-XX, ezazikhuliswe zingamantombazane, zingaqala ukuthatha izici zesilisa.
46, XY I-INTERSEX
Umuntu unama-chromosomes womuntu wesilisa, kepha izitho zangasese zangaphandle azakhiwe ngokuphelele, ziyindida, noma ngokusobala zingowesifazane. Ngaphakathi, ukuhlolwa kungahle kube okujwayelekile, okungalungile, noma okungekho. Lesi simo sibizwa nangokuthi i-46, XY nge-undervirilization. Kwakuvame ukubizwa ngokuthi i-pseudohermaphroditism yesilisa. Ukwakheka kwezitho zobulili zangaphandle zesilisa ezijwayelekile kuncike ebhalansi efanelekile phakathi kwamahomoni owesilisa nowesifazane. Ngakho-ke, kudinga ukukhiqizwa okwanele nokusebenza kwamahomoni wesilisa. 46, i-XY intersex inezimbangela eziningi ezingaba khona:
- Izinkinga ngama-testes: Amasende ngokuvamile akhiqiza ama-hormone wesilisa. Uma ama-testes engakheki kahle, kuzoholela ekusetshenzisweni kabi kwamandla. Kunezimbangela eziningi ezingaba khona zalokhu, kufaka phakathi i-XY pure gonadal dysgenesis.
- Izinkinga ngokwakhiwa kwe-testosterone: I-Testosterone yakhiwa ngochungechunge lwezinyathelo. Isinyathelo ngasinye kulezi sidinga i-enzyme ehlukile. Ukushoda kunoma iyiphi yalezi enzyme kungaholela ekungeneni kwe-testosterone futhi kuveze i-syndrome ehlukile ye-46, XY intersex. Izinhlobo ezahlukahlukene ze-hyperplasia yokuzalwa kwe-adrenal zingawela kulesi sigaba.
- Izinkinga zokusebenzisa i-testosterone: Abanye abantu banezivivinyo ezijwayelekile futhi benza amanani anele e-testosterone, kepha basenayo i-46, XY intersex ngenxa yezimo ezinjenge-5-alpha-reductase defence noma i-androgen insensitivity syndrome (AIS).
- Abantu abanenkinga ye-5-alpha-reductase abanayo i-enzyme edingekayo ukuguqula i-testosterone ibe yi-dihydrotestosterone (DHT). Kukhona okungenani izinhlobo ezi-5 ezahlukahlukene zokushoda kwe-5-alpha-reductase. Ezinye izingane zinezitho zangasese zesilisa ezijwayelekile, ezinye zinezitho zobulili ezijwayelekile zabesifazane, futhi eziningi zinokuthile phakathi. Iningi liguqukela ezithweni zobulili zabesilisa bangaphandle ngesikhathi sokuthomba.
- I-AIS iyimbangela ejwayelekile ye-46, XY intersex. Iphinde yabizwa ngokuthi yi-testicular feminization. Lapha, ama-hormone wonke ajwayelekile, kepha ama-receptors kuma-hormone wesilisa awasebenzi kahle. Kukhona ukukhubazeka okungaphezulu kuka-150 okukhonjisiwe kuze kube manje, futhi ngakunye kubangela uhlobo oluhlukile lwe-AIS.
I-INTERSEX YANGEMPELA YOKUPHAKATHI
Umuntu kufanele abe nezicubu zombili ze-ovarian kanye ne-testicular. Lokhu kungaba ku-gonad efanayo (i-ovotestis), noma umuntu angaba ne-ovary eyodwa ne-testis eyodwa. Umuntu angaba nama-chromosomes ama-XX, ama-chromosomes we-XY, noma kokubili. Izitho zangasese zangaphandle zingahle zidideke noma zivele njengabesifazane noma abesilisa. Lesi simo sasibizwa ngokuthi yi-hermaphroditism yangempela. Kubantu abaningi abane-gonadal intersex yangempela, imbangela eyimbangela ayaziwa, yize kwezinye izifundo zezilwane ixhunyaniswe nokuchayeka kwimithi yokubulala izinambuzane ejwayelekile yezolimo.
OKUYINKINGA NOMA OKUNGENAKULINGANISWA KWE-INTERSEX DISORDERS ZOKUTHUTHUKISWA KOBULILI
Ukuhlelwa okuningi kwe-chromosome ngaphandle kwe-46 elula, i-XX noma i-46, i-XY kungaholela ekuphazamisekeni kokuthuthuka kocansi. Lokhu kufaka phakathi i-45, i-XO (i-chromosome eyodwa kuphela ye-X), ne-47, i-XXY, i-47, i-XXX - womabili amacala ane-chromosome yocansi eyengeziwe, kungaba yi-X noma i-Y. Lokhu kuphazamiseka akuholeli esimeni lapho kunokungafani phakathi kwangaphakathi nezitho zobulili zangaphandle. Kodwa-ke, kungahle kube nezinkinga ngamazinga ama-hormone ocansi, ukukhula ngokuphelele kocansi, nezinombolo eziguquliwe zama-chromosomes ezocansi.
Izimpawu ezihambisana ne-intersex zizoya ngesizathu esiyimbangela. Zingafaka:
- Izitho zangasese eziyindida lapho kuzalwa
- I-Micropenis
- I-Clitoromegaly (i-clitoris ekhulisiwe)
- Ukuhlanganiswa kwe-labial okuyingxenye
- Ngokusobala izivivinyo ezingathandiswanga (ezingaphenduka izibele zamaqanda) kubafana
- Uquqaba lwamaLabial noma ama-inguinal (groin) (okungaphenduka ama-testes) emantombazaneni
- I-Hypospadias (ukuvulwa kwepenisi kwenye indawo ngaphandle kwethiphu; kwabesifazane, umchamo [umsele womchamo] uvula ungene esithweni sangasese sowesifazane)
- Ngaphandle kwalokho isitho sangasese esingajwayelekile esivela lapho kuzalwa
- Ukungajwayelekile kwe-Electrolyte
- Ukuthomba okulibazisekile noma okungekho
- Izinguquko ezingalindelekile ngesikhathi sokuthomba
Ukuhlolwa nokuhlolwa okulandelayo kungenziwa:
- Ukuhlaziywa kwe-Chromosome
- Amazinga ama-hormone (ngokwesibonelo, izinga le-testosterone)
- Ukuhlolwa kokukhuthaza amaHormone
- Ukuhlolwa kwe-Electrolyte
- Ukuhlolwa kwamangqamuzana athile
- Ukuhlolwa kwe-Endoscopic (ukuqinisekisa ukungabi khona noma ubukhona besifazane noma umlomo wesibeletho)
- I-Ultrasound noma i-MRI yokuhlola ukuthi ngabe izitho zocansi zangaphakathi zikhona (ngokwesibonelo, isibeletho)
Ngokufanelekile, iqembu labasebenzi bezempilo abanolwazi kwi-intersex kufanele basebenzisane ukuze baqonde futhi baphathe ingane nge-intersex futhi basekele umndeni.
Abazali kufanele baqonde izingxabano nezinguquko ekwelapheni i-intersex eminyakeni yamuva.Esikhathini esedlule, umbono owawukhona ukuthi kwakungcono kakhulu ukwabela ubulili ngokushesha okukhulu. Lokhu bekuvame ukususelwa ezithweni zangasese zangaphandle kunokobulili be-chromosomal. Abazali batshelwe ukuthi bangabi nokungaqondakali emiqondweni yabo mayelana nobulili bengane. Ukuhlinzwa ngokushesha kwakutuswa. Izicubu ze-ovarian noma ze-testicular ezivela kobunye ubulili zizosuswa. Ngokuvamile, kwakuthathwa njengokulula ukwakha kabusha izitho zangasese zabesifazane kunokusebenzisa izitho zobulili zabesilisa, ngakho-ke uma ukukhetha "okulungile" kungacaci, ingane yayijwayele ukunikezwa ukuba yintombazane.
Muva nje, umbono wochwepheshe abaningi ushintshile. Inhlonipho enkulu ngokuxakaniseka kokusebenza kwabesifazane ocansini sekuholele ekutheni baphethe ngokuthi izitho zangasese zabesifazane ezingaphansi zingase zingabi ngcono ngokwemvelo kunezitho zangasese zabesilisa, ngisho noma ukwakhiwa kabusha "kulula." Ngaphezu kwalokho, ezinye izinto zingabaluleka kakhulu ekwanelisekeni ngokobulili kunokusebenzisa izitho zangasese zangaphandle. Izici ze-Chromosomal, neural, hormonal, psychological, and behaviour zingathonya ubunikazi bobulili.
Ochwepheshe abaningi manje banxusa ukubambezeleka kokuhlinzwa okucacile inqobo nje uma kunempilo, futhi kufakwe kahle ingane esinqumweni sobulili.
Ngokusobala, i-intersex yinkinga eyinkimbinkimbi, futhi ukwelashwa kwayo kunemiphumela yesikhashana nesikhathi eside. Impendulo enhle izoncika ezintweni eziningi, kufaka phakathi imbangela ethile ye-intersex. Kungcono ukuthatha isikhathi ukuqonda izindaba ngaphambi kokujaha ukuthatha isinqumo. Iqembu labasizi be-intersex lingasiza ukujwayela imindeni ngocwaningo lwakamuva, futhi linganikeza umphakathi weminye imindeni, izingane nabantu abadala ababhekane nezinkinga ezifanayo.
Amaqembu okusekela abaluleke kakhulu emindenini ebhekene ne-intersex.
Amaqembu ahlukene okusekela angahluka emibonweni yawo maqondana nalesi sihloko esibucayi kakhulu. Funa eyodwa esekela imicabango nemizwa yakho ngesihloko.
Lezi zinhlangano ezilandelayo zinikeza imininingwane eyengeziwe:
- Inhlangano yokuhlukahluka kwe-X ne-Y chromosome - genetic.org
- I-CARES Foundation - www.caresfoundation.org/
- I-Intersex Society yaseNyakatho Melika - isna.org
- I-Turner Syndrome Society yase-United States - www.turnersyndrome.org/
- 48, XXYY - XXYY Project - genetic.org/variations/about-xxyy/
Sicela ubone imininingwane ngezimo ezingazodwana. Isibikezelo sincike kwisizathu esithile se-intersex. Ngokuqonda, ukwesekwa, kanye nokwelashwa okufanele, umbono jikelele muhle kakhulu.
Uma uqaphela ukuthi ingane yakho inezitho zobulili ezingavamile noma ukukhula kwezocansi, xoxa lokhu nomhlinzeki wakho wezokunakekelwa kwempilo.
Ukuphazamiseka kokuthuthuka kocansi; Ama-DSD; I-pseudohermaphroditism; I-Hermaphroditism; UHermaphrodite
IDayimane DA, Yu RN. Ukuphazamiseka kokuthuthuka kwezocansi: i-etiology, ukuhlolwa, kanye nokuphathwa kwezokwelapha. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 150.
IDonohoue PA. Ukuphazamiseka kokukhula kocansi. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 606.
I-Wherrett DK. Sondela osaneni olunenkinga okusolwa ngayo yokukhula kocansi. Umtholampilo Wezingane eNyakatho Am. 2015; 62 (4): 983-999. I-PMID: 26210628 www.ncbi.nlm.nih.gov/pubmed/26210628.