Ukuhlinzwa Ngezansi: Okudinga Ukwazi

-Delile

• Kubiza malini ukuhlinzwa okuphansi?
• Imvume enolwazi vs. amazinga wokunakekelwa we-WPATH
• Ukutholakala komshuwalense nokuhlinzwa okuphansi
• Ungamthola kanjani umhlinzeki
• Inqubo yokuhlinzwa engezansi ye-MTF / MTN
• Ukuguqulwa kwePenile
• I-Rectosigmoid vaginoplasty
• Ukuguqulwa okungafani ne-penile
• Inqubo yokuhlinzwa engezansi ye-FTM / FTN
• I-Metoidioplasty
• I-Phalloplasty
• Ungakulungiselela kanjani ukuhlinzwa okuphansi
• Izingozi nemiphumela emibi yokuhlinzwa phansi
• Ukululama ekuhlinzweni okungezansi

Ukubuka konke

Abantu beTransgender kanye ne-intersex balandela izindlela eziningi ezahlukahlukene zokubona ukukhuluma kwabo ngokobulili.

Abanye abenzi lutho nhlobo futhi bagcina ubunikazi babo nobulili babo kuyimfihlo. Abanye bafisa ukuguquka komphakathi - batshele abanye ngobunikazi babo - ngaphandle kokungenelela kwezokwelapha.

Abaningi balandela kuphela i-hormone replacement therapy (HRT). Abanye bazophishekela i-HRT kanye nokuhlinzwa okuhlukahlukene, kufaka phakathi ukwakhiwa kabusha kwesifuba noma ukuhlinzwa kobuso besifazane (i-FFS). Bangase futhi banqume ukuthi ukuhlinzwa okuphansi - okwaziwa nangokuthi ukuhlinzwa ngokobulili, ukuhlinzekwa kabusha ngokobulili (SRS), noma okungcono, ukuhlinzekwa kobulili (GCS) - kuyisinqumo esifanele kubo.

Ukuhlinzwa okuphansi ngokuvamile kubhekisela ku:

• isitho sangasese sangasese
• phalloplasty
• metoidioplasty

IVaginoplasty imvamisa ilandelwa ngabesifazane be-transgender kanye ne-AMAB (eyabelwe owesilisa ngesikhathi sokuzalwa) abantu abangabhalisi, kuyilapho i-phalloplasty noma i-metoidioplasty, imvamisa ilandelwa ngabesilisa be-transgender kanye ne-AFAM (eyabelwe abesifazane ngesikhathi sokuzalwa) abantu abangabhalisile.

Kubiza malini ukuhlinzwa okuphansi?

Imvume enolwazi vs. amazinga wokunakekelwa we-WPATH

Abahlinzeki bezempilo abahamba phambili be-transgender bazolandela imodeli yokuvuma enolwazi noma amazinga wokunakekelwa we-WPATH.

Imodeli yokuvuma enolwazi ivumela udokotela ukuthi akwazise ngobungozi besinqumo esithile. Ngemuva kwalokho, uzinqumela ukuthi uzoqhubeka ngaphandle kokufaka okuvela kunoma yimuphi omunye uchwepheshe wezokunakekelwa kwempilo.

Izindinganiso zokunakekelwa kwe-WPATH zidinga incwadi yokwesekwa evela kumelaphi ukuqala i-HRT, nezincwadi eziningi zokuhlinzwa kwangaphansi.

Indlela yeWPATH idonsela ukugxekwa kwabanye abantu emphakathini wama-transgender. Bakholelwa ukuthi kuthatha ukulawula ezandleni zomuntu futhi kusikisela ukuthi umuntu oguqukayo ufanelwe igunya elincane lomuntu kunomuntu we-cisgender.

Kodwa-ke, abanye abahlinzeki bokunakekelwa baphikisa lokho. Ukufuna izincwadi ezivela kubelaphi nakodokotela kunxusa ezinye izibhedlela, odokotela abahlinzayo, nabahlinzeki bokunakekela, abangabheka lolu hlelo njengokuvikela ngokomthetho uma kunesidingo.

Zombili lezi zindlela zibhekwa ngabathile emphakathini we-transgender njengokuthuthuka kwemodeli yangaphambilini futhi esabalele yomgcini wesango. Le modeli idinga izinyanga noma iminyaka "yesipiliyoni sangempela" (RLE) kubunikazi babo ngaphambi kokuba bathole i-HRT noma ukuhlinzwa okuvamile.

Abanye baphikisa ngokuthi lokhu kucabanga ukuthi ubunikazi be-transgender bungaphansi noma busemthethweni ngaphezu kobunikazi be-cisgender. Bakholelwa futhi ukuthi i-RLE yisikhathi esibuhlungu ngokwengqondo, esingenakwenzeka emphakathini, futhi esiyingozi lapho umuntu we-transgender kufanele azikhiphe emphakathini wakhe - ngaphandle kosizo lokuguqulwa komzimba okulethwa ama-hormone noma ukuhlinzwa.

Imodeli yomgcini wesango ibuye ijwayele ukusebenzisa izindlela ezi-heteronormative, cisnormative zokufanelekela isipiliyoni sangempela sempilo. Lokhu kuletha inselelo enkulu kubantu abangama-transgender abanokuheha kwabantu bobulili obufanayo noma izinkulumo zobulili ngaphandle kwesimiso esikhohlisayo (izingubo nezimonyo zabesifazane, isethulo se-hyper-masculine sabesilisa), futhi empeleni kusula umuzwa wabantu abadlulayo abangazenzeli.

Ukutholakala komshuwalense nokuhlinzwa okuphansi

E-United States, ezinye izindlela eziyinhloko zokukhokha izindleko eziphezulu zokuphuma ephaketheni zifaka ukusebenzela inkampani elandela izindinganiso ze-Human Rights Campaign Foundation ye-Equality Index yayo, noma ngokuhlala ezweni elidinga abomshwalense ukumboza ukunakekelwa kwabesilisa nabesifazane njengeCalifornia noma iNew York.

ECanada nase-UK, ukuhlinzwa okuphansi kumbozwe ngaphansi kokunakekelwa kwezempilo okwenziwe kuzwelonke, ngamazinga ahlukahlukene okugadwa nezikhathi zokulinda kuye ngesifunda.

Ungamthola kanjani umhlinzeki

Lapho ukhetha udokotela ohlinzayo, landela izingxoxo eziqondene nawe noma ze-skype nodokotela abaningi abahlinzayo ngangokunokwenzeka. Buza imibuzo eminingi, ukuze uthole umuzwa wokuhlukahluka kukadokotela ngamunye ohlinzekweni lwabo, kanye nangendlela yabo esembhedeni. Ufuna ukukhetha umuntu onethezekile naye, nokuthi ngubani okholelwa ukuthi uyena olungele wena.

Odokotela abaningi abahlinzayo benza izethulo noma babonisane emadolobheni amakhulu unyaka wonke futhi bangavela ezingqungqutheleni zama-transgender. Kuyasiza futhi ukufinyelela kwiziguli zangaphambili zabahlinzayo ozithandayo, ngokusebenzisa izinkundla ze-inthanethi, amaqembu okusekela, noma abangane bobabili.

Inqubo yokuhlinzwa engezansi ye-MTF / MTN

Kunezindlela ezintathu eziyinhloko ze-vaginoplasty ezenziwe namuhla:

• ukuguqulwa kwe-penile
• ama-rectosigmoid noma i-colon graft
• i-vaginoplasty ye-non-penile inversion

Kuzo zontathu izindlela zokuhlinzwa, i-clitoris ibunjiwe kusuka ekhanda lomthondo.

Ukuguqulwa kwePenile

Ukuguqulwa kwe-penile kuhilela ukusebenzisa isikhumba se-penile ukwakha i-neovagina. Ama-labia amakhulu kanye ne-minora enziwe ikakhulukazi ngezicubu zesikhumba. Lokhu kubangela isitho sangasese sezinzwa kanye nelabia.

Enye inkinga enkulu ukungabikho kokuzigcoba ngodonga lwangasese. Ukwehluka okuvamile kufaka ukusebenzisa izicubu ezisele ezisele njengesixhoxho sokujula kwesitho sangasese sowesifazane, nokusebenzisa i-mucosal urethra eqinile etholwe ethweni lobudoda ukuya kolayini wengxenye yesitho sangasese sowesifazane, kwakheka ukuzithambisa.

I-Rectosigmoid vaginoplasty

I-Rectosigmoid vaginoplasty ifaka ukusetshenziswa kwezicubu zamathumbu ukwakha udonga lwesitho sangasese sowesifazane. Le ndlela kwesinye isikhathi isetshenziswa ngokuhlangana ne-penile inversion. Izicubu zamathumbu ziyasiza lapho izicubu ze-penile ne-scrotal ziyindlala.

Le ndlela ijwayele ukusetshenziselwa abesifazane abangama-transgender abaqala ukwelashwa ngama-hormone ngesikhathi sokuthomba futhi bengakaze badalulwe ku-testosterone.

Izicubu zamathumbu zinenzuzo eyengeziwe yokuba mucosal, ngakho-ke ukuzithambisa. Le ndlela isetshenziselwa ukwakha kabusha izitho zangasese zabesifazane be-cisgender abathuthukisa imisele emincane yesitho sangasese sowesifazane.

Ukuguqulwa okungafani ne-penile

Inversion engeyona eye-penile yaziwa nangokuthi inqubo yeSuporn (ngemuva kukaDkt.Suporn owayisungula) noma iChonburi Flap.

Le ndlela isebenzisa ukufakelwa kwezicubu ze-perforated ezicijile kulwelwesi lwesitho sangasese sowesifazane, kanye nezicubu eziqinile ze-labia majora (ngokufana ne-penile inversion). Izicubu ze-penile zisetshenziselwa i-labia minora kanye ne-clitoral hood.

Odokotela abahlinzayo abasebenzisa le nqubo bahlose ukujula kwesitho sowesifazane sangasese, bazizwe bebukeka ngaphakathi, kanye nokubukeka kwezimonyo okuthuthukile.

Inqubo yokuhlinzwa engezansi ye-FTM / FTN

I-Phalloplasty ne-metoidioplasty izindlela ezimbili ezibandakanya ukwakhiwa kwe-neopenis.

I-Scrotoplasty ingenziwa ngokuhlinzwa, okuguqula ama-labia amakhulu abe yi-scrotum. Ukufakwa kwama-testicular ngokuvamile kudinga ukulinda ukuhlinzwa okulandelwayo.

I-Metoidioplasty

I-Metoidioplasty inqubo elula kakhulu futhi esheshayo kune-phalloplasty. Kule nqubo, i-clitoris, esevele yanwetshwa ngamasentimitha angu-3-8 yi-HRT, ikhishwa ezicutshini ezizungezile, futhi yabekwa kabusha ukufanisa ukuma kwepenisi.

Ungase futhi ukhethe ukwenza ubude be-urethral nge-metoidioplasty yakho, eyaziwa nangokuthi i-metoidioplasty ephelele.

Le ndlela isebenzisa izicubu ezinikelayo ezivela esihlathini noma ezivela esithweni sangasese ukuxhuma i-urethra neopenis entsha, ekuvumela ukuthi uchame umile.

Ungase futhi ulandele inqubo ye-Centurion, lapho imisipha engaphansi kwama-labia amakhulu ibekwa kabusha ukufaka ibhande ku-neopenis. Ukususwa kwesitho sangasese sowesifazane kungenziwa ngalesi sikhathi, kuya ngezinhloso zakho.

Ngemuva kwalezi zinqubo, i-neopenis ingakwazi noma ingagcini ukwakheka yodwa futhi kungenzeka ukuthi inikeze ucansi lokungena olunengqondo.

I-Phalloplasty

I-Phalloplasty ifaka ukusebenzisa ukuhlanganiswa kwesikhumba ukunweba i-neopenis ibe ngamasentimitha angu-5-8. Izindawo ezijwayelekile zabanikeli ngokuxhunyelelwa kwesikhumba ingalo, ithanga, isisu, nomhlane ongaphezulu.

Kunobuhle nobubi kwisiza ngasinye sabanikeli. Ingalo yangaphambilini nethanga zinamandla amakhulu okuzwa imizwa ngemuva kokuhlinzwa. Kodwa-ke, isibazi sangemuva sithambekele ekubonakaleni okuncane futhi sivumela ubude obengeziwe bepipi.

Izimpande zesisu nethanga zihlala zixhumene nomzimba phakathi nokuhlinzwa.

Ingalo yangaphambili kanye namasayithi angemuva "ngama-flaps amahhala" okumele ahlukaniswe ngokuphelele futhi axhumeke kabusha nge-microsurgery.

I-urethra nayo iyandiswa ngokusebenzisa izicubu zabanikeli ezivela kusayithi efanayo. Ukufakwa kwe-penile kungafakwa ekuhlolweni okulandelwayo, okunikeze amandla okugcina ukwakhiwa okugcwele okulungele ucansi lokungena.

Ungakulungiselela kanjani ukuhlinzwa okuphansi

Kuholela ekuhlinzeni phansi, iningi labantu lidinga ukususwa kwezinwele nge-electrolysis.

Okwe-vaginoplasty, izinwele zizosuswa esikhunjeni ekugcineni ezizofaka ulwelwesi lwe-neovagina. Nge-phalloplasty, izinwele ziyasuswa esizeni sesikhumba sabanikeli.

Udokotela wakho ohlinzayo uzokudinga ukuthi umise i-HRT emasontweni amabili ngaphambi kokuhlinzwa, futhi uyeke amasonto amabili ngemuva kokuhlinzwa. Khuluma nodokotela wakho ohlinzayo ngeminye imithi oyiphuza njalo. Bazokwazisa uma udinga ukuyeka ukubathatha ngaphambi kokuhlinzwa, futhi.

Abanye odokotela abahlinzayo badinga ukulungiswa kwamathumbu ngaphambi kokuhlinzwa kwangaphansi.

Izingozi nemiphumela emibi yokuhlinzwa phansi

I-vaginoplasty ingaholela ekulahlekelweni kwemizwa ngokwengxenye noma yonke i-neoclitoris ngenxa yokulimala kwezinzwa. Abanye abantu bangathola i-rectovaginal fistula, inkinga enkulu evula amathumbu esithweni sangasese. Ukuqubuka kwesitho sangasese sangasese nakho kungavela. Kodwa-ke, konke lokhu kuyinkinga engajwayelekile.

Ngokuvamile, abantu abathola i-vaginoplasty bangathola ukungasebenzi kahle kwe-urinary, okufana nalokho umuntu abhekana nakho ngemuva kokubeletha. Ezimweni eziningi, ukungazibambi okunjalo kuyancipha ngemuva kwesikhathi esithile.

I-metoidioplasty ephelele ne-phalloplasty zithwala ingozi ye-urethral fistula (imbobo noma ukuvuleka ku-urethra) noma ukuqina kwe-urethral (ukuvinjelwa). Zombili zingalungiswa ngokuhlinzwa okuncane okulandelwayo. I-Phalloplasty ibuye ibe nengozi yokwenqatshwa kwesikhumba sabanikeli, noma ukutheleleka endaweni yabanikeli. Nge-scrotoplasty, umzimba ungazenqaba izimila zamasende.

IVaginoplasty, metoidioplasty, ne-phalloplasty konke kunobungozi bokuthi umuntu angamukeleki ngomphumela wobuhle.

Ukululama ekuhlinzweni okungezansi

Kudingeka izinsuku ezintathu kuya kweziyisithupha zokulaliswa esibhedlela, zilandelwe ezinye izinsuku eziyi-7-10 zokuphathwa kweziguli eziseduze. Ngemuva kwenqubo yakho, lindela ukuyeka umsebenzi noma umsebenzi okhandlayo cishe amasonto ayisithupha.

IVaginoplasty idinga ipayipi lokuhambisa ipayipi isikhathi esingangesonto elilodwa. I-metoidioplasty ephelele ne-phalloplasty idinga i-catheter kuze kube amasonto amathathu, kuze kufike lapho ungahlanza khona umchamo wakho omningi nge-urethra yakho wedwa.

Ngemuva kwe-vaginoplasty, iningi labantu ngokuvamile lidinga ukunwebeka njalo unyaka wokuqala noma emibili, ngokusebenzisa uchungechunge lweziqu zepulasitiki eqinile. Ngemuva kwalokho, ucansi olungena ngokuvamisile lwanele ukugcinwa. I-neovagina ithuthukisa i-microflora efana nesitho sangasese sowesifazane esijwayelekile, yize izinga le-pH lincika kakhulu i-alkaline.

Izibazi zivame ukuthi zifihlwe ezinweleni zasesidlangalaleni, emaphethweni we-labia majora, noma zimane zelaphe kahle ukuze zingabonakali.