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Taiwanese Mandarin version (#159)

Browse Source 
* Init and Index.md for Chinese (Taiwanese)

* Translate what-is gender Chinese (Taiwanese)

* init Chinese (Taiwanese)

* init Chinese (Taiwanese)

* Add Harry Benjamin entry and update wording in Taiwanese Chinese

* Update translate for depersonalization

* Translate and update "Gender Euphoria" content to Taiwanese Chinese

* Update link title to Taiwanese Chinese in the Gender Dysphoria Bible

* Update translation for "Physical Gender Dysphoria" content to Taiwanese Chinese

* Update navigation links to Taiwanese Chinese in euphoria, history, and physical dysphoria pages

* Update title and description in physical dysphoria page to improve clarity in Taiwanese Chinese

* Add translations for biochemical-dysphoria in Taiwanese Chinese

* Taiwanese Chinese translations for social dysphoria

* Update Taiwanese Chinese translations and improve clarity in the Gender Dysphoria content

* Update Taiwanese Chinese translations for societal  dysphoria content

* Fix links in societal dysphoria page for Taiwanese Chinese translations

* update Taiwanese Chinese translations for sexual dysphoria content

* Update Taiwanese Chinese translations for presentational dysphoria content

* Update Taiwanese Chinese translations for existential dysphoria content

* Update Taiwanese Chinese translations for managed dysphoria content

* Update Taiwanese Chinese translations for cause, diagnoses and treatment content

* Update Taiwanese Chinese translation for impostor syndrome content

* Add Taiwanese Chinese translation to the concatenation list

* Add Taiwanese Chinese locale support in engines.js

* Update Taiwanese Chinese translation for am-i-trans content

* Fix layout

* Enhance Taiwanese Chinese translation for chromosomes page

* Fix layout

* Update Taiwanese Chinese translations for hormones content

* Update Taiwanese Chinese translations for second puberty masc content

* Update Taiwanese Chinese translations for second puberty fem content

* Update Taiwanese Chinese translation for conclusion page

* Update Taiwanese Chinese translations for menu items

* Add Taiwanese Mandarin option to language menu

* Fix lang menu

* fix lang menu

* update titlecard for Taiwanese version

* Updata translation

---------

Co-authored-by: Pichu <pichu@mobagel.com>
This commit is contained in:
Pichu Chen
2025-04-09 23:08:04 +08:00
committed by GitHub
parent 2ef1de1816
commit 0936e3718c
54 changed files with 4303 additions and 0 deletions
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{
"output": "public/tw/printable.md",
"sources": [
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"meta": {
"title": "性別不安聖經 - The Gender Dysphoria Bible",
"lang": "tw",
"description": "深入探討性別不安的各種表現形式，以及身為跨性別者的意義。",
"classes": [ "gdb", "longform" ],
"preBody": "_disclaimer"
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<div class="disclaimer"><div>
<strong>《性別不安聖經》 (The Gender Dysphoria Bible) 是一份持續更新的文件</strong>
<p>網站的內容將隨著時間推移而變化，因為新的增補和修訂將會持續擴展，以涵蓋性別不安的全部範圍。在目前的版本中，它嚴重缺乏針對非二元性別、無性別和流性人的性別不安，以及第三性別和雙靈敘事的描述。《性別不安聖經》(GDB) 是一個開源且由公眾資助的項目； <a href="/contributing/">非常歡迎大家進行貢獻</a>.</p>
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<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="1053.79" y="384.735" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2094-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="1053.79" y="384.735" id="tspan2096-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">кортикостерон</svg:tspan></svg:text><svg:text x="1053.79" y="384.735" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2094" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="1053.79" y="384.735" id="tspan2096" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">Corticosterone</svg:tspan></svg:text></svg:switch>
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<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="49.0352" y="511.771" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2102-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="49.0352" y="511.771" id="tspan2104-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">17α-гідрокси</svg:tspan><svg:tspan x="49.0352" y="531.149" id="tspan2106-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">прегненолон</svg:tspan></svg:text><svg:text x="49.0352" y="511.771" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2102" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="49.0352" y="511.771" id="tspan2104" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">17α-hydroxy</svg:tspan><svg:tspan x="49.0352" y="531.149" id="tspan2106" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">pregnenolone</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="360.091" y="509.89" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2114-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="360.091" y="509.89" id="tspan2116-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">17α-гідрокси</svg:tspan><svg:tspan x="360.091" y="529.268" id="tspan2118-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">прогестерон</svg:tspan></svg:text><svg:text x="360.091" y="509.89" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2114" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="360.091" y="509.89" id="tspan2116" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">17α-hydroxy</svg:tspan><svg:tspan x="360.091" y="529.268" id="tspan2118" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">progesterone</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="640.884" y="523.057" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2120-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="640.884" y="523.057" id="tspan2122-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">11-деоксикортизол</svg:tspan></svg:text><svg:text x="640.884" y="523.057" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2120" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="640.884" y="523.057" id="tspan2122" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">11-deoxycortisol</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="1058.21" y="597.127" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2124-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="1058.21" y="597.127" id="tspan2126-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">кортизол</svg:tspan></svg:text><svg:text x="1058.21" y="597.127" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2124" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="1058.21" y="597.127" id="tspan2126" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">Cortisol</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="179.363" y="755.266" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2128-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="179.363" y="755.266" id="tspan2130-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">дегідроепі-</svg:tspan><svg:tspan x="179.363" y="774.643" id="tspan2132-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">андростерон</svg:tspan></svg:text><svg:text x="179.363" y="755.266" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2128" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="179.363" y="755.266" id="tspan2130" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">Dehydroepi-</svg:tspan><svg:tspan x="179.363" y="774.643" id="tspan2132" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">androsterone</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="498.364" y="755.266" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2134-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="498.364" y="755.266" id="tspan2138-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">андросте-</svg:tspan><svg:tspan x="498.364" y="774.643" id="tspan2142-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">недіон</svg:tspan></svg:text><svg:text x="498.364" y="755.266" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2134" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="498.364" y="755.266" id="tspan2138" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">Androste-</svg:tspan><svg:tspan x="498.364" y="774.643" id="tspan2142" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">nedione</svg:tspan></svg:text></svg:switch>
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<svg:switch style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;"><svg:text x="204.613" y="924.604" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2152-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan x="204.613" y="924.604" id="tspan2156-uk" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">андтростенедіол</svg:tspan></svg:text><svg:text x="204.613" y="924.604" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Arial;" id="text2152" xml:space="preserve" transform="scale(1.03215, 0.968852)" sodipodi:linespacing="125%"><svg:tspan x="204.613" y="924.604" id="tspan2156" style="font-size: 20px; font-style: normal; font-variant: normal; font-weight: normal; font-stretch: normal; text-align: start; line-height: 125%; text-anchor: start; font-family: Arial;">Androstenediol</svg:tspan></svg:text></svg:switch>
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<svg:switch style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: start; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;"><svg:text x="408.483" y="814.915" style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: start; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;" id="text30251-uk" xml:space="preserve" transform="scale(1.03215, 0.968852)" systemLanguage="uk"><svg:tspan x="408.483" y="814.915" id="tspan30253-uk">17β-HSD</svg:tspan></svg:text><svg:text x="408.483" y="814.915" style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: start; text-anchor: start; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;" id="text30251" xml:space="preserve" transform="scale(1.03215, 0.968852)"><svg:tspan x="408.483" y="814.915" id="tspan30253">17β-HSD</svg:tspan></svg:text></svg:switch>
<svg:switch style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Sans"><svg:text x="803.17493" y="-886.42822" transform="matrix(0,0.9688517,-1.0321497,0,0,0)" style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Sans" id="text3501-uk" xml:space="preserve" systemLanguage="uk"><svg:tspan id="trsvg50-uk">(печінка і плацента)</svg:tspan></svg:text><svg:text x="803.17493" y="-886.42822" transform="matrix(0,0.9688517,-1.0321497,0,0,0)" style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Sans" id="text3501" xml:space="preserve"><tspan id="trsvg50">(liver and placenta)</tspan></svg:text></svg:switch>
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<svg:switch style="font-size:19.37759972px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans"><svg:text x="407.819" y="-651.03003" style="font-size:19.37759972px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans" id="text30197-uk" xml:space="preserve" transform="matrix(0,1.03215,-0.968852,0,0,0)" systemLanguage="uk"><svg:tspan x="407.819" y="-651.03003" id="tspan30199-uk">21-гідроксилаза</svg:tspan></svg:text><svg:text x="407.819" y="-651.03003" style="font-size:19.37759972px;font-style:normal;font-weight:normal;text-align:center;text-anchor:middle;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans" id="text30197" xml:space="preserve" transform="matrix(0,1.03215,-0.968852,0,0,0)"><svg:tspan x="407.819" y="-651.03003" id="tspan30199">21-hydroxylase </svg:tspan></svg:text></svg:switch>
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<svg:switch style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: center; text-anchor: middle; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;"><svg:text x="421.884" y="-961.709" style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: center; text-anchor: middle; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;" id="text30165-uk" xml:space="preserve" transform="matrix(0, 1.03215, -0.968852, 0, 0, 0)" systemLanguage="uk"><svg:tspan x="421.884" y="-961.709" id="tspan30167-uk">11β-гідроксилаза</svg:tspan></svg:text><svg:text x="421.884" y="-961.709" style="font-size: 19.3776px; font-style: normal; font-weight: normal; text-align: center; text-anchor: middle; fill: rgb(0, 0, 0); fill-opacity: 1; stroke: none; stroke-width: 1px; stroke-linecap: butt; stroke-linejoin: miter; stroke-opacity: 1; font-family: Sans;" id="text30165" xml:space="preserve" transform="matrix(0, 1.03215, -0.968852, 0, 0, 0)"><svg:tspan x="421.884" y="-961.709" id="tspan30167">11β-hydroxylase</svg:tspan></svg:text></svg:switch>
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<svg:switch style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-anchor:end;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans"><svg:text x="511.56573" y="985.3313" style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-anchor:end;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans" id="text30269-uk" xml:space="preserve" transform="scale(1.0321497,0.96885171)" systemLanguage="uk"><svg:tspan x="511.56573" y="985.3313" style="text-anchor:end" id="tspan30271-uk">5α-редуктаза</svg:tspan></svg:text><svg:text x="511.56573" y="985.3313" style="font-size:19.37760544px;font-style:normal;font-weight:normal;text-anchor:end;fill:#000000;fill-opacity:1;stroke:none;font-family:Sans" id="text30269" xml:space="preserve" transform="scale(1.0321497,0.96885171)"><svg:tspan x="511.56573" y="985.3313" style="text-anchor:end" id="tspan30271">5α-reductase</svg:tspan></svg:text></svg:switch>
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<switch style="font-size: 14.5332px; fill: rgb(0, 0, 0); stroke-linecap: round; font-family: sans;"><text transform="scale(1.03215, 0.968851)" x="249.496" y="842.887" style="font-size: 14.5332px; fill: rgb(0, 0, 0); stroke-linecap: round; font-family: sans;" id="text962-uk" systemLanguage="uk"><tspan id="trsvg52-uk">OH</tspan></text><text transform="scale(1.03215, 0.968851)" x="249.496" y="842.887" style="font-size: 14.5332px; fill: rgb(0, 0, 0); stroke-linecap: round; font-family: sans;" id="text962"><tspan id="trsvg52">OH</tspan></text></switch>
<switch style="font-size:14.5331974px;fill:#000000;stroke-linecap:round;font-family:sans"><text transform="scale(1.0321502,0.96885121)" x="74.412605" y="947.03693" style="font-size:14.5331974px;fill:#000000;stroke-linecap:round;font-family:sans" id="text964-uk" systemLanguage="uk"><tspan id="trsvg53-uk">HO</tspan></text><text transform="scale(1.0321502,0.96885121)" x="74.412605" y="947.03693" style="font-size:14.5331974px;fill:#000000;stroke-linecap:round;font-family:sans" id="text964"><tspan id="trsvg53">HO</tspan></text></switch>
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<svg:switch style="font-size:20.00000572px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#000080;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial"><svg:text x="636.88287" y="-19.052544" style="font-size:20.00000572px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#000080;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial" id="text3531-uk" xml:space="preserve" transform="matrix(0,1.0321497,-0.9688517,0,0,0)" sodipodi:linespacing="125%" systemLanguage="uk"><svg:tspan id="trsvg54-uk">андрогени (19 карбонів)</svg:tspan></svg:text><svg:text x="636.88287" y="-19.052544" style="font-size:20.00000572px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#000080;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial" id="text3531" xml:space="preserve" transform="matrix(0,1.0321497,-0.9688517,0,0,0)" sodipodi:linespacing="125%"><tspan id="trsvg54">Androgens (19 carbons)</tspan></svg:text></svg:switch>
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<switch style="font-size:20px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#005522;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial"><text sodipodi:linespacing="125%" transform="scale(1.03215,0.968852)" xml:space="preserve" id="text4508-uk" style="font-size:20px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#005522;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial" y="160.638" x="905.98102" systemLanguage="uk"><tspan id="trsvg56-uk">глюкокортикоїди</tspan></text><text sodipodi:linespacing="125%" transform="scale(1.03215,0.968852)" xml:space="preserve" id="text4508" style="font-size:20px;font-style:normal;font-variant:normal;font-weight:bold;font-stretch:normal;text-align:start;line-height:125%;text-anchor:start;fill:#005522;fill-opacity:1;stroke:none;stroke-width:1px;stroke-linecap:butt;stroke-linejoin:miter;stroke-opacity:1;font-family:Arial" y="160.638" x="905.98102"><tspan id="trsvg56">Glucocorticoids </tspan></text></switch>
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<a href="/tw/" class="top-nav-item dropdown-toggle" id="nav-gdb" data-toggle="dropdown" data-flip="false" aria-haspopup="true" aria-expanded="false">性別不安聖經 - The Gender Dysphoria Bible</a>
<div class="dropdown-menu" aria-labelledby="nav-gdb">
<a href="/tw/printable" class="{{#is meta.url '/tw/printable' }}active {{/is}}dropdown-item">檢視全部</a>
<a href="/gdb.pdf" class="dropdown-item">下載 PDF (英文) {{icon 'pdf' size="1em" style="vertical-align:middle;margin-bottom:3px;"}} </a>
<hr class="dropdown-divider">
<a href="/tw/" class="{{#is meta.url '/tw/index' '/' }}active {{/is}}dropdown-item">簡介</a>
<a href="/tw/what-is-gender" class="{{#is meta.url '/tw/what-is-gender' }}active {{/is}}dropdown-item">性別是什麼？</a>
<a href="/tw/history" class="{{#is meta.url '/tw/history' }}active {{/is}}dropdown-item">性別不安的歷史</a>
<a href="/tw/euphoria" class="{{#is meta.url '/tw/euphoria' }}active {{/is}}dropdown-item">性別欣快</a>
<a href="/tw/physical-dysphoria" class="{{#is meta.url '/tw/physical-dysphoria' }}active {{/is}}dropdown-item">身體不安</a>
<a href="/tw/biochemical-dysphoria" class="{{#is meta.url '/tw/biochemical-dysphoria' }}active {{/is}}dropdown-item">生化不安</a>
<a href="/tw/social-dysphoria" class="{{#is meta.url '/tw/social-dysphoria' }}active {{/is}}dropdown-item">社交不安</a>
<a href="/tw/societal-dysphoria" class="{{#is meta.url '/tw/societal-dysphoria' }}active {{/is}}dropdown-item">社會不安</a>
<a href="/tw/sexual-dysphoria" class="{{#is meta.url '/tw/sexual-dysphoria' }}active {{/is}}dropdown-item">性慾不安</a>
<a href="/tw/presentational-dysphoria" class="{{#is meta.url '/tw/presentational-dysphoria'}}active {{/is}}dropdown-item">表現不安</a>
<a href="/tw/existential-dysphoria" class="{{#is meta.url '/tw/existential-dysphoria' }}active {{/is}}dropdown-item">存在不安</a>
<a href="/tw/managed-dysphoria" class="{{#is meta.url '/tw/managed-dysphoria' }}active {{/is}}dropdown-item">應付不安</a>
<a href="/tw/impostor-syndrome" class="{{#is meta.url '/tw/impostor-syndrome' }}active {{/is}}dropdown-item">冒名頂替症候群</a>
<a href="/tw/am-i-trans" class="{{#is meta.url '/tw/am-i-trans' }}active {{/is}}dropdown-item">我是跨嗎?</a>
<a href="/tw/diagnoses" class="{{#is meta.url '/tw/diagnoses' }}active {{/is}}dropdown-item">臨床診斷</a>
<a href="/tw/treatment" class="{{#is meta.url '/tw/treatment' }}active {{/is}}dropdown-item">治療性別不安</a>
<a href="/tw/causes" class="{{#is meta.url '/tw/causes' }}active {{/is}}dropdown-item">性別不安的成因</a>
<a href="/tw/chromosomes" class="{{#is meta.url '/tw/chromosomes' }}active {{/is}}dropdown-item">染色體</a>
<a href="/tw/hormones" class="{{#is meta.url '/tw/hormones' }}active {{/is}}dropdown-item">荷爾蒙如何工作的</a>
<a href="/tw/second-puberty-masc" class="{{#is meta.url '/tw/second-puberty-masc' }}active {{/is}}dropdown-item">雄性第二次青春期 101</a>
<a href="/tw/second-puberty-fem" class="{{#is meta.url '/tw/second-puberty-fem' }}active {{/is}}dropdown-item">雌性第二次青春期 101</a>
<a href="/tw/conclusion" class="{{#is meta.url '/tw/conclusion' }}active {{/is}}dropdown-item">結論</a>
</div>

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module.exports = exports = {
MENU_LANGUAGE: '台灣華語 (TW)',
SITE_TITLE: '這就是性別不安，FYI',
HEADER_TITLE: '這就是性別不安，<abbr title="For Your Information">FYI</abbr>',
SITE_DESCRIPTION: '為那些正在質疑自己性別、已在性別探索旅程中，或只是想了解更多關於跨性別者資訊的人提供的資源。',
PATREON_FOOTER_BODY: '感謝社群的貢獻，才得以讓本網站順利運作。如果您覺得本網站很有價值，請考慮<a href="https://www.patreon.com/curvyandtrans">在 Patreon 上贊助</a>或<a href="https://ko-fi.com/curvyandtrans">透過 Ko-fi 捐款</a>。',
PATREON_FOOTER_THANKS: '特別感謝以下 Patreon 支持者：',
FOOTER_COPYRIGHT: '網站文字、網站程式碼和原創圖像 <a href="https://creativecommons.org/licenses/by-nc-sa/2.0/">採用 CC BY-NC-SA 授權。</a>',
FOOTER_COPYRIGHT2: '以及其他貢獻者',
TRANS_TWITTER_TOPICS: '跨性別推特話題',
MISSING_TWEET_FOR: '缺少推文：',
QUOTED_TWEET_UNAVAILABLE: '引用的推文無法使用',
TWEET_DATE_FORMAT: 'h:mm aa - EEE, LLL do, yyyy',
};

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "我是跨嗎?"
linkTitle: "我是跨嗎?"
description: "了解最難問題的路線圖"
siblings:
prev: /tw/impostor-syndrome
prevCaption: 冒牌者症候群
next: /tw/diagnoses
nextCaption: 臨床診斷
classes:
- gdb
preBody: '_disclaimer'
---
æææ<div class="cw"><p><strong>編者註</strong>: 以下頁面來自 Cassie LaBelle 撰寫的<a href="https://aninjusticemag.com/am-i-trans-a-roadmap-to-figuring-out-the-toughest-question-7bb0e809a32d" target="_blank" rel="noopener">一篇精彩的文章</a>（英文），並已獲得許可轉載。<a href="https://cassielabelle.medium.com/" target="_blank" rel="noopener">你可以在 Medium 上閱讀她更多的作品。</a>（英文）</div>æææ
<!-- # Am I Trans? -->
# 我是跨嗎？
<!-- Long before I started questioning my gender, I had this idle fantasy where one of my best lady friends would walk up to me and say, “Give it up. You’re not fooling anyone.” -->
在我開始質疑自己的性別很久以前，我就有一個無聊的幻想，我的其中一位女性好友會走到我面前說：「放棄吧。你騙不了任何人。」
<!-- If you’d confronted me about this fantasy at the time, I couldn’t have told you what, exactly, I meant by “you’re not fooling anyone.” Deep down I knew that it was probably related to gender, but my lips wouldn’t have been able to form those words. All I knew was that I was pretending to be someone I was not, in some vague, passive, and ephemeral way. -->
如果你當時問我這個幻想是什麼意思，我無法告訴你「你騙不了任何人」究竟是什麼意思。在我的內心深處，我知道這可能與性別有關，但我的嘴唇卻無法說出這些話。我只知道，我在假裝成另一個人，以一種模糊、被動和短暫的方式。
<!-- Once I self-accepted as a trans woman and started the long process of coming out, all I wanted was for someone to tell me that they already knew. “I’m so happy you figured it out,” I wanted them to gush. “I’ve known the truth for years. It was so obvious. I don’t know how anyone could have ever thought that you were a boy. I’m so happy that you’ll finally get to live as your true self now.” -->
一旦我接受自己是一名跨性別女性，並開始漫長的出櫃過程，我只希望有人告訴我，他們早就知道了。「我很高興你想通了，」我希望他們滔滔不絕地說。「我多年來一直都知道真相。這太明顯了。我不知道怎麼會有人覺得你是男的。我很高興你終於可以以真實的自我生活了。」
<!-- Nobody ever said this to me, though. My coming-out process was successful, and most of my friends were supportive, but I never got the external validation that I craved. My friends and family accepted me as trans because I told them I was trans. They hadn’t noticed that I’d spent the past two decades wearing the ill-fitting costume of a man who barely existed. -->
然而，從來沒有人對我說過這樣的話。我的出櫃過程很成功，我的大多數朋友都很支持我，但我從未得到我渴望的外在肯定。我的朋友和家人接受我作為跨性別者，是因為我告訴他們我是跨性別者。他們沒有注意到，我在過去的二十年裡一直穿著一個幾乎不存在的男人的不合身的戲服。
---
<!-- My good friend Lily coined the phrase **“Egg Prime Directive”** to describe the fact that trans people have an unspoken agreement not to tell people who are questioning their gender whether or not they are trans. -->
我的好朋友 Lily 創造了「蛋的最高指導原則」(Egg Prime Directive)這個詞，來描述跨性別者之間有一個不成文的約定，那就是不要告訴那些正在質疑自己性別的人他們是否是跨性別者。
<!-- When someone is just told they are trans, that opens ground for denial; it activates defense mechanisms built by internalized transphobia, and it has a high probability of pushing them further into the closet, if not making them outright transphobic. Even when it doesn’t, it leaves ground for their own subconscious to reject their dysphoria, claiming that they were just manipulated or deceived. -->
<!-- The much more effective strategy is to talk about your own experiences with dysphoria so that they see the common grounds and come to their own conclusion about their gender. The code doesn’t forbid helping them to explore their gender; it forbids assigning a gender to them. -->
<!-- Or, to put it more succinctly, you cannot be told what the Matrix is; you can only be shown. -->
當有人被告知自己是跨性別者時，這就為否認開闢了道路；它會啟動由內化跨性別恐懼症建立的防禦機制，並且很有可能將他們推向更深的櫃中，甚至使他們徹底成為跨性別恐懼症者。即使沒有這樣做，它也會讓他們的潛意識拒絕他們的不安，聲稱他們只是被操縱或欺騙了。
更有效的策略是談論你自己對不安的經歷，這樣他們就能看到共同點，並得出關於自己性別的結論。這個準則不禁止幫助他們探索自己的性別；它禁止為他們指定性別。
或者，更簡潔地說，你無法被告知母體(Matrix)是什麼；你只能被展示。
<!-- I’m sure there are some trans people out there who don’t follow the Egg Prime Directive, but I haven’t met them. It’s one of the only things that seems to unify the whole trans community, myself included. Even though I wanted my own external validation more than anything, I now see that true acceptance could have only come from within. The only person who can tell you that you are trans is yourself. -->
我相信有一些跨性別者不遵守蛋的最高指導原則，但我沒有遇到過他們。這是唯一一件似乎團結了整個跨性別群體的事情，包括我自己。即使我比什麼都想要我自己的外在肯定，我現在也明白，真正的接納只能來自內心。唯一能告訴你你是跨性別者的人就是你自己。
<!-- The paradox is that most closeted trans people are absolutely terrible at trusting their inner voice. When you spend your whole life with a nagging disconnect between how the world sees you and how you see yourself, it becomes easier to rely on other people to tell you “who you really are.” Even if you know deep down that all the people in your life are missing some fundamental fact about your identity, it’s nearly impossible to avoid listening to others over oneself. -->
矛盾的是，大多數未出櫃的跨性別者都非常不善於相信自己的內心聲音。當你一生都在世界如何看待你和你如何看待自己之間的持續脫節中度過時，依靠其他人來告訴你「你到底是誰」就變得更容易了。即使你內心深處知道你生活中所有的人都忽略了你身份中的一些基本事實，也很難避免聽從別人的意見而不是自己的意見。
<!-- My goal today, then, is to give you some of the information and mental framing that helped me self-accept. I can’t tell you whether or not you are transgender, but I can point you down a path that you might be able to travel down yourself. I can’t provide the answers, but I can try to give you the right questions. -->
那麼，我今天的目標是向你提供一些幫助我自我接納的資訊和思維框架。我無法告訴你你是否是跨性別者，但我可以指引你一條你可以自己走的道路。我無法提供答案，但我可以試著給你正確的問題。
æææ
<div class="gutter flex flex-end">
<div class="card">
<div class="card-header"><strong>為什麼我們需要蛋的最高指導原則？</strong></div>
<div class="card-body">
æææ
<!-- It is never safe to simply tell someone that they are transgender when they haven't asked themselves, even when you are 100% certain that they are. You can educate them on gender dysphoria and you can show them parallels between their feelings and your feelings, but you *cannot* simply say to a person, "You are transgender". -->
在別人沒有問自己的情況下，直接告訴他們是跨性別者永遠是不安全的，即使你 100% 確定他們是跨性別者。你可以教他們關於性別不安的知識，你可以向他們展示他們的感受和你感受之間的相似之處，但你 *不能* 只是對一個人說：「你是跨性別」。
<!-- Why? Because most of the time they won't believe you. -->
為什麼？因為大多數時候他們不會相信你。
<!-- Internalized transphobia has indoctrinated us all to believe that it's impossible that we are trans, or that being trans is something negative and reviled. Pressures from within a person's family or from their upbringing can make it extremely hard to accept themselves. -->
內化的跨性別恐懼症讓我們所有人都相信，我們不可能是跨性別者，或者成為跨性別者是消極和令人厭惡的事情。來自個人家庭或成長環境的壓力會讓他們極難接受自己。
<!-- Trying to tell someone who isn't already questioning that you think they're transgender triggers a self-defense mechanism; their subconscious actively tries to reject the statement, and there is a high probability that the suggestion will not only push them further into the closet, but can even make them hostile towards you for making it. Many transphobes show clear evidence of fighting their own struggles with gender, and there is no shortage of trans people who [have a history of being transphobic](https://curvyandtrans.tumblr.com/post/661595258598113280/interview-with-an-ex-radfem) out of self-preservation. -->
試圖告訴一個還沒有在質疑的人你認為他們是跨性別者會觸發一種自衛機制；他們的潛意識會積極地試圖拒絕這種說法，而且這種暗示很有可能不僅會將他們推向更深的櫃中，甚至會讓他們因為你的這種說法而對你產生敵意。許多跨性別恐懼症者都表現出與自身性別鬥爭的明顯證據，而且不乏跨性別者[有過跨性別恐懼症的歷史](https://curvyandtrans.tumblr.com/post/661595258598113280/interview-with-an-ex-radfem)（英文），這是出於自我保護。
<!-- Even when the person accepts your declaration, the fact that you told them instead of letting them discover it themselves leaves an opening for their own self-conscious to instill doubt about their dysphoria and believe that the idea was suggestive, or that they were manipulated into believing they were trans. The only safe pathway forward for someone to learn they are trans is to realize it on their own. -->
即使當事人接受了你的聲明，你告訴他們而不是讓他們自己發現這一事實，也會讓他們的自我意識對他們的不安產生懷疑，並相信這個想法是暗示性的，或者他們是被操縱而相信自己是跨性別者。一個人了解自己是跨性別者的唯一安全途徑就是自己意識到這一點。
<!-- Finally, the entire purpose of being trans is self-assignment and self-actualization. Telling a person that they are trans is surely as coercive an assignment as what was done when they were born. If you want to help them figure themselves out, tell them about your life, tell them how dysphoria works, send them to this site, and give them ways to see how what they experience isn't something that cis people live with. -->
最後，身為跨性別者的全部目的就是自我指定和自我實現。告訴一個人他們是跨性別者無疑與他們出生時所做的指定一樣具有脅迫性。如果你想幫助他們了解自己，就告訴他們你的生活，告訴他們不安是如何運作的，把他們送到這個網站，並讓他們知道他們所經歷的並不是順性別者所經歷的。
<!-- Unless, of course, they ask you if you think they're trans... then the prime directive no longer applies. -->
當然，除非他們問你是否認為他們是跨……那麼最高指導原則就不再適用。
æææ
</div>
</div>
</div>
æææ
<!-- As always, please understand that I have no professional training in gender therapy. I am simply writing this from my own amateur research and personal experiences — mostly my own journey and conversations I’ve had with other trans women and gender questioners. Keep in mind that I am coming at this from the perspective of a fairly binary trans lady who transitioned in her early thirties, which means that I am still blind to a lot of the trans experience. Things are different for trans-masculine and non-binary people, as well as for many other trans women. This is not meant to be a universal expert guide — it’s just the best I can give you right now. -->
一如既往，請理解我沒有接受過任何性別治療的專業訓練。我只是根據我自己的業餘研究和個人經驗來寫這篇文章——主要是我的個人經歷以及我與其他跨女和性別質疑者的對話。請記住，我是從一個相當二元化的跨女的角度來看待這個問題的，她在三十出頭就開始了轉變，這意味著我仍然對許多跨性別者的經歷一無所知。跨男和非二元性別者的情況有所不同，許多其他跨女也是如此。這並不是一個普遍的專家指南——這只是我現在能給你的最好的東西。
<!-- ### Consider That Most Cis People Don’t Think About Their Gender Very Much -->
### 想想大多數順性別者不會經常思考他們的性別
<!-- If you’re already at the stage where you are questioning your gender — even if that just means looking up “Am I Trans?” and then slamming your laptop shut before you get a search result — congratulations, you’ve already thought about your gender more than most cis people will in their entire lifetimes. -->
如果你已經到了質疑自己性別的階段——即使這只是意味著搜尋「我是跨性別嗎？」，然後在得到搜尋結果之前就關上你的筆電——恭喜你，你對自己性別的思考已經超過了大多數順性別者一生的思考。
<!-- I’ve asked many of my cis friends if they’ve ever seriously thought about their gender identity, and nine times out of ten they have not. Cis people don’t constantly wonder what it would be like to be a girl. They haven’t had daydreams about how nice it would be if they woke up in a different body. Their hearts don’t race when they think about body-swap movies. Some of them may have imagined what it would be like to be in a body with a gender other than their assigned gender at birth, but those thought experiments have been brief and purely intellectual. -->
我問過我的許多順性別朋友，他們是否認真思考過自己的性別認同，十次有九次他們沒有。順性別者不會不斷地想知道成為一個女孩是什麼樣的感覺。他們沒有做過關於如果他們在不同的身體裡醒來會有多美好的白日夢。當他們想到身體交換電影時，他們的心不會怦怦直跳。他們中的一些人可能想像過，如果他們的身體性別與他們出生時指定的性別不同，那會是什麼樣子，但這些思想實驗是簡短的，而且純粹是智力上的。
<!-- There’s no *energy* there. Not for them. If you feel a weird kind of *energy* when you think about gender, that probably means something. -->
那裡沒有 *能量* 。對他們來說沒有。如果你在思考性別時感覺到一種奇怪的 *能量* ，那可能意味著什麼。
<!-- ### Consider That Most Cis People Actively Like Being The Gender They Were Assigned At Birth -->
### 想想大多數順性別者都積極地喜歡他們出生時被指定的性別
<!-- This was hard for me to believe at first, but cis people actually enjoy their gender! Cis men like being men, and cis women like being women. They don’t secretly wish they had been born a member of the “opposite” gender or a genderless being or anything else, really. As we’ve already established, they don’t think about their gender much at all. -->
起初我很難相信這一點，但順性別者實際上很享受他們的性別！順性別男性喜歡身為男性，順性別女性喜歡身為女性。他們並沒有偷偷地希望自己出生時是「異性」或無性別者，或者其他任何東西。正如我們已經確定的那樣，他們根本不怎麼思考他們的性別。
<!-- There are complications here, of course. Plenty of cis men find toxic masculinity stifling and awful, choosing to actively reject the problematic social aspects of their gender. Plenty of women are deeply frustrated by misogyny, the patriarchy, and the tyranny of classical gender roles. “Enjoying being a man” does not necessarily mean loving having to bottle up your emotions in all non-NFL situations, and “enjoying being a woman” rarely means that you love getting belittled by your male co-workers or being constantly asked, “So, when are you getting married?” -->
當然，這裡也有一些複雜的情況。很多順性別男性覺得有害的男子氣概令人窒息和可怕，選擇積極拒絕他們性別中存在問題的社會方面。很多女性對厭女症、父權制和傳統性別角色的暴政深感沮喪。「喜歡身為男人」並不一定意味著喜歡在所有沒有國家美式足球聯盟(NFL)的情況下壓抑自己的情緒，「喜歡身為女人」也很少意味著你喜歡被男同事貶低，或者不斷被問到：「那麼，你什麼時候結婚？」
<!-- Once you cut through all of that, though? Cis people still enjoy their genders. They might wish that certain aspects of how their gender is performed in society were different, but they would still choose to keep their assigned genders if swapping were on the table. Unfortunately, a lot of closeted trans people hear cis people complaining about the frustrating and problematic aspects of their gender and assume that everybody has the same low-grade dislike for their gender that they do. -->
然而，一旦你擺脫了所有這些呢？順性別者仍然享受他們的性別。他們可能會希望社會上對其性別的某些表現方式有所不同，但如果可以交換的話，他們仍然會選擇保留其指定的性別。不幸的是，很多未出櫃的跨性別者聽到順性別者抱怨他們性別中令人沮喪和有問題的方面，並認為每個人都和他們一樣，對自己的性別都有一種輕微的厭惡。
<!-- Closeted trans people also assume that “I don’t hate being a man” is the same thing as “I enjoy being a man.” I can’t tell you how many of these questioning ladies tell me some variation of “I can’t be trans because I don’t hate being a man,” and then go on to describe countless little things they dislike about being seen as male, as if their gender were a pair of wet socks that they could never quite find a way to take off. -->
未出櫃的跨性別者也認為「我不討厭身為男人」等同於「我喜歡身為男人」。我無法告訴你，有多少這樣正在質疑的女性告訴我「我不可能是跨性別者，因為我不討厭身為男人」的變體，然後繼續描述無數她們不喜歡被視為男性的小事情，就好像她們的性別是一雙濕襪子，她們永遠也找不到辦法脫下來一樣。
<!-- You might be surprised to hear that I didn’t actively hate being seen as a man before I came out to myself, either. Being seen as a guy wasn’t a constant source of misery for me. It just… was who I was, apparently, so I learned to just kind of live with it. A lot of people believe that you can only be trans if you feel actively hurt by being seen as a man, but that particular feeling won’t usually arrive until after you’ve started to transition and you finally know who you truly are. Before self-acceptance, your relationship with your assigned gender at birth is likely to feel a lot more like disconnection than distress. -->
你可能會驚訝地聽到，在我向自己出櫃之前，我並不積極地討厭被視為男人。被視為男人並不是我持續痛苦的來源。它只是……顯然就是我的身份，所以我學會了忍受它。很多人認為，只有當你因為被視為男人而感到積極地受到傷害時，你才可能是跨性別者，但那種特殊的感覺通常要等到你開始轉變，你終於知道你真正的身份後才會出現。在自我接納之前，你與你出生時被指定的性別的關係可能更像是一種脫節，而不是痛苦。
<!-- I also can’t tell you how many times I’ve heard closeted trans women say something like, “well, I don’t hate being a man, and men have lots of institutional privilege. I don’t think I’d choose to be a woman, even if I could, because I wouldn’t want to give up my male privilege.” Male privilege is a real thing, of course, but it isn’t a reward that men get for having to endure the eternal discomfort of being men. Men enjoy being men, and they would still enjoy being men without their social privileges. If the only thing you like about masculinity is male privilege, that probably means something. -->
我也無法告訴你我聽過多少次未出櫃的跨性別女性說這樣的話：「嗯，我不討厭身為男人，而且男人有很多制度上的特權。我不認為我會選擇成為女人，即使我可以，因為我不想放棄我的男性特權。」男性特權當然是真實存在的，但這並不是男人因為不得不忍受身為男人的永恆不適而得到的獎勵。男人喜歡身為男人，即使沒有社會特權，他們仍然會喜歡身為男人。如果你喜歡男性氣概的唯一原因是男性特權，那可能意味著什麼。
<!-- ### Consider That Gender Dysphoria Looks Different For Trans Women Who Haven’t Self-Accepted Yet -->
### 想想對於尚未自我接納的跨女來說，性別不安的表現形式是不同的
<!-- For years, I thought that I couldn’t be trans because I didn’t experience gender dysphoria. I was dead wrong. -->
多年來，我一直認為自己不可能是跨性別者，因為我沒有經歷過性別不安。我大錯特錯了。
<!-- One thing that kept me from realizing that I was experiencing dysphoria was the same reason that fish don’t know they’re swimming in water — it’s just what my life had always been like, so I thought being dysphoric all the time was normal human behavior. I knew that I was kind of sad and more than a little odd, and I knew that my experiences with masculinity were at least slightly gender non-conforming, but I was dealing with the pain of dysphoria every single day without having any idea what was actually going on. No matter how bad I felt, I could always come up with a good enough explanation that had nothing to do with gender. -->
有一件事讓我沒有意識到自己正在經歷不安，那就是魚不知道它們在水中游泳的原因——我的生活一直都是這樣的，所以我認為一直不安是正常的人類行為。我知道我有點悲傷，而且有點古怪，我知道我對男性氣概的經歷至少有點不符合性別規範，但我每天都在處理不安的痛苦，卻不知道實際上發生了什麼。無論我感覺多麼糟糕，我總能想出一個與性別無關的足夠好的解釋。
<!-- The other problem is that gender dysphoria manifests differently in pre-acceptance trans women than it does in post-acceptance trans women. I always thought that gender dysphoria was the distress that you get from looking in the mirror and seeing a boy starting back at you instead of a girl, but that wasn’t a feeling I actually had until I started transitioning. You can’t get distressed about not seeing a girl in the mirror until after you’ve realized you’re a girl! -->
另一個問題是，性別不安在未接納自己的跨性別女性身上的表現形式與在已接納自己的跨性別女性身上的表現形式不同。我一直認為性別不安是你照鏡子時看到的痛苦，你看到的是一個男孩而不是一個女孩，但直到我開始轉變，我才真正有這種感覺。在你意識到自己是個女孩之前，你不可能因為在鏡子裡沒有看到女孩而感到痛苦！
<!-- Before that, dysphoria manifests in dozens of other, much subtler ways. [I wrote about my experience with pre-acceptance dysphoria here, in what has become my most popular essay ever.](https://cassielabelle.medium.com/gender-dysphoria-isnt-what-you-think-6fdc7ae3ac85) I highly recommend reading it in full if you are questioning your gender. -->
在此之前，不安會以其他幾十種更微妙的方式表現出來。[我在這裡寫了我關於轉變前不安的經歷，這篇文章成為了我最受歡迎的文章。](https://cassielabelle.medium.com/gender-dysphoria-isnt-what-you-think-6fdc7ae3ac85)（英文）如果你正在質疑自己的性別，我強烈建議你完整閱讀這篇文章。
<!-- ### Consider The Null HypotheCis -->
### 考慮順性別虛無假設(Null HypotheCis)
<!-- In mathematics, a [null hypothesis](https://en.wikipedia.org/wiki/Null_hypothesis) is something that is generally assumed to be true until it is proven false. It’s a default assumption, like “innocent until proven guilty.” If you’re going to convict someone of a murder, for example, circumstantial evidence just won’t do. You generally need overwhelming physical proof, or a confession, or some other obvious sign of guilt. -->
在數學中，[虛無假設](https://zh.wikipedia.org/wiki/%E8%99%9B%E7%84%A1%E5%81%87%E8%AA%AA)是指在被證明為假之前通常被認為是真的東西。這是一個預設假設，就像「無罪推定」。例如，如果你要判定一個人犯了謀殺罪，間接證據是不夠的。你通常需要壓倒性的物理證據，或者一份供詞，或者其他一些明顯的犯罪跡象。
<!-- [This excellent article by Natalie Reed](https://freethoughtblogs.com/nataliereed/2012/04/17/the-null-hypothecis/) argues that being cisgender (not trans) is treated as a null hypothesis by our society. We are all assumed to be our assigned gender at birth, and we feel as if we need overwhelming evidence to prove our transness. Otherwise, we continue to assume that we are cis. -->
[Natalie Reed 的這篇優秀文章](https://freethoughtblogs.com/nataliereed/2012/04/17/the-null-hypothecis/)（英文）認為，順性別（非跨性別）在我們的社會中被視為一種虛無假設。我們都被假定為出生時被指定的性別，我們覺得我們需要壓倒性的證據來證明我們的跨性別身份。否則，我們繼續假設我們是順性別者。
<!-- This makes sense in the grand scheme of things, because there are probably more cis people in the world than trans people. As we discussed earlier, however, most people who are comfortable with their gender identity aren’t doing this kind of questioning. If you’ve arrived at this stage of self-discovery, there’s a fairly high chance that you aren’t completely cis. -->
從全局來看，這是合理的，因為世界上順性別者可能比跨性別者多。然而，正如我們前面討論的那樣，大多數對自己的性別認同感到滿意的人都不會進行這種質疑。如果你已經到了自我發現的這個階段，你很有可能不是完全的順性別者。
<!-- The Null HypotheCis poses a simple and effective question: once you take your finger off the scale, how likely is it that you are trans? If you give the twin hypotheses of “I am cis” and “I am trans” equal weight, and you stop demanding that transness carry the full burden of proof, what feels right to you? If you start looking for proof of cis-ness the same way you look for proof of trans-ness, the whole illusion can sometimes come tumbling down. -->
跨性別虛無假設提出了一個簡單而有效的問題：一旦你不再偏袒，你是跨的可能性有多大？如果你給「我是順」和「我是跨」這兩個假設同等的權重，並且你不再要求跨性別身份承擔全部的舉證責任，你感覺哪個是對的？如果你開始像尋找跨性別者的證據一樣尋找順性別者的證據，整個幻覺有時就會崩潰。
<!-- ### Consider That If You Want To Be A Girl/Boy, Then You Are Already A Girl/Boy -->
### 考慮如果你想成為女孩/男孩，那麼你已經是女孩/男孩了
<!-- It really is that simple. Men want to be men, and women want to be women. If you want to be a man, then you‘re a man. If you want to be a woman, then you’re a woman. If you don’t want to be either, or you want to be both, or you want to be a woman sometimes and a man other times, then you’re probably some flavor of genderfluid or non-binary. -->
真的就是這麼簡單。男人想成為男人，女人想成為女人。如果你想成為男人，那麼你就是男人。如果你想成為女人，那麼你就是女人。如果你不想成為其中任何一個，或者你想成為兩個，或者你想有時成為女人，有時成為男人，那麼你可能是某種流性人或非二元性別者。
<!-- “But you can’t just… do that!” I hear you say. But you absolutely can just do that. In fact, this is basically the one and only question you really have to answer for yourself. If you want to be a girl and you’ve always thought of yourself as a guy, then you will probably be happier living as a girl. It’s at least worth taking some steps to see if transitioning will bring you happiness, right? -->
「但是你不能只是……這樣做！」我聽到你說。但你絕對可以這樣做。事實上，這基本上是你真正必須為自己回答的唯一問題。如果你想成為一個女孩，而你一直認為自己是一個男孩，那麼你以女孩的身份生活可能會更快樂。至少值得採取一些步驟，看看轉變是否會給你帶來快樂，對吧？
<!-- ### Consider That Doubting Yourself Does Not Invalidate Your Possible Trans-ness -->
### 考慮自我懷疑並不能否定你可能的跨性別身份
<!-- For years — decades, even — I “knew” that I wasn’t trans because “real” trans people are supposed to have an unshakable certainty in their own identity. I internalized this fictional image of a young trans woman demanding that everyone treat her like the woman she is, defiant in the face of oppression. -->
多年來——甚至是幾十年——我「知道」我不是跨性別者，因為「真正的」跨性別者應該對自己的身份有不可動搖的把握。我內化了這個虛構的年輕跨性別女性的形象，她要求每個人都像對待女人一樣對待她，在面對壓迫時毫不畏懼。
<!-- This is what being trans was like, I thought; bravery, courage, and absolute unwavering certainty in your identity. That wasn’t me, so I couldn’t be trans! -->
我以為，這就是身為跨性別者的樣子；勇敢、有勇氣，以及對自己身份的絕對堅定不移的把握。那不是我，所以我不可能是跨性別者！
<!-- As it turns out, very few actual trans people feel this way before transition. Instead, we nearly all start out our journeys awash in self-doubt. That unwavering certainty does usually come, in time, but it can take months or years of self-acceptance as well as (in my case, at least) further validation in the form of hormone therapy and social transition. -->
事實證明，很少有真正的跨性別者在轉變前有這種感覺。相反，我們幾乎都是在一開始的旅程中充滿了自我懷疑。隨著時間的推移，這種堅定不移的把握確實會出現，但它可能需要幾個月或幾年的自我接納，以及（至少在我的情況下）激素治療和社會轉變形式的進一步驗證。
<!-- But at the start, we nearly all feel like our gender is a confusing mess. We feel like we can’t possibly be trans enough to claim a queer identity, and we definitely don’t feel trans enough to transition. We worry that we are making the wrong decision, that we are overreacting, that stepping outside of our little cocoon of self-preservation is liable to be the biggest mistake we could ever make in our life. -->
但在開始的時候，我們幾乎都覺得自己的性別是一團糟。我們覺得我們不可能跨到足以聲稱自己是一個酷兒身份，而且我們絕對不覺得自己跨到足以轉變。我們擔心我們正在做出錯誤的決定，我們反應過度，走出我們小小的自我保護的繭可能是我們一生中所能犯下的最大錯誤。
<!-- If you feel all of this stuff, you’re in good company. My therapist even jokes that asking “am I trans enough?” is so common that it’s practically a symptom of being trans. You cannot figure out your gender identity without questioning it, and self-doubt is a normal part of that process. -->
如果你有所有這些感覺，那麼你並不孤單。我的治療師甚至開玩笑說，「我夠跨嗎？」這個問題太常見了，以至於它實際上是身為跨性別者的一種症狀。你不可能在沒有質疑的情況下弄清楚你的性別認同，而自我懷疑是這個過程中的正常組成部分。
<!-- ### Consider That Your Trans Journey Might Not Fit The Accepted, Popular Narrative -->
### 考慮你的跨性別旅程可能不符合公認的流行敘事
<!-- Popular culture has basically decided that there’s only one transfeminine story worth telling. It’s the story of a young trans girl who figures out her identity at a very young age. Even in childhood, she gravitates toward dolls and tea parties. She tries on her older sister’s dresses and begs her mom to buy her make-up and jewelry. She basically always looks like a girl, too — feminine facial features, short stature, thin and androgynous. If she doesn’t transition in childhood or adolescence, then she’ll still somehow make it to adulthood still looking more or less like a woman. She crossdresses all the time, and might even be a drag queen. She is also probably attracted to men, and might have worked a spell as a sex worker. -->
流行文化基本上已經決定，只有一個跨性別女性的故事值得講。這是一個年輕的跨性別女孩在很小的時候就發現自己身份的故事。即使在童年時期，她也喜歡洋娃娃和茶會。她試穿姐姐的裙子，並乞求媽媽給她買化妝品和首飾。她也基本上總是看起來像個女孩——女性化的面部特徵、矮小的身材、苗條而中性。如果她沒有在童年或青春期轉變，那麼她仍然會以某種方式成年，並且仍然或多或少地看起來像個女人。她總是穿異性服裝，甚至可能是一個變裝皇后。她也許會被男人吸引，而且可能做過一段時間的性工作者。
<!-- This is a valid and common trans narrative. I know many girls who have experienced some or all of these tropes. There’s a reason why this story is told over and over again, after all. -->
這是一個合理且常見的跨性別敘事。我知道很多女孩都經歷過這些比喻中的一些或全部。畢竟，這個故事被一遍又一遍地講是有原因的。
<!-- That said, the vast majority of trans women I know are nothing like this. Many of them had classically male childhoods, complete with toy cars, video games, and NERF guns. Many of them never cross-dressed at all, and felt somewhat repulsed by drag culture. Many of them grew up with large bodies, broad shoulders, and bushy beards. Many of them aren’t attracted to men at all, while others are bi or pansexual. Many of them did not begin seriously questioning their gender until their late twenties or early thirties. Many have no “signs” of being trans in their past. They simply spent their entire lives accepting that they were men, and that was that. Until it wasn’t. -->
話雖如此，我認識的絕大多數跨女都不是這樣的。她們中的許多人都有典型的男性童年，包括玩具車、電子遊戲和 NERF 槍。她們中的許多人從未穿過異性服裝，並且對變裝文化感到有些反感。她們中的許多人長大後身材高大、肩膀寬闊、鬍鬚濃密。她們中的許多人根本不喜歡男人，而其他人則是雙或泛性戀。她們中的許多人直到二十多歲或三十出頭才開始認真質疑自己的性別。許多人在過去沒有任何身為跨性別者的「跡象」。她們只是花了一輩子的時間接受她們是男人，僅此而已。直到她們不再是男人。
<!-- This is a common trans narrative, but nobody really talks about it. Trans women like this — like me — have only really started to open up about our stories in the past few years. Before that? The only story you heard was the one I chronicled above. That’s why that trans narrative seems “right” and this one seems “wrong.” -->
這是一個常見的跨性別敘事，但卻沒有人真正談論它。像我這樣的跨性別女性在過去幾年中才真正開始公開講述我們的故事。在那之前呢？你聽到的唯一故事就是我上面記錄的那個。這就是為什麼那個跨性別敘事看起來「對」，而這個看起來「錯」。
<!-- But girls like us are incredibly common. [This scientific study from 2003](https://web.archive.org/web/20220222143959/http://www.avitale.com/developmentalreview.htm) (warning for dated language if you read it) chronicles the observations of a researcher who spent decades working with trans women. In her experience, there are three distinct groups of trans women, two of which follow the “I’ve always known” path I chronicled above, and one of which does not. According to her, “Group Three” trans women have classically male childhoods, tend not to show the normal signs of being trans, and tend to come out later in life. While some of them cross-dress, many do not, choosing to deal with their dysphoria in more subtle and internal ways. I can’t tell you how validated I felt reading that paper during my questioning phase, realizing that there were so many other trans women out there just like me. -->
但是像我們這樣的女孩非常普遍。[2003 年的這項科學研究](https://web.archive.org/web/20220222143959/http://www.avitale.com/developmentalreview.htm)（英文）（如果你閱讀它，請注意過時的語言）記錄了一位研究人員的觀察結果，她花了數十年時間與跨女一起工作。根據她的經驗，跨女有三種不同的群體，其中兩種遵循我上面記錄的「我一直都知道」的道路，而另一種則不遵循。據她所說，「第三組」跨女有典型的男性童年，往往沒有表現出身為跨性別者的正常跡象，並且往往在以後的生活中才出櫃。雖然她們中的一些人會穿異性服裝，但許多人不會，他們選擇以更微妙和內在的方式來處理他們的不安。我無法告訴你在我質疑的階段閱讀那篇論文時，我感到多麼的被肯定，我意識到有這麼多其他的跨性別女性和我一樣。
<!-- I also believe that more trans women like us are coming out now because there’s so much more representation and so many more resources. In 1991, 2001, even 2011, the path to transition was much more difficult, and most people didn’t know any openly trans people. In this world, the only people who chose to transition were those for whom not doing so was just about impossible. -->
我也相信，現在有更多像我們這樣的跨性別女性出櫃了，因為現在有更多的代表性和更多的資源。在 1991 年、2001 年，甚至是 2011 年，轉變的道路要困難得多，而且大多數人都不認識公開的跨性別者。在這個世界上，只有那些幾乎不可能不轉變的人才會選擇轉變。
<!-- It isn’t just easier to question your gender here in 2021; it’s easier to gain access to trans communities, hormones, and other crucial resources. If I’d been born thirty years earlier, I might not have transitioned at all. If I’d been born thirty years later, I’d probably have transitioned as a teenager. Don’t worry about whether or not you’ve “always known” if this is the first time you’ve ever had the freedom and resources to truly ask yourself this question. -->
在 2021 年的今天，質疑自己的性別不僅更容易了；也更容易獲得跨性別社群、賀爾蒙和其他關鍵資源。如果我早出生三十年，我可能根本就不會轉變。如果我晚出生三十年，我可能在青少年時期就轉變了。如果這是你第一次有自由和資源真正問自己這個問題，不要擔心你是否「一直都知道」。
<!-- ### Consider That The Things Keeping You From Self-Acceptance Might Have Nothing To Do With Your Identity -->
### 考慮那些阻止你自我接納的事情可能與你的身份無關
<!-- Whenever I’m talking to a questioning trans woman, the conversation eventually turns to the obstacles that she might face if she chooses to transition. “I worry that I’m too tall/large/hairy/ugly to transition” is a pretty common fear. “I worry that my family will disown me/my partner will leave me” is another worry I hear a lot. Other girls are really worried about their career, education, or college situation. Many fear that they simply can’t handle the medical bills for HRT or trans surgeries. -->
每當我和一個正在質疑的跨性別女性交談時，話題最終都會轉到如果她選擇轉變可能會面臨的障礙。「我擔心我太高/太胖/毛髮太多/太醜而無法轉變」是一種相當普遍的恐懼。「我擔心我的家人會與我斷絕關係/我的伴侶會離開我」是另一個我經常聽到的擔憂。其他女孩真的很擔心她們的職業、教育或大學狀況。許多人擔心她們根本無法負擔 HRT 或跨性別手術的醫療費用。
<!-- Everyone — everyone — doubts that they have the fortitude to deal with socially transitioning. Coming out to friends, wearing women’s clothing, dealing with transphobia… it’s a terrifying mess, especially for closeted trans women, who usually feel pretty short on resilience as it is. The whole thing can seem chronically overwhelming. -->
每個人——每個人——都懷疑自己是否有毅力來應對社會轉變。向朋友出櫃、穿女裝、應對跨性別恐懼症……這是一件可怕的事情，尤其是對於未出櫃的跨女來說，她們通常覺得自己的韌性很差。整件事看起來會讓人慢曼的被壓倒。
<!-- These fears often manifest in the form of self-gatekeeping. “I’m afraid that I will never be a pretty girl” turns into “I can’t be trans, because what if I’m not pretty enough after I transition?” This seems somewhat silly in a vacuum, but pre-acceptance trans girls will sometimes do anything to convince themselves that they aren’t actually trans. I definitely thought that I wasn’t trans because I simply couldn’t imagine actually taking HRT and dressing like a woman every day. That was something that brave people did, not people like me, so I couldn’t be trans! -->
這些恐懼通常表現為自我設限的形式。「我擔心我永遠不會成為一個漂亮的女孩」變成了「我不可能是跨，因為如果我轉變後不夠漂亮怎麼辦？」這單獨來看有點愚蠢，但轉變前的跨性別女孩有時會做任何事情來說服自己，她們實際上不是跨性別者。我絕對認為我不是跨性別，因為我根本無法想像實際服用 HRT 並每天穿得像個女人。那是勇敢的人做的事情，而不是像我這樣的人，所以我不可能是跨性別！
<!-- Why do we do this to ourselves? I think it’s all about self-protection. We know that transition is incredibly difficult, and so we will try literally everything else in the world before we’re even willing to start facing the “am I trans?” question. We develop really strong self-protective voices that push back hard against the truth because then we don’t have to worry about the terror of what comes next. -->
為什麼我們要這樣對待自己？我認為這都是為了自我保護。我們知道轉變是非常困難的，所以在我們願意開始面對「我是跨嗎？」這個問題之前，我們會嘗試世界上所有其他的事情。我們會發展出非常強烈的自我保護的聲音，強烈反對真相，因為這樣我們就不必擔心接下來會發生的恐怖事情。
<!-- Here’s the thing, though: even if you are trans, you don’t actually have to do anything about it. While I highly recommend transitioning, it’s definitely possible to self-accept and then just… do nothing. Keep your name, your pronouns, your life as it is. Or you can just change a few things, and enjoy those little pings of gender euphoria where you can. -->
然而，問題是：即使你是跨性別者，你實際上也不必做任何事情。雖然我強烈建議轉變，但絕對有可能自我接納，然後……什麼也不做。保留你的名字、你的代詞、你的生活原樣。或者你可以只改變一些事情，並享受那些你能感受到的微小的性別欣快感。
<!-- The important thing to remember is that the truth of your identity is separate from all of the hopes and fears you have about transitioning. If you’re a girl on the inside, it doesn’t matter what you look like. It doesn’t matter what your family thinks of you. It doesn’t matter whether or not you have the means or even the desire to medically transition. Identity is a mental and spiritual thing, separate from all of this. If you’re a girl, you’re a girl. -->
重要的是要記住，你的身份的真相與你對轉變的所有希望和恐懼是分開的。如果你內心是一個女孩，你的長相如何並不重要。你的家人對你的看法並不重要。你是否有能力或甚至是否有意願進行醫療轉變並不重要。身份認同是一種精神和靈魂上的東西，與所有這些都無關。如果你是個女孩，你就是個女孩。
<!-- So start there. Figure out who you ARE, regardless of what you do about it. -->
所以從那裡開始。弄清楚你是 *誰*，不管你怎麼做。
<!-- Whenever I talk to a questioning trans woman who is stuck on this stuff, I always try to factor out these social factors as best I can. I’ll ask hypothetical questions like this: -->
每當我和一個被這些事情困擾的正在質疑的跨女交談時，我總是盡可能地排除這些社會因素。我會問這樣的假設性問題：
<!-- You are given a magical button that will permanently swap your gender, giving you an “opposite-gendered” body that is equivalent to your own in age, fitness, and attractiveness. If you press the button, everybody in your life will have always known you as a girl. They will accept you immediately. You will not lose your partner, your job, or your family. Do you press it? -->
你得到一個神奇的按鈕，它可以永久地改變你的性別，給你一個與你年齡、健康狀況和吸引力相當的「異性」身體。如果你按下這個按鈕，你生命中的每個人都會一直把你當成女孩。他們會立即接受你。你不會失去你的伴侶、你的工作或你的家人。你會按下它嗎？
<!-- Cis people would not even consider pressing this button, by the way. If you know deep down that you’d press it but are still afraid to self-accept as trans, then your sticking point probably has more to do with your fear of transitioning than it does with your true identity. -->
順便說一下，順性別者根本不會考慮按下這個按鈕。如果你內心深處知道你會按下它，但仍然害怕承認自己是跨性別者，那麼你的癥結可能更多地與你對轉變的恐懼有關，而不是與你真正的身份有關。
<!-- ### Consider That It’s Rarely “Just A Fetish.” -->
### 考慮它很少「只是種戀物癖」
<!-- I cannot tell you how many trans people — including me — began exploring their gender feelings in the realm of sexual fantasy. -->
我無法告訴你，有多少跨性別者——包括我——開始在性幻想的領域探索他們的性別感受。
<!-- There are many different ways for this to manifest: gender-play with partners, enjoying transformation-related drawings, reading stories about boys who are turned into girls, or role-playing gender transformation fantasies with partners on online forums or messaging apps. There’s so much of this stuff out there, and a lot of the people who enjoy it are closeted trans women like I was. -->
有很多不同的表現方式：與伴侶進行性別遊戲、喜歡與變身相關的圖畫、閱讀關於男孩變成女孩的故事，或者在線上論壇或通訊應用程式上與伴侶角色扮演性別變身幻想。有很多這樣的東西，而且很多喜歡它的人都是像我一樣未出櫃的跨性別女性。
<!-- This makes a lot of sense when you think about it. Sex is one of the few realms of human experience where it’s safe to explore gender without having to face larger questions about identity. It’s extremely possible to separate these two things in your head for years and years and years. You’re just a man who occasionally likes to fantasize about being turned into a woman. That doesn’t mean you’re trans! -->
仔細想想，這就很有道理了。性是人類經驗中為數不多的可以安全探索性別而不必面對更大的身份認同問題的領域之一。在你的腦海中將這兩件事分開很多很多年是極有可能的。你只是一個偶爾喜歡幻想自己變成女人的男人。這並不意味著你是跨！
<!-- Unfortunately, exploring gender this way can actually make self-acceptance harder for many trans women. While I found this sort of sexual exploration absolutely necessary in my pre-self-acceptance days, it also meant that I was able to write off my intrusive gender thoughts or daydreams as “just a fetish.” I treated them as something hidden and shameful instead of something to investigate further. -->
不幸的是，以這種方式探索性別實際上會讓許多跨性別女性更難自我接納。雖然我發現在我自我接納之前的日子裡，這種性探索是絕對必要的，但這也意味著我能夠將我侵入性的性別想法或白日夢視為「只是種戀物癖」。我把它們當作隱藏的、可恥的東西，而不是進一步研究的東西。
<!-- This issue is further complicated by the term “autogynephilia,” a bogus transphobic “theory” posited by a crank psychologist named Ray Blanchard. Autogynephilia posits that many people who self-identify as trans women aren’t actually women at all, but are instead creepy men who are turned on by the idea of being a woman or having a vagina. According to Blanchard, their entire transition is just an elaborate fetish game that they’re forcing the world to participate in. -->
「自體女性戀物癖」(AG) 這個詞彙使這個問題進一步複雜化，這是一個由一個名叫布蘭查德(Ray Blanchard) 的古怪心理學家提出的虛假的跨性別恐懼症「理論」。自體女性戀物癖認為，許多自認為是跨性別女性的人實際上根本不是女性，而是令人毛骨悚然的男人，他們被成為女人或擁有陰道的想法所激發。根據布蘭查德的說法，她們的整個轉變只是一個精心製作的戀物癖遊戲，她們正在強迫世界參與其中。
<!-- I want to be clear, here: autogynephilia is bullshit. [It has been discredited by actual scientists and researchers many, many times.](https://juliaserano.medium.com/making-sense-of-autogynephilia-debates-73d9051e88d3) The entire point of this theory, as far as I can tell, was to try and get cis people to start viewing trans women as male sex predators. Thankfully, most cis people don’t feel this way, and most of them haven’t heard of Blanchard or autogynephilia at all. -->
在這裡，我想說清楚：自體女性戀物癖是胡說八道。[它已被真正的科學家和研究人員多次駁斥。](https://juliaserano.medium.com/making-sense-of-autogynephilia-debates-73d9051e88d3)（英文）據我所知，這個理論的全部意義在於試圖讓順性別者開始將跨女視為男性性掠食者。值得慶幸的是，大多數順性別者並不這麼認為，而且他們中的大多數人根本沒有聽說過布蘭查德或自體女性戀物癖。
<!-- Unfortunately, a lot of closeted trans women come across this stuff as they’re questioning and think, “oh, do I just have autogynephilia? Maybe I’m not actually trans.” This is doubly true for trans women who have spent a lot of time expressing their gender feelings in sexual spaces, especially if they feel sexually aroused by the idea of becoming a woman. -->
不幸的是，很多未出櫃的跨性別女性在質疑時會遇到這些東西，並想：「哦，我只是 AG 嗎？也許我實際上不是跨。」對於那些花了很多時間在性空間表達性別感受的跨性別女性來說，尤其如此，尤其是如果她們因為成為女人的想法而感到性興奮的話。
<!-- While this feeling of arousal is too complex to fully unpack in this tiny section of a much longer essay, I will say that this feeling is really common early on but it tends to fade as your transition progresses. Some of it has to do with the fact that if you tie gender euphoria to sexual arousal for long enough, one will express partially as the other. Some of it also has to do with the fact that being seen as your true gender, or experiencing sexual pleasure as your true gender, feels fucking terrific. Either way, it’s not “just a fetish” if your feelings go deeper than pure sexual arousal. -->
雖然這種興奮的感覺太複雜了，無法在這篇長文中的一小部分中完全闡述，但我要說的是，這種感覺在早期真的很常見，但隨著你的轉變進展，它往往會消失。其中一部分與這樣一個事實有關：如果你將性別欣快感與性興奮聯繫在一起足夠長的時間，其中一個就會部分地表現為另一個。另一部分也與這樣一個事實有關：被視為你真正的性別，或以你真正的性別體驗性快感，感覺非常棒。無論如何，如果你的感覺比單純的性興奮更深層次，那就不「只是一種戀物癖」。
<!-- ### Consider The Broad Umbrella of Trans Identities -->
### 考慮跨性別身份的廣泛範圍
<!-- If you haven’t spent a lot of time in a community with openly queer people, you might not have fully internalized just how many different ways there are to both experience and express your gender. -->
如果你沒有在一個公開的酷兒群體中待過很長時間，你可能沒有完全內化有多少不同的方式來體驗和表達你的性別。
<!-- The wider world makes it seem like the “man” box and the “woman” box are two entirely different things with a massive gulf of emptiness between them, but that’s not really true. There are a roughly infinite number of ways to express gender, both inside and outside those boxes, and your gender might be somewhere in that undefined space. I am a fairly binary trans woman, and I like being inside the girl box, but my conception of gender as well as how I choose to express it are often entirely different from other people who are also in the girl box. -->
更廣闊的世界讓人覺得「男人」的框框和「女人」的框框是兩個完全不同的東西，它們之間有著巨大的空隙，但這並不是真的。在這些框框的內部和外部，都有無限多種表達性別的方式，而你的性別可能就在那個未定義的空間中的某個地方。我是一個相當二元化的跨性別女性，我喜歡待在女孩的框框裡，但我對性別的概念以及我選擇如何表達它的方式通常與其他也在女孩框框裡的人完全不同。
<!-- There is no right way to be trans. Some trans people change their presentation but don’t change their pronouns. Some trans people change their name and pronouns but don’t change their presentation. Some trans people are okay living as their assigned gender at birth as long as they know who they are on the inside. -->
沒有正確的方式成為跨性別者。一些跨性別者改變了他們的表現方式，但沒有改變他們的代詞。一些跨性別者改變了他們的名字和代詞，但沒有改變他們的表現方式。一些跨性別者可以接受以他們出生時被指定的性別生活，只要他們知道自己內心是誰。
<!-- Many trans people don’t opt for gender affirming surgeries or hormones. Many trans people use a different name and different pronouns depending on how they’d like to be seen in a given situation. Many trans people simply forge a relationship to gender that is slightly askew from cisnormativity, plant their flag, and call it a day. -->
許多跨性別者不選擇性別肯定手術或賀爾蒙。許多跨性別者根據他們在特定情況下希望如何被看待而使用不同的名字和不同的代詞。許多跨性別者只是與性別建立一種略微偏離順性別規範的關係，插上他們的旗幟，然後就這樣了。
<!-- Many trans people set out to transition one way, and ultimately realize that their identity better matches with something that they couldn’t have even begun to see when their process started. -->
許多跨性別者一開始就以一種方式轉變，但最終意識到，當他們的過程開始時，他們的身份與他們根本無法看到的東西更匹配。
<!-- All of this is valid, and my goal by including all this stuff here is to take the pressure off. It’s harder to accept yourself as trans if you feel like self-acceptance is going to come with a whole new set of impossible expectations. In truth, one of the great joys of being trans is realizing that you are actually free from all of these narrow ideas about what gender can and cannot be. -->
所有這些都是合理的，我把所有這些東西都包含在這裡的目的是為了減輕壓力。如果你覺得自我接納會伴隨著一系列新的不可能的期望，那麼就更難接受自己作為跨性別者。事實上，身為跨性別者的最大樂趣之一就是意識到，你實際上擺脫了所有這些關於性別可以是什麼和不可以是什麼的狹隘觀念。
<!-- No matter what you decide about your gender, the important thing is to be true to yourself. This sounds cheesy, but giving yourself permission to be honest about what does and does not bring you joy in terms of gender and gender presentation can be an explicitly radical act. This journey might lead you toward more comfort in your assigned gender at birth, or toward some sort of non-binary or gender-fluid identity, or perhaps you will come join me over here in the girl box (we have cupcakes!). -->
無論你對你的性別做出什麼決定，重要的是要忠於你自己。這聽起來很俗氣，但在性別和性別表現方面，允許自己誠實地對待什麼會給你帶來快樂，什麼不會給你帶來快樂，可以說是一種明確的激進行為。這段旅程可能會讓你對你出生時被指定的性別感到更舒適，或者走向某種非二元性別或流性身份，或者你會來加入我這邊的女孩框框（我們有紙子蛋糕！）。
<!-- Whatever you choose, do it because it helps you feel more like yourself. -->
無論你選擇什麼，都要去做，因為它能幫助你感覺更像你自己。
<!-- ### Consider That Transition Is Less About Discovering A Single Metaphysical Truth And More About Doing What Makes You Happy -->
### 考慮轉變不是發現一個單一的形上學真理，而是做讓你快樂的事情
<!-- One sticking point I come across a lot when I talk to questioning trans women is that they’ve paralyzed themselves with fear and are unwilling to act until they’ve solved the equation at the center of themselves and completely and fully accepted that they are, without a doubt, 100% trans. -->
當我和正在質疑的跨性別女性交談時，我經常遇到的一個癥結是，她們因恐懼而癱瘓，不願採取行動，直到她們解開了自身中心的方程式，並完全充分地接受她們毫無疑問地 100% 是跨性別者。
<!-- Unfortunately, this is pretty much impossible to do, especially before you’ve taken any actions toward affirming your gender. There’s no blood test or brain scan that can confirm trans-ness, so you will never have unequivocal proof. I can’t tell you how many girls have messaged me weeks or months into their self-acceptance and said things like, “hey, so I actually had a good day today presenting as male. Does that mean that I’m not actually trans?” -->
不幸的是，這幾乎是不可能做到的，尤其是在你沒有採取任何肯定你性別的行動之前。沒有血液檢查或大腦掃描可以證實跨性別身份，所以你永遠不會有明確的證據。我無法告訴你，有多少女孩在自我接納幾周或幾個月後給我發訊息說：「嘿，所以我今天以男性的身份出現時，實際上過得很好。這是否意味著我實際上不是跨性別者？」
<!-- (To answer: nope! I’ve had plenty of good days in boy-mode. I’m still a girl.) -->
（回答：不是！我在男孩模式下有很多美好的日子。我仍然是一個女孩。）
<!-- To that end, it’s worth keeping in mind that you are not a puzzle to be solved. You do not have to perform an exact taxonomic classification of your own gender. You’re just a human with your own complex set of needs, desires, dreams, goals, fears, triggers, and a whole mess of everything else. You are a contradictory, complex, illogical being who contains vast multitudes. -->
為此，值得記住的是，你不是一個需要解決的謎題。你不必對你自己的性別進行精確的分類學分類。你只是一個人，有著自己複雜的需求、慾望、夢想、目標、恐懼、觸發因素，以及一大堆其他的東西。你是一個矛盾的、複雜的、不合邏輯的、包含著眾多事物的個體。
<!-- This is kind of scary, but hopefully it’s also somewhat freeing. There’s no “proper” timeline to your transition. No list of things that you absolutely have to do. You can keep your name, or change it. You can get gender confirmation surgery, or you can keep what you’ve got. You can wear dresses every day, or you can leave them all for me. Some trans ladies have been dressing like women since they were old enough to buy clothes, but I didn’t once wear a full femme outfit until I was already three months into HRT. There are no rules. They were all made up by people who have been dead for hundreds of years. -->
這有點可怕，但也許也有些許的解放。你的轉變沒有「合適的」時間表。沒有你絕對必須要做的事情的清單。你可以保留你的名字，或者改變它。你可以做性別確認手術，或者你可以保留你現有的東西。你可以每天都穿裙子，或者你可以把它們都留給我。有些跨性別女性從她們會買衣服開始就穿得像女人，但我直到 HRT 三個月後才第一次穿全套女性服裝。沒有規則。它們都是幾百年前就去世的人編造出來的。
<!-- You also don’t have to commit to anything right away. Transition isn’t one giant leap into the abyss — it’s a series of small, willing steps. All of the early steps are easily reversible, and you never have to do anything that you don’t think will help make your life better. If you keep your eyes on your feet, you’ll cross the chasm before you know it. -->
你也不必馬上承諾任何事情。轉變不是一次巨大的跳躍到深淵——而是一系列小的、自願的步驟。所有早期的步驟都是很容易逆轉的，你不必做任何你認為不會讓你的生活變得更好的事情。如果你把目光放在腳下，你會在不知不覺中跨越鴻溝。
<!-- I like to recommend that people who are questioning their gender pick one or two small things and try them out instead of being stuck in their head all day, waiting for more evidence to present itself. Shave your arms, your legs, or your chest. Get some nail polish. Buy a piece of female clothing. Make an “alt” account on social media with a female name and she/her pronouns and engage with the digital world as a girl. Tell a trusted friend or two that you are questioning your gender, and ask them to call you by a different name/pronouns in private to see how it feels. Even the first few months of HRT are easily reversed, if you want to see how your mind works on estrogen. -->
我喜歡建議那些正在質疑自己性別的人選擇一兩件小事並嘗試一下，而不是整天困在自己的腦海裡，等待更多證據的出現。刮掉你的手毛、腿毛或胸毛。塗指甲油。買一件女裝。在社交媒體上建立一個帶有女性名字和她/她的代詞的「小號」，並以女孩的身份與數位世界互動。告訴一兩個值得信賴的朋友你正在質疑你的性別，並請他們私下裡用不同的名字/代詞稱呼你，看看感覺如何。即使是 HRT 的前幾個月也很容易逆轉，如果你想看看你的大腦對雌激素的反應如何。
<!-- While some of these steps are probably going to make you feel overwhelmed — heck, you might feel overwhelmed just thinking about them — you might also feel a few pings of absolute bliss somewhere in the process. Little moments of “oh, oh, OH, I like this, this feels good!!” -->
雖然其中一些步驟可能會讓你感到不知所措——哎呀，你可能只是想想它們就感到不知所措——但你也可能會在這個過程中感受到一些絕對的幸福。一些「哦，哦，哦，我喜歡這個，這感覺很好！！」的時刻。
<!-- That’s gender euphoria, and it’s a sign that you’re proceeding in the right direction. If you follow those feelings, wherever they take you, I guarantee you it will lead to so much happiness and joy. -->
這就是性別欣快感，這表明你正朝著正確的方向前進。如果你追隨這些感覺，無論它們帶你去哪裡，我保證它會帶來如此多的幸福和快樂。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現：生化不安"
linkTitle: "生化不安"
description: "造成心理困擾的性別不安的真實生物因素。"
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prevCaption: 身體不安
next: /tw/social-dysphoria
nextCaption: 社交不安
---
<!-- # Biochemical Dysphoria -->
# 生化不安
<!-- The primary sexual features of the body begin development during the eighth week of human gestation. Typically, by week 11, it is possible to determine the genitals of a fetus via ultrasound. The brain, however, forms [between weeks 14 and 24](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989000/#Sec5title). Current prevailing understanding of neurological development suggests that it is during these 10 weeks when the brain will either masculinize or feminize based upon the presence of testosterone in the fetus bloodstream (initiated by the SRY gene on the Y chromosome, or introduced from other sources). This process locks the brain into a pattern of either desiring estrogens or androgens. -->
人體的第一性徵始於妊娠第八週。通常情況下，到第 11 週，就可以通過超音波檢查確定胎兒的生殖器官。然而，大腦的形成則是在[第 14 週到第 24 週之間](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989000/#Sec5title)。目前主流的神經發育學觀點認為，在這 10 週內，大腦會根據胎兒血液中睪固酮的存在與否（由 Y 染色體上的 SRY 基因啟動，或從其他來源引入）而男性化或女性化。這個過程會將大腦鎖定成渴望雌激素或雄激素的模式。
<!-- If your brain is wired for one kind of gonadal hormones (such as testosterone) and your body produces the other hormone (such as estradiol), this can result in a biochemical malfunction within your brain chemistry. This produces a sort of brain fog: a reduction in mental capacity and a general state of anxiety and unease. This is the source of the first two symptoms that often alleviate with medical hormonal therapy: **depersonalization and derealization (DPDR)**. -->
如果你的大腦天生需要某一種性腺激素（例如睪固酮），而你的身體卻產生另一種激素（例如雌二醇），這可能會導致大腦化學的生化功能失常。這會產生一種腦霧：心智能力下降，並伴隨著普遍的焦慮和不安感。這就是通常透過荷爾蒙治療可以緩解的前兩種症狀的根源：**失自我感(depersonalization)和 失現實感(derealization)（DPDR）**。
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#TransformationTuesday - 我在這樣的貼文中經常提到，我們的眼睛反映了我們的人生。我看到的跨性別者在轉變後外貌最大的不同，永遠都在眼神；過去的眼神通常看起來悲傷或疏離，而現在則明亮且充滿活力。
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<!-- **Depersonalization** is a disconnect from your own body: an inability to believe that the person you see in the mirror is actually yourself. You feel like you are watching someone else in your body. You may find yourself not caring about what happens to your body, feeling a lack of concern with weight changes or improving your fitness because you have no ownership of this fleshy vehicle that transports you around your life. -->
**失自我感(depersonalization)** 是指與自身身體的脫節：無法相信你在鏡子中看到的人實際上就是你自己。你感覺像是正在觀看別人操控著你的身體。你可能會發現自己不在乎身體發生了什麼事，對體重變化或增進體能缺乏關心，因為你對這個載著你生活的肉體容器沒有所有權感。
<!-- Zinnia Jones [gives these descriptions for Depersonalization](https://web.archive.org/web/20190406141617/https://genderanalysis.net/2017/06/depersonalization-in-gender-dysphoria-widespread-and-widely-unrecognized/): -->
Zinnia Jones [對失自我感的描述如下](https://web.archive.org/web/20190406141617/https://genderanalysis.net/2017/06/depersonalization-in-gender-dysphoria-widespread-and-widely-unrecognized/)：
<!-- - A sense of detachment or estrangement from your own thoughts, feelings, or body: “I know I have feelings but I don’t feel them”
- Feeling split into two parts, with one going through the motions of participating in the world and one observing quietly: “There is this body that walks around and somebody else just watches”
- Feeling as if you have an “unreal” or absent self: “I have no self”
- Experiencing the world as distant, dreamlike, foggy, lifeless, colorless, artificial, like a picture with no depth, or less than real
- Being absorbed in yourself and experiencing a compulsive self-scrutiny or extreme rumination
- Having an ongoing and coherent dialog with yourself
- Feeling like a veil or glass wall separates you from the world
- Emotional or physical numbness, such as a feeling of having a head filled with cotton
- Lacking a sense of agency – feeling flat, robotic, dead, or like a “zombie”
- Inability to imagine things
- Being able to think clearly, but feeling as if some essential quality is lacking from your thoughts or experience of the world
- A sense of disconnectedness from life, impeding you from creative and open involvement with the world -->
- 與你自己的想法、感受或身體分離或疏離的感覺：「我知道我有感覺，但我感覺不到它們」
- 感覺分裂成兩個部分，一個部分經歷著參與世界的動作，另一個部分則靜靜地觀察：「有一個身體在走動，而另一個人只是看著」
- 感覺好像你有一個「不真實」或不存在的自我：「我沒有自我」
- 感覺世界是遙遠的、夢幻般的、朦朧的、沒有生氣的、沒有色彩的、人造的，像一幅沒有深度的圖畫，或是不真實的
- 全神貫注於自己，經歷強迫性的自我審視或極端的沉思
- 與自己持續不斷地進行連貫的對話
- 感覺像有一層面紗或玻璃牆將你與世界隔開
- 情緒或身體麻木，例如感覺頭裡塞滿了棉花
- 缺乏自主感——感覺平淡、像機器人、像死了一樣，或者像個「殭屍」
- 無法想像事物
- 能夠清晰地思考，但感覺你的思想或對世界的體驗缺乏一些重要的特質
- 與生活脫節的感覺，阻礙你創造性地、開放地參與世界
<!-- You may put little care into your physical appearance, reaching for only the basic utilitarian needs in clothing and personal hygiene. Alternatively, you may hyperfocus on your appearance, attempting to try to spark some kind of joy, any kind of feeling of pride in your own body, only to be met with more hollowness. -->
你可能不太在意自己的外表，只追求服裝和個人衛生方面的基本實用需求。或者，你可能會過度關注自己的外表，試圖激發某種快樂，任何一種對自己身體的自豪感，卻只會遇到更多的空虛感。
<!-- You may be unconcerned with the state of your body, perhaps not even fearing death, because you have so little attachment to your life. -->
你可能不關心你的身體狀況，甚至可能不害怕死亡，因為你對自己的生命沒有什麼依戀。
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> 你潛意識裡覺得自己和大多數人「不一樣」。你的朋友或許懂你，但你本能地、無意識地在自身和「一般人」之間劃清界線。當你和「一般人」互動時，你不太確定該說什麼或怎麼做。
>
> 你發現很難將自己的感受放在優先位置。你知道自己 *應該* 有什麼感受，但這些感受卻很遙遠，而且像是裝出來的。當別人感到沮喪時，那感覺卻真實且急迫得多。你認為這只是你堅忍、保護自己的天性使然。
>
> 你常常覺得人生沒有方向。在高中時期被問到職涯目標時，你其實不太在意自己的答案。即使是圍繞著你興趣發展的職業，似乎也讓你難以忍受。你很難想像一個自己感到快樂或滿足的未來。
>
> 你只會在外部力量 *迫使* 你的情況下，才會採取行動改善生活。你寧願退縮、降低自己的存在感，並專注於逃避現實的嗜好。你就是沒有動力去為自己爭取美好的事物。（你告訴自己，這是一種佛系，一種擺脫慾望的自由。）
<!-- **Derealization** is a detachment from the world around you: a mental sense that everything you perceive is false. -->
**失現實感(Derealization)** 是指與周圍世界的脫離：一種認為你所感知的一切都是虛假的心理狀態。
<!-- - Your surroundings seem alien or unfamiliar, even if you've always been there, like someone has swapped out your house for a stage replica.
- Moving through the world feels like you're walking on a treadmill, with the buildings moving around you instead of you through them.
- Feeling emotionally disconnected from people you care about, as if you were separated by a glass wall, or like they are just actors pretending to be the people they claim to be.
- Surroundings that appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings. Leaves on trees feel like they have extra sharp edges, for example.
- Distortions in perception of time, such as recent events feeling like distant past.
- Distortions of distance and the size and shape of objects
- Feeling like a passive observer in the events of your life -->
- 你周圍的環境看起來很陌生，即使你一直都在那裡，就像有人把你的房子換成了一個舞台複製品。
- 在世界上移動感覺就像在跑步機上行走，建築物在你周圍移動，而不是你在建築物中移動。
- 感覺與你在乎的人情感上脫節，好像你們被一堵玻璃牆隔開，或者他們只是演員，假裝是他們自稱的人。
- 周圍的環境看起來扭曲、模糊、無色、二維或人造，或者對周圍環境的意識和清晰度提高。例如，樹上的葉子感覺邊緣格外銳利。
- 時間感知的扭曲，例如最近的事件感覺像是遙遠的過去。
- 距離以及物體大小和形狀的扭曲
- 感覺像是你生活中事件的被動觀察者
<!-- If you found yourself strongly relating to *The Matrix* or *The Truman Show*, you might be experiencing derealization. This can also manifest as a feeling of otherworldliness, like you don't belong in this society. You're just walking around waiting for your super powers to appear, or for an owl to fly up with your letter to Hogwarts. As a teen I was obsessed with an episode of *The Outer Limits* where a boy discovers a spaceship under his house and learns that he and his parents aren't actually human. -->
如果你對《駭客任務》或《楚門的世界》強烈產生共鳴，你可能正在經歷去現實感。這種感覺也可能表現為一種異世界感，就像你不屬於這個社會。你只是四處遊走，等待你的超能力出現，或者等待一隻貓頭鷹飛來，帶著你前往霍格華茲的錄取通知。在我青少年時期，我非常著迷於《第九空間》(The Outer Limits) 的一集，內容是一個男孩在他家底下發現了一艘太空船，並得知他和他的父母其實不是人類。
<!-- DPDR sometimes comes with an emotional stunting. You are able to laugh and find humor, but rarely ever genuine joy. Moments of sadness or grief cause you to just go numb, dissociated by the event that caused it. This can also go in the opposite direction, where the person is under so much anxiety that their emotional response is extremely disproportionate to the catalyst, resulting in severe crying or violent outbursts from seemingly small events. -->
現實解離人格解離症 (DPDR) 有時會伴隨著情緒上的遲鈍。你能夠笑也能找到幽默感，但卻很少感受到真正的快樂。傷心或哀痛的時刻只會讓你感到麻木，與造成它的事件脫離。這也可能走向相反的方向，患者處於極度焦慮的狀態，他們的情緒反應與觸發事件的比例極度不相稱，導致看似微不足道的小事就引起劇烈哭泣或暴怒。
<!-- It's important to note that DPDR is not exclusive to gender dysphoria. This condition is comorbid with several other mental health issues, including chronic depression, obsessive compulsive disorder, and borderline personality disorder. DPDR should not be taken as a sign of gender dysphoria purely on its own; it's just a big alarm signal that something is very wrong. It's also usually pretty easy to spot externally, once you know how to watch for it. People with DPDR tend to have a mile long stare as they move about in the world; eyes so gloomy and dead that they look like a shell. One of the most common comments on transition timelines is how the eyes gain so much spark. -->
重要的是，現實解離人格解離症(DPDR)並非性別不安所獨有。這種病症與其他幾種心理健康問題共病，包括慢性憂鬱症、強迫症和邊緣型人格障礙。不應單純將現實解離人格解離症視為性別焦慮的徵兆；它只是一個很大的警訊，表明情況非常不對勁。一旦你知道如何觀察它，通常也很容易從外部發現。現實解離人格解離症患者在世上走動時，往往眼神茫然，目光呆滯無神，看起來像個空殼。在跨性別者轉變過程的記錄中，最常見的評論之一就是眼神如何變得更有神采。
<!-- ### The Ebb and Flow -->
### 潮起潮落
<!-- The intensity of physical and biochemical dysphoria is highly influenced by other factors in the body. Because it is a function of endocrine balance, it is also manipulated by those balances. This means that it can rise and fall from day to day. For example: -->
生理和生化性別焦慮的強度會受到體內其他因素的高度影響。由於它是內分泌平衡的一種功能，它也會被這些平衡所操縱。這意味著它會每天起伏變化。例如：
<!-- - If your blood sugar is out of whack, or you have a thyroid condition, it could cause your dysphoria to spike.
- If you are having dopamine withdrawal because of ceasing stimulants, that can make it worse.
- If you start on an SSRI antidepressant and start running with more serotonin, that can make it less intense.
- Transfeminine AMABs (people assigned male at birth) with testicles experience surges in testosterone in relation to attraction and desire, which can make them more dysphoric.
- Transmasculine AFABs (people assigned female at birth) with unsuppressed ovaries experience rises and falls in estrogen and progesterone over the course of their menstrual cycle, making their dysphoria intensify and lessen based on what day of the cycle they are on. -->
- 如果你的血糖失調，或者你有甲狀腺疾病，它可能會導致你的不安感加劇。
- 如果你因為停止使用興奮劑而出現多巴胺戒斷症狀，那會使情況變得更糟。
- 如果你開始服用 SSRIs 抗憂鬱藥，並開始分泌更多血清素，那可以降低它的強度。
- 睪丸未摘除的指定男性出生 (AMAB) 跨性別女性，會因為性吸引和性慾而經歷睪固酮的激增，這會使他們的焦慮更加嚴重。
- 卵巢未抑制的指定女性出生 (AFAB) 跨性別男性，會在月經週期中經歷雌激素和黃體酮的上升和下降，這會使他們的焦慮隨著週期中的哪一天而加劇或減輕。
<!-- There are dozens of systems in the body that all work in tandem, and they all fluctuate from day to day, manipulating general mental state. This general dysphoria can amplify the affect of all other dysphoria. One day you can shrug off misgendering like it's nothing, and then the next it hurts like a stab in the heart every time. One day you see yourself in the mirror, the next you're staring at the old you. -->
體內有數十個系統協同工作，它們每天都在波動，操縱著整體的心理狀態。這種普遍的不安感會放大所有其他不安感的影響。有一天，你可能對被誤認性別毫不在意，但第二天，每次被誤認性別都像心如刀割。有一天你在鏡子裡看到的是自己，第二天你看到的卻是過去的你。
<!-- Some people experience this in a genderfluid way, with some days leaning male, same days leaning female, and other days not feeling any gender, or both. Others just feel it like a seasonal river; sometimes it swells because of rains up stream, sometimes it slows to a trickle because of drought. -->
有些人以性別流動的方式體驗這種情況，有些日子偏向男性，有些日子偏向女性，還有些日子沒有任何性別認同，或者兼具兩者。其他人則感覺它像一條季節性河流；有時因為上游的雨水而水位上漲，有時因為乾旱而水流緩慢。
<!-- All of this is valid, and just because you feel very dysphoric one day and not dysphoric the next does not mean that you aren't really trans. -->
所有這些都是合理的，你今天感到非常不安，而第二天卻沒有，並不意味著你不是真正的跨性別者。
<!-- ### This Happens Both Ways -->
### 雙向皆然
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> 請注意，如果一個感到困惑的順性別人士嘗試進行醫療變性，而沒有被眾多荒謬的守門人或需要簽字的真正醫學專業人士阻止的話，以下是可能會發生的事情：他們會服用一些藥物或注射。
>
> 接著會讓他們感覺非常糟糕，就像把糖倒進大腦的油箱一樣。在這個時候，我們可以假設他們會立即停止服用他們實際上不需要的激素補充劑，並恢復正常生活，不會有任何持續的後果。
>
> 如果一個 **真的** 非常固執且困惑的順性別者忽略這種極度糟糕的感覺，並持續服用他們不應該服用的HRT數個月，他們可能還會經歷一些痤瘡和/或皮膚變得乾淨透亮，看起來很棒，而女性則可能開始長出鬍鬚。
>
> 處於這種情況的男性在服用不需要的雌二醇補充劑大約一年左右後，可能會出現男性女乳症，感覺完全就像是垃圾。在類似的時間範圍內，任何人的生殖器都可能表現得不像原本的樣子，
>
> 我想這也是一種會讓人覺得「嘿，這不對」的情況，然後就會停止服用他們誤用的藥物。然後，一切又會恢復正常。
>
> 喔，以上我說的都是HRT。通常那些偏執的人談論的是
>
> 青春期阻斷劑，好像它們是HRT一樣。如果一些困惑的順性別孩子服用青春期阻斷劑，實際會發生的總體情況是……青春期延遲，直到他們意識到自己服用這些藥物沒有任何特殊原因並停止服用。沒有任何副作用需要擔心。
<!-- Sometimes you will hear naysayers suggesting that taking hormone therapy always improves mental health. I heard this myself when I came out to my mother. "Estrogen makes everyone happier." This is flat out false. When cis people are put on cross-hormone therapy it always results in dysphoria. This is one reason why Spironolactone is rarely ever prescribed to men, because the anti-androgen factor causes mental instability. Five to ten percent of cis women suffer from [polycystic ovary syndrome (PCOS)](https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome), a condition which causes the ovaries to produce testosterone instead of estrogen. Ask any one of them how their mental health has been, and they will give you an earful. -->
有時你會聽到反對者聲稱，接受激素治療總是能改善心理健康。當我向我母親出櫃時，我自己也聽到了這種說法。「雌激素讓每個人都更快樂。」這完全是錯誤的。當順性別者接受跨性別激素治療時，總是會導致不安感。這就是螺環固醇內酮(Spironolactone)很少開給男性的原因之一，因為它的抗雄激素作用會導致心理不穩定。百分之五到十的順性別女性患有多囊性卵巢症候群 (PCOS)，這種疾病會導致卵巢產生睪固酮而不是雌激素。問她們任何一個人的心理健康狀況如何，她們都會滔滔不絕地向你傾訴。
<!-- One very potent demonstration of this is the tragic case of [David Reimer](https://en.wikipedia.org/wiki/David_Reimer). At seven months of age David and his twin brother were given circumcisions to treat a bad case of phimosis (a skin condition on the foreskin). David's went horribly wrong, and the penis was destroyed. The decision was made to perform vaginoplasty and raise him as a girl, including estrogen therapy at pubescence. By the age of 13, he was deep into suicidal depression and suffering greatly, as no amount of coaching and encouraging can make a boy enjoy being a girl. When his parents informed him of what had happened, he returned to a male presentation, switched to testosterone therapy, and over the course of his teen years had multiple operations in order to transition back to male. -->
一個非常有力的例子是 [大衛·利馬(David Reimer)](https://zh.wikipedia.org/wiki/%E5%A4%A7%E8%A1%9B%C2%B7%E5%88%A9%E9%A6%AC) 的悲慘案例。大衛和他的雙胞胎兄弟在七個月大的時候接受了包皮環切術來治療嚴重的包莖（包皮上的一種皮膚病）。大衛的手術嚴重出了差錯，陰莖被毀掉了。於是決定進行陰道成形術，並把他當作女孩撫養，包括在青春期接受雌激素治療。到了 13 歲，他陷入了深深的自殺性抑鬱，並且非常痛苦，因為再多的指導和鼓勵都不能讓一個男孩享受作為女孩的生活。當他的父母告訴他發生的事情後，他恢復了男性的裝扮，改用睪固酮治療，並在青少年時期接受了多次手術，以便變回男性。
<!-- People know when they're living the wrong gender. -->
人們知道自己是否活在錯誤的性別當中。
<!-- Psychologist John Money oversaw David's case and was largely responsible for the decisions that were made in David's upbringing. Money, seeking to make a name for himself, massively misreported on David's case, calling it a complete success in his reports. The result of this echoes to this day, as Money's reports were used as an example of why performing genital corrective surgeries on intersex infants was an appropriate course of action. Fifty years later there are still doctors who believe that you can just change a child's genitals and raise them as that gender and it will stick. -->
心理學家約翰·曼尼(John Money) 負責大衛的案例，並且對大衛成長過程中所做的決定負有主要責任。曼尼為了揚名立萬，在他的報告中嚴重歪曲了大衛的案例，稱其完全成功。這一結果至今仍有影響，因為曼尼的報告被用作一個例子，說明為什麼對雙性嬰兒進行生殖器矯正手術是適當的做法。五十年後，仍然有醫生認為，你可以改變一個孩子的生殖器，並將他們按照該性別撫養長大，而且這種做法會有效。
<!-- This is the tragedy of the [intersex](https://en.wikipedia.org/wiki/Intersex) community. Roughly one in every 60 births results in some kind of intersex condition (though not all of these are related to genitalia). Often times the "corrective" procedures used on intersex children results in a loss of function and/or sensation. Far too frequently, doctors would opt towards forced female assignment because it was easier to construct a vulva than a penis. -->
這就是[陰陽人](https://zh.wikipedia.org/wiki/%E9%9B%99%E6%80%A7%E4%BA%BA)社群的悲劇。大約每 60 個新生兒中就有一個患有某種陰陽人疾病（儘管並非所有這些都與生殖器相關）。通常情況下，用於陰陽人兒童的「矯正」手術會導致功能和/或感覺的喪失。醫生往往會選擇強制指定女性，因為構造外陰比構造陰莖更容易。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不一致的成因是什麼"
linkTitle: "性別不安的成因"
description: "是荷爾蒙，寶貝。"
preBody: '_disclaimer'
classes:
- gdb
tweets:
- https://twitter.com/LisaTMullin/status/1224039568971710464
- https://twitter.com/LisaTMullin/status/1224040716365524993
- https://twitter.com/LisaTMullin/status/1224041800513380352
- https://twitter.com/LisaTMullin/status/1224041800513380352
- https://twitter.com/LisaTMullin/status/1224042620164296705
- https://twitter.com/LisaTMullin/status/1224043995413639168
- https://twitter.com/LisaTMullin/status/1224044949160611840
siblings:
prev: /tw/treatment
prevCaption: 治療性別不安
next: /tw/chromosomes
nextCaption: 但是... 但是... 染色體！
---
<!-- # What is the Cause of Gender Incongruence? -->
# 性別不一致的成因是什麼？
<!-- To put it bluntly, we don't know (at least not firmly). Science and modern psychology has proven that it is **not** caused by nurture; no one *becomes* transgender, gender identity is congenital, solidifying before we even exit the womb. It also appears to sometimes be hereditary; transgender parents have a higher likelihood of having transgender children, and many times they realize this in reverse. The child comes out to the parent, and that helps the parent realize they can come out as well. -->
坦率地說，我們不知道（至少不確定）。科學和現代心理學已經證明，它 **不是** 由後天造成的；沒有人會 *變成* 跨性別者，性別認同是先天的，在我們離開子宮之前就已經確定了。它似乎有時也是遺傳的；跨性別父母更有可能擁有跨性別孩子，而且很多時候他們是反過來意識到這一點的。孩子向父母出櫃，這幫助父母意識到他們也可以出櫃。
<!-- Here is the science that is believed to influence gender identity. This does not mean that it *defines* gender identity, nor does it fully encapsulate one's gender, as so many aspects of gender are cultural and social. None of this is prescriptive of a person's identity, none of it is cast in stone. -->
以下是被相信會影響性別認同的科學。這並不意味著它 *定義* 了性別認同，也不意味著它完全涵蓋了一個人的性別，因為性別的很多方面都是文化和社會的。這些都不是對一個人身份的規定，都不是一成不變的。
<!-- If you've seen Jurassic Park, you may remember this scene: -->
如果你看過《侏羅紀公園》，你可能會記得這個場景：
<!-- {!{
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className="card borderless center span34"
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}!} -->
{!{
{{import '~/img' images.jurassicpark
className="card borderless center span34"
alt="所有脊椎動物的胚胎本來都是雌性的。它們只需要在正確的發育階段給予額外的賀爾蒙，就能使它們變成雄性。"
caption="這不是科幻小說，雖然它被簡化了。"
}}
}!}
<!-- {!{
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{{import '~/img' images.fetalgenitals
className="card"
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alt="Fetal development of internal sexual anatomy"
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{!{
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{{import '~/img' images.fetalgenitals
className="card"
caption="<a href=\"https://schoolbag.info/biology/concepts/188.html\">來源</a>"
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<!-- The gonads in human fetuses initially develop in a bi-potential state, meaning they can become either ovaries or testes. The SRY gene on the Y chromosome releases a protein called [testis-determining factor](https://en.wikipedia.org/wiki/Testis-determining_factor) (TDF). This protein then starts a chain reaction with SOX9 production (another protein), which causes the gonadal cells to form into the Sertoli and Leydig cells that make up the testes. If TDF is never produced or is interfered with, the gonad cells form into the Theca cells and follicles which comprise the ovaries. -->
人類胎兒的性腺最初是在雙向潛能狀態下發育的，這意味著它們可以發育成卵巢或睪丸。Y 染色體上的 SRY 基因會釋放一種叫做[睪丸決定因子](https://zh.wikipedia.org/wiki/SRY%E5%9F%BA%E5%9B%A0)（TDF）的蛋白質。然後，這種蛋白質會啟動與 SOX9 生成（另一種蛋白質）的連鎖反應，這會導致性腺細胞形成組成睪丸的塞爾托利氏(Sertoli)細胞和萊迪希(Leydig)細胞。如果 TDF 從未產生或受到干擾，性腺細胞就會形成組成卵巢的膜細胞和濾泡。
<!-- Once formed, the testes then begin producing a testosterone surge which typically starts in the eighth week of gestation and continues until the 24th week. This surge, [combined with another hormone from the placenta](https://www.sciencedaily.com/releases/2019/02/190214153053.htm), is responsible for the development of the penis and scrotum. Genitalia formation starts around week nine and becomes identifiable by the 11th week. If the surge does not occur, or the body does not respond to it (such as in the case of androgen insensitivity syndrome) then the genitalia form into the vulva, vagina, and uterus instead. -->
一旦形成，睪丸就會開始產生睪固酮激增，通常從妊娠第八週開始，持續到第 24 週。這種激增[與來自胎盤的另一種激素相結合](https://www.sciencedaily.com/releases/2019/02/190214153053.htm)（英文），是陰莖和陰囊發育的原因。生殖器形成大約在第九週開始，到第 11 週就可以辨認出來。如果沒有出現這種激增，或者身體對它沒有反應（例如在雄激素不敏感症候群的情況下），那麼生殖器就會形成外陰、陰道和子宮。
<!-- If there is an interference in this process then you can end up with the wrong bits, and this is the result of many intersex conditions. Oftentimes this is a partial development, where the external genitalia only partially form but functional gonads still exist. Sometimes the child comes out with fully functional male or female genitalia, but mismatched gonads. Sometimes the TDF protein fails to release and the fetus grows completely functional female reproductive organs, despite the presence of a Y chromosome. -->
如果這個過程受到干擾，那麼你最終可能會得到錯誤的部位，這就是許多雙性人情況的結果。通常情況下，這是一種部分發育，外部生殖器只部分形成，但功能性性腺仍然存在。有時，孩子出生時具有功能齊全的男性或女性生殖器，但性腺不匹配。有時，儘管存在 Y 染色體，但 TDF 蛋白質未能釋放，胎兒長出了功能齊全的女性生殖器官。
<!-- This is known as Swyer syndrome, and an unknown number of women may have this condition. In 2015 [an XY woman with Swyer syndrome who was born without ovaries](https://www.independent.co.uk/news/science/mostly-male-woman-gives-birth-to-twins-in-medical-miracle-10033528.html) successfully carried and gave birth to a child via IVF. Usually, Swyer syndrome results in completely non-functional ovaries, but [in 2008 a woman was found with Swyer syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190741/) who had gone through puberty, menstruated normally, and had two unassisted pregnancies. Her condition went undiscovered until her daughter was found to also have it. -->
這就是所謂的斯威爾症候群(Swyer syndrome)，而且不知道有多少女性可能患有這種疾病。2015 年，[一位患有斯威爾症候群且出生時沒有卵巢的 XY 女性](https://www.independent.co.uk/news/science/mostly-male-woman-gives-birth-to-twins-in-medical-miracle-10033528.html)（英文）透過試管嬰兒成功懷孕並生下了一個孩子。通常斯威爾症候群會導致卵巢完全無功能，但在[2008 年，一位患有斯威爾症候群的女性](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190741/)（英文）經歷了青春期、正常月經，並且有兩次自然受孕。直到她的女兒也被發現患有這種疾病，她的病情才被發現。
<!-- The fact is, the vast majority of the population has never been tested for genetic karyotype, so we don’t know how common these cases actually are. Where does this come into effect for gender identity? Well, the exact same process that causes the external genitals to differentiate also occurs for the brain. -->
事實上，絕大多數人都沒有接受過基因核型檢測，所以我們不知道這些病例實際上有多普遍。這對性別認同有什麼影響呢？嗯，導致外生殖器分化的過程也發生在大腦中。
<!-- {!{
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<strong style="display: block;text-align: center;">And it gets even weirder!</strong>
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<strong style="display: block;text-align: center;">而且他更奇怪!</strong>
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<!-- #### Brain Split -->
#### 大腦分裂
<!-- The prenatal brain doesn't really start to develop until between week 12 and 24. The cerebral cortex, the thin outer layer of the brain that contains most of what we think of as consciousness, grows substantially during those periods of time. Prior to that, the structure present is more like a scaffolding — the basic parts of the nervous system necessary for bodily function. The primary sulci (the wrinkles in the cerebral cortex that allow for more surface area) [start to form at week 14](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989000/#Sec5title), well after the genitals have developed. -->
胎兒的大腦在第 12 到 24 週之間才真正開始發育。大腦皮層是大腦的薄薄的外層，包含了我們認為的大部分意識，在這段時間內會大量生長。在此之前，存在的結構更像是一個框架——身體機能所需的神經系統的基本組成部分。主要的腦溝（大腦皮層的皺褶，允許更大的表面積）[在第 14 週開始形成](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989000/#Sec5title)（英文），遠在生殖器發育之後。
<!-- It [has been confirmed multiple times](https://www.the-scientist.com/features/are-the-brains-of-transgender-people-different-from-those-of-cisgender-people-30027) via MRI studies that there are small but significant differences between cis male and cis female brains — differences which align with the gender identities of trans people in the study. Note that **this does not mean that anyone with those differences will have that gender**; gender identity isn't that simple, but it provides evidence that there is a clear difference in masculine and feminine brains. [There is also evidence](https://www.pnas.org/content/112/50/15468) that brains can have mosaic combinations of these differences, which may be the case in non-binary people. -->
透過 MRI 研究[已經多次證實](https://www.the-scientist.com/features/are-the-brains-of-transgender-people-different-from-those-of-cisgender-people-30027)（英文），順性別男性和順性別女性的大腦之間存在微小但顯著的差異——這些差異與研究中跨性別者的性別認同相符。請注意，**這並不意味著任何有這些差異的人都會有那種性別**；性別認同沒有那麼簡單，但它提供了證據，表明男性和女性的大腦有明顯的差異。[也有證據](https://www.pnas.org/content/112/50/15468)（英文）表明，大腦可以有這些差異的鑲嵌組合，這可能是非二元性別者的情況。
<!-- A change in the testosterone levels in the fetus after the 11th week can directly impact the masculinization of the cerebral cortex, as well as changes in other parts of the brain structure. This has been examined [over and over again](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350266/) in studies of female-assigned children with CAH (congenital adrenal hyperplasia) and CAIS (complete androgen insensitivity syndrome). -->
在第 11 週之後，胎兒體內睪固酮水平的變化會直接影響大腦皮層的男性化，以及大腦結構其他部分的變化。在對患有 CAH（先天性腎上腺增生症）和 CAIS（完全雄激素不敏感症候群）的女性指定兒童的研究中，這一點已經被[反覆檢驗](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350266/)（英文）。
<!-- <blockquote class="cite"><p>We found a significant relationship between fetal testosterone and sexually differentiated play behavior in both girls and boys.</p>&mdash; <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778233/">Fetal Testosterone Predicts Sexually Differentiated Childhood Behavior in Girls and in Boys</a></blockquote> -->
<blockquote class="cite"><p>我們發現，胎兒睪固酮與女孩和男孩的性別差異遊戲行為之間存在顯著的關係。</p>&mdash; <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778233/">胎兒睪固酮預測女孩和男孩的性別差異童年行為</a>（英文）</blockquote>
<!-- An excess of testosterone in the mother’s body during the second trimester can (and does) cause masculinization of the brain in an externally female fetus, and an interference in testosterone production or uptake can (and does) cause feminization of the brain in an externally male fetus. This interference does not have to be external in origin, either. Any number of genetic traits can cause the brain to respond differently to testosterone. -->
在妊娠中期，母親體內過多的睪固酮會（而且確實會）導致外部為女性胎兒的大腦男性化，而睪固酮產生或吸收受到干擾會（而且確實會）導致外部為男性胎兒的大腦女性化。這種干擾也不一定是外源性的。任何數量的基因特徵都可能導致大腦對睪固酮的反應不同。
<!-- A fairly large study of transgender individuals released in 2018 [found several key genes](https://academic.oup.com/jcem/article/104/2/390/5104458) which were statistically more likely to be longer among trans women (longer as in having more repeated fragments). Individually these genes may not have an impact strong enough to cause a malfunction of masculinization, but collectively they absolutely could reduce the ability for the fetal brain to masculinize. These genes are all passed from parent to child, giving credence to a tendency for trans parents to have trans children. -->
2018 年發布的一項針對跨性別者的相當大規模的研究[發現了幾個關鍵基因](https://academic.oup.com/jcem/article/104/2/390/5104458)（英文），這些基因於統計學中在跨性別女性上更可能更長（更長是指有更多重複的片段）。單獨來看，這些基因的影響可能不足以導致男性化功能失調，但總的來說，它們絕對會降低胎兒大腦男性化的能力。這些基因都是從父母傳給孩子的，這也證明了跨性別父母更有可能擁有跨性別孩子的傾向。
<!-- #### Gender is Biological -->
#### 性別是生理的
<!-- Sadly, western society has actively prevented a deeper understanding of gender. Ancient civilizations understood it well, but colonialism wiped them off the map. 100 years ago, [scientists in Germany were actively studying](https://en.wikipedia.org/wiki/Institut_f%C3%BCr_Sexualwissenschaft) transgender medicine and made extraordinary advancements, until the Nazis burned it all in 1933. Conservative and fascist pressures in the modern day have hindered advancements in transgender healthcare whenever possible. -->
可悲的是，西方社會積極地阻礙了對性別的更深層次的理解。古代文明對此很了解，但殖民主義將它們從地圖上抹去了。100 年前，[德國的科學家正在積極地研究](https://en.wikipedia.org/wiki/Institut_f%C3%BCr_Sexualwissenschaft)（英文）跨性別醫學，並取得了非凡的進展，直到 1933 年納粹將所有這些都燒毀。現代社會中保守主義和法西斯主義的壓力盡可能地阻礙了跨性別醫療保健的進展。
<!-- Yet, progress continues, and every few years we learn a little bit more. -->
然而，進步仍在繼續，每隔幾年我們就會學到更多東西。
<!-- What we know for certain is that it is not a psychological condition. It is not something caused by trauma or by any external influence; nothing can make a person transgender. It happens in the womb, and is not something that a person can choose to be, any more than they could choose their race or their eye color. It has nothing to do with sexual orientation, it has nothing to do with kinks or fetishes, and it has nothing to do with social influences from their parents or from their peers. [Transgender children are as firm in their identities as cisgender children are](https://www.forbes.com/sites/dawnstaceyennis/2020/12/29/study-transgender-children-recognize-their-authentic-gender-at-early-age-just-like-other-kids/#20bbb14526bf). -->
我們可以肯定的是，這不是一種心理疾病。它不是由創傷或任何外在影響引起的；沒有任何東西可以使一個人成為跨性別者。它發生在子宮內，不是一個人可以選擇的，就像他們無法選擇自己的種族或眼睛顏色一樣。它與性取向無關，與禁羈(kink)或戀物癖無關，也與來自父母或同儕的社會影響無關。[跨性別兒童的性別認同與順性別兒童一樣堅定](https://www.forbes.com/sites/dawnstaceyennis/2020/12/29/study-transgender-children-recognize-their-authentic-gender-at-early-age-just-like-other-kids/#20bbb14526bf)（英文）。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性發育差異:性別不是染色體"
linkTitle: "染色體"
description: "DNA 更像是指導方針，而不是實際規則。"
preBody: '_disclaimer'
classes:
- gdb
siblings:
prev: /tw/causes
prevCaption: 性別不安的成因
next: /tw/hormones
nextCaption: 荷爾蒙如何運作
tweets:
- https://twitter.com/RebeccaRHelm/status/1207834357639139328
- https://twitter.com/RebeccaRHelm/status/1207835110617309191
- https://twitter.com/RebeccaRHelm/status/1207835384358604802
- https://twitter.com/RebeccaRHelm/status/1207835597206937600
- https://twitter.com/RebeccaRHelm/status/1207835815071473664
- https://twitter.com/RebeccaRHelm/status/1207835999130259456
- https://twitter.com/RebeccaRHelm/status/1207837155667718145
- https://twitter.com/RebeccaRHelm/status/1207838570276372480
- https://twitter.com/RebeccaRHelm/status/1207838924263084033
- https://twitter.com/RebeccaRHelm/status/1207839452619522048
- https://twitter.com/RebeccaRHelm/status/1207839986801922048
- https://twitter.com/alicemiriel/status/1208181235593490433
- https://twitter.com/TransEthics/status/1223942625708761088
---
<!-- # But the Chromosomes!!! -->
# 但是染色體！！！
{!{ <div class="gutter">
{{import '~/tweet' ids=[
'1223942625708761088'
] tweets=meta.tweets className="" }}
</div>}!}
<!-- There are dozens of ways that chromosomes can be much more complex than XX and XY. Referred to as DSDs ([differences in sex development](https://en.wikipedia.org/wiki/Disorders_of_sex_development)), not all of them result in an intersex condition, and many only manifest at the onset of puberty. -->
染色體的複雜程度遠遠超過 XX 和 XY，有很多種情況。被稱為 DSD（[性別分化多元性](https://zh.wikipedia.org/wiki/%E6%80%A7%E5%88%A5%E5%88%86%E5%8C%96%E5%A4%9A%E5%85%83%E6%80%A7)），並非所有情況都會導致雙性人狀況，而且許多情況只在青春期開始時才會出現。
<!-- - [De la Chapelle syndrome](https://en.wikipedia.org/wiki/XX_male_syndrome) (46,XX Male) occurs when the SRY gene from the sperm parent crosses over into a non-Y-bearing sperm during spermatogenesis. When the egg and sperm merge, it results in an XX embryo with an SRY gene, creating a phenotypically-male child with two X chromosomes. -->
- [德拉夏佩爾症候群](https://en.wikipedia.org/wiki/XX_male_syndrome)（46,XX 男性）發生在精子母體的 SRY 基因在精子發生過程中交叉到非 Y 染色體的精子中時。當卵子和精子融合時，就會產生一個帶有 SRY 基因的 XX 胚胎，從而產生一個具有兩條 X 染色體的表型男性兒童。
<!-- - [Swyer syndrome](https://en.wikipedia.org/wiki/Swyer_syndrome) (46,XY Female) produces a phenotypically-female child with an XY chromosome. This results from a dozen different genetic conditions, including: -->
- [斯威爾症候群](https://zh.wikipedia.org/wiki/XY%E6%80%A7%E8%85%BA%E7%99%BC%E8%82%B2%E4%B8%8D%E5%85%A8)（英文）（46,XY 女性）會產生一個帶有 XY 染色體的表型女性兒童。這是由十幾種不同的基因狀況引起的，包括：
<!-- - Absence or defect of an SRY gene
- Absence or defect of [DHH](https://en.wikipedia.org/wiki/Desert_hedgehog_(protein)) synthesis
- Absence of the [SF-1](https://en.wikipedia.org/wiki/Steroidogenic_factor_1) protein due to adrenal failure
- Absence of or defect the [CBX2](https://en.wikipedia.org/wiki/CBX2_(gene)) gene, preventing TDF cascade -->
- 缺乏或缺陷的 SRY 基因
- 缺乏或缺陷的[DHH](https://en.wikipedia.org/wiki/Desert_hedgehog_(protein))（英文）合成
- 由於腎上腺衰竭而缺乏[SF-1](https://en.wikipedia.org/wiki/Steroidogenic_factor_1)（英文）蛋白質
- 缺乏或缺陷的[CBX2](https://en.wikipedia.org/wiki/CBX2_(gene))（英文）基因，阻止 TDF 級聯
<!-- - [XX gonadal dysgenesis](https://en.wikipedia.org/wiki/XX_gonadal_dysgenesis) is very similar to Swyer syndrome, except it occurs in XX children and results in nonfunctional ovaries. -->
- [XX 性腺發育不全](https://en.wikipedia.org/wiki/XX_gonadal_dysgenesis)（英文）與斯威爾症候群非常相似，只是它發生在 XX 兒童身上，導致卵巢無功能。
<!-- - [Turner syndrome](https://en.wikipedia.org/wiki/Turner_syndrome) (45,X) produces a phenotypically-female child with numerous abnormalities. It occurs when neither an X or Y chromosome crosses over from the sperm. -->
- [特納症候群](https://zh.wikipedia.org/wiki/%E7%89%B9%E7%BA%B3%E7%BB%BC%E5%90%88%E5%BE%81)（45,X）會產生一個表型女性的兒童，並伴有許多異常。它發生在 X 或 Y 染色體都沒有從精子交叉過來的時候。
<!-- - [Klinefelter syndrome](https://en.wikipedia.org/wiki/Klinefelter_syndrome) (47,XXY) results in a phenotypically-male child with more feminine traits. In extremely rare cases [it appears in female-assigned children](https://www.ncbi.nlm.nih.gov/pubmed/15755052) as well, resulting in feminized testicles instead of ovaries. -->
- [克林費爾特症候群](https://zh.wikipedia.org/wiki/%E5%85%8B%E8%8E%AB%E8%8F%B2%E7%88%BE%E7%89%B9%E7%97%87%E5%80%99%E7%BE%A4)（47,XXY）會導致一個表型男性的兒童，但具有更多女性化的特徵。在極少數情況下，[它也出現在女性指定的兒童身上](https://www.ncbi.nlm.nih.gov/pubmed/15755052)（英文），導致女性化的睪丸而不是卵巢。
<!-- - [48,XXXY Klinefelter syndrome](https://en.wikipedia.org/wiki/XXXY_syndrome) has similar results to 47,XXY Klinefelter syndrome, but with more intense health issues. -->
- [48,XXXY 克林費爾特症候群](https://en.wikipedia.org/wiki/XXXY_syndrome)（英文）的結果與 47,XXY 克林費爾特症候群相似，但健康問題更嚴重。
<!-- - [49,XXXXY Klinefelter syndrome](https://en.wikipedia.org/wiki/49,XXXXY) is often fatal, but when it isn't, it often results in a sterile child. -->
- [49,XXXXY 克林費爾特症候群](https://en.wikipedia.org/wiki/49,XXXXY)（英文）通常是致命的，但如果不是，它通常會導致不育的兒童。
<!-- - [Trisomy X](https://en.wikipedia.org/wiki/Triple_X_syndrome) (47,XXX), [Tetrasomy X](https://en.wikipedia.org/wiki/Tetrasomy_X) (48,XXXX), and [Pentasomy X](https://en.wikipedia.org/wiki/49,_XXXXX) (49,XXXXX) all result in a female child, but with progressively more intense health issues. -->
- [三 X 症候群](https://zh.wikipedia.org/wiki/%E4%B8%89%E6%9F%93%E8%89%B2%E9%AB%94X%E7%97%87%E5%80%99%E7%BE%A4)（47,XXX）、[四 X 症候群](https://en.wikipedia.org/wiki/Tetrasomy_X)（英文）（48,XXXX）和[五 X 症候群](https://en.wikipedia.org/wiki/49,_XXXXX)（英文）（49,XXXXX）都會導致女性兒童，但健康問題會越來越嚴重。
<!-- - [XXYY Syndrome](https://en.wikipedia.org/wiki/XXYY_syndrome) results in male children (due to two SRY genes) who often experience hypogonadism, needing testosterone supplements, but otherwise seeming like a typical male. -->
- [XXYY 症候群](https://en.wikipedia.org/wiki/XXYY_syndrome)（英文）會導致男性兒童（由於兩個 SRY 基因）經常經歷性腺功能減退，需要補充睪固酮，但在其他方面看起來像典型的男性。
<!-- - [Mosaicism](https://en.wikipedia.org/wiki/Mosaic_(genetics)) results when some cells in the body have one set of chromosomes and other cells have another due to a mutation of the genome during gestation. This may be XX/XY (resulting in a dual set of genitalia), X/XY (a milder form of Swyer or Turner syndromes) or XX/XXY (a milder form of Klinefelter syndrome). -->
- [鑲嵌現象](https://zh.wikipedia.org/wiki/%E9%91%B2%E5%B5%8C%E7%8F%BE%E8%B1%A1)是指由於妊娠期間基因組突變，體內某些細胞具有一組染色體，而其他細胞具有另一組染色體。這可能是 XX/XY（導致兩套生殖器）、X/XY（斯威爾或特納症候群的輕度形式）或 XX/XXY（克林費爾特症候群的輕度形式）。
<!-- - [Chimerism](https://en.wikipedia.org/wiki/Chimera_(genetics)) occurs when two fertilized embryos merge together into one zygote, causing half of the child to contain one set of DNA and the other half to contain another. This can result in an otherwise completely typical human being of either male or female phenotype, even capable of producing offspring, but which comes back on a karyotype test as not matching their phenotype based on where the sample was taken on their body. In extremely rare cases this can result in two full sets of reproductive organs. -->
- [嵌合體](https://zh.wikipedia.org/wiki/%E5%B5%8C%E5%90%88%E9%AB%94)發生在兩個受精胚胎融合成一個合子時，導致孩子的一半包含一組 DNA，另一半包含另一組 DNA。這可能導致一個在其他方面完全典型的男性或女性表型的人，甚至能夠生育後代，但在核型檢測中，根據其身體上的採樣位置，其結果與表型不符。在極少數情況下，這可能導致兩套完整的生殖器官。
<!-- - [Congenital adrenal hyperplasia](https://en.wikipedia.org/wiki/Congenital_adrenal_hyperplasia) (CAH) is masculinization of the female genitals in an XX child due to overactive adrenal glands. -->
- [先天性腎上腺增生症](https://zh.wikipedia.org/wiki/%E5%85%88%E5%A4%A9%E6%80%A7%E8%85%8E%E4%B8%8A%E8%85%BA%E5%A2%9E%E7%94%9F%E7%97%87)（CAH）是由於腎上腺過度活躍導致 XX 兒童的女性生殖器男性化。
<!-- - [Androgen insensitivity syndrome](https://en.wikipedia.org/wiki/Androgen_insensitivity_syndrome) (AIS) is a total or partial resistance to all androgens, preventing masculinization of all organs, save for the testicles, in an XY child. AIS subjects typically develop a female gender identity, but some partial cases may be male. -->
- [雄激素不敏感症候群](https://en.wikipedia.org/wiki/Androgen_insensitivity_syndrome)（英文）（AIS）是指對所有雄激素的全部或部分抵抗，阻止 XY 兒童除睪丸外的所有器官男性化。AIS 患者通常會發展出女性的性別認同，但有些部分病例可能是男性。
<!-- - [5-alpha-reductase deficiency](https://en.wikipedia.org/wiki/5-alpha-reductase_deficiency) (5ARD) is a failure in the body's ability to metabolize testosterone into dihydrotestosterone (DHT), preventing masculinization of the genitalia until the onset of puberty, when the child suddenly grows a penis. -->
- [5α-還原酶缺乏症](https://en.wikipedia.org/wiki/5-alpha-reductase_deficiency)（英文）（5ARD）是指身體無法將睪固酮代謝成雙氫睪固酮 (DHT)，從而阻止生殖器男性化，直到青春期開始，孩子的陰莖才會突然長出來。
<!-- - [Aromatase deficiency](https://en.wikipedia.org/wiki/Aromatase_deficiency) causes masculinization of an otherwise female child due to excess levels of testosterone (and can bleed over into the mother during gestation). -->
- [芳香酶缺乏症](https://en.wikipedia.org/wiki/Aromatase_deficiency)（英文）是由於睪固酮水平過高而導致原本是女性的兒童男性化（並且會在妊娠期間影響到母親）。
<!-- - [Aromatase excess](https://en.wikipedia.org/wiki/Aromatase_excess_syndrome) causes feminisation in an otherwise male child, as all testosterone is converted into estrogen. -->
- [芳香酶過多症](https://en.wikipedia.org/wiki/Aromatase_excess_syndrome)（英文）會導致原本是男性的兒童女性化，因為所有的睪固酮都會轉化為雌激素。
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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "總而言之"
linkTitle: "結論"
description: "不要再當守門員了。"
siblings:
prev: /tw/second-puberty-fem
prevCaption: 雌性第二青春期
classes:
- gdb
preBody: '_disclaimer'
---
<!-- # Choice -->
# 選擇
<!-- What is choice? No, I’m not talking about free will and fate. That is not a subject within the scope of this essay. However, in the context of gender, I do believe it is important to consider the processes that drive us to make decisions. -->
什麼是選擇？不，我不是在談論自由意志和命運。這不是本文的討論範圍。然而，在性別的背景下，我認為考慮驅使我們做出決定的過程是很重要的。
<!-- In the philosophy of decision theory, choice is broken down into two pieces: [preferences and prospects](https://plato.stanford.edu/entries/decision-theory/#WhaPreOvePro). Prospects are the different paths that lay before us — the unresolved potential of any given choice. Preferences are our internal factors that drive us towards one prospect over another. Sometimes these are overtly clear, rational choices that we can describe easily with language. These motivations come from what is coined as the rational mind. Just as often, however, these preferences come to us without clear reasoning, stemming from our past experiences, our biochemical driving forces, or instinctual drives that exist below all of that. Sometimes our preference is just a gut feeling, deep inside. Proponents of mindfulness refer to this as the emotional mind. -->
在決策理論哲學中，選擇被分解成兩個部分：[偏好和前景](https://plato.stanford.edu/entries/decision-theory/#WhaPreOvePro)（英文）。前景是擺在我們面前的不同道路——任何特定選擇的未解決的潛力。偏好是驅使我們選擇一種前景而不是另一種前景的內在因素。有時，這些是我們可以用語言輕鬆描述的明顯、理性的選擇。這些動機來自於所謂的理性思維。然而，同樣常見的是，這些偏好是在沒有明確推理的情況下產生的，源於我們過去的經歷、我們的生化驅動力，或存在於所有這些之下的本能驅動力。有時，我們的偏好只是一種發自內心的直覺。正念的支持者將其稱為感性思維。
<!-- Regardless of where a preference originates from, however, it is shaped by its position between two poles. Pleasure and discomfort. Peace and dissonance. Euphoria and dysphoria. Everything we do, every choice we make, comes from either positive or negative responses. When faced with two options, we will select the one we find most beneficial or least harmful to our own internal needs. -->
然而，無論偏好源於何處，它都受到兩個極點之間的位置的影響。快樂和不適。平靜與不和諧。欣快感和不安感。我們所做的一切，我們所做的每一個選擇，都來自於正面或負面的反應。當面臨兩個選項時，我們會選擇我們認為對我們自己的內在需求最有利或危害最小的選項。
<!-- What does this have to do with gender? A person’s gender is not a choice; it comes from somewhere deep inside them at a level of the brain’s function that is not subject to change. There are factors which may result in fluctuation of a person's perception of their gender (as in genderfluid individuals and those with dissociative identities), and a person may change how they describe their gender over time, but no one *chooses* their gender identity. We only choose how to present it to the rest of the world. -->
這與性別有什麼關係？一個人的性別不是一種選擇；它來自於他們內心深處大腦功能的一個層面，這個層面是不受改變的。有一些因素可能會導致一個人對其性別的感知發生波動（例如流性人身份和具有分離性身份的人），而且一個人隨著時間的推移可能會改變他們描述自己性別的方式，但沒有人會*選擇*他們的性別認同。我們只選擇如何將其展現給世界其他地方。
<!-- Those choices, those preferences, are driven by what feels good and what feels bad. A person who chooses to publicly identify as a gender different from the one assigned to them at their birth is making that choice based on what feels right to do. A person defending that identity does so based on what feels wrong. We make these choices against the social stigma and discrimination that comes with the transgender label, and indeed a not-insignificant number of trans people may choose to go stealth and abandon that label once it is safe to do so. Even among those who are not stealth, many trans people accept the safety of being presumed cisgender, and take no effort to break people of that presumption. That is, again, a choice. Being visibly trans produces a negative experience for them. -->
這些選擇、這些偏好，是由什麼感覺良好和什麼感覺不好所驅動的。一個選擇公開表明自己與出生時被指定的性別不同的性別的人，是根據什麼感覺對來做出這個選擇的。一個捍衛這種身份的人是根據什麼感覺錯來這樣做的。我們做出這些選擇是為了對抗跨性別標籤所帶來的社會污名和歧視，事實上，數量不少的跨性別者可能會選擇隱藏身份，並在安全的情况下放棄這個標籤。即使在那些沒有隱藏身份的跨性別者中，許多人也接受了被假定為順性別者的安全性，並且不努力去打破人們的這種假設。這，同樣是一種選擇。公開跨性別身份會給他們帶來負面體驗。
<!-- There are those who find the notion that euphoria and dysphoria are central motivators behind gender variance to be uncomfortable; one could even say they experience dysphoria at the concept of dysphoria. To them, ask, if you believe you do not have dysphoria, why did you take on the mantle of the trans label? That *choice* did not happen in a vacuum; even if your motivations stem entirely from happy feelings, ask yourself how you feel when your gender is not respected. How do you feel when others invalidate your identity? -->
有些人覺得欣快感和不安感是性別差異背後的核心驅動力，這種觀點令人不安；甚至可以說，他們對不安感這個概念感到不安。對於他們，問問，如果你認為你沒有不安感，你為什麼要披上跨性別者的標籤？這種*選擇*不是憑空發生的；即使你的動機完全來自於快樂的感覺，也要問問自己在性別不被尊重時的感覺。當別人否定你的身份時，你感覺如何？
<!-- Is it not _a state of unease or generalized dissatisfaction_? -->
這難道不是 _一種不安或普遍不滿的狀態_ 嗎？
<!-- That’s dysphoria, baby. -->
這就是不安感，寶貝。
<!-- ## We’re here, we’re queer. -->
## 我們在這裡，我們是酷兒。
<!-- Every single year, we get new studies that show an increase in the size of the transgender population. As awareness continues to grow, more and more people are realizing what has been wrong with their lives and are coming out of the closet. People who transitioned decades ago are coming out of stealth. GLAAD estimates as much as 3% of the population could be transgender, and I have seen numbers as high as 5% or even 10% from more liberal estimations. The more we come to understand about gender, the more language we gain to describe gender, the more people realize that the rigid Male and Female sexual structure that we have been forced into is false. -->
每年，我們都會有新的研究表明跨性別者的人數在增加。隨著意識的持續增長，越來越多的人意識到他們生活中出了什麼問題，並開始走出櫃子。幾十年前轉變的人開始公開自己的身份。GLAAD 估計，多達 3% 的人口可能是跨性別者，而我從更自由的估計中看到高達 5% 甚至 10% 的數字。我們對性別了解得越多，我們獲得的描述性別的語言就越多，就越多人意識到，我們一直以來被迫進入的僵化的男性和女性的性別結構是錯誤的。
<!-- Yet all this change frightens people. It frightens conservatives who see their patriarchal social structures dissolving under the new understanding of gender. It frightens old-school transgender people who transitioned under the Harry Benjamin rules and now see so many people easily obtaining what they had to act and lie and manipulate to achieve. They fear that if anyone can be trans, the public will stop taking trans people seriously. It frightens the misogynistic or misandristic trans-exclusionary groups that fight so hard to invalidate transgender rights because they think, if anyone can be a man or a woman, their status as a man or a woman is harmed. -->
然而，所有這些變化都讓人們感到害怕。它讓保守派感到害怕，他們看到父權制的社會結構在新對性別的理解下瓦解。它讓老派的跨性別者感到害怕，他們在班傑明規則下轉變，現在看到這麼多人輕易地獲得了他們必須表演、撒謊和操縱才能獲得的東西。他們擔心，如果任何人都可以是跨性別者，公眾就會不再認真對待跨性別者。它讓那些厭惡女性或厭惡男性的排斥跨性別者的群體感到害怕，他們如此努力地否定跨性別者的權利，因為他們認為，如果任何人都可以成為男人或女人，那麼他們作為男人或女人的地位就會受到損害。
<!-- There is no such thing as a "Transtrender". -->
沒有「跨性別潮流者」這種東西。
<!-- There is no such thing as "Rapid Onset Gender Dysphoria". -->
沒有「快速發作型性別不安」這種東西。
<!-- There is no such thing as people "transing" kids. -->
沒有人「讓」孩子「變性」這種東西。
<!-- These mentalities have to stop. -->
這些心態必須停止。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
# title: "Diagnosing Gender Dysphoria"
# linkTitle: "Clinical Diagnoses"
# description: "It's clinical."
title: "診斷性別不安"
linkTitle: "臨床診斷"
description: "這是臨床的。"
preBody: '_disclaimer'
classes:
- gdb
siblings:
prev: /tw/am-i-trans
prevCaption: 我是跨性別者嗎？
next: /tw/treatment
nextCaption: 治療性別不安
---
<!-- # How is Gender Dysphoria Diagnosed? -->
# 如何診斷性別不安？
<!-- This section is going to focus on the diagnostic criteria under the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, version five (DSM-5). The reason I'm focusing on this standard is because, well, nobody else has one. The UK's National Health Service basically mirrors the APA's DSM. Other countries have their own local standards, but they're all either very similar or a lot more outdated. -->
本節將重點介紹美國精神醫學學會出版的《精神疾病診斷與統計手冊》第五版 (DSM-5) 中的診斷標準。我之所以關注這個標準，是因為，嗯，沒有其他標準了。英國國家醫療服務體系基本上與 APA 的 DSM 相同。其他國家有自己的地方標準，但它們要麼非常相似，要麼更加過時。
<!-- The WPATH SoC describes ways that gender dysphoria manifests, but does not define clear diagnostic criteria, instead leaving it up to individual mental health professionals to make their own diagnoses. In general, it advocates that, if the patient is of sound mind and body and says that they have gender dysphoria, they should be believed. The key piece here is "sound mind and body"; it is left to the mental health professional to do the due diligence to ensure that there are no other conditions which may be causing the patient to believe this. -->
WPATH SoC 描述了性別不安的表現方式，但沒有定義明確的診斷標準，而是讓個別的心理健康專業人員自行診斷。一般來說，它主張，如果患者身心健康，並且說他們有性別不安，就應該相信他們。這裡的關鍵是「身心健康」；心理健康專業人員有責任進行盡職調查，以確保沒有其他可能導致患者相信這一點的情況。
<!-- Or, to put it bluntly, WPATH says that if you think you're trans, you're trans. This has been the attitude that the majority of the community has adopted as well. As long as you believe your gender does not match what you were assigned at birth, you are transgender. However, insurance companies aren't so happy with self-diagnoses, so here are the criteria which are defined in the DSM-5 for diagnosing someone with gender dysphoria. -->
或者，坦率地說，WPATH 說，如果你認為自己是跨性別者，你就是跨性別者。這也是社群大多數人所採用的態度。只要你相信你的性別與你出生時被指定的性別不符，你就是跨性別者。然而，保險公司對自我診斷並不滿意，所以這裡列出了 DSM-5 中定義的用於診斷某人患有性別不安的標準。
{!{ <div class="gutter d-md-block d-sm-none"><div class="card"><div class="card-body"><h4 class="card-title">For Your Information</h4> }!}
<!-- Diagnosis of gender dysphoria in prepubescent children requires the child must have a documented six month history of meeting six of these criteria (one of which must be Criterion 1), as well as demonstrated distress or impairment in social, school, or other important areas of functioning. -->
診斷青春期前兒童的性別不安需要兒童有記錄的六個月符合以下六項標準的病史（其中一項必須是標準 1），以及在社交、學校或其他重要功能領域表現出痛苦或損害。
<!-- 1. A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one's assigned gender). -->
1. 強烈渴望成為另一種性別，或堅持自己就是另一種性別（或與自己被指定的性別不同的其他性別）。
<!-- 2. A strong preference for wearing clothes typical of the other gender. -->
2. 強烈偏好穿著另一種性別的典型服裝。
<!-- 3. A strong preference for cross-gender roles in make-believe play or fantasy play. -->
3. 強烈偏好在假裝遊戲或幻想遊戲中扮演另一性別角色。
<!-- 4. A strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender. -->
4. 強烈偏好另一種性別刻板印象中使用的玩具、遊戲或活動。
<!-- 5. A strong preference for playmates of the other gender. -->
5. 強烈偏好另一種性別的玩伴。
<!-- 6. A strong rejection of toys, games, and activities typical of one’s assigned gender. -->
6. 強烈排斥自己被指定性別的典型玩具、遊戲和活動。
<!-- 7. A strong dislike of one’s sexual anatomy. -->
7. 強烈厭惡自己的性器官。
<!-- 8. A strong desire for the physical sex characteristics that match one’s experienced gender. -->
8. 強烈渴望擁有與自己所體驗的性別相符的身體性徵。
{!{ </div></div></div> }!}
<!-- **Note** These are the criteria for children. Adolescents and adults have a different set of criteria. Both sets [can also be found here](https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria). I have also changed the wording slightly, here, as the official criteria are binary-centric. -->
**注意** 這些是針對兒童的標準。青少年和成人的標準不同。[這兩套標準也可以在這裡找到](https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria)（英文）。我這裡也稍微修改了一下措辭，因為官方標準是以二元性別為中心的。
<!-- For an adult to be diagnosed with gender dysphoria by a licensed mental health professional, they must meet two of these six criteria and have experienced those criteria for longer than six months. -->
要讓一位成年人被有執照的心理健康專業人員診斷為性別不安，他們必須符合以下六項標準中的兩項，並且經歷這些標準的時間超過六個月。
<!-- - **A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics** -->
* **一個人經歷/表達的性別與第一和/或第二性徵之間明顯不一致**
<!-- The way the person sees the world and interacts with the world does not align with the way it is typically expected for someone of the gender they were assigned at birth. There are a very broad number of traits which fit into this description. It can be in the way they interact with others, how they talk, what hobbies they prefer, how they dress, their body language and mannerisms, what gender(s) they relate to more. -->
這個人看待世界和與世界互動的方式與他們出生時被指定的性別的人通常被期望的方式不一致。有很多特徵符合這種描述。這可以體現在他們與他人互動的方式、他們說話的方式、他們喜歡的興趣愛好、他們的穿著打扮、他們的肢體語言和舉止，以及他們與哪種（些）性別更相關。
<!-- - **A strong desire to be rid of one’s primary and/or secondary sex characteristics** -->
* **強烈渴望擺脫自己的第一和/或第二性徵**
<!-- - **A strong desire for the primary and/or secondary sex characteristics of another gender** -->
* **強烈渴望擁有另一種性別的第一和/或第二性徵**
<!-- These two are pretty well paired. This is physical dysphoria as previously defined. The person finds discomfort with aspects of their body which are a result of their sex at birth. -->
這兩者搭配得很好。這就是前面定義的身體不安。當事人對他們出生時性別的身體某些方面感到不適。
<!-- - **A strong desire to be of another gender** -->
* **強烈渴望成為另一種性別**
<!-- - **A strong desire to be treated as another gender** -->
* **強烈渴望被當作另一種性別對待**
<!-- These are the social and societal dysphoria. They are how a person wants to interact with the world, and wants the world to interact with them. -->
這些是社交和社會性別不安。它們是一個人想要如何與世界互動，以及想要世界如何與他們互動。
<!-- - **A strong conviction that one has the typical feelings and reactions of another gender** -->
* **堅信自己有另一種性別的典型感受和反應**
<!-- This is pretty self explanatory. -->
這不言自明。
<!-- As I said, only two of these conditions need to be met for a formal diagnosis. You may notice that only two of these comprise the physical body. It is perfectly valid for a trans person to be experiencing gender dysphoria without actually hating any part of their body or wanting to change any part of their body. Physical dysphoria is only one fraction of the many things that lead to being trans. -->
正如我所說的，正式診斷只需要滿足這些條件中的兩項。你可能會注意到，其中只有兩項與身體有關。跨性別者在沒有真正憎恨自己身體的任何部分或想要改變自己身體的任何部分的情況下經歷性別不安是完全正常的。身體不安只是導致一個人成為跨性別者的眾多因素中的一小部分。
<!-- Now, here is the kicker. If you identify as transgender, meaning that your gender does not align with the binary sex you were assigned at birth, you already meet two of these criteria! You have a strong enough desire to be of another gender that you are identifying that you *are* another gender, and you have a strong conviction of what your gender feels like, and it isn't what you were given at birth. -->
現在，重點來了。如果你認同自己是跨性別者，意味著你的性別與你出生時被指定的二元性別不一致，那麼你已經符合了這兩項標準！你對成為另一種性別有足夠強烈的渴望，以至於你認同你 *是* 另一種性別，而且你對你的性別感受有堅定的信念，而這與你出生時被賦予的性別不同。
<!-- So, it is literally impossible for a person to identify as trans and not experience gender dysphoria. By the WPATH requirements anyone can identify as trans. Ergo, the statement "you do not have to have dysphoria to be transgender" is a logical paradox. -->
所以，一個人如果認同自己是跨性別者，卻沒有經歷性別不安，這是不可能的。根據 WPATH 的要求，任何人都可以認同自己是跨性別者。因此，「你不必有不安才能成為跨性別者」這句話是一個邏輯悖論。
<!-- Then why do we still say it? Because most people don't know what gender dysphoria actually is, and it is easier to repeat the mantra than to explain the nuances and subtleties of how gender dysphoria manifests. But hey, look, now you've got a nice article to link to that can help people understand that. -->
那麼為什麼我們還要這樣說呢？因為大多數人都不知道性別不安究竟是什麼，而且重複這個口號比解釋性別不安表現的細微之處更容易。但是，你看，現在你有一篇很好的文章可以連結到，可以幫助人們理解這一點。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的表現: 欣快感"
linkTitle: "性別欣快"
description: "有陰影的地方就一定有光。"
preBody: '_disclaimer'
siblings:
prev: /tw/history
prevCaption: 性別不安的歷史
next: /tw/physical-dysphoria
nextCaption: 身體不安
classes:
- gdb
tweets:
- '1215716433210105856'
- https://twitter.com/ErinInTheMorn/status/1228141518386585607
- https://twitter.com/TwippingVanilla/status/1228165207316287489
- https://twitter.com/ErinInTheMorn/status/1228165767264256003
---
# 性別欣快
{!{
<div class="gutter"><blockquote>
<strong>欣快感 Eu·pho·ri·a</strong> - <em>名詞</em><br>
<!-- A feeling or state of intense excitement and happiness. Elation, joy, glee. -->
一種強烈興奮和快樂的感覺或狀態。狂喜、喜悅、歡欣。
</blockquote></div>
}!}
<!-- Before I can talk about discomfort, I have to talk about relief. Gender euphoria is itself a sign of gender dysphoria. You might be asking yourself, "how can happiness be sadness?" The answer to that is simple. -->
在談論不舒服之前，我必須先談論解脫。性別愉悅本身就是性別焦慮的跡象。你可能會問自己：「快樂怎麼可能是悲傷？」答案很簡單。
<!-- Imagine a person who was born in a cave, who spent their entire life living underground, with their only source of illumination being candles and oil lamps. Imagine they've never been above ground; they don't even know the surface exists. Then, one day, a cave-in happens in a side tunnel, and reveals an opening to the surface. Sunlight pours into the opening, and at first it is blinding and the person runs away in fear. Later, they return to the opening, and, as the person's eyes adjust, they look out through the hole and see a bright and brilliant world full of colors they didn't even know existed. -->
想像一個人生來就在洞穴中的人，一生都在地下生活，唯一的照明來源是蠟燭和油燈。想像他們從未在地面上生活過，他們甚至不知道地面的存在。然後，有一天，一側隧道發生了坍塌，露出了通往地面的開口。陽光照進開口，起初它是耀眼的，那人嚇得逃跑了。後來，他們回到開口處，隨著眼睛的適應，他們透過洞口看到一個明亮而燦爛的世界，充滿了他們甚至不知道存在過的顏色。
<!-- That world is scary, huge, and full of unknowns, so they crawl back into the cave for safety, but that hole is still there, and they see the light every time they pass it. Gradually, they peek out more and more frequently, and further and further from the opening. They start to want that light; they find reasons to visit it more often. -->
那個世界很可怕、很大、充滿未知，所以他們爬回洞裡求安全，但那個洞還在，每次經過時他們都能看到光。漸漸地，他們更頻繁地窺視，並且離開口越來越遠。他們開始想要那道光；他們找到更多理由去拜訪它。
<!-- Eventually they realize that they don't want to go back into the hole any more. They have to go back, because that is where their family and friends are, but this place is so much better, and they want to stay here. Going back into the hole feels wrong; it starts to hurt to be in the dark so much. -->
最終，他們意識到自己不想再回到洞裡了。他們必須回去，因為那是他們的家人和朋友所在的地方，但這個地方好多了，他們想留下來。回到洞裡感覺不對；在黑暗中待太久開始感到痛苦。
<!-- This is what gender euphoria is like: brief flashes of a light that may be too bright to handle at first, too confusing to understand, but as time goes on you become more accustomed to them and you realize that this is where you belong, and the darkness becomes the dysphoria. -->
這就是性別欣快的樣子：最初可能太刺眼而無法處理、太混亂而無法理解的光的短暫閃爍，但隨著時間的推移，你變得越來越習慣它們，你意識到這就是你屬於的地方，而黑暗變成了焦慮。
{!{ <div class="gutter">{{import '~/tweet' ids=[
'1215716433210105856'
] tweets=meta.tweets className="hide-reply" }}</div> }!}
<!-- Many trans people have no idea how much pain they are in until they find small bits of relief. Cosplay, stage acting, drag, role playing games, video games; small little forays into a different gender than they have lived as. They find that it feels just a little bit more comfortable. They'll make up excuses for why ("If I'm gonna be looking at this character's ass, it might as well be a girl's ass."), they'll try to convince themselves it's all just for fun, or an artistic expression. They might tell themselves that the bits of joy they feel at hearing a different pronoun are just novelty. But soon they find themselves looking for reasons to get that more often. More and more frequently they're role playing characters of a different sex, building more costumes, buying more clothes, performing more often. You find yourself wanting to do that all the time, because it just feels better than your real life, and being "you" starts to hurt. Eventually, the old you becomes the costume. -->
許多跨性別者在找到微小的解脫之前，都不知道自己有多痛苦。角色扮演、舞台表演、變裝、角色扮演遊戲、電子遊戲；對他們所生活的性別之外的不同性別的小小嘗試。他們發現這感覺舒服了一點點。他們會為此編造藉口（「如果我要看這個角色的屁股，那還不如是女生的屁股。」），他們會試圖說服自己這一切只是為了好玩，或者是一種藝術表達。他們可能會告訴自己，聽到不同的代詞而感到的一點點喜悅只是新鮮感。但很快他們就會發現自己尋找更多的理由來獲得這種感覺。他們越來越頻繁地扮演不同性別的角色，製作更多的服裝，購買更多的衣服，更頻繁地表演。你會發現自己一直想這樣做，因為這比現實生活感覺更好，「你」開始感到痛苦。最終，舊的你變成了服裝。
<!-- This is the most fundamental reason why we as a community say "you do not need dysphoria to be trans", because black ink on a black canvas isn't visible without close examination and a lot of light. -->
這就是我們作為一個社群說「你不必有不安才能是跨性別者」的最根本原因，因為黑畫布上的黑色墨水如果不仔細檢查和大量的光線是看不見的。
<!-- Anything that can be a source of dysphoria has an equal and opposite euphoria. -->
任何可能成為不安感源頭的東西都有同等且相反的欣快感。
{!{ <div class="print-break-before"></div> }!}
{!{ <div class="gutter">{{import '~/tweet' ids=[
'1228141518386585607'
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舉例來說:
<!-- - Being gendered correctly
- Being addressed by your chosen name
- Wearing correctly-gendered clothing
- Seeing and feeling changes in your body
- Seeing yourself in the mirror (removal of depersonalization)
- Socializing in a way that conforms with gendered expectations
- Getting a haircut in a masculine / feminine / androgynous manner
- Shaving your legs
- NOT shaving your legs
- Being included in something you wouldn't otherwise because of your assigned gender (e.g. bridal shower or bachelor party)
- Feeling sexy / having sex in a way that aligns with your gender and sexuality. -->
- 被正確地辨識性別
- 被用你選擇的名字稱呼
- 穿著符合性別認同的服裝
- 看到並感覺到身體的變化
- 在鏡子裡看到自己（消除失自我感）
- 以符合性別期待的方式進行社交
- 以男性化/女性化/中性風格剪頭髮
- 刮腿毛
- *不*刮腿毛
- 因為你的性別認同而被納入你原本不會參與的活動（例如：單身派對(bridal shower / bachelor party)）
- 感到性感/以符合你的性別和性向的方式進行性行為
<!-- Even just being out in the world as yourself and being seen as yourself can be massively euphoric. -->
即使只是做自己並被視為真正的自己，在世界上也能感受到巨大的欣快感。
<!-- **What euphoria is NOT** is a sexual high, turn-on, or fetish. Sometimes euphoria can trigger a sexual response, and there are many factors at play that cause that (feeling good about your body is a turn-on, for example), but it is not a source of sexual excitement. Trans people are not "getting off" on presenting or acting like their true selves. -->
**欣快感**並**不是**性高潮、性興奮或是戀物癖(fetish)。有時欣快感會引發性反應，而造成這種情況的原因有很多（例如，對自己的身體感覺良好是一種興奮），但它本身並不是性興奮的來源。跨性別者並不會因為展現或表現得像他們真正的自己而「得到快感」。
<!-- That said, many people who have not yet realized they are trans may resort to fetishes and kinks to express their gender and/or relieve their dysphoria. They may maintain some of these kinks through transition. There is no shame in this; how they find sexual fulfillment is their own business. However, these things are *alongside* their gender. A trans person's sense of gender persists indefinitely; it does not go away when they go back to their daily lives. -->
話雖如此，許多尚未意識到自己是跨性別者的人可能會訴諸戀物癖和禁羈(kink)來表達他們的性別認同和/或減輕他們的性別不安。他們可能會在轉變過程中保留其中一些禁羈。這並沒有什麼好羞愧的；他們如何找到性滿足是他們自己的事。然而，這些東西是與他們的性別認同*並存*的。跨性別者的性別認同會持續存在；當他們回到日常生活時，它並不會消失。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現: 存在不安"
linkTitle: "存在不安"
description: "我不後悔我做過的事；我後悔的是那些我機會但是卻沒去做的事。"
classes:
- gdb
preBody: '_disclaimer'
siblings:
prev: /tw/presentational-dysphoria
prevCaption: 表現不安
next: /tw/managed-dysphoria
nextCaption: 應付不安
---
<!-- # Existential Dysphoria -->
# 存在不安
<!-- When you grow up as the wrong assigned gender, you are going to miss out on a lot of things that should have been available to you if only people had known. Sleepovers, camping trips, girl/boy scouts, shopping trips, cheerleading or sports. Events that are co-ed may have very different feelings attached to them based on how you engage with them, like going to prom, religious ceremonies (such as having a bat mitzvah instead of a bar mitzvah), and even just the act of courtship. This dysphoria may also be biological in origin, such as a sorrow over having not given birth to or breastfed your children. -->
當你以錯誤的指定性別成長時，你將會錯過很多事情，如果人們早知道的話，這些事情本應是你可以擁有的。例如，過夜派對、露營旅行、女童/男童軍、購物之旅、啦啦隊或體育運動。男女同校的活動可能會有截然不同的感受，這取決於你如何參與其中，例如參加畢業舞會、宗教儀式（例如舉行成年禮），甚至只是求愛行為。這種不安也可能源於生理因素，例如對沒有生育或哺乳自己的孩子感到悲傷。
<!-- These missed opportunities can manifest as feelings of loss and hurt. Furthermore, the memories of things you *did* have access to but wouldn't have otherwise, or events that were performed in the wrong gender, can also be a sour point, as these may have awkward attachments. Imagine having to be a groom at your wedding when you know you should have been a bride; growing up dreaming about your perfect wedding, and then playing the wrong role in it. -->
這些錯過的機會可能表現為失落感和痛苦感。此外，你 *確實* 經歷過但本來不應該經歷的事情的記憶，或以錯誤的性別進行的事件，也可能是一個痛點，因為這些事情可能帶有不愉快的聯想。想像一下，當你知道自己應該成為新娘時，卻不得不在你的婚禮上扮演新郎；從小就夢想著你完美的婚禮，然後卻在婚禮上扮演了錯誤的角色。
<!-- Sometimes existential dysphoria can manifest existentially, hitting you with all the grief of the youth lost. All the dating, the teenage antics, the parties, even just having been able to be sexual with the correct parts while your body was young and you had no responsibilities. It is time that can never be gained back. -->
有時，存在不安會以存在主義的方式表現出來，讓你感受到失去青春的所有悲傷。所有的約會、青少年時期的滑稽行為、派對，甚至只是在你年輕、沒有責任的時候能夠用正確的身體部位體驗性愛。這是永遠無法挽回的時間。
<!-- Many trans people attempt to recapture some of these lost events, hosting or attending queer proms, organizing sleepovers, performing vow renewals with their spouses, and engaging in common puberty rites of passage like having a mother figure help them shop for their first bra, or having a father figure teach them to shave. However, ultimately, existential dysphoria is something that can never be relieved. You can make new experiences to replace the ones you lost, but you can never turn back the clock. -->
許多跨性別者試圖重溫這些失去的事件，例如舉辦或參加酷兒畢業舞會、組織過夜派對、與配偶舉行婚禮誓言更新儀式，以及參與常見的青春期儀式，例如讓一位母親形象的人幫助他們購買第一件胸罩，或者讓一位父親形象的人教他們刮鬍子。然而，最終，存在性不安是永遠無法消除的。你可以創造新的體驗來取代你失去的體驗，但你永遠無法讓時光倒流。
<!-- This is one of many reasons why affirming trans youth is so important. Boys want to do common boy things, girls want to do common girl things, and non-binary children want to do whatever feels correct to them, and when they miss out they will not forget. -->
這就是肯定跨性別青少年如此重要的諸多原因之一。男孩想做常見的男孩做的事情，女孩想做常見的女孩做的事情，非二元性別兒童想做任何他們覺得正確的事情，當他們錯過這些事情時，他們不會忘記。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "關於性別不安的歷史的簡介"
linkTitle: "性別不安的歷史"
# en:
# description: "The origins of Gender Dysphoria and the current meaning today."
# zh-tw:
description: "性別不安的起源和今天的意義。"
classes:
- gdb
preBody: '_disclaimer'
siblings:
prev: /tw/what-is-gender
prevCaption: 性別是什麼？
next: /tw/euphoria
nextCaption: 性別欣快
---
<!-- en:
# A Brief History of Gender Dysphoria
zh-tw: -->
# 關於性別不安的歷史的簡介
<!-- en:
In 1948, noted sexologist Dr. Alfred Kinsey (yes, [*that* Kinsey](https://en.wikipedia.org/wiki/Alfred_Kinsey)) was contacted by a woman whose male child adamantly insisted that they were in fact a girl, and that something had gone very wrong. The mother, rather than trying to suppress her daughter, wished to help her become who she knew herself to be. Kinsey reached out to a German endocrinologist named [Dr. Harry Benjamin](https://en.wikipedia.org/wiki/Harry_Benjamin) to see if he could help the child. Dr. Benjamin then developed a protocol of estrogen therapy for the teen, and worked with the family to find surgical help.
zh-tw: -->
在 1948 年，著名的性學家阿爾弗雷德·金賽博士（是的，[*那個*金賽](https://zh.wikipedia.org/wiki/%E9%98%BF%E5%B0%94%E5%BC%97%E8%8E%B1%E5%BE%B7%C2%B7%E9%87%91%E8%B5%9B)）被一位母親聯繫，她的兒子堅持自己是一個女孩，並且認為出了什麼問題。 這位母親不是試圖壓制她的女兒，而是希望幫助她成為她自己。 金賽博士聯繫了一位名叫[哈利·班傑明博士 (Dr. Harry Benjamin)](https://en.wikipedia.org/wiki/Harry_Benjamin)的德國內分泌學家，看看他是否能幫助這位孩子。 班傑明博士隨後為這位少年制定了一個雌激素治療方案，並與家人合作尋找手術幫助。
<!-- en:
Benjamin then went on to refine his protocol and treated thousands of patients with similar feelings over the course of his career. He refused to take payment for his work, instead taking satisfaction from the relief he granted these patients, and using their treatment to further his understanding of the condition. He coined a term for this feeling of incongruence in 1973: **gender dysphoria**. Unfortunately, this term would not be used in the United States until 2013, with the American Psychiatric Association opting for the term "gender identity disorder" instead.
zh-tw: -->
班傑明博士隨後繼續完善他的方案，並在他的職業生涯中治療了數千名有類似感受的患者。 他拒絕接受他的工作報酬，而是從他給予這些患者的幫助中獲得滿足感，並利用他們的治療來進一步了解這種狀況。 他在 1973 年為這種不一致感創造了一個術語：**性別不安**。 不幸的是，這個術語直到 2013 年才在美國使用，美國精神病學會選擇使用“性別認同障礙”這個術語。
{!{
<div class="gutter print-inline">
{{import '~/img' images.hbscale
className="card print-span34 print-center"
caption="哈利·班傑明診斷量表"
}}
</div>
}!}
<!-- en:
If you are a trans person reading this, you may have heard the name Harry Benjamin before, but probably not in a favorable context. In 1979 his name was used (with permission) in the forming of the Harry Benjamin International Gender Dysphoria Association (HBIGDA), which released a Standards of Care (SoC) for transgender people. This SoC came to be known as the Harry Benjamin Rules, and were infamously limiting in regards to how gender dysphoria could be diagnosed. Patients were placed within a six tier scale based upon their level of misery and sexual dysfunction. If you did not land at Tier 5 or higher, classified as a "True Transsexual", you were usually rejected for treatment.
zh-tw: -->
如果您是一位跨性別者，您可能以前聽過哈利·班傑明的名字，但可能不是在一個有利的情況下。 1979 年，他的名字被用於（經過許可）成立了哈利·班傑明國際性別不安協會（HBIGDA），該協會針對跨性別者發布了一套標準護理（SoC）。 這套SoC被稱為哈利·班傑明規則，並以限制性而聞名，關於如何診斷性別不安。 患者根據他們的痛苦程度和性功能障礙被分為六個層級。 如果您沒有達到第 5 級或更高級，被歸類為「真正的變性者」，則通常會被拒絕接受治療。
<!-- en:
The problem was that Tiers 5 and 6 required that you had to be exclusively attracted to your own birth sex. Transition *had* to be making you straight, not gay, and bisexuals were not allowed. You also had to be experiencing severe distress with your body and genitals and already be living as your true gender without treatment. Many trans people got around these limitations through community coaching and performative presentations, but for many people (myself included) it was believed that, if you did not fit all the criteria, you were not trans enough to transition.
zh-tw: -->
問題在於第 5 級和第 6 級要求您必須被自己的出生性別以外的性別吸引。 變性 *必須* 讓您變成直的，而不是同性戀，而且雙性戀者是不被允許的。 您還必須對自己的身體和生殖器感到嚴重的困擾，並且在未接受治療的情況下已經以自己真正的性別生活。 許多跨性別者通過社群指導和表演性表現來克服這些限制，但對許多人（包括我在內）來說，如果您不符合所有標準，代表你不夠跨所以不能轉換。
<!-- en:
In 2011, the HBIGDA reorganized itself to respond to mounting pressures in trans understanding and acceptance, taking on the new name World Professional Association for Transgender Health (WPATH). Under guidance by actual transgender people (a first for the organization), WPATH then proceeded to release an entirely new Standards of Care (SoC, version 7, the first in ten years) which abandoned the Benjamin Scale, focusing on specific individual symptoms and disconnecting gender from sexuality entirely. Two years later, in 2013, the American Psychiatric Association changed their diagnostic criteria to match the WPATH SoC in their Diagnostic and Statistical Manual of Mental Disorders (DSM) version 5, replacing Gender Identity Disorder with Gender Dysphoria. With this change, medical transition became available to all trans people in the United States.
zh-tw: -->
2011 年，HBIGDA 重新組織自己以應對跨性別理解和接受上的壓力，並採用了新名稱世界跨性別健康專業協會（WPATH）。 在實際跨性別者的指導下（這是該組織的首次），WPATH 隨後發布了一個全新的護理標準（SoC，第 7 版，十年來的第一個），放棄了班傑明量表，專注於特定的個人症狀，並完全將性別與性取向分開。 兩年後，2013 年，美國精神病學會將他們的診斷標準更改為與 WPATH SoC 相匹配，並在他們的《精神疾病診斷與統計手冊》（DSM）第 5 版中將性別認同障礙替 (Gender Identity Disorder) 換為性別不安 (Gender Dysphoria)。 有了這個變化，美國所有跨性別者都可以進行醫學轉變。
<!-- en:
This is why trans presence across the world has suddenly exploded in the last decade. With easier access comes larger numbers, with larger numbers comes more visibility, with more visibility comes more awareness, and with more awareness comes more people accessing treatment. [A study conducted in 2014](https://williamsinstitute.law.ucla.edu/wp-content/uploads/TransAgeReport.pdf) showed 0.6% of adults and 0.7% of youth in the United States identified as transgender, [a study conducted in 2016](https://www.cdc.gov/mmwr/volumes/68/wr/mm6803a3.htm) showed 1.8% of high school age students identified as transgender, and [a survey conducted by GLAAD in 2017](https://www.glaad.org/files/aa/2017_GLAAD_Accelerating_Acceptance.pdf) showed a whopping 12% of respondents 18 to 34 did not identify as cisgender.
zh-tw: -->
這就是為什麼在過去的十年中，全世界的跨性別者突然激增。 隨著更容易的取得資源，人數就會增加，人數增加，能見度就會增加，能見度增加，意識就會增加，意識增加，就會有更多人接受治療。 [2014 年進行的一項研究](https://williamsinstitute.law.ucla.edu/wp-content/uploads/TransAgeReport.pdf) 顯示美國有 0.6% 的成年人和 0.7% 的青少年自認為跨性別，[2016 年進行的一項研究](https://www.cdc.gov/mmwr/volumes/68/wr/mm6803a3.htm) 顯示 1.8% 的高中生自認為跨性別，[2017 年 GLAAD 進行的一項調查](https://www.glaad.org/files/aa/2017_GLAAD_Accelerating_Acceptance.pdf) 顯示有高達 12% 的 18 至 34 歲的受訪者不認為自己是順性別。
<!-- en:
Transgender people are coming out of the woodwork; we are everywhere.
zh-tw: -->
跨性別者正在走出來；我們無處不在。
<!-- en:
## So What Is Gender Dysphoria?
zh-tw: -->
## 那麼什麼是性別不安？
{!{
<div class="gutter print-span4">
<blockquote>
<strong>不安 Dys·pho·ri·a</strong> - <em>名詞</em><br>
一種對生活感到憂心或普遍不滿的狀態。 正相反的是欣快(euphoria)。
<!-- A state of unease or generalized dissatisfaction with life. The opposite of euphoria. -->
</blockquote>
{{import '~/img' images.glue className="card print-span4"}}
</div>
}!}
<!-- en:
There is a common misconception among both cisgender and transgender people that gender dysphoria refers exclusively to a physical discomfort with ones own body. However, this belief that body discomfort is central to gender dysphoria is in fact a misconception, and is not even a majority component of a gender dysphoria diagnosis. Gender dysphoria crosses a large number of all aspects of life, including how you interact with others, how others interact with you, how you dress, how you behave, how you fit into society, how you perceive the world around you, and, yes, how you relate to your own body. Consequently, proponents of the WPATH SoC 7 and the DSM-5 have taken to a habit of saying that you do not have to have dysphoria to be transgender. This statement is often repeated like a mantra, as it informs people who do not feel significant body discomfort that they may also be transgender.
zh-tw: -->
在順性別者和跨性別者中有一個常見的誤解，即性別不安專指對自己的身體感到不適。 然而，這種認為身體不適是性別不安的核心的觀念實際上是一種誤解，甚至不是性別不安診斷的主要組成部分。 性別不安涉及生活的許多方面，包括您如何與他人互動、他人如何與您互動、您的穿著、您的行為、您如何適應社會、您如何感知周圍的世界，以及，是的，您如何與自己的身體相處。 因此，WPATH SoC 7 和 DSM-5 的支持者已經形成了一種習慣，即您不必患有不安才能成為跨性別者。 這句話經常像一句口頭禪一樣被重複，因為它告訴那些不感到明顯身體不適的人，他們也可能是跨性別者。
<!-- en:
In principle, gender dysphoria is a feeling of wrongness intrinsic to the self. There is no logical backing to this wrongness; there is nothing which explains it, and you can not describe why you feel this way; it is just there. Things in your existence are incorrect, and even knowing which things *are* incorrect can be hard to properly identify.
zh-tw: -->
原則上，性別不安是一種與自我的錯誤感。 這種錯誤感沒有邏輯依據； 沒有什麼可以解釋它，你也無法描述為什麼你會這樣感覺； 它就在那裡。 您存在的事物是不正確的，即使知道哪些事物是不正確的也可能很難正確識別。
<!-- en:
The way I used to describe it is like wearing an adult's glove when you are a child. You can put your hand into the glove, and your fingers feed into the digits of the glove, but your dexterity with the glove is severely hindered. You might be able to pick something up, but you can not manipulate it like an adult could. Things just aren't quite right.
zh-tw: -->
我以前用來描述它的方式是，當你是一個孩子時穿著成人的手套。 你可以把手放進手套裡，你的手指可以伸進手套的指頭裡，但是你的手套的靈巧性受到了嚴重的阻礙。 你可能能夠拿起東西，但你無法像成年人那樣操縱它。 事情就是不太對。
<!-- en:
Evey Winters described it this way [in her Dysphoria post](https://eveywinters.com/on-dysphoria-before-enduring-and-after/).
zh-tw: -->
Evey Winters 在她的[不安貼文](https://eveywinters.com/on-dysphoria-before-enduring-and-after/)中這樣描述。
<!-- en:
> Have you ever been sitting somewhere in a public or a formal place and all of a sudden the bottom of your foot itches? It’s not like you can remove your shoes right there and scratch it, so you endure the feeling of dying inside while this itch grows and grows until you are ready to murder the next person that speaks to you.
>
> Or when I was younger I used to watch cable TV in the mornings before school. Because it was cable TV in rural WV in the early 90’s, every so often I’d turn on my favorite channel to watch my shows while I ate my maple oatmeal and I’d be seeing Power Rangers — but the audio would be from another station (usually the weather channel). The video was fine. The audio was fine. But the mismatch between them? That’s the kind of frustration that sits with you all day as a child.
>
> It’s the feeling you get when you ask for a crisp refreshing Diet Coke and the server says, “Is Pepsi ok?”
>
> It is knowing that something is wrong and not being able to do a damn thing about it.
zh-tw: -->
> 你曾有過坐在某個公開或是正式的場合而突然間你的腳底開始癢? 這不太像是你可以在這邊脫鞋然後開始抓，所以你忍受著內心即將死去的感覺，同時這種渴望越來越強烈，直到你準備好謀殺下一個與你說話的人。
>
> 或者當我年輕的時候，我經常在早上上學前看有線電視。因為在90年代初，西維吉尼亞的農村地區還使用有線電視，所以我時不時會一邊吃楓燕麥片，一邊打開我最喜歡的頻道觀看節目，而且我會看到《金剛戰士》(Power Rangers) ，但音訊來自另一個頻道站（通常是天氣頻道）。影像很好、音訊很好。但他們之間的不匹配呢？當你還是個孩子的時候，這種挫折感就會整天伴隨著你。
<!-- en:
Gender dysphoria is, at its core, simply emotional reactions to the brain knowing that something does not fit. This incongruence is so deep inside the brain's subsystems that there is no obvious message of what the problem is. The only way we have to identify it is via the emotions that it triggers. Our consciousness receives either positive (euphoria) or negative (dysphoria) feedback according to how well our current environment aligns with our internal sense of self. Part of transition is learning to recognize those signals.
zh-tw: -->
性別不安在其核心上，僅僅是大腦知道某些事情不合適而引起的情感反應。 這種不一致性深深地存在於大腦的子系統中，沒有明顯的問題信息。 我們唯一能夠識別它的方式是通過它觸發的情感。 我們的意識根據我們當前的環境與我們內在自我的一致性有多好，接收到積極（欣快）或消極（不安）的反饋。 轉變的一部分是學會識別這些信號。
<!-- en:
Cisgender people receive them as well, but since the signals usually align with their environment, they take them for granted. There have been a few notable occasions, however, when a cisgender person has been [put into a situation](https://www.teenvogue.com/story/maisie-williams-arya-stark-game-of-thrones-affected-her-body-image) where they experience gender dysphoria. Attempts to raise cisgender children [as the opposite sex](https://www.nytimes.com/2004/05/12/us/david-reimer-38-subject-of-the-john-joan-case.html) (Content warning: suicide) have always met with failure when the child inevitably declares themselves differently.
zh-tw: -->
順性別者也會收到他們，但因為這些訊號通常與他們的環境相符，他們會認為這是理所當然的。然而，也有一些值得注意的場合，當一個順性別者被[置於一個情境中](https://www.teenvogue.com/story/maisie-williams-arya-stark-game-of-thrones-affected-her-body-image)，經歷了性別焦慮。嘗試將順性別孩童[以對立性別扶養](https://www.nytimes.com/2004/05/12/us/david-reimer-38-subject-of-the-john-joan-case.html)（內容警告：自殺）通常會以失敗告終，當孩子最終表明自己有不同的性別認同時。
<!-- en:
These impulses of euphoria and dysphoria, arousal and aversion — they all manifest in many different ways: some obvious, some much more subtle. Dysphoria changes over time as well, taking on new shapes as one moves from pre-awareness into understanding and through transition. The goal of this book is to break down these manifestations into their distinct categories and describe them so that others may learn to recognize them.
zh-tw: -->
這些欣快和不快的衝動、興奮和厭惡——它們以多種不同的方式表現出來：有些顯而易見，有些則更加微妙。不快感也會隨著時間的推移而改變，當一個人從尚未意識到到理解並經歷轉變的過程中，它會呈現出新的面貌。本書的目標是將這些表現分解為不同的類別並加以描述，以便其他人學會識別它們。
<!-- However, first I must stress something very important, so important that I am putting it into big bold letters:
**EVERY SINGLE TRANS PERSON EXPERIENCES A DIFFERENT SET OF DYSPHORIA SOURCES AND INTENSITIES**
There is no one single trans experience; there is no standard set of feelings and discomforts; there *is no one true trans narrative*. Every trans person experiences dysphoria in their own way to their own degree, and what bothers one person may not bother another.
Okay, with that disclaimer out of the way, let's get to the meat and potatoes. -->
然而，首先我要強調非常重要的一點，重要到我要用粗體表示：
**每一位跨性別者都會經歷不同來源和強度的不快感**
不存在唯一的跨性別經歷；沒有標準的感受和不適集；*沒有一個真正的跨性別敘述*。每個跨性別者都以各自的方式和程度經歷不快感，而讓一個人感到困擾的事情，可能不會困擾另一個人。
好了，聲明到此結束，讓我們來進入正題。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "荷爾蒙：它們如何運作"
linkTitle: "荷爾蒙如何運作"
description: "鑰匙、鎖和汽車點火裝置"
preBody: '_disclaimer'
siblings:
prev: /tw/chromosomes
prevCaption: 染色體
next: /tw/second-puberty-masc
nextCaption: 雄激素性第二青春期
classes:
- gdb
---
<!-- # How Hormones Work -->
# 荷爾蒙如何運作
<!-- As we described in the [Causes of Gender Dysphoria](/en/causes) section, every human's DNA contains the genetic instructions for both male and female bodies, and which set of instructions gets used is controlled by what hormones your gonads produce. That differentiation occurs entirely based on whether you happen to have an SRY gene which, between the sixth and eighth weeks of gestation, kicks off a chain reaction that produces testes instead of ovaries. From that point on, every sexual attribute of the human body (primary and secondary) is a result of the hormones that those gonads produce. -->
正如我們在[性別不安的成因](/tw/causes)一節中所描述的，每個人的 DNA 都包含男性和女性身體的基因指令，而使用哪一套指令則取決於你的性腺產生的荷爾蒙。這種分化完全取決於你是否碰巧擁有一個 SRY 基因，它在妊娠的第六週到第八週之間會啟動一個連鎖反應，產生睪丸而不是卵巢。從那時起，人體的所有性徵（第一和第二）都是這些性腺產生的荷爾蒙的結果。
<!-- If they produce estrogens (primarily estradiol), the genitals form into a vulva, vagina, and uterus. If they produce androgens (primarily testosterone), the genitals form into a penis and scrotum, shifting the [Skene's gland](https://en.wikipedia.org/wiki/Skene%27s_gland) downward and enlarging it into a prostate. Differentiation ends here until the onset of puberty, nine to ten years later, and we all know what puberty does. -->
如果它們產生雌激素（主要是雌二醇），生殖器就會形成外陰、陰道和子宮。如果它們產生雄激素（主要是睪固酮），生殖器就會形成陰莖和陰囊，將[斯基恩氏腺](https://zh.wikipedia.org/wiki/%E6%96%AF%E5%9F%BA%E6%81%A9%E6%B0%8F%E8%85%BA)向下移動並將其擴大成前列腺。分化到此結束，直到九到十年後青春期開始，我們都知道青春期會做什麼。
<!-- So how does this work? Why do the cells differentiate like this? Well, before we can explain that, first we have to explain the concept of a **receptor**. -->
那麼這是如何運作的呢？為什麼細胞會這樣分化呢？嗯，在我們解釋這個之前，我們首先要解釋 **受體** (receptor) 的概念。
<!-- ## Hormone Receptors -->
## 荷爾蒙受體 (Hormone Receptors)
<!-- In simplest terms, a receptor is like the keyed lock ignition on a car (do new cars still have keyed ignitions?). Every cell in the body has a set of locks which activate different functions within that cell. They’re like switches which signal to the cell that it should activate a different part of its genetic sequence. Each receptor can only accept certain chemical compounds, much like how a lock can only accept certain keys, and different chemicals have different capabilities at turning the key. Some can completely start the car, while others only turn it to Accessory Mode. -->
簡單來說，受體就像汽車上的鑰匙點火裝置（現在的新車還有鑰匙點火裝置嗎？）。體內的每個細胞都有一組鎖，可以啟動細胞內不同的功能。它們就像開關，向細胞發出信號，讓它啟動其基因序列的不同部分。每個受體只能接受特定的化合物，就像一把鎖只能接受特定的鑰匙一樣，不同的化學物質轉動鑰匙的能力也不同。有些可以完全啟動汽車，而有些只能將其轉到配件模式(Accessory Mode)。
<!-- The ability for a chemical to fit into a receptor is called **relational binding affinity**, and is measured as a percentage of how likely a chemical will bind to a receptor compared to another. So, for example, if hormone B binds only 10% of the time in relation to hormone A, then it is said to have a 10% binding affinity. Similarly, the ability for a chemical to turn the key is called *transactivational ability*. Compounds which fit into a receptor but don’t do anything are called *antagonists*; compounds which are able to turn the key are called **agonists**. If it can only turn the key a tiny bit, it’s called a **partial agonist**. -->
一種化學物質與受體結合的能力稱為 **相對結合親和力** (relational binding affinity)，用一種化學物質與受體結合的可能性與另一種化學物質相比的百分比來衡量。例如，如果與荷爾蒙 A 相比，荷爾蒙 B 只有 10% 的時間與受體結合，那麼就說它的結合親和力為 10%。同樣，一種化學物質轉動鑰匙的能力稱為 *反式啟動能力* (transactivational ability) 。能與受體結合但不產生任何作用的化合物稱為 *拮抗劑* (antagonists)；能轉動鑰匙的化合物稱為 **促效劑** (agonists) 。如果它只能稍微轉動鑰匙，就稱為 **部分促效劑** (partial agonist)。
<!-- You can think of antagonists like bouncers at a club. They stand in the doorway and prevent anything else from getting through, but don’t enter the club themselves. Most antagonists are referred to as **blockers**. This is different from an **inhibitor**, which is a compound that slows down a chemical reaction, or an *activator*, which speeds up a reaction. In receptors, an inhibitor lowers the ability of the receptor, causing it to respond less effectively to things that bind to the receptor, and an activator increases the ability of the receptor, making it respond stronger, like a booster. -->
你可以把拮抗劑想像成俱樂部的保鏢。他們站在門口，阻止任何其他東西通過，但自己不進入俱樂部。大多數拮抗劑都被稱為 **阻斷劑** (blockers)。這與 **抑制劑** (inhibitor) 不同，抑制劑是一種減緩化學反應的化合物，而 *活化劑* (activator) 則是一種加速反應的化合物。在受體中，抑制劑會降低受體的能力，使其對與受體結合的物質的反應效率降低，而活化劑會增強受體的能力，使其反應更強，就像加速器一樣。
<!-- In some cases, a hormone can function as an inhibitor or an activator for a different hormone by slowing down or increasing behavior in a cell. For example, progesterone increases cell activity, making cells respond more effectively to estrogens and androgens, and testosterone increases the transactivational ability of dopamine receptors, so less dopamine is needed in the brain for the same effect. -->
在某些情況下，荷爾蒙可以透過減緩或增強細胞內的行為而充當另一種荷爾蒙的抑制劑或活化劑。例如，黃體素(progesterone)會增強細胞活性，使細胞對雌激素和雄激素的反應更有效，而睪固酮會增強多巴胺受體的反式啟動能力，因此大腦中需要較少的多巴胺就能達到相同的效果。
<!-- ## What's in a Hormone -->
## 荷爾蒙是什麼
<!-- There are four main kinds of hormones: -->
荷爾蒙主要有四種類型：
<!-- - [Amino acids](https://en.wikipedia.org/wiki/Amino_acid) such as melatonin (which controls sleep) or thyroxine (which regulates metabolism).
- [Peptides](https://en.wikipedia.org/wiki/Peptide_hormone) like oxytocin and insulin, which are collections of amino acids.
- [Eicosanoids](https://en.wikipedia.org/wiki/Eicosanoid) that are formed from lipids and fatty acids and predominantly affect the immune system.
- [Steroids](https://en.wikipedia.org/wiki/Steroid), which signaling molecules produced by various internal organs in order to pass messages to other organs within the body. -->
- [胺基酸(Amino acids)](https://zh.wikipedia.org/wiki/%E6%B0%A8%E5%9F%BA%E9%85%B8)，例如褪黑激素（控制睡眠）或甲狀腺素（調節新陳代謝）。
- [肽(Peptides)](https://zh.wikipedia.org/wiki/%E8%82%BD%E7%B1%BB%E6%BF%80%E7%B4%A0)，例如催產素和胰島素，它們是由胺基酸組成的。
- [類花生酸(Eicosanoids)](https://zh.wikipedia.org/wiki/%E7%B1%BB%E8%8A%B1%E7%94%9F%E9%85%B8)由脂質和脂肪酸形成，主要影響免疫系統。
- [類固醇(Steroids)](https://zh.wikipedia.org/wiki/%E7%94%BE%E4%BD%93)，是由各種內臟器官產生的信號分子，以便向體內其他器官傳遞訊息。
<!-- {!{ <div class="gutter print-span3">{{import '~/img' images.steroidogenesis
className="card"
link="https://en.wikipedia.org/wiki/File:Steroidogenesis.svg"
external=1
alt="Chart of steroid metabolism flow"
caption="All steroids are formed from cholesterols (top left) and are derived from other steroids. Progestogens form into androgens which form into estrogens. This is a one-way exchange, and does not reverse, so don't believe it when someone tells you that too much estrogen will turn it into testosterone."
}}</div> }!} -->
{!{ <div class="gutter print-span3">{{import '~/img' images.steroidogenesis
className="card"
link="https://commons.wikimedia.org/wiki/File:Steroidogenesis_(zh-tw).svg"
external=1
alt="類固醇代謝流程圖"
caption="所有類固醇都是由膽固醇（左上角）形成的，並且衍生自其他類固醇。孕激素形成雄激素，雄激素形成雌激素。這是一個單向的交換，不會逆轉，所以當有人告訴你雌激素過多會轉化成睪固酮時，不要相信。"
}}</div> }!}
<!-- For the purposes of transition, this last category is what we care about the most, as all of the sex hormones are steroids. They fall into seven main categories: -->
就轉變而言，我們最關心的是最後一類，因為所有的性荷爾蒙都是類固醇。它們主要分為七類：
<!-- - [Androgens](https://en.wikipedia.org/wiki/Androgen)
- [Estrogens](https://en.wikipedia.org/wiki/Estrogen)
- [Progestogens](https://en.wikipedia.org/wiki/Progestogen)
- [Glucocorticoids](https://en.wikipedia.org/wiki/Glucocorticoid)
- [Mineralocorticoids](https://en.wikipedia.org/wiki/Mineralocorticoid)
- [Neurosteroids](https://en.wikipedia.org/wiki/Steroid)
- [Aminosteroids](https://en.wikipedia.org/wiki/Aminosteroid) -->
- [雄激素(Androgens)](https://zh.wikipedia.org/wiki/%E9%9B%84%E6%BF%80%E7%B4%A0)
- [雌激素(Estrogens)](https://zh.wikipedia.org/wiki/%E9%9B%8C%E6%BF%80%E7%B4%A0)
- [孕激素(Progestogens)](https://zh.wikipedia.org/wiki/%E5%AD%95%E6%BF%80%E7%B4%A0)
- [糖皮質素(Glucocorticoids)](https://zh.wikipedia.org/wiki/%E7%B3%96%E7%9A%AE%E8%B4%A8%E6%BF%80%E7%B4%A0)
- [鹽皮質素(Mineralocorticoids)](https://zh.wikipedia.org/wiki/%E7%9B%90%E7%9A%AE%E8%B4%A8%E6%BF%80%E7%B4%A0)
- [神經類固醇(Neurosteroids)](https://zh.wikipedia.org/wiki/%E7%94%BE%E4%BD%93)
- [氨基甾體(Aminosteroids)](https://zh.wikipedia.org/wiki/%E6%B0%A8%E5%9F%BA%E7%94%BE%E4%BD%93)
<!-- The first three of these are what we care about most when it comes to hormone therapy. Note: All human beings, regardless of phenotype, have some of every one of these hormones in their bodies. The ratios are what affect body shape. -->
在激素治療方面，我們最關心的是前三種。注意：所有人，不論表現型如何，體內都有一些這些荷爾蒙。比例是影響體型的因素。
<!-- ### Androgens -->
### 雄激素
<!-- There are nearly a dozen different androgens, but the ones we care about the most are [testosterone](https://en.wikipedia.org/wiki/Testosterone) and [dihydrotestosterone](https://en.wikipedia.org/wiki/Dihydrotestosterone). -->
雄激素有將近十幾種，但我們最關心的是[睪固酮(testosterone)](https://zh.wikipedia.org/wiki/%E7%9D%BE%E9%85%AE)和[二氫睪固酮(dihydrotestosterone)](https://zh.wikipedia.org/wiki/%E5%8F%8C%E6%B0%A2%E7%9D%BE%E9%85%AE)。
<!-- Testosterone is the primary masculinizing hormone for the human body and is produced in the adrenal glands, the testes, and in the ovaries (where it is immediately converted into estrone and estradiol). It tells both muscle and bone cells to grow and, in higher concentrations, encourages larger muscle mass and thicker skeletal structure. This also means that testosterone is critical for bone health, as it affects calcium distribution within the skeletal structure. Thus, severe depletion of testosterone can result in osteoporosis and fragile bones. Testosterone also plays a major role in sex drive and libido, encouraging mating behavior within the cerebral cortex. -->
睪固酮是人體主要的男性化荷爾蒙，在腎上腺、睪丸和卵巢中產生（在卵巢中，它會立即轉化為雌酮和雌二醇）。它會指示肌肉細胞和骨骼細胞生長，並且在較高濃度下，會促進更大的肌肉質量和更厚的骨骼結構。這也意味著睪固酮對骨骼健康至關重要，因為它會影響骨骼結構中的鈣分佈。因此，嚴重的睪固酮耗竭會導致骨質疏鬆症和骨骼脆弱。睪固酮在性慾和性衝動中也起著重要作用，促進大腦皮層內的交配行為。
<!-- Dihydrotestosterone (DHT), which is converted from testosterone in the prostate, skin, and liver, plays a major role in the development of the male genitalia during puberty by inducing random erections, and the growth of facial and body hair. Paradoxically, DHT is also what causes male pattern baldness, as it chokes off blood circulation to the follicles on the top of the scalp (sorry, trans guys, it's a double-edged sword). DHT binds to androgen receptors ten times more strongly than testosterone, which is why it is critical to eliminate it for feminizing transition. -->
二氫睪固酮 (DHT) 是由前列腺、皮膚和肝臟中的睪固酮轉化而來的，它透過誘導隨機勃起以及面部和身體毛髮的生長，在青春期男性生殖器的發育中起著重要作用。矛盾的是，DHT 也是導致男性型禿髮的原因，因為它會阻礙頭皮頂部毛囊的血液循環（抱歉，跨男們，這是一把雙刃劍）。DHT 與雄激素受體的結合力是睪固酮的十倍，這就是為什麼在女性化轉變過程中消除它是至關重要的。
<!-- ### Estrogens -->
### 雌激素
<!-- There are four estrogens: [estradiol](https://en.wikipedia.org/wiki/Estradiol), [estrone](https://en.wikipedia.org/wiki/Estrone), estriol and estetrol. The latter two are only produced during pregnancy and are important for fetal health, but have no bearing on transition. -->
雌激素有四種：[雌二醇(estradiol)](https://zh.wikipedia.org/wiki/%E9%9B%8C%E4%BA%8C%E9%86%87)、[雌酮(estrone)](https://zh.wikipedia.org/wiki/%E9%9B%8C%E9%85%AE)、雌三醇(estriol)和雌四醇(estetrol)。後兩種只在懷孕期間產生，對胎兒健康很重要，但與轉變無關。
<!-- Estradiol is the feminizing hormone, as it is the primary signaling hormone for growth in the mammary glands (breast tissue), and because it encourages fat deposits in the thighs, hips, butt, chest, and arms, while discouraging fat deposits in the abdomen, thus producing a curvier figure. Estradiol also promotes increased collagen production, resulting in softer skin and more flexible tendons & ligaments. -->
雌二醇是女性化荷爾蒙，因為它是乳腺（乳房組織）生長的主要信號荷爾蒙，而且它會促進大腿、臀部、臀部、胸部和手臂的脂肪沉積，同時抑制腹部的脂肪沉積，從而產生更有曲線的身材。雌二醇還能促進膠原蛋白(collagen)的產生，使皮膚更柔軟，肌腱和韌帶更靈活。
<!-- Estrone's role in the body has been something of a puzzle in medical research, as it has significantly lower binding affinity compared to estradiol (0.6%) and very low transactivational ability (4%). The hormone doesn't appear to *do* anything; it just sits in the bloodstream. However, it has a unique ability to convert to and from estradiol via an enzyme group called [17β-HSD](https://en.wikipedia.org/wiki/17%CE%B2-Hydroxysteroid_dehydrogenase), making it ideally suited to function like an estrogen battery within the body. -->
雌酮在體內的作用一直是醫學研究中的一個謎，因為與雌二醇相比，它的結合親和力要低得多 (0.6%)，而且反式啟動能力也很低 (4%)。這種荷爾蒙似乎沒有 *做* 任何事；它只是存在於血液中。然而，它具有一種獨特的能力，可以透過一種稱為[17β-HSD](https://zh.wikipedia.org/wiki/17%CE%B2-%E7%BE%9F%E5%9F%BA%E7%B1%BB%E5%9B%BA%E9%86%87%E8%84%B1%E6%B0%A2%E9%85%B6)的酵素群與雌二醇相互轉化，使其非常適合在體內充當雌激素電池的作用。
<!-- New research is starting to suggest that the body may regulate total estradiol levels by releasing HSD17B1 to turn estradiol into estrone, and releasing HSD17B2 to convert it back, but this is a very early study. Both enzymes are produced in breast tissue, and may play a role in the presence of cyclical period-like symptoms in estrogenic individuals who do not have ovaries, such as trans women. -->
新的研究開始表明，身體可能透過釋放 HSD17B1 將雌二醇轉化為雌酮，並釋放 HSD17B2 將其轉化回來，從而調節雌二醇的總水平，但這還是一項非常早期的研究。這兩種酶都在乳房組織中產生，並且可能在沒有卵巢的雌激素個體（例如跨性別女性）出現週期性類似經期症狀中起作用。
{!{ <div class="gutter"><div class="card"><div class="card-body"><h4 class="card-title">For Your Information</h4> }!}
<!-- **Why aren't AFAB trans people prescribed estrogen blockers alongside testosterone?** -->
**為什麼出生指定性別女性(AFAB)的跨性別者在服用睪固酮的同時不用服用雌激素阻斷劑？**
<!-- There are two separate sources for estrogens within the female reproductive system. Ovaries contain thousands of follicles: cell structures which produce eggs. The pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which encourages the follicles to grow into luteal cells. Theca cells within the follicle produce testosterone, and granulosa cells produce the enzyme [aromatase](https://en.wikipedia.org/wiki/Aromatase), which converts that testosterone into estradiol. This is the first source of estrogen, but it is not the largest source. -->
女性生殖系統中有兩個不同的雌激素來源。卵巢包含數千個濾泡：產生卵子的細胞結構。腦垂腺產生黃體生成素 (LH) 和促濾泡激素 (FSH)，促進濾泡生長成黃體細胞。濾泡內的膜細胞產生睪固酮，顆粒細胞產生[芳香酶(aromatase)](https://zh.wikipedia.org/wiki/%E8%8A%B3%E9%A6%99%E5%8C%96%E9%85%B6)，將睪固酮轉化為雌二醇。這是雌激素的第一個來源，但不是最大的來源。
<!-- Note: This is why PCOS causes ovaries to produce testosterone; the ovarian cysts disrupt the aromatase production, so the testosterone does not get converted. -->
注意：這就是為什麼多囊卵巢症候群(PCOS)會導致卵巢產生睪固酮的原因；卵巢囊腫會擾亂芳香酶的產生，因此睪固酮不會被轉化。
<!-- Two weeks into the period cycle the hypothalamus tells the pituitary gland to produce an LH and FSH spike three to four times stronger than earlier in the cycle. That surge causes the follicles to swell until one pops, releasing an egg, at which point the remains of the follicle become a structure known as the corpus luteum. That corpus luteum then begins to produce progesterone and significantly more estrogens in order to prepare the womb for a fertilized egg. This is the second source. -->
月經週期的兩週後，下視丘會指示腦垂腺產生比週期早期高三到四倍的 LH 和 FSH 激增。這種激增會導致濾泡腫脹，直到一個濾泡破裂，釋放出一個卵子，此時濾泡的殘餘部分變成一種稱為黃體的結構。然後，黃體開始產生黃體酮和更多的雌激素，為子宮準備受精卵。這是第二個來源。
<!-- Taking testosterone causes the hypothalamus to deactivate the genes that initiate this LH and FSH spike, so the follicles never reach maturity, ovulation never occurs, and the corpus luteum is never formed, removing a significant source of estrogen within the ovaries. -->
服用睪固酮會導致下視丘關閉啟動 LH 和 FSH 激增的基因，因此濾泡永遠不會成熟，永遠不會排卵，也不會形成黃體，從而去除了卵巢內雌激素的一個重要來源。
<!-- *So no, Reddit, it isn't just "because testosterone is stronger", it's because ovaries are a hell of a lot more complex than testes and are easier to disrupt. Please stop spreading this falsehood.* -->
*所以，Reddit，這不只是「因為睪固酮更強」，而是因為卵巢比睪丸複雜得多，更容易受到干擾。請停止散播這種不實之詞。*
{!{ </div></div></div> }!}
<!-- ### Progestogens -->
### 孕激素 (Progestogens)
<!-- The primary progestogen is [progesterone](https://en.wikipedia.org/wiki/Progesterone), which plays numerous roles in the body and has been found to be [an important component for feminizing hormone therapy](https://academic.oup.com/jcem/article/104/4/1181/5270376). -->
主要的孕激素是[助孕酮(progesterone)](https://zh.wikipedia.org/wiki/%E5%AD%95%E9%85%AE)，它在體內扮演著許多角色，並且已被發現是[女性化賀爾蒙療法的重要組成部分](https://academic.oup.com/jcem/article/104/4/1181/5270376)（英文）。
<!-- One of the largest roles that the progestogen receptor plays is in the regulation of gonadal function (ovaries and testes). The hypothalamus is positively *littered* with progestogen receptors and responds strongly to their activation, downregulating the production of [GnRH](https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone), which then reduces the production of [luteinizing hormone](https://en.wikipedia.org/wiki/Luteinizing_hormone) by the pituitary gland. -->
孕激素受體扮演的最大角色之一是調節性腺功能（卵巢和睪丸）。下視丘中 *充滿* 了孕激素受體，並且對它們的活化反應強烈，下調[促性腺激素釋放激素(GnRH)](https://zh.wikipedia.org/wiki/%E4%BF%83%E6%80%A7%E8%85%BA%E6%BF%80%E7%B4%A0%E9%87%8A%E6%94%BE%E6%BF%80%E7%B4%A0) 的產生，從而減少腦垂腺產生[黃體生成素(LH)](https://zh.wikipedia.org/wiki/%E9%BB%84%E4%BD%93%E7%94%9F%E6%88%90%E7%B4%A0) 。
<!-- LH is what tells the ovaries and testes to produce estrogen and androgens. LH and its sibling hormone [FSH](https://en.wikipedia.org/wiki/Follicle-stimulating_hormone) both play central roles in ovulation, which is another large source of estrogen in ovary-havers. Thus, synthetic progestogens (chemicals that fit into progestogen receptors) are often included in birth control in order to prevent ovulation. In AMABs, progestogens are a useful tool for blocking testosterone production. -->
LH 是指示卵巢和睪丸產生雌激素和雄激素的物質。LH 及其姊妹荷爾蒙[促濾泡激素 (FSH) ](https://zh.wikipedia.org/wiki/%E4%BF%83%E5%8D%B5%E6%B3%A1%E6%BF%80%E7%B4%A0)都在排卵中起著核心作用，排卵是卵巢擁有者的另一個主要的雌激素來源。因此，合成孕激素（能與孕激素受體結合的化學物質）通常被包含在避孕藥中，以防止排卵。對於出生指定性別男性(AMAB)的人來說，孕激素是阻斷睪固酮產生的一個有用工具。
<!-- Another type of cell that is full of progestogen receptors is mammary tissue. Progesterone plays a major role in the growth and maturation of milk ducts within breast tissue. While little formal research has been conducted into progesterone's effect on breast development, anecdotally it has been seen widely across the transfem community to provide significant improvements in breast fullness. Progesterone has also been demonstrated to increase blood flow to breast tissue, and encourages fat deposits in the breasts, both of which increase breast size. -->
另一種類型充滿孕激素受體的細胞是乳腺組織。助孕酮在乳腺組織中乳腺管的生長和成熟中起著重要作用。雖然很少有正式的研究來探討助孕酮對乳房發育的影響，但坊間證據表明，它在跨性別女性群體中廣泛使用，可以顯著改善乳房的豐滿度。助孕酮也被證明可以增加流向乳房組織的血液，並促進乳房中的脂肪沉積，這兩者都會增加乳房的大小。
<!-- Additionally, progesterone promotes better sleep, improves cardiovascular health, increases ketogenesis (reducing triglycerides), increases metabolic function, and has been found to reduce breast cancer risk. -->
此外，助孕酮還能促進更好的睡眠，改善心血管健康，增加生酮作用（降低三酸甘油酯），增強代謝功能，並且已被發現可以降低患乳腺癌的風險。
<!-- ### Mineralocorticoids -->
### 鹽皮質素 (Mineralocorticoids)
<!-- Mineralocorticoids play no role in transition, but they are worth mentioning because of one major hormone: [aldosterone](https://en.wikipedia.org/wiki/Aldosterone). -->
鹽皮質激素在轉變過程中不起作用，但由於一種主要的荷爾蒙：[醛固酮(aldosterone)](https://zh.wikipedia.org/wiki/%E9%86%9B%E5%9B%BA%E9%85%AE)，它們值得一提。
<!-- Aldosterone is what instructs the kidneys to *stop* extracting water from the bloodstream. It is produced by the adrenal glands in order to regulate body hydration. Why is this significant? -->
醛固酮是指示腎臟*停止*從血液中提取水分的物質。它由腎上腺產生，以調節身體的水分。為什麼這很重要？
<!-- Because one drug that is very commonly used in trans hormone therapy is an extremely powerful aldosterone antagonist: spironolactone. Spiro binds to mineralocorticoid receptors more strongly than aldosterone does, but does not activate the receptor. It just clogs it, preventing the kidneys from receiving the signal to stop extracting water. -->
因為一種在跨性別荷爾蒙治療中非常常用的藥物是一種極其強大的醛固酮拮抗劑：螺環固醇內酮(spironolactone)。螺環固醇內酮與鹽皮質素受體的結合力比醛固酮更強，但不會激活受體。它只是堵塞受體，阻止腎臟接收停止提取水分的信號。
<!-- This is why spiro makes people pee so much. -->
這就是為什麼螺環固醇內酮(spiro)會讓人這麼容易頻尿的原因。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "冒牌者症候群，跨性別版本"
linkTitle: "冒名頂替症候群"
description: "我真的是跨嗎?"
preBody: '_disclaimer'
siblings:
prev: /tw/managed-dysphoria
prevCaption: 應付不安
next: /tw/am-i-trans
nextCaption: 我是跨嗎?
classes:
- gdb
tweets:
- '1219963582063968258'
- '1221970265862811650'
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- '1153300374133981186'
---
<!-- # Impostor Syndrome -->
# 冒名頂替症候群
{!{ <div class="gutter">{{import '~/tweet' ids=[
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<!-- > [Impostor syndrome](https://en.wikipedia.org/wiki/Impostor_syndrome) (also known as impostor phenomenon, impostorism, fraud syndrome, or the impostor experience) is a psychological pattern in which an individual doubts their accomplishments and has a persistent internalized fear of being exposed as a "fraud". -->
> [冒名頂替症候群](https://zh.wikipedia.org/wiki/%E5%86%92%E7%9A%84%E8%80%85%E7%97%87%E5%80%99%E7%BE%A4)（英語：impostor syndrome，也稱為冒名頂替現象、冒名頂替主義、騙子症候群或冒名頂替經歷）是一種心理模式，個體會懷疑自己的成就，並持續害怕被揭露為「騙子」。
<!-- Society in general is very good about making trans people doubt themselves. We receive tons and tons of subliminal messages through out our lives saying that being trans isn't normal and that anyone who is has to be exceptionally special. Cis media's obsession with the "born in the wrong body" narrative has led to a lot of false information being internalized by trans youth. Many, *many* trans kids grow up thinking they aren't actually trans because they don't *know* that they are a different gender but simply *wish* they were. Many non-binary children grow up knowing something is wrong, but not believing they're trans because they don't feel like a binary trans person. -->
一般來說，社會非常擅長讓跨性別者懷疑自己。我們一生中會收到成千上萬的潛意識訊息，說身為跨性別者是不正常的，任何跨性別者都必須非常特別。順性別媒體對「生錯身體」敘事的執著導致許多錯誤的資訊被跨性別青少年內化。許多、 *許多* 跨性別孩子在成長過程中認為自己實際上不是跨性別者，因為他們不 *知道* 自己是不同的性別，而只是 *希望* 自己是不同的性別。許多非二元性別的兒童在成長過程中知道某些地方不對勁，但不相信自己是跨性別者，因為他們感覺不像二元跨性別者。
<!-- On top of this, messages saying that trans people hate their bodies or hate their genitalia have polluted the awareness landscape, so that many people who either do not experience physical dysphoria (or simply think theirs isn't very strong) go around believing they aren't "trans enough". -->
除此之外，關於跨性別者憎恨自己的身體或憎恨自己生殖器的訊息污染了認知環境，以至於許多沒有經歷過身體不安（或者只是認為自己的身體不安不是很強烈）的人會認為自己不夠「跨」。
***[是的，你夠跨](https://us.jkp.com/products/yes-you-are-trans-enough)***
{!{ <div class="gutter">{{import '~/tweet' ids=[
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<!-- On top of this, the constant messaging from transphobic media that trans people are not actually their true genders and are simply trying to trick people into believing otherwise gets internalized like a virus. This creates a lot of self doubt about the authenticity of one's gender, especially in the face of so many gender stereotypes. Seeing oneself fail to meet those stereotypes can make it very easy to convince yourself that you do not live up to your own gender (note: cis men and women get this too, far too often). -->
除此之外，來自恐跨媒體的持續訊息，即跨性別者實際上並非他們真正的性別，而只是試圖欺騙人們相信他們是，這些訊息像病毒一樣被內化。這對一個人性別的真實性產生了很多自我懷疑，尤其是在面對如此多的性別刻板印象時。看到自己沒有達到這些刻板印象，很容易說服自己，你沒有達到自己性別的標準（注意：順性別男性和女性也經常遇到這種情況）。
<!-- Furthermore, due to a history of transphobic abuse, many trans people suffer from damaged self-esteems, and often already have difficulty with self-doubt. Gender dysphoria also causes depression, which further contributes to and reinforces those doubts. This all leads into a massive cluster of self-invalidation that can lead someone to struggle over and over again to accept their own gender identity. -->
此外，由於恐跨的虐待歷史，許多跨性別者的自尊心受到損害，並且經常難以自我懷疑。性別不安也會導致抑鬱，這進一步加劇並強化了這些懷疑。所有這些都會導致大量的自我否定，導致一個人一次又一次地難以接受自己的性別認同。
<!-- But here's the thing... only trans people are worried about if they are actually transgender! A cisgender person does not have this obsession with their identity: they think about it, they process it, they move on. If you keep returning to these thoughts over and over again, this is your brain telling you that you took a wrong turn. -->
但問題是……只有跨性別者擔心自己是否真的是跨性別者！順性別者不會執著於自己的身份認同：他們思考它，處理它，然後繼續前進。如果你不斷地回到這些想法，這就是你的大腦在告訴你，你走錯路了。
<!-- The world is *full* of influences put in place to fill us with doubt and keep us from breaking outside of the established social order. These are some of the systems and ideologies that seek to invalidate trans people and keep us from self-actualizing. -->
世界上 *充滿* 了各種影響，讓我們充滿懷疑，阻止我們打破既定的社會秩序。以下是一些試圖否定跨性別者並阻止我們自我實現的制度和意識形態。
<!-- ### Autogynephilia -->
### 自體女性戀物癖 (Autogynephilia)
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<!-- This pattern was strongly reinforced during the late 1980s when the autogynephelia (AGP) theory of Ray Blanchard gained a lot of traction as trans awareness was just starting to escalate. AGP is a pseudo-scientific explanation intended to "explain" the source of trans women's identities using [paraphilias](https://en.wikipedia.org/wiki/Paraphilia). Blanchard separated trans women according to if they were attracted to men or to women, while simultaneously invalidating their womanhood. His work completely ignored transgender men, and he dismisses non-binary identities outright. -->
這種模式在 1980 年代後期得到了極大的強化，當時隨著跨性別意識的興起，Ray Blanchard 的自體女性戀物癖 (AGP) 理論獲得了很大的關注。AGP 是一種偽科學的解釋，試圖用[性慾倒錯](https://zh.wikipedia.org/wiki/%E6%80%A7%E5%81%8F%E9%9B%A2)來「解釋」跨性別女性身份的來源。Blanchard 根據跨性別女性是否被男性或女性所吸引來區分她們，同時否定她們的女性身份。他的研究完全忽略了跨性別男性，並且完全否定了非二元性別身份。
<!-- Autogynephelia attests that straight trans women are actually just gay men who seek a feminine appearance to draw desire from straight men, and that trans lesbians are actually straight men who have become so obsessed with their desire for women that they wish to become a woman in order to gain sexual gratification from themselves. -->
自體女性戀物癖認為，異性戀跨性別女性實際上只是男同性戀者，她們追求女性化的外表是為了吸引異性戀男性的慾望，而跨性別女同性戀者實際上是異性戀男性，她們對女性的慾望如此痴迷，以至於她們希望變成女性，以便從自身獲得性滿足。
<!-- Blanchard's theory largely hinged on the way that presenting feminine often resulted in sexual arousal within newly transitioning women. You see, most of his study subjects were patients who were trying to seek hormone therapy for the first time, and as such were still very new to presenting female. -->
Blanchard 的理論很大程度上取決於女性化的外表通常會在新轉變的女性身上引起性興奮。你看，他的大多數研究對象都是第一次嘗試尋求激素治療的患者，因此她們對女性化的表現還很陌生。
<!-- Yes, it boggles the mind, but this was actually considered a valid theory of psychology for years. It even appeared in college textbooks. Blanchard's research studies did not meet scientific rigor, and his data was found to be extremely flawed (he manipulated his patients, and simply just threw out any data that didn't fit his hypothesis). A lot of his theories are based in misogynistic views of womanhood, and the man never actually involved any cisgender women in his study to function as a control group. You can read more about how flawed the theory is in Julia Serano's excellent essay [The Case Against Autogynephilia](https://www.juliaserano.com/av/Serano-CaseAgainstAutogynephilia.pdf). -->
是的，這令人難以置信，但這實際上多年來一直被認為是一種有效的心理學理論。它甚至出現在大學教科書中。Blanchard 的研究不符合科學嚴謹性，而且他的數據被發現存在極大的缺陷（他操縱他的病人，並且只是扔掉任何不符合他的假設的數據）。他的許多理論都基於對女性的厭女觀點，而且這個男人從未真正讓任何順性別女性參與他的研究，以作為對照組。你可以在 Julia Serano 的優秀文章[反對自體女性戀物癖的案例](https://www.juliaserano.com/av/Serano-CaseAgainstAutogynephilia.pdf)中閱讀更多關於該理論的缺陷。
<!-- AGP had been thoroughly dismissed by modern psychology by the late 2000s, but the damage has been done. In the public's eye, trans women were all perverted fetishists. Media portrayals of trans women mirrored this attitude, further spreading negative imagery into the public consciousness. -->
到 2000 年代後期，AGP 已被現代心理學徹底否定，但損害已經造成。在大眾眼中，跨性別女性都是變態的戀物癖者。媒體對跨性別女性的描寫反映了這種態度，進一步將負面形象傳播到大眾意識中。
<!-- Transfeminine individuals then internalize these messages, and come to the conclusion that they are not actually transgender — just fetishists. It happened to me, and it's happened to nearly every millennial trans woman I know who figured themselves out as a teen. -->
跨性別女性隨後內化了這些訊息，並得出結論，認為她們實際上並非跨性別者，而只是戀物癖者。這發生在我身上，也發生在我認識的幾乎每個在青少年時期發現自己的千禧一代跨性別女性身上。
<!-- You are not a fetishist. The feeling you get from thinking of yourself as a woman is gender euphoria. -->
你不是戀物癖者。你從把自己想像成女人中得到的感覺是性別欣快感。
<!-- ### Patriarchal Oppression -->
### 父權壓迫 (Patriarchal Oppression)
<!-- A common source of invalidation for AFABs is the conflation of gender with the systemic oppression of women, particularly among non-medically-transitioning non-binary people. The message of "oh you just don't want to be a woman because of how women are treated" is far too often heard, and it can deeply infest your subconscious to the point of self-doubt. But this doesn't make much sense, because if you're AFAB and not a woman, that makes you transgender, and, on average, society treats transgender folks worse than women. So transitioning to escape systemic oppression is a dumb concept (and I personally have never met a trans person who has done this). -->
對出生時指定性別為女性的人來說，一個常見的否定來源是將性別與對女性的系統性壓迫混為一談，尤其是在非醫療轉變的非二元性別者中。「哦，你只是因為女性的待遇而不想成為女人」這句話太常聽到了，它會深深地感染你的潛意識，以至於你會自我懷疑。但這沒有什麼意義，因為如果你出生時指定性別為女性，但你不是女性，那你就跨性別，而平均而言，社會對待跨性別者的態度比女性更糟。所以轉變以逃避系統性壓迫是一個愚蠢的概念（我個人從未見過這樣做的跨性別者）。
<!-- Radical feminism's messaging of abandoning female gender roles can also make parsing your own feelings harder. "Am I actually non-binary, or am I just a feminist?" "Am I actually a man, or am I just a very butch lesbian?". For this, I encourage you to talk to cis woman feminists, especially lesbians. They'll complain about systems of oppression and the patriarchy, but the problems are all external, and they *want to be women*. Even very butch lesbians want to be women, just in a different way from mainstream femininity. -->
激進女性主義關於放棄女性性別角色的訊息也可能使你更難分析自己的感受。「我真的是非二元性別者，還是只是一個女性主義者？」「我真的是男人，還是只是一個非常男性化的女同性戀者？」為此，我鼓勵你與順性別女性女性主義者，尤其是女同性戀者交談。她們會抱怨壓迫制度和父權制，但問題都是外在的，而且她們 *想成為女人* 。即使是非常男性化的女同性戀者也想成為女人，只是她們的方式與主流女性氣質不同。
<!-- Then you have the problem of people believing that to be non-binary is to be androgynous, and to be androgynous is to be less feminine. Feminine enbies are valid! It is okay if you do not want to remove your breasts. It is okay if you enjoy your curves. It is okay if you do not mind being called "she" and "her". That does not make you any less transgender. -->
然後你會遇到人們認為非二元性別就是中性，而中性就是不那麼女性化。女性化的非二元性別者是合理的！如果你不想切除乳房，沒關係。如果你喜歡你的曲線，沒關係。如果你不介意被稱為「她」，沒關係。這並不會讓你變得不那麼跨性別。
<!-- If you feel like you are not a binary woman, than you are not a binary woman. Cis women do not experience that detachment. -->
如果你覺得自己不是二元性別女性，那麼你就不是二元性別女性。順性別女性不會經歷這種疏離感。
<!-- ### Toxic Masculinity -->
### 有毒的男子氣概 (Toxic Masculinity)
<!-- Male-assigned kids grow up positively drenched in messaging of what it is to "be a man". There are so few examples of positive masculinity in popular media, and AMAB masculine enbies are also so commonly erased in trans representation that being a genderqueer male can feel very lonely. AMAB enbies are often either grouped in with gay cis men or treated like trans women. -->
被指定為男性的孩子在成長過程中，會被灌輸關於「成為男人」的訊息。在大眾媒體中，積極的男性氣概的例子很少，而且在跨性別者的代表中，出生時指定性別為男性的男性非二元性別者也經常被抹去，因此身為一個性別酷兒男性會感到非常孤獨。出生時指定性別為男性的非二元性別者通常要麼與順性別男同性戀者歸為一類，要麼被當作跨性別女性對待。
<!-- You can just be genderqueer! Your identity is valid! -->
你可以只是性別酷兒！你的認同是合理的！
<!-- ### Transmedicalism -->
### 跨性別醫療主義 (Transmedicalism)
<!-- This one hits *everybody*. Transmedicalism (aka Truetrans) is a transgender ideology derived from the Harry Benjamin scale (ranks 5 and 6). It seeks to reinforce the pre-WPATH rules, requiring intense physical dysphoria, demanding medical transition, and often invalidating all non-binary identities. At its core, transmedicalism is a supremacist concept, elevating binary trans people above the needs of any other gender identity, and is a push back against the expansion of the transgender identity. They wish for more gatekeeping than we have today, rail against enbies using the transgender label, and would prefer to see fewer people receive treatment for their gender dysphoria. -->
這一條 *每個人* 都會遇到。跨性別醫療主義（又稱真跨(Truetrans)）是一種源自班傑明量表（等級 5 和 6）的跨性別意識形態。它試圖強化 WPATH 之前的規則，要求強烈的生理不安，要求醫療轉變，並且經常否定所有非二元性別身份。從本質上講，跨性別醫療主義是一種至上主義概念，將二元跨性別者的需求凌駕於任何其他性別認同的需求之上，並且是對跨性別身份擴張的反擊。他們希望比現在有更多的把關，反對非二元性別者使用跨性別標籤，並且更願意看到更少的人接受性別不安治療。
<!-- To put it succinctly, many transmedicalists hate that the newer generation "has it so easy," despite the fact that many of their ranks are part of that generation. This ideology started among disgruntled trans elders, but has since spread to other binary individuals, particularly among young trans men. -->
簡而言之，許多跨性別醫療主義者憎恨新一代人「如此輕鬆」，儘管事實上他們中的許多人都是那一代人。這種意識形態始於心懷不滿的跨性別長者，但後來傳播到其他二元性別者，尤其是在年輕的跨性別男性中。
<!-- If a trans person's first exposure to transness is a transmedicalist, this can severely set back their own self-acceptance and push them even further into the closet. Transmeds are well known to actually tell people "No, you are not trans." -->
如果一個跨性別者第一次接觸跨性別是跨性別醫療主義者，這會嚴重阻礙他們自我接納，並將他們推向更深的櫃中。眾所周知，跨性別醫療主義者實際上會告訴人們「不，你不是跨」。
<!-- **Do not believe these lies.** They are bully tactics explicitly designed to gaslight and dismiss people's pain for self-gratification. -->
**不要相信這些謊言。** 它們種霸凌策略，專門用來在煽動和消除人們的痛苦以實現自我滿足。。
<!-- There are related hurtful concepts a trans person can internalize, revolving around seeing transition as a list of required actions. One such idea is a belief that a person shouldn't expect being gendered correctly or even complain about misgendering as long as they haven't changed their gender marker. In other words, legally conditioned pronoun respect, or translegalism. Not only can changing gender marker be a complicated, prolonged process, not only can some people not afford to out themselves by pursuing it, but most countries wouldn't even allow a gender marker outside of the gender binary. Translegalism convinces a person that they deserve misgendering because of their ID. -->
跨性別者可能會內化一些相關的有害概念，這些概念圍繞著將轉變視為一系列必要的行動。其中一個觀點是，只要一個人沒有改變其性別標記，就不應該期望被正確地性別化，甚至不應該抱怨被錯誤地性別化。換句話說，合法條件下的代名詞尊稱，或跨性別合法主義。改變性別標記不僅可能是一個複雜、漫長的過程，不僅有些人無法透過這樣做來公開自己，而且大多數國家甚至不允許二元性別以外的性別標記。跨性別合法主義使人相信，由於他們的身分證，他們應該被錯誤地性別化。
<!-- ### Trans-Exclusionary Reactionary Feminism / Gender Critical Movement / Gender Essentialism -->
### 排斥跨性別者的反動女性主義(TERF)/性別批判運動/性別本質主義
<!-- [Gender Essentialism](https://en.wikipedia.org/wiki/Gender_essentialism) is the belief that there are innate attributes to a person's existence that are derived based on what sex organs the person is born with. TERF and GC ideology was born out of the lesbian separatist movement of second wave feminism and fully denies the existence of transgender biology and non-binary identities. The movement has been largely overtaken by right-wing reactionaries, racists, and homophobes, and is now being bolstered by evangelical Christian organizations. -->
[性別本質主義](https://en.wikipedia.org/wiki/Gender_essentialism)認為，一個人的存在有基於其出生時性器官的先天屬性。TERF 和 GC 意識形態起源於第二波女性主義的女同性戀分離主義運動，完全否認跨性別生物學和非二元性別身份的存在。該運動很大程度上已被右翼反動分子、種族主義者和恐同者所佔領，現在正得到福音派基督教組織的支持。
<!-- These people will stop at nothing to invalidate your existence. Do not give them the time of day. -->
這些人會不擇手段地否定你的存在。不要浪費時間在他們身上。
<!-- ### Gender Abolitionism / Postgenderism -->
### 性別廢除主義 (Gender Abolitionism)/後性別主義 (Postgenderism)
<!-- [Postgenderism](https://en.wikipedia.org/wiki/Postgenderism) is a [transhumanist](https://en.wikipedia.org/wiki/Transhumanism) philosophy originating in radical feminism which states that gender causes more harm than good, and seeks to eradicate it from our society. Old-school TERFs latched on to GA as reasoning for why trans people should not exist. This trans-exclusionary faction of gender abolitionism believes that all gender is a construct and that anyone who feels strongly connected to a binary gender is either nefariously propagating gender stereotypes or ignorantly following systemic indoctrination. They do not believe in the existence of gender dysphoria, and will attempt to invalidate those who experience it. -->
[後性別主義](https://zh.wikipedia.org/wiki/%E5%BE%8C%E6%80%A7%E5%88%A5%E4%B8%BB%E7%BE%A9)是一種起源於激進女性主義的[超人類主義](https://zh.wikipedia.org/wiki/%E8%B6%85%E4%BA%BA%E7%B1%BB%E4%B8%BB%E4%B9%89)哲學，它聲稱性別弊大於利，並試圖將其從我們的社會中消除。老派的 TERF 堅持 GA 作為跨性別者不應該存在的原因。這種排斥跨性別者的性別廢除主義派別認為，所有性別都是一種建構，任何強烈認同二元性別的人要麼是惡意地宣傳性別刻板印象，要麼是愚昧地遵循系統性灌輸。他們不相信性別不安的存在，並會試圖否定那些經歷過性別不安的人。
<!-- Note, this is NOT about trans people who identify as postgender or gender abolitionism as a whole. This is specifically about TERF abuse of the concepts. -->
請注意，這 *不是* 關於認同為後性別主義者的跨性別者或整個性別廢除主義。這專門針對 TERF 對這些概念的濫用。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安聖經 - The Gender Dysphoria Bible"
linkTitle: 簡介
description: "探討性別不安的多種表現方式以及成為跨性別者的意義。"
preBody: '_disclaimer'
classes:
- gdb
siblings:
next: /tw/what-is-gender
nextCaption: 性別是什麼?
---
{!{
{{import
'~/img'
images.titlecard
srcSizes="(max-width: 800px) 100vw, (max-width: 1000px) 70vw, 767px"
alt="性別不安聖經 - The Gender Dysphoria Bible"
style="margin-bottom: 1em;"
imgStyle="width: 100%"
}}
}!}
### 目錄：
{!{ <div class="two-column-list"> }!}
1. [簡介](/tw/#簡介)
2. [性別是什麼？](/tw/what-is-gender)
3. [性別不安的歷史](/tw/history)
4. [性別欣快](/tw/euphoria)
5. [身體不安](/tw/physical-dysphoria)
6. [生化不安](/tw/biochemical-dysphoria)
7. [社交不安](/tw/social-dysphoria)
8. [社會不安](/tw/societal-dysphoria)
9. [性慾不安](/tw/sexual-dysphoria)
10. [表現不安](/tw/presentational-dysphoria)
11. [存在不安](/tw/existential-dysphoria)
12. [應付不安](/tw/managed-dysphoria)
13. [冒名頂替症候群](/tw/impostor-syndrome)
14. [我是跨嗎?](/tw/am-i-trans)
15. [臨床診斷](/tw/diagnoses)
16. [治療性別不安](/tw/treatment)
17. [性別不安的成因](/tw/causes)
18. [染色體](/tw/chromosomes)
19. [荷爾蒙如何工作的](/tw/hormones)
20. [雄性第二次青春期 101](/tw/second-puberty-masc)
21. [雌性第二次青春期 101](/tw/second-puberty-fem)
22. [結論](/tw/conclusion)
{!{ </div> }!}
<hr class="print-break-after print-hidden">
## 簡介
{!{
<div class="gutter"><blockquote>
<strong>跨性別 - Trans·gen·der</strong> - <em>形容詞</em><br>
指的是一個人的自我認同與性別，不符合其出生時被指定的性別。
</blockquote></div>
}!}
在全球各地的文化中，自人類文明存在以來，就[一直有人](https://en.wikipedia.org/wiki/Transgender_history)的性別認同經驗與基於生殖器結構的盎格魯-歐洲概念的二元性別不一致。 4500年前，蘇美爾帝國的中性別祭司階級Gala存在。 北美洲的土著文化在歐洲殖民主義之前就認識到[第三性別](https://en.wikipedia.org/wiki/Third_gender)，直到今天仍然如此。 非洲各地的部落[文化](https://medium.com/@janelane_62637/the-splendor-of-gender-non-conformity-in-africa-f894ff5706e1)認識到許多性別身份，[歐洲人試圖消滅](https://daily.jstor.org/the-deviant-african-genders-that-colonialism-condemned/)。 人類長期以來一直擁有與所謂的西方文化中今天的所謂「傳統」性別觀念不同的身份，規範和符合度。
然而，現代西方對於跨性別經驗的理解只有約130年的歷史。即使是「跨性別」這個詞也只有1965年約翰·奧利文（John Oliven）提出來取代大衛·考爾德威爾（David Cauldwell）在1949年提出的「變性人」（transsexual），而後者曾取代了馬格努斯·赫希菲爾德（Magnus Hirschfield）在1910年提出的「異裝癖」（transvestite）。
身為跨性別者，可能意味著一個出生時擁有陰莖的人其實是女孩，一個出生時擁有陰戶的人其實是男孩，或是無論任何生殖器配置的人，都可能無法完全符合性別光譜的兩端，而是非二元性別。
一個跨性別者可以在生命中的 *任何時刻* 認識到這件事。有些小孩在他們能夠理解性別概念時就已經察覺到，有些則是等到青春期開始才開始感受到，還有些實際上沒有感到任何不對勁直到他們長大成人。許多人只是根本沒有接觸過他們的性別可能和出生時指定的性別不同的概念，也無法理解這種感覺，因此只是簡單地接受了自己的命運。
更普遍的是，即使有人對自己出生時被指定的性別感到不滿，他們也認為這與跨性別者的經驗不同。有些人可能認為，希望成為跨性別者並進行性別轉變是對那些「真正」知道自己其實是男孩或女孩「靈魂裝錯身體」的跨性別者的一種不尊重。大眾媒體傳播的跨性別經驗故事可能會創造出一個非常錯誤的印象，讓人誤解成為跨性別者意味著什麼，以及成長為跨性別者是什麼感覺。
這種社會預設性別與內在自我感覺之間的不一致感受，我們稱之為**性別不安**，幾乎所有跨性別者都會經歷，不論他們在性別二元體系內還是外。這有時在跨性別社群中是一個政治話題，因為不同的團體對性別不安有自己的看法，它如何表現，以及什麼資格使一個人成為跨性別者。為了避免混淆，本網站將性別不安定義為與出生時被指定的性別不一致。如果你感受到的性別認同與出生時被指定的性別不一致，不論這種不一致如何表現，你宣稱自己是跨性別者的認同就是有效的。
本網站的目的是記錄性別不安的多種表現方式，以及性別轉變的多種形式，為那些對自己的性別認同感到疑惑的人，那些剛開始跨性別之旅的人，那些已經走上這條路的人，以及那些希望成為更好盟友(Ally)的人提供指南。
{!{
<div class="gutter flex flex-end print-inline print-span2 print-center">
<span>封面藝術基於<a href="https://www.instagram.com/jp_means_jumpei/">Jumpei JP Ueoka</a>的作品</span>
<div class="grid-row" style="grid-template-columns: 1fr 1fr">
{{import '~/img' images.jpjumpei_1 className="" link="https://www.instagram.com/p/Bq2uRCtFttU/"}}
{{import '~/img' images.jpjumpei_2 className="" link="https://www.instagram.com/p/BlA3IUrAnTi/"}}
</div>
</div>
}!}

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "應付不安: 偽裝的性別"
linkTitle: "應付不安"
description: "我們應對的方式。"
preBody: '_disclaimer'
siblings:
prev: /tw/existential-dysphoria
prevCaption: 存在不安
next: /tw/impostor-syndrome
nextCaption: 冒名頂特症候群
classes:
- gdb
tweets:
- '1215746083487461379'
- '1215749725456125952'
---
<!-- # Managed Dysphoria -->
# 應付不安
<!-- Growing up in the closet, even when you don't know you're in the closet, becomes an existence built on top of coping mechanisms intended to alleviate dysphoria. The following are ways a closeted trans person may find to alleviate the dysphoria they experience in their day to day lives: -->
在櫃中成長，即使你不知道你在櫃中，也會變成一種建立在應對機制之上的存在，旨在減輕不安。以下是一個未出櫃的跨性別者可能會在日常生活中找到減輕他們所經歷的不安的方法：
<!-- - When a video game gives you the option of choosing your gender, you tend to choose differently than your assigned gender. This may be accompanied with excuses to defend that choice. "It defaulted to male and I didn't care." "I don't want to stare at a guy's butt for hours." -->
- 當遊戲讓你選擇性別時，你傾向於選擇與你指定性別不同的性別。這可能伴隨著一些藉口來為這個選擇辯護。「它預設是男性，我沒差。」「我不想盯著一個男的屁股看幾個小時。」
<!-- - A preference for literature and film with characters of your true gender, or with characters who break gender norms (_Mulan_, _Little Women_). -->
- 偏愛有你真實性別角色的文學和電影，或者有打破性別規範的角色的文學和電影（例如《花木蘭》、《小婦人》）。
<!-- - Pornographic outlets which satisfy strong desires or feel more relatable, such as a draw towards gay/lesbian porn, bridal kink, or transformation sequences. -->
- 能滿足強烈慾望或感覺更相關的色情內容，例如被男/女同色情片新娘癖好(bridal kink)或變身情節所吸引。
<!-- - Crossdressing or performing drag. -->
- 穿異性服裝或表演變裝。
<!-- - Finding excuses to cut hair short, or to grow it out. -->
- 找藉口剪短頭髮，或者留長頭髮。
<!-- - Shaving of body hair, or a refusal to shave hair you're expected to. -->
- 剃除體毛，或拒絕剃除你期待被剃除的毛髮。
<!-- - Wearing loose and baggy clothing that hides the shape of your body. -->
- 穿寬鬆的衣服來遮蓋你的體型。
<!-- - Avoiding social gatherings whenever possible, seeking isolation. -->
- 盡可能避免社交聚會，尋求獨處。
<!-- - Becoming intimately educated about some gender-associated topic, such as men's or women's clothing design. -->
- 熟悉某些與性別相關的話題，例如男裝或女裝設計。
<!-- - Obsessively working out (AFABs). -->
- 強迫性地健身（出生時指定性別為女性）。
<!-- - Helping cis partners to shop in order to live vicariously through their presentation. -->
- 幫助順性別伴侶逛街購物，以便透過他們的表現來間接體驗。
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<!-- Because so much abuse is handed down onto gender non-conforming children, many trans people grow up learning to hide their natural personalities out of sheer necessity. Many trans people speak about having a phase of life where they attempted to "buy-in" on their assigned gender, performing masculinity or femininity to extremes in order to try to "fix" themselves. This leads to repression tendencies which may even superficially appear toxic, but are simply the results of trying to hide every scrap of their true selves. -->
由於不符合性別規範的兒童會遭受如此多的虐待，許多跨性別者在成長過程中學會出於純粹的必要性而隱藏他們的天生個性。許多跨性別者談到他們人生中曾經歷過一個階段，試圖「接受」他們被指定的性別，極端地表現男性氣概或女性氣質，以試圖「修復」自己。這導致了壓抑傾向，甚至可能表面上看起來有毒，但這只是試圖隱藏他們真實自我的每一點點碎片的結果。
<!-- - Growing and meticulously grooming facial hair (the so-called "denial beard"). -->
- 留並精心修飾臉上的毛髮（所謂的「否認鬍鬚」）。
<!-- - Taking up makeup artistry in order to perfect a high femme look. -->
- 學習化妝技巧，以完善高度女性化的妝容。
<!-- - Presenting extremely masculine or hyper feminine. -->
- 表現得極端男性化或極端女性化。
<!-- - Avoiding any conversation about fashion for any gender. Dissociating whenever fashion conversations or activities occur. -->
- 避免任何關於任何性別的時尚話題。在任何時尚話題或活動出現時，都會發生解離 (dissociating)。
<!-- - Obsessively working out (AMABs). -->
- 強迫性地鍛鍊身體（出生時指定性別為男性）。
<!-- - Assuming a strongly stereotyped gender role in a relationship (e.g. the dutifully modest housewife). -->
- 在一段關係中扮演一種刻板的性別角色（例如盡職盡責、端莊的家庭主婦）。
<!-- - Marrying and having kids in anticipation that it will "fix" what's wrong with you. -->
- 結婚生子，期望它能「修復」你的問題。
<!-- - Buying in to ultra-conservative attitudes towards gender and sexuality. -->
- 接受對性別和性傾向的極端保守態度。
<!-- - Expressing homophobia and transphobia in self-defense to ward off suspicion. -->
- 出於自衛而表達恐同和跨性別恐懼症，以避免被懷疑。
<!-- - Aggressively-passive engagement in anything connected to one's true gender. -->
- 以消極攻擊的方式參與任何與自己真實性別相關的事情。
<!-- Finally, another very common coping mechanism is to find means of escape or mental engagement in order to forget your own feelings. -->
最後，另一個非常常見的應對機制是尋找逃避或精神寄託的方式，以忘記自己的感受。
<!-- - Intensely investing large amounts of time into hobbies. -->
- 將大量時間投入到興趣愛好中。
<!-- - Long hours spent at work. -->
- 長時間工作。
<!-- - Chain-binging movies, TV shows, or books. -->
- 狂看電影、電視節目或書籍。
<!-- - Spending all idle time playing video games or on social media. -->
- 將所有空閒時間都花在玩電子遊戲或社交媒體上。
<!-- - Obsessively cleaning one's living space. -->
- 強迫性地清潔自己的生活空間。
<!-- - Sleeping. Lots and lots of sleeping. -->
- 睡覺。大量的睡覺。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現：身體不安"
linkTitle: "身體不安"
description: "身體不適僅是性別不安諸多體現方式之一。"
preBody: '_disclaimer'
siblings:
prev: /tw/euphoria
prevCaption: 性別欣快
next: /tw/biochemical-dysphoria
nextCaption: 生化不安
classes:
- gdb
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- '1220143004821938176'
- '1184580976581775366'
- '1184837108919230464'
- '947522372315369472'
- '947523244948680705'
---
<!-- # Physical Gender Dysphoria
Everyone has heard of the "born in the wrong body" narrative. Physical dysphoria is discomfort over the shape of one's body due to the sexual characteristics it presents. So what body features are we talking about here? -->
# 身體性別不安
每個人都聽說過「靈魂裝錯身體」的說法。身體不安是由於身體呈現的性徵而對身體樣貌感到不適。那麼這裡指的是哪些身體特徵呢？
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<h4>第一性徵</h4>
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<!-- The core reproductive features which develop during pregnancy -->
在懷孕期間發育的核心生殖特徵
<!-- - Gonads
- Testicles
- Ovaries
- External Genitalia
- Penis
- Clitoris
- Scrotum
- Labia
- Vulva
- Internal Reproductive Organs
- Prostate / Skene's Gland
- Uterus -->
- 性腺
- 睪丸
- 卵巢
- 外生殖器
- 陰莖
- 陰蒂
- 陰囊
- 陰唇
- 陰戶
- 內生殖器官
- 前列腺／斯基恩氏腺
- 子宮
{!{ </div> <h4>第二性徵</h4>
<div class="two-col"> }!}
<!-- All sexually dimorphic features which develop during and after puberty as a result of hormone exposure. In general, these features are all nearly identical for both male and female prepubescent children. -->
所有在青春期期間和之後由於荷爾蒙暴露而發育的性二型特徵(sexually dimorphic features)。一般來說，這些特徵對於男女青春期前的兒童幾乎完全相同。
<!-- - Fat Distribution
- Waist, Hips, Butt Shape
- Thighs, Arms, Back
- Cheeks and Jaw Line
- Muscle Mass
- Neck, Shoulders and Upper Body
- Arms and Legs
- Abdominal
- Skeletal Build
- Range of Height
- Size of Feet and Hands
- Width of Shoulders
- Rib Cage Breadth
- Thickness and Density of Limbs
- Forehead, Brow, Cheek and Jaw bones
- Pelvic Width
- Skin Texture and Tone
- Voice Pitch and Resonance
- Breast Development
- Facial Hair
- Body Hair (excluding genitals and arm pits) -->
- 脂肪分布
- 腰、臀、臀部形狀
- 大腿、手臂、背部
- 臉頰和下巴線
- 肌肉量
- 頸部、肩膀和上半身
- 手臂和腿部
- 腹肌
- 骨骼結構
- 身高範圍
- 腳和手的尺寸
- 肩寬
- 肋骨寬度
- 四肢的厚度和密度
- 額頭、眉毛、臉頰和下巴骨
- 骨盆寬度
- 皮膚紋理和色調
- 聲音音高和共鳴
- 乳房發育
- 面部毛髮
- 體毛（不包括生殖器和腋窩）
{!{ </div></div> }!}
{!{ <div class="gutter"><div class="card"><div class="card-body"><h4 class="card-title">供您參考</h4> }!}
<!-- The genitals of a transgender person on hormone therapy do not behave remotely like their cisgender counterparts. -->
接受荷爾蒙治療的跨性別者的生殖器與順性別的生殖器表現截然不同。
<!-- - The estrogenic penis softens, erections become less pronounced, and the skin thins and begins to perspire like a vaginal wall. The scrotum softens and changes color, with the perineal raphe becoming more distinct. Due to the cessation of random erections, the erectile tissue will atrophy if not regularly put to use, causing the entire penis to shrink over time. Vibration becomes more effective for arousal. -->
- 接受雌激素治療的陰莖會變得柔軟，勃起不再明顯，皮膚變薄，並開始像陰道壁一樣分泌愛液。陰囊變軟且顏色改變，會陰縫變得更明顯。由於自發性勃起停止，如果不經常使用，勃起組織(erectile tissue)會萎縮，導致整個陰莖隨著時間推移而縮小。震動刺激在性喚起方面變得更有效。
<!-- - The androgenic vagina becomes dryer & prone to tearing (lubrication can be an issue). The skin of the clitoris thickens, and the clitoral glans grows in length and girth due to the onset of random erections. Labia also become thicker, and often hairier. The onset of HRT often results in extreme sensitivity of the clitoris. -->
- 接受雄激素治療的陰道會變得乾燥且容易撕裂（潤滑可能成為一個問題）。陰蒂的皮膚變厚，陰蒂頭由於開始出現自發性勃起而增長增粗。陰唇也會變厚，而且通常毛髮會變多。開始接受荷爾蒙治療通常會導致陰蒂極度敏感。
{!{ </div></div></div> }!}
<!-- Primary characteristics can only be altered through surgical intervention. Some secondary sexual characteristics are also one-way trips and require medical intervention to undo, namely the growth of breast tissue and the deepening of the vocal chords. Estrogen does not make the voice more feminine, and testosterone does not make breasts shrink (aside from the loss of fat). Changes to skeletal structure (such as enlarging from testosterone and the widening of hips from estrogen) can only occur prior to the age of 25, while the body is still growing. -->
第一性徵只能通過手術介入來改變。一些第二性徵也是單向的，需要醫療介入才能逆轉，例如乳房組織的發育和聲帶的變厚。雌激素不會使聲音更女性化，而睪固酮也不會使乳房縮小（除了脂肪減少）。骨骼結構的變化（例如睪固酮導致的骨骼增大以及雌激素導致的臀部變寬）只能在 25 歲之前，身體仍在發育時發生。
<!-- Some secondary traits can be surgically enhanced (breast augmentation, body contouring, facial masculinization / feminization), and some cannot be changed at all. -->
一些第二性徵可以通過手術改善（隆胸、塑身、臉部男性化／女性化），而有些則完全無法改變。
<!-- Physical dysphoria manifests in several different ways. Sometimes this is felt in a sort of phantom limb phenomenon, where the person can feel sensations from a penis or vagina that is not there, an ache in a uterus that does not exist, or a sense of absence on the chest from breasts that have not grown in. -->
身體不安會以幾種不同的方式表現出來。有時，這種感覺就像一種幻肢現象，患者會感覺到不存在的陰莖或陰道的感覺、不存在的子宮的疼痛，或者因為胸部沒有發育乳房而產生的空虛感。
<!-- It can be felt as a sort of *reverse* phantom effect, where the person is persistently aware of something that should *not* be there. The brain is receiving sensory input that it does not expect, such as the weight of breasts, or the presence of testicles or a uterus, and this input takes priority because it isn't expected. -->
它也可以被感覺為一種*反向的*幻肢效應，患者會持續意識到某些*不應該*存在的事物。大腦接收到它預期之外的感覺輸入，例如乳房的重量，或者睪丸或子宮的存在，而這種輸入會被優先處理，因為它並非預期中的感覺。
<!-- It may be felt as horror or revulsion when looking at or touching the external genitals, triggering emotional outbursts or a strong desire to remove the offending organ. AFAB (assigned female at birth) trans people may experience feelings of wrongness during menstruation, or a sense of alien disconnect from their hormone cycle. -->
當看到或觸摸外生殖器時，可能會感到恐懼或厭惡，引發情緒爆發或強烈想要移除令人不快的器官。生理女的跨性別者可能會在月經期間感到不適，或者對自己的荷爾蒙週期感到疏離和格格不入。
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> 我高中的朋友們討論他們理想中的女人時，他們描述的都是想交往對象的外貌特徵……而我描述的卻是我想成為的樣子。
>
> 我一直以為每個人都跟我一樣有個不能說的秘密，在衣櫃裡藏著一點點羞恥感。
<!-- It can manifest as a compulsion to be rid of certain body traits, such as obsessively shaving body or facial hair. This can also manifest in the opposite compulsion, leading to meticulous grooming of those traits in order to try to control them, like maintaining a perfect beard, persistently keeping one's nails manicured and polished, or spending hours in the gym attempting to hone one's shape. -->
它可以表現為一種想要擺脫某些身體特徵的衝動，例如強迫性地刮除身體或臉部的毛髮。它也可能表現為相反的衝動，導致一絲不苟地修飾這些特徵以試圖控制它們，例如精心維護完美的鬍鬚、持續修剪指甲並塗上指甲油，或者花費數小時在健身房試圖雕塑自己的體型。
<!-- Undesired physical features may prompt a person to experience envy of people who have been forced to remove those features due to illnesses, such as testicular or breast cancer. AMABs with severe genital dysphoria tend to have a wish for some kind of freak accident that would cause the loss of their phallus. -->
不想要的身體特徵可能會讓患者羨慕那些因為疾病（例如睪丸癌或乳腺癌）而被迫移除這些特徵的人。患有嚴重生殖器焦慮的生理男(AMAB)往往會希望發生某種意外事故，導致他們失去陰莖。
<!-- Sometimes it may just simply be a feeling of being incorrect, which you may not even attribute to gender or sex. For most of my life, I believed that the reason I hate my body was because I was fat. It wasn't until I started transition that I realized I don't hate my fat at all; I hated having *male* fat. The feminine curves that HRT gave me make me feel so much more in tune with my body. -->
有時候，那可能只是一種單純覺得「不對勁」的感覺，你甚至不會把它歸咎於性別或生理性別。大半輩子以來，我都認為我討厭自己身體的原因是因為我很胖。直到我開始變性療程後，我才意識到我根本不討厭我的肥肉；我討厭的是擁有「男性」的肥肉。荷爾蒙療法賦予我的女性曲線讓我感覺和自己的身體更加契合。
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> 有人告訴我，因為我沒有生殖器焦慮，所以我不夠「跨」到可以變性。結果，我在接下來的十年裡活在否認和自我厭惡中。
>
> 諷刺的是，在開始變性後，我開始意識到我的一些痛苦其實是：生殖器焦慮。
> @MamaCoffeeCat HRT 前的我：我一點也不討厭我的陰莖。
>
> HRT 兩年半後的我：快把這玩意兒從我身上拿掉！
<!-- The dysphoria one feels about their body can and will change over time, for better and worse. For example, many trans women enter into transition feeling no disconnect with their genitals, but later find that as larger sources of dysphoria melt away, that they become less comfortable with their original configuration. Alternatively, some may assume that they will absolutely need facial feminization surgery, but then, two years into transition, realize they're actually okay with how they look. -->
一個人對自身身體的性別焦慮會隨著時間推移而改變，有好有壞。舉例來說，許多跨性別女性在開始變性療程時對自己的生殖器沒有任何不適感，但隨著其他更大的焦慮來源消退後，他們反而開始對原本的生理構造感到不自在。又或者，有些人一開始可能認為自己絕對需要做臉部女性化手術，但在變性兩年後，卻發現自己其實可以接受現在的樣貌。
<!-- It's okay for you to realize you need more or less than when you started. -->
你可能會發現自己需要的比一開始想像的多或少，這都是OK的。
<!-- It's okay if you don't hate anything about your body and just wish you looked more feminine or masculine. -->
就算你對自己的身體沒有任何不滿，只是希望自己看起來更女性化或男性化一點，這也是OK的。
<!-- It's okay if you only hate some aspects of your body and don't wish to change all of its sexual characteristics. -->
如果你只討厭自己身體的某些部分，而不希望改變所有第二性徵，這也是OK的。
<!-- It's okay if you don't need medical transition *at all*. Body feelings are not the be-all-end-all of transition. -->
就算你*一點也*不需要醫療上的變性療程，這也完全OK。身體感受並不是變性的全部。
<!-- **Total body physical dysphoria is not a requirement to be transgender. AFABs do not have to hate their chest, AMABs do not have to hate their penis. Every trans person's experience is different. All are valid.** -->
**並非所有跨性別者都一定會對全身的生理性別感到焦慮。生理女(AMAB)不一定要討厭自己的胸部，生理男不一定要討厭自己的陰莖。每個跨性別者的經歷都不同，而且都是有效的、值得被認可的。**
<!-- ### Internalized Body Image Issues -->
### 內化身體形象問題
<!-- The world is full of subconscious messages about how men and women's bodies should be shaped. We are bombarded with advertising and media creating a normalized view of what is and is not beautiful. Don't be too fat, don't be too skinny, don't be too tall, don't be too short, don't have too broad of a chin, don't have too large of a nose, wear makeup but don't wear too much makeup, don't leave the house without a bra, but don't let the bra show. On and on and on, the constant barrage of expectations of gendered appearance. -->
這個世界充斥著關於男女身形應該如何的潛意識訊息。我們被鋪天蓋地的廣告和媒體轟炸，它們塑造了對於什麼是以及什麼不是美麗的標準化觀點。不能太胖、不能太瘦、不能太高、不能太矮、下巴不能太寬、鼻子不能太大、要化妝但不能化太濃、出門一定要穿胸罩但不能讓胸罩露出來。這些關於性別外表的期待不斷地、持續地轟炸著我們。
<!-- Everyone absorbs these messages, and trans people internalize the factors which matter to the gender they align with. Those who align with femininity grow up mapping feminine standards onto themselves, those who align with masculinity map masculine standards on to themselves, and enbies may internalize shame around androgyny. This is *on top* of the shame they are loaded with for not living up to their assigned gender's standards. -->
每個人都會吸收這些訊息，而跨性別者則會將符合自身認同性別的因素內化。認同女性特質的人會以女性的標準審視自己，認同男性特質的人會以男性的標準審視自己，而非二元性別者則可能將對中性特質的羞恥感內化。而這一切，*還加上*了他們因為不符合指定性別標準而承受的羞恥感。
<!-- What is the end result of this? Kathryn said it best: -->
這樣的結果是什麼？Kathryn 說得最好：
{!{ {{import '~/tweet' ids=[
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> 如果你認為自己是順性別男性，但一直夢想成為女生，而你尚未變性的唯一原因是害怕自己會成為一個「醜陋」的女生：
>
> 那就是性別焦慮。親愛的，你其實已經是個跨性別女孩了。
> 別因為從未意識到這點而感到太難過。我自己也是剛剛才頓悟的。
>
> 但這就是性別焦慮。你會因為被提醒你和你想成為的樣子（你真正的樣子）之間的落差而感到不適。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現：表現不安"
linkTitle: "表現不安"
description: "帽T和運動褲永遠不退流行。"
preBody: '_disclaimer'
siblings:
prev: /tw/sexual-dysphoria
prevCaption: 性慾不安
next: /tw/existential-dysphoria
nextCaption: 存在不安
classes:
- gdb
tweets:
- https://twitter.com/NightlingBug/status/1215716435068100611
- https://twitter.com/NightlingBug/status/1215716435974066176
- https://twitter.com/NightlingBug/status/1215716436980703233
- https://twitter.com/NightlingBug/status/1215716438020849664
- https://twitter.com/DameKraft/status/1191555135756853249
---
<!-- # Presentational Dysphoria -->
# 表現不安
<!-- Clothes. Hair. Makeup. Jewelry. Glasses. Piercings and other body modifications. Even personal hygiene can be a factor of presentation, such as the shaving of body hair or how you take care of your skin. All of these things are gendered in society, clothing and hair especially. -->
服裝、髮型、化妝、珠寶、眼鏡、穿孔和其他身體改造。即使是個人衛生也可能是表現的一個因素，例如剃除體毛或如何保養皮膚。所有這些東西在社會中都被賦予了性別，尤其是服裝和髮型。
<!-- While the sexual revolution of the 1960s and the business fashion craze of the 80s did wonders for blurring the gap between masculine and feminine presentation (largely by normalizing masc fashion as androgynous), there are still enormous pressures to conform to traditional gender norms. Gender non-conforming dress is so instantly marked as queer that any time a woman wears a tailored suit she is marked as a lesbian, and a dad who [puts on an Elsa costume because his son wants to have a Frozen party](https://twitter.com/cbsnews/status/1088441623846023168?lang=en) is labeled as subversive and abusing his child. -->
雖然 1960 年代的性革命和 1980 年代的商務時尚熱潮確實模糊了男性和女性表現之間的界限（主要是透過將男性時尚正常化為中性），但仍然存在著巨大的壓力，要求人們遵守傳統的性別規範。不符合性別規範的服裝會立即被標記為酷兒，以至於任何時候一個女人穿著剪裁合身的西裝，她就會被標記為女同性戀，而一個[因為兒子想要舉辦冰雪奇緣派對而穿上艾莎服裝的爸爸](https://twitter.com/cbsnews/status/1088441623846023168?lang=en)則被貼上顛覆和虐待孩子的標籤。
<!-- Long hair on men has been seen as [an act of rocker rebellion](https://www.youtube.com/watch?v=3w7CrxLj36I) for decades, and men with long hair get discriminated against as being layabouts and bums. Short hair on women is often read as queer or butch (unless they're old, then it's expected), and women are often pressured to keep their hair long. Pierced ears on men became somewhat more normalized in the 90s, but are still seen as an act of rebellion, and some employers won't allow men to wear earrings. Makeup on men is so stigmatized by toxic masculinity that even men who *like* makeup feel pressured to avoid it. -->
幾十年來，男性的長髮一直被視為[搖滾叛逆的行為](https://www.youtube.com/watch?v=3w7CrxLj36I)，留長髮的男性會被歧視為懶漢和遊民。女性的短髮通常被解讀為酷兒或女同性戀的 T（除非她們年紀大了，那短髮就是預期的），而且女性經常承受留長髮的壓力。男性穿耳洞在 90 年代變得更加正常化，但仍然被視為一種叛逆行為，有些雇主不允許男性戴耳環。化妝在男性身上被有害的男子氣概所污名化，以至於即使 *喜歡* 化妝的男性也感到壓力，不得不避免化妝。
<!-- Like it or not, presentation is gendered, and it is extremely common for trans people to want to present themselves in the fashion of their true gender, and a desire to be free of the shackles of gendered presentation is common among all trans people, regardless of where they sit on the gender spectrum. For AMAB individuals they may manifest as a wish to incorporate more feminine elements; for AFABs it may manifest as a want for a more masculine appearance. This may come as a full push towards the opposite of their assigned gender, or a desire to seek a middle-ground in pursuit of androgyny. It may even simply be a wish to *not* present as your assigned gender. -->
無論你喜不喜歡，表現都被賦予了性別，跨性別者想要以他們真實性別的方式來表現自己是非常普遍的，而擺脫性別表現束縛的願望在所有跨性別者中都很常見，無論他們處於性別光譜的哪個位置。對於出生時指定性別為男性(AMAB)的人來說，這可能表現為希望融入更多女性化的元素；對於出生時指定性別為女性(AFAB)的人來說，這可能表現為想要更男性化的外表。這可能表現為完全朝著與他們指定性別相反的方向發展，或者渴望在追求中性的過程中找到一個中間地帶。它甚至可能只是一種 *不想* 以你被指定的性別來表現的願望。
<!-- **Not all transfems present feminine, not all transmascs present masculine, and not all non-binary people seek androgyny. Butch AMAB trans people are valid; femme AFAB trans people are valid. Presentation is not gender; gender is not presentation.** -->
**並非所有跨性別女性都表現得女性化，並非所有跨性別男性都表現得男性化，也並非所有非二元性別的人都追求中性。表現得陽剛的出生指定性別男性(AMAB)者是合理的；表現得陰柔的出生指定性別女性者也是合理的。表現不是性別；性別不是表現。**
<!-- Presentational dysphoria typically appears early on in the form of a fascination with the styling of another gender, and a wish to be able to present as people of that gender do. That desire may be fulfilled somewhat by seeking out styling that is unisex, but typically that wish is self-gatekept by statements of "I'm not confident enough to attempt that." AMABs often run into issue here where this desire often gets trapped behind heteronormative expectations, causing an interest in feminine presentation to be misinterpreted as sexual desire. -->
表現不安通常在早期以對另一種性別的造型著迷的形式出現，並希望能夠像該性別的人一樣表現。這種願望可能透過尋找中性風格的造型來得到一定程度的滿足，但通常這種願望會被「我沒有足夠的信心去嘗試」這樣的陳述所自我設限。出生指定性別男性者(AMAB)經常在這裡遇到問題，這種願望常常被困在異性戀霸權的期望背後，導致對女性化表現的興趣被誤解為性慾。
<!-- Post-transition presentational dysphoria is usually simply a case of high discomfort when attempting to present as one's assigned gender. It may not even be about how one looks, but just the way the clothing makes you feel. For the first year and a half of my own transition I could not bear to wear unisex t-shirts because they just made me feel more masculine. Even now I have to cut the collars out of them because the close neck makes me feel dysphoric. -->
轉變後的表現不安通常只是在試圖以其指定性別來表現時的高度不適感。它甚至可能與一個人的外表無關，而只是與衣服給你的感覺有關。在我自己轉變的第一年半裡，我無法忍受穿中性T恤，因為它們只會讓我感覺更男性化。即使是現在，我也必須把T恤的領口剪掉，因為緊貼脖子的領口會讓我感到性別不安。
<!-- ### Presentation's Effect on Physical Dysphoria. -->
### 表現對身體不安的影響。
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<!-- Clothing can also play a major role in the level of physical dysphoria a person experiences. Men's clothing is always cut very boxy, straight up and down on the vertical and very square in the horizontal. Women's clothing is cut for more curves, accentuating waistlines and hip shape. Men's pants feature a lower crotch to make room for external genitals, and no fitting for curves, where women's bottoms are the opposite. Women's clothing is often form fitting, where men's clothing is rarely form fitting at all. Men's clothing is often made of sturdier and thicker materials, meant to be worn as a single layer. Women's clothing is often made of thinner and stretchier materials, expected to be layered together. -->
服裝也會對一個人經歷的身體不安程度產生重大影響。男裝的剪裁總是方方正正的，垂直方向上直上直下，水平方向上非常方正。女裝的剪裁則更有曲線，突出了腰線和臀部形狀。男褲的褲襠較低，以便為外生殖器留出空間，並且不考慮曲線的合身性，而女褲則相反。女裝通常是合身的，而男裝則很少合身。男裝通常由更堅固和更厚的材料製成，旨在作為單層穿著。女裝通常由更薄、更有彈性的材料製成，預計會層層疊疊地穿著。
<!-- Because these structures are meant to fit the masculine or feminine forms, they tend to amplify the sensation of wrongness. A classic effect is the way that the difference between men's and women's jeans can have a radical effect on a trans person's comfort level. Unfortunately this works both ways, as even affirming clothing can reveal how your shape is a mismatch. -->
由於這些結構旨在符合男性或女性的體型，因此它們往往會放大錯誤的感覺。一個典型的影響是男女牛仔褲之間的差異會對跨性別者的舒適度產生根本性的影響。不幸的是，這兩種方式都有用，因為即使是肯定的服裝也能夠顯示出你的體型是如何不匹配的。
<!-- I, myself, am very feminine in my preferred presentation, and I've had a longing to wear dresses from when I was just five years old. I abhorred wearing suits, hating the way they fit on my body, since they always tugged in ways that felt very incorrect for what my body needed. I refused to wear any denim for most of my life because men's jeans always felt so incorrect (women's jeans and leggings, however, feel amazing). Then as I entered into transition and began to present more female, my dysphoria struck again in the ways my body did not conform to what women's clothing was expecting (too much in the crotch, too wide and bulky in the shoulders, too large in the waist, not large enough in the chest). It wasn't until the second year that I had experienced enough change in my shape to where women's clothing was properly affirming of my shape. -->
我自己在我喜歡的表現上非常女性化，而且我從五歲起就渴望穿裙子。我討厭穿西裝，討厭它們穿在我身上的感覺，因為它們總是拉扯著，感覺與我身體的需要非常不符。在我一生的大部分時間裡，我都拒絕穿任何單寧布，因為男式牛仔褲總是讓我感覺很不舒服（然而，女式牛仔褲和緊身褲感覺很棒）。然後，當我進入轉變期，開始表現得更女性化時，我的性別不安再次出現，因為我的體型與女裝所期望的不符（褲襠太突出，肩膀太寬太壯，腰太粗，胸部不夠大）。直到第二年，我的體型才發生了足夠的變化，以至於女裝才真正肯定了我的體型。
<!-- What does this look like? Well, it looks a lot like other common body image issues: a tendency to avoid anything form fitting, leaning towards softer fabrics and baggier clothes. A classic gender dysphoria trope is the kid who wears nothing but sweatpants and hoodies. Clothes will be oversized in order to keep them from hugging the body. AFABs may prefer to wear compressing sports bras in order to minimize their chests, and avoid anything with a tight waistline. -->
這看起來像什麼呢？嗯，這看起來很像其他常見的身體形象問題：傾向於避免任何合身的衣服，傾向於更柔軟的面料和更寬鬆的衣服。一個典型的性別不安比喻是孩子只穿運動褲和連帽衫。衣服會 oversize，以防止它們緊貼身體。出生指定性別女性(AFAB)可能更喜歡穿壓縮型運動內衣，以盡量縮小胸部，並避免任何有腰身的衣服。
{!{ <div class="gutter">{{import '~/tweet' ids=[
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<!-- Internally it most often manifests as intense jealousy of the people you wish you could be: jealousy over an influencer's body shape, a strong desire for the outfit of a person on the street, and most especially envy of other trans people. This feeling often persists well into transition, because this sensation of wanting to be other people of your gender is actually completely natural, even for cis people. -->
在內心深處，它最常表現為對你希望成為的人的強烈嫉妒：嫉妒網紅的身材，強烈渴望街上某人的穿搭，尤其嫉妒其他跨性別者。這種感覺通常會持續到轉變過程中，因為這種想要成為你性別的其他人的感覺實際上是完全自然的，即使對順性別者也是如此。
<!-- ### Presentation's Effect on Social Dysphoria. -->
### 表現對社會不安的影響。
<!-- Presentation can be important for avoiding misgendering, especially early in transition. A lot of trans people feel a need to perform their gender in order to be accepted for who they are, leaning in to feminine or masculine presentation more than they actually would like in order to make up for their body and ensure that people gender them correctly. Those pursuing medical transition may find this need becomes less important as their bodies change and they become able to be gendered correctly without all of the performance. -->
表現對於避免被性別錯稱(misgendering)很重要，尤其是在轉變初期。很多跨性別者覺得需要表現自己的性別才能被接受他們是誰，傾向於比他們實際想要的更女性化或男性化的表現，以彌補他們的身體，並確保人們正確地分辨他們的性別。那些正在進行醫療轉變的人可能會發現，隨著他們的身體發生變化，並且他們能夠在沒有所有這些表現的情況下被正確地被分類，這種需求變得不那麼重要了。
<!-- Performative presentation was practically required prior to the reformation of WPATH in 2011; anyone who showed up to a doctors appointment without extreme feminine or masculine presentation risked be labeled a fake and losing their treatment under the Harry Benjamin Scale. Trans women actually would lose their estrogen simply for wearing jeans and a blouse instead of a dress, or for not putting on enough makeup. This is one of the reasons why [transmedicalist](https://en.wikipedia.org/wiki/Transmedicalism) ideology is so dangerous: it would see us returning to this system, labeling anyone who doesn't meet stereotypical views of femininity and masculinity as not actually transgender. -->
在 2011 年 WPATH 改革之前，表演性表現實際上是必需的；任何沒有極端女性化或男性化表現就去看醫生的人都有可能被貼上假貨的標籤，並根據班傑明量表失去治療。跨性別女性實際上會因為穿牛仔褲和襯衫而不是洋裝，或者沒有化足夠的妝而失去雌激素。這就是為什麼[跨性別醫療主義](https://en.wikipedia.org/wiki/Transmedicalism)意識形態如此危險的原因之一：它會看到我們回到這個體系，將任何不符合女性氣質和男性氣質刻板印象的人貼上並非真正跨性別者的標籤。
<!-- Presentation is especially important among prepubescent children, as they lack any significant secondary sexual characteristics. Clothing and hair are the only ways we have to show the gender of a child, so much so that if a baby simply wears a pink shirt, strangers assume it is a girl. Even unisex clothing for kids is strongly gendered by way of colors and graphics. For trans children, it can be extremely distressing to be either forced to cut their hair or required to grow it out. Denying dresses to a trans girl or transfeminine non-binary child, or forcing them onto a trans boy or transmasculine non-binary child, can be debilitating to their morale. -->
表現對於青春期前的兒童尤其重要，因為他們缺乏任何明顯的第二性徵。服裝和髮型是我們表現孩子性別的唯一方式，以至於如果一個嬰兒只穿一件粉紅色的襯衫，陌生人就會認為她是女孩。即使是兒童的中性服裝也因顏色和圖案而強烈地性別化。對於跨性別兒童來說，被迫剪頭髮或被要求留長髮可能會讓他們非常痛苦。拒絕讓跨性別女孩或跨性別女性非二元性別兒童穿裙子，或者強迫跨性別男孩或跨性別男性非二元性別兒童穿裙子，可能會削弱他們的士氣。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "雌激素性第二青春期 101"
linkTitle: 雌激素性青春期
description: "女性化 HRT 的預期變化"
preBody: '_disclaimer'
siblings:
prev: /tw/second-puberty-masc
prevCaption: 雄激素性第二青春期
next: /tw/conclusion
nextCaption: 結論
classes:
- gdb
---
<!-- # Estrogenic Second Puberty 101 -->
# 雌激素性第二青春期 101
<!-- ## What To Expect from Feminizing HRT -->
## 女性化 HRT 的預期變化
<!-- This is a compilation of reported medical transition changes collected from testimonials of AMAB trans people taking estrogen-based hormone therapy. This information is gathered from social media and chat rooms. Yes, that means this is all anecdotal, but historically, most of transgender medical study is anecdotal because no one wants to fund transgender medical research. -->
這是從接受以雌激素為基礎的激素療法的出生時指定性別為男性的跨性別者的證詞中收集的已報告的醫療轉變變化的彙編。這些資訊是從社交媒體和聊天室收集的。是的，這意味著這些都是軼事，但從歷史上看，大多數跨性別醫學研究都是軼事，因為沒有人願意資助跨性別醫學研究。
<!-- **Note that this is a list of _possible_ changes. There is no guarantee that every person on feminizing HRT will experience all of these. Your age, genetics, medical history, degree of masculinization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness — every body is different — and some things can take years to appear.** -->
**請注意，這是一個*可能*發生的變化的清單。不能保證每個接受女性化 HRT 的人都会經歷所有這些變化。你的年齡、基因、病史、原生青春期的男性化程度以及激素療法方案都會對結果產生影響。也存在一定程度的隨機性——每個人的身體都是不同的——有些事情可能需要數年的時間才會出現。**
<!-- ### Breast Growth -->
### 乳房發育
<!-- Despite public perceptions, the majority of transfems do not pursue breast augmentation, as it often isn't necessary (and, for many, is not within reach). Every human is born with breast tissue, it simply remains inactive without estrogen to make it grow. Development typically takes 2-5 years, but can continue for more than ten years, just as it does for cisgender women. -->
儘管公眾的認知如此，但大多數跨性別女性並不會追求隆乳，因為這通常沒有必要（而且，對許多人來說，也遙不可及）。每個人出生時都有乳房組織，只是在沒有雌激素使其生長的情況下，它會保持休眠狀態。發育通常需要 2-5 年的時間，但可以持續十多年，就像順性別女性一樣。
<!-- Expect aches and pains in the chest, along with lots of tenderness in the area surrounding and behind the areola. Avoid bumping into anything, as it *will* hurt. Nipples and areolae will become much more sensitive while also becoming larger and darker. You'll want to invest in some sports bras. -->
預計胸部會出現疼痛，乳暈周圍和後面的區域會非常容易有壓痛。避免撞到任何東西，因為它*會*很痛。乳頭和乳暈會變得更加敏感，同時也會變得更大、顏色更深。你需要投資一些運動內衣。
<!-- This may be accompanied with lactation. Some secretion is normal and can be expected as milk ducts form and open up, so there is no cause for alarm. However, significant discharge without intentional stimulation may be a sign of a prolactin imbalance, so you should tell your doctor if this happens. -->
這可能伴隨著泌乳。一些分泌物是正常的，在乳腺管形成和打開時是可以預期的，所以沒有必要驚慌。然而，沒有刻意刺激的情況下出現大量分泌物可能是催乳素(prolactin)失衡的跡象，所以如果發生這種情況，你應該告訴你的醫生。
<!-- ### Skin Softening -->
### 皮膚變柔軟
<!-- Testosterone promotes the thickening and toughening of the epidermis, so removing it makes the skin thinner. Additionally, estrogen promotes the production of collagen, which causes skin to become softer and more iridescent. Expect to see more varicose veins on your legs. Tattoos that may have faded over time might become bolder and clearer. -->
睪固酮會促進表皮變厚和變硬，因此去除它會使皮膚變薄。此外，雌激素會促進膠原蛋白的產生，使皮膚變得更柔軟、更有光澤。預計你的腿上會出現更多的靜脈曲張。隨著時間的推移，褪色的紋身可能會變得更清晰、更醒目。
<!-- The removal of testosterone also causes a severe drop in skin oils, particularly on the face and scalp. This results in a significant reduction of acne and/or dandruff. -->
去除睪固酮還會導致皮膚油脂急劇減少，尤其是在臉部和頭皮上。這會導致粉刺和/或頭皮屑顯著減少。
<!-- ### Increased Flexibility -->
### 柔韌性增加
<!-- Testosterone causes water retention in ligaments and tendons, rendering them less stretchable. Removing androgens from the body causes the tendons to release those fluids and regain their elasticity. -->
睪固酮會導致韌帶和肌腱儲水，使它們的伸展性降低。從體內去除雄激素會導致肌腱釋放這些液體並恢復彈性。
<!-- ### Slimmer Hands and Wrists -->
### 更纖細的手和手腕
{!{
<div class="gutter flex">
{{import '~/img' images.hands className="card" caption="作者的手。這種變化發生在三年半的時間裡。"}}
</div>
}!}
<!-- As the skin begins to soften and slim down, the hands gradually begin to shrink. Without testosterone, less blood flows to the hands, causing further reduction in tissue sizes. Ring size will drop as fat and fluids move off the fingers. Finger length shortens as ligaments thin and stretch. -->
隨著皮膚開始變軟和變薄，手會逐漸變小。沒有睪固酮，流向手的血液會減少，導致組織尺寸進一步縮小。隨著脂肪和液體從手指上移走，戒指尺寸會變小。隨著韌帶變薄和拉伸，手指長度會縮短。
<!-- ### Smaller Feet -->
### 更小的腳
<!-- Much like hands, the feet also experience changes in shape. Androgens encourage more blood flow to the feet, and encourage water build up in cartilage. Estrogens allow the ligaments in the foot to stretch more. Collectively, this causes the arch of the foot to increase, shortening its total length by as much as two centimeters. Many people report a drop of one to two shoe sizes. -->
與手很像，腳的形狀也會發生變化。雄激素會促進更多的血液流向腳部，並促進軟骨中的水分積聚。雌激素會使腳部的韌帶伸展得更多。總的來說，這會導致足弓增加，使腳的總長度縮短多達兩厘米。許多人報告說，他們的鞋子減少了一到兩個尺碼。
<!-- ### Thinner & Softer Fingernails -->
### 更薄、更軟的指甲
<!-- Fingernails are made of keratin, and many keratin genes are activated by androgen receptors, thus causing thicker fingernails. The loss of testosterone will make the nails thinner and more prone to breakage. -->
指甲是由角蛋白構成的，許多角蛋白基因是由雄激素受體啟動的，因此會導致指甲變厚。睪固酮的減少會使指甲變薄，更容易斷裂。
<!-- ### Reduced Body Hair -->
### 體毛減少
<!-- Do not expect a total cessation of body hair; once the follicles are made terminal by DHT, they remain that way. However, much like fingernails, hair thickness is an expression of keratin genes activated by androgens. Removing testosterone causes the body hairs to become thinner and lighter. Genetics plays a major role in this, however. -->
不要期望體毛完全停止生長；一旦毛囊被 DHT 變成永久性的，它們就會保持這種狀態。然而，就像指甲一樣，毛髮的粗細是由雄激素激活的角蛋白基因的表達。去除睪固酮會導致體毛變薄和變淺。然而，基因在這方面起著重要作用。
<!-- ### Changes in Body Temperature Placement -->
### 體溫分佈的變化
<!-- Androgens encourage extra blood flow to extremities, making them warmer. Because of this, women tend to have warmer core temperatures but lower oral and surface level temperatures. You may see your basal body temperature drop to around 97.6°F (36.4°C). -->
雄激素會促進血液流向四肢，使它們變暖。因此，女性的核心體溫往往更高，但口腔和表層體溫更低。你可能會看到你的基礎體溫下降到 97.6°F (36.4°C) 左右。
<!-- This, unfortunately, results in a reduced tolerance to cold, so expect to need to layer clothing more frequently, especially since many buildings [set their thermostats for male comfort levels](https://www.popsci.com/study-finds-gender-bias-office-air-conditioning/). -->
不幸的是，這會導致對寒冷的耐受性降低，因此預計需要更頻繁地穿多層衣服，尤其是在許多建築物[將恆溫器設定為男性的舒適水平](https://www.popsci.com/study-finds-gender-bias-office-air-conditioning/)（英文）的情況下。
<!-- ### Changes in Perspiration Patterns -->
### 排汗模式的變化
<!-- With the above shift in temperature distribution, this also results in a significant change in how one sweats. Sweat becomes more of a full body experience, as opposed to being largely centered on the head and armpits. Underboob sweat becomes a thing. -->
隨著上述體溫分佈的變化，排汗的方式也會發生重大變化。出汗變成了一種全身性的體驗，而不是主要集中在頭部和腋窩。乳房下方的汗水變成了一種常見現象。
<!-- ### Reduction and/or Change of Body Odor -->
### 體味減少和/或改變
<!-- A major component in male body odor is the presence of [the steroid pheromone androstadienone](https://www.sciencedaily.com/releases/2007/09/070916143523.htm) in sweat. Androstadienone is metabolized directly from testosterone, so halting testosterone removes the source. Without it, sweat takes on a much sweeter smell, which is often attributed to feminine odors. -->
男性體味的一個主要成分是汗水中[類固醇費洛蒙雄甾二烯酮](https://www.sciencedaily.com/releases/2007/09/070916143523.htm)（英文）的存在。雄甾二烯酮是直接由睪固酮代謝而來的，因此停止服用睪固酮會去除其來源。沒有它，汗水會散發出一種更甜的氣味，這通常被認為是女性的氣味。
<!-- People taking spironolactone may experience a total cessation of any body odor due to the way the drug alters cortisol uptake within the body. -->
服用螺環固醇內酮(spironolactone)的人可能會因為藥物改變了體內皮質醇的吸收方式而完全沒有體味。
<!-- ### Reduced Muscle Mass -->
### 肌肉量減少
<!-- Androgens stimulate muscle growth, which is why anabolic steroids (which are literally testosterone) are so common amongst bodybuilders. People running on androgens naturally have more muscle mass, particularly in the upper body, without even having to work out. Removing androgens causes that muscle mass to atrophy and makes it harder to gain muscle. This is a major contributor to the feminine shoulder and neck line, as well as the waist line. -->
雄激素會刺激肌肉生長，這就是為什麼合成代謝類固醇（實際上就是睪固酮）在健美運動員中如此普遍的原因。即使不運動，使用雄激素的人自然會有更多的肌肉量，尤其是在上半身。去除雄激素會導致肌肉萎縮，並且更難增加肌肉。這是女性肩膀和頸部線條以及腰圍線條的一個主要因素。
<!-- With this comes a significant loss in strength. Carrying things becomes more difficult, pickle jars become harder to open. -->
隨之而來的是力量的顯著下降。搬運東西變得更加困難，打開酸黃瓜罐也變得更加困難。
<!-- ### Fat Redistribution into Feminine Proportions -->
### 脂肪重新分佈成女性比例
<!-- Androgens encourage the body to deposit fats into the abdomen, while estrogen encourages the body to deposit fats into the thighs, buttocks, and hips. Switching profiles causes new fats to be deposited according to the estrogen profile, and fats that were stored while on androgens break down. This produces the illusion of fat migration as the shape of the body changes. The waistline shrinks and defines itself below the ribs, and the belly becomes softer and flatter. -->
雄激素會促進身體將脂肪沉積到腹部，而雌激素則會促進身體將脂肪沉積到大腿、臀部和臀部。改變荷爾蒙曲線會導致新的脂肪根據雌激素曲線沉積，而儲存在雄激素上的脂肪會分解。隨著體型的變化，這會產生脂肪遷移的錯覺。腰圍會縮小，並在肋骨下方形成清晰的線條，腹部會變得更柔軟、更平坦。
<!-- Because estrogen deposits weight much lower on the body, and the muscle mass in the upper body is lost, this lowers the center of gravity, which alters one's walking gait. It becomes more natural to cantilever the body with the hips while walking, as opposed to the shoulders. -->
由於雌激素將脂肪沉積在身體的更下方，而上半身的肌肉量會減少，這會降低重心，從而改變人的行走步態。行走時，用臀部而不是肩膀來保持身體平衡會變得更自然。
<!-- ### Facial Feature Changes -->
### 面部特徵的變化
<!-- Along with body fat migration, fat in the face also migrates. The neck, chin, and jawline thin out while the lips and upper cheeks puff up. The brow and upper eyelids lift, exposing more of the eyeball. Changes in skin and musculature around the eye can alter the shape of the eyeball, changing focal depth and altering vision clarity. The color of the eyes may also change and become bolder, as testosterone causes the pigmentation in the iris to fade. -->
隨著體脂的遷移，臉部的脂肪也會遷移。頸部、下巴和下顎線會變細，而嘴唇和上臉頰會變豐滿。眉毛和上眼瞼會提升，露出更多的眼球。眼睛周圍皮膚和肌肉的變化會改變眼球的形狀，改變焦深並影響視力清晰度。隨著睪固酮導致虹膜中的色素沉澱褪色，眼睛的顏色也可能會改變，變得更醒目。
<!-- This is an extremely subtle and slow moving process that takes years, and it is easy to think nothing is changing at all. Take selfies to compare. -->
這是一個非常微妙且緩慢的過程，需要數年的時間，而且很容易認為什麼都沒有改變。拍自拍照來對照。
<!-- ### Changes to Scalp Hair -->
### 頭皮毛髮的變化
<!-- With the removal of androgens, blood flow to the scalp increases. Follicles that had been lost to male pattern baldness may reactivate, causing some return of the hairline and a filling-in of bald spots. Scalp hair becomes thicker and follicles grow stronger, allowing hair to grow to longer lengths. -->
隨著雄激素的去除，流向頭皮的血液會增加。因男性型禿髮而失去的毛囊可能會重新啟動，導致髮際線有所恢復，禿斑處長出頭髮。頭皮毛髮會變粗，毛囊會變得更強壯，使頭髮能夠長得更長。
<!-- With this thickening, curliness may become more pronounced, and a change in hair color may also occur. You might find your hair taking on a texture more like your mother's than your father's. -->
隨著頭髮變粗，捲髮可能會變得更明顯，頭髮的顏色也可能會發生變化。你可能會發現你的頭髮質地更像你母親的，而不是你父親的。
<!-- ### [Anterior Pelvic Tilt](http://en.wikipedia.org/wiki/Pelvic_tilt) -->
### [骨盆前傾](https://en.wikipedia.org/wiki/Pelvic_tilt)（英文）
<!-- As musculature atrophies, ligament flexibility increases, and weight shifts lower on the body, the orientation of the pelvic bone in relation to the spine and femurs rotates forward — not by much (only about 10-20 degrees), but enough to cause a change in the alignment of the spine and hips, increasing the arch of the back and causing the buttocks to jut out more. The added arch to the back can cause a relative drop in total height, between 1 and 2 inches (2-5 cm) depending on pelvic shape. -->
隨著肌肉萎縮、韌帶柔韌性增加以及脂肪向下半身移動，骨盆與脊柱和股骨的相對位置會向前旋轉——幅度不大（只有 10-20 度左右），但足以導致脊柱和臀部的排列發生變化，增加背部的弧度，使臀部更加突出。背部弧度的增加會導致身高相對降低，根據骨盆形狀的不同，降低幅度在 1 到 2 英寸（2-5 公分）之間。
<!-- Note: this is NOT the same as the hip rotation that occurs in AFAB puberty and during pregnancy. That is the result of migration of bone cells, altering the shape of the pelvic bone itself. **However**, hip rotation *can* occur if the person is young enough to still be within initial puberty, where the body is producing elevated human growth hormone. There have also been examples of hip rotation happening over long periods of time in trans elders. In 2017 an 80 year old trans woman reported on reddit that over the course of her 30 years on HRT, her doctor observed changes in her pelvis consistent with female hip rotation. -->
注意：這與出生指定性別女性(AFAB)的青春期和懷孕期間發生的臀部旋轉不同。那是骨細胞遷移的結果，改變了骨盆本身的形狀。*然而*，如果當事人足夠年輕，仍在初始青春期內，身體產生大量的人體生長激素，那麼臀部旋轉*可能會*發生。也有跨性別長者在很長一段時間內發生臀部旋轉的例子。2017 年，一位 80 歲的跨性別女性在 Reddit 上報告說，在她接受 HRT 治療的 30 年裡，她的醫生觀察到她的骨盆發生了與女性臀部旋轉一致的變化。
<!-- ### Reduced Tolerance of Caffeine, Alcohol, and/or Psychotropics -->
### 對咖啡因、酒精和/或精神藥物的耐受性降低
<!-- Less body mass means less blood to dilute chemicals into. Losing testosterone also means a slower metabolic rate, decreasing the speed at which toxins are reduced from the bloodstream. Some anti-androgens also put strain on the liver, further reducing how quickly chemicals are processed. -->
較少的體重意味著較少的血液來稀釋化學物質。失去睪固酮也意味著新陳代謝速度減慢，降低了毒素從血液中清除的速度。一些抗雄激素還會對肝臟造成壓力，進一步降低化學物質的處理速度。
<!-- ### Mental Changes -->
### 心理變化
<!-- As covered in the Biochemical Dysphoria section, brains can be wired for a certain hormone profile, and running on the wrong profile is like using a laptop with low batteries or an overheated processor. Starting HRT almost universally results in a cessation of depersonalization and derealization (DPDR) symptoms within the first two weeks. A mental fog lifts, and it becomes easier to concentrate on complex concepts (assuming you don't also have other mental processing difficulties such as ADHD). -->
正如生化不安一節中所述，大腦可以根據特定的荷爾蒙曲線連接，而使用錯誤的荷爾蒙曲線就像使用電池電量低或處理器過熱的筆電一樣。開始 HRT 幾乎普遍會導致在最初兩週內停止人格解體和現實解體 (DPDR) 症狀。大腦的迷霧消散了，更容易集中注意力思考複雜的概念（假設你沒有其他心理處理困難，例如注意力不足過動症(ADHD)）。
<!-- ##### ADHD -->
##### 注意力不足過動症(ADHD)
<!-- If you have ADHD, there may be some changes in your symptoms. Androgens amplify [dopamine](https://en.wikipedia.org/wiki/Dopamine) receptor function, so reducing testosterone can reduce the activation potential for dopamine in the brain. Dopamine is a key neurotransmitter in the behavior of [working memory](https://en.wikipedia.org/wiki/Working_memory), the short-term memory of the brain. Less working memory means you become more prone to distractions and have more difficulty maintaining [cognitive load](https://en.wikipedia.org/wiki/Cognitive_load). -->
如果你患有注意力不足過動症，你的症狀可能會有一些變化。雄激素會放大[多巴胺](https://zh.wikipedia.org/wiki/%E5%A4%9A%E5%B7%B4%E8%83%BA)受體的功能，因此減少睪固酮會降低大腦中多巴胺的激活潛力。多巴胺是[工作記憶](https://zh.wikipedia.org/wiki/%E5%B7%A5%E4%BD%9C%E8%AE%B0%E5%BF%86)（大腦的短期記憶）行為中的關鍵神經遞質。較少的工作記憶意味著你更容易分心，更難以保持[認知負荷](https://zh.wikipedia.org/wiki/%E8%AA%8D%E7%9F%A5%E8%B2%A0%E8%8D%B7)（英文）。
<!-- The good news is that estradiol prompts the brain to produce MORE dopamine. -->
好消息是，雌二醇會促使大腦產生*更多*的多巴胺。
{!{ <div class="gutter flex" style="justify-content: flex-end"><div class="card"><div class="card-body"><h4 class="card-title">作者註：</h4> }!}
<!-- There is a known problem with spironolactone hampering working memory due to its effects on mineralocorticoids. This can significantly worsen ADHD issues and make it much harder to maintain focus or be aware of your surroundings. I was involved in a car accident in 2017 that I blame on spiro fog. -->
由於螺環固醇內酮(spironolactone)對鹽皮質激素的影響，已知它會損害工作記憶。這會顯著加劇注意力不足過動症的問題，並使你更難集中注意力或意識到周圍的環境。2017 年，我發生了一起車禍，我認為這是螺環固醇內酮造成的。
{!{ </div></div></div> }!}
<!-- ##### Emotional Expansion -->
##### 情緒擴張
<!-- The alleviation of DPDR almost universally is accompanied with a much broader capacity for emotion and expression. The stoicism and dissociation lifts and emotions land with much greater intensity. Highs are higher and lows are lower. Those who may have been unable to cry before transition gain it back, both for sadness and for joy. -->
DPDR 的緩解幾乎普遍伴隨著更廣泛的情緒和表達能力。冷漠和分離感消失了，情緒以更大的強度襲來。高潮更高，低谷更低。那些在轉變前無法哭泣的人重新獲得了哭泣的能力，無論是悲傷還是喜悅。
<!-- Unfortunately, this also means that, if you had trauma from events earlier in life (and who doesn't), you may start to experience PTSD episodes. This is why it is good (and, in some places, required) to have a therapist. -->
不幸的是，這也意味著，如果你在早年生活中經歷過創傷（誰沒有呢？），你可能會開始經歷創傷後壓力症候群 (PTSD) 發作。這就是為什麼擁有一個治療師是好的（在某些地方是必需的）。
<!-- ##### Mood Swings -->
##### 情緒波動
<!-- As estrogen levels fluctuate between doses, you may experience noticeable and sometimes dramatic shifts in your mood. Unexplained crying happens; PMS rage happens; be ready for it. -->
由於雌激素水平在劑量之間波動，你可能會經歷明顯的、有時是戲劇性的情緒變化。莫名其妙的哭泣會發生；經前症候群(PMS)的憤怒會發生；做好準備。
<!-- ##### Appetite -->
##### 食慾
<!-- Many people report being unable to eat as much as they could pre-transition. The loss of lean muscle in the arms and shoulders means that the body has a reduced capacity for burning lipids, and as such the fullness sensation occurs earlier. -->
許多人報告說，他們無法像轉變前那樣吃那麼多東西。手臂和肩膀上肌肉的減少意味著身體燃燒脂質的能力降低，因此飽腹感會更早出現。
<!-- However, progesterone increases mitochondrial function within the body, boosting metabolic rate. This can cause an increase in appetite as the body attempts to replenish calories burned. -->
然而，黃體素(progesterone)會增強體內的粒線體功能，提高新陳代謝率。隨著身體試圖補充燃燒的卡路里，這可能會導致食慾增加。
<!-- That said, you may find yourself unable to eat *as much* food as you could before. Many report that they become full/satisfied sooner than before. -->
也就是說，你可能會發現自己無法像以前那樣吃 *那麼多* 東西。許多人報告說，他們比以前更快感到飽/滿足。
<!-- ##### Sleep -->
##### 睡眠
<!-- Many people report having better sleep patterns after starting HRT. This is likely a factor of the alleviation of DPDR, as it seems to occur in both AMAB and AFAB trans people. That said, initiating progesterone can *significantly* improve sleep, allowing for deeper sleep and more dreaming. -->
許多人報告說，開始 HRT 後，他們的睡眠模式得到了改善。這可能是 DPDR 緩解的一個因素，因為它似乎發生在出生時指定性別為男性和出生時指定性別為女性的跨性別者身上。也就是說，開始服用黃體素可以*顯著*改善睡眠，使睡眠更深沉，更容易做夢。
<!-- ##### Extroversion -->
##### 外向性
<!-- It's extremely common for trans people of all types to find themselves much more sociable post-transition. This may not actually be a factor of hormone therapy, however, and may simply be a result of no longer having to suppress large portions of their personality. -->
各種跨性別者在轉變後發現自己更善於交際是非常普遍的。然而，這可能實際上不是激素治療的一個因素，而可能只是不再需要壓抑自己大部分個性的結果。
<!-- ### Sensory Enhancements -->
### 感官增強
<!-- Transgender HRT has [been shown several times](https://academic.oup.com/cercor/article/28/5/1582/3064956) to cause changes in the distribution of gray matter and white matter within the brain for trans people on both forms of HRT. New structures and neuro-pathways are formed as a result of the shift in hormone profiles, and this results in changes of sensory perception. These are some of the changes that have been observed and reported, but it is not clear if this is a function of the hormones themselves, or a factor of the brain receiving the hormones it is wired for. -->
跨性別 HRT 已經[多次被證明](https://academic.oup.com/cercor/article/28/5/1582/3064956)（英文）會導致兩種形式的 HRT 中跨性別者的大腦灰質和白質分佈發生變化。由於荷爾蒙曲線的變化，會形成新的結構和神經通路，這會導致感官知覺的變化。以下是一些已被觀察和報告的變化，但尚不清楚這是荷爾蒙本身的功能，還是大腦接收到它所連接的荷爾蒙的一個因素。
<!-- - **Improved sense of smell**, especially of other bodies. Human sweat becomes very discernible — even overpowering at times.
- **Improved color perception**. Colors may become bolder, richer.
- **Improved spatial awareness**. Many trans people experience poor proprioception and a tendency towards clumsiness that goes away after starting HRT.
- **Changes in perception of taste**. Certain foods become more or less palatable; cilantro, for example, may become more or less soapy. Increased tolerance of capsaicin (spicy peppers). Chocolate and wine become more flavorful. -->
- **嗅覺改善**，尤其是對其他身體的嗅覺。人體的汗水變得非常容易辨別——有時甚至非常強烈。
- **顏色感知改善**。顏色可能會變得更醒目、更飽滿。
- **空間感知改善**。許多跨性別者經歷過本體感覺不良和笨拙的傾向，這些症狀在開始 HRT 後就消失了。
- **味覺的變化**。某些食物變得更可口或更不可口；例如，芫荽可能會變得更有肥皂味或更少肥皂味。對辣椒素（辣椒）的耐受性增加。巧克力和葡萄酒的味道變得更好。
<!-- Users of spironolactone often develop strong cravings for foods high in salt, such as pickles, olives, or potato products. This is because spiro is a potassium-sparing diuretic which causes you to pee out all your sodium. The brain creates cravings to encourage you to replace that sodium. -->
螺環固醇內酮的使用者通常會對高鹽食物產生強烈的渴望，例如泡菜、橄欖或馬鈴薯製品。這是因為螺環固醇內酮是一種保鉀利尿劑，它會導致你排出所有的鈉。大腦會產生渴望，促使你補充鈉。
<!-- ### Spatial Shift, Reduced Confidence -->
### 空間變化，自信心下降
<!-- There is a very frequently reported experience of feeling smaller within the world, even when wearing heels. People taller than you seem to tower over you, and spaces feel larger. -->
有一種非常常見的經歷，那就是感覺自己在世界上的體型變小了，即使穿著高跟鞋也是如此。比你高的人似乎高你很多，空間感覺更大。
<!-- People have also reported a tendency to be less prone to start arguments, as well as a desire to avoid confrontation rather than create it. Testosterone has been shown to increase a person's sense of confidence, and removing it has the opposite effect. -->
人們還報告說，他們不太容易發起爭論，並且希望避免衝突而不是製造衝突。睪固酮已被證明可以增加一個人的自信心，而去除它則會產生相反的效果。
<!-- ### Genital Changes -->
### 生殖器變化
{!{
<div class="gutter flex">
{{import '~/img' images.homology link='https://www.vielma.at/' }}
</div>
}!}
<!-- All genitalia are constructed from the same tissues; they are merely organized differently during gestation. Much of the behavior of these tissues is regulated by the hormones one's body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions, which means that when you remove androgens and add estrogens, these tissues start acting like they are in the shape of a vulva, even though they aren't. -->
所有生殖器都是由相同的組織構成的；它們只是在妊娠期間的組織方式不同。這些組織的許多行為都受到一個人身體運作的荷爾蒙的調節。皮膚分泌物、質地、敏感性和勃起行為都是荷爾蒙的表達，這意味著，當你去除雄激素並添加雌激素時，這些組織就會開始像外陰一樣活動，即使它們不是外陰。
<!-- ##### Increased Sensitivity -->
##### 敏感性增加
<!-- The skin on the glans and shaft becomes much thinner and fragile, more prone to tearing and irritation, while also becoming *significantly* more sensitive to touch. The entire organ also becomes much more sensitive to pressure, and vibration becomes a better form of stimulation over stroking, which may become painful. -->
龜頭和陰莖桿上的皮膚變得更薄、更脆弱，更容易撕裂和刺激，同時也變得*明顯*更敏感。整個器官也變得對壓力更敏感，振動比撫摸更能刺激，撫摸可能會變得疼痛。
<!-- #### Moisture and Feminine Odor -->
#### 濕潤和女性氣味
<!-- The skin along the shaft begins to secrete the same fluids as the vaginal canal, particularly during arousal (yes, trans girls get wet). These fluids encourage the development of the same microbiome that develops within the vaginal canal. The combination of these factors means that odor (and taste) of the penis changes to align more to that of a vulva. -->
陰莖桿上的皮膚開始分泌與陰道相同的液體，尤其是在興奮時（是的，跨性別女孩也會濕）。這些液體會促進與陰道內相同的微生物群的發展。這些因素的結合意味著陰莖的氣味（和味道）會發生變化，更接近於外陰。
<!-- ##### Color and Texture Changes -->
##### 顏色和質地的變化
<!-- The scrotum is an analog of the outer and inner labia, and takes on a softer, more velvety texture, extending down into the perineum. The skin along the perineal raphe (the vertical line where the vulva opening had been before the scrotum formed) will also darken. Some people experience a kind of striping pattern along the scrotum. -->
陰囊是大陰唇和小陰唇的類似物，質地變得更柔軟、更像天鵝絨，向下延伸到會陰。會陰縫（陰囊形成前外陰開口所在的垂直線）的皮膚也會變黑。有些人會在陰囊上出現一種條紋圖案。
<!-- ##### Fewer Erections -->
##### 勃起減少
<!-- Without free-floating testosterone, the levels of [DHT](https://en.wikipedia.org/wiki/Dihydrotestosterone) in the bloodstream drop significantly. DHT plays a major role in the stimulation of random erections during sleep through the enlargement of the prostate, and these erections are what is responsible for the maintenance of the erectile tissue. Without DHT, the prostate shrinks again, and random erections cease (no more morning wood). -->
沒有游離的睪固酮，血液中[DHT](https://zh.wikipedia.org/wiki/%E5%8F%8C%E6%B0%A2%E7%9D%BE%E9%85%AE) 的水平會顯著下降。DHT 透過前列腺的增大，在睡眠期間隨機勃起的刺激中起著重要作用，而這些勃起是維持勃起組織的原因。沒有 DHT，前列腺會再次萎縮，隨機勃起也會停止（不再有晨勃）。
<!-- However, this means that the erectile tissue will begin to atrophy. Prolonged atrophy will result in shrinkage of the entire organ, for better or worse. The shape of the penis changes as this occurs, often becoming more conical. The glans is the first part to shrink and may lose the ability to become rigid. Penetrative sex may become more difficult, and erections themselves may become painful. -->
然而，這意味著勃起組織將開始萎縮。長時間的萎縮會導致整個器官萎縮，無論好壞。陰莖的形狀會隨著萎縮而發生變化，通常會變得更像圓錐形。龜頭是最先萎縮的部分，可能會失去勃起的能力。插入式性交可能會變得更加困難，勃起本身也可能會變得疼痛。
<!-- This can be countered by regularly inducing erections, but that may become more and more difficult as time goes on. -->
這可以透過定期勃起來抵消，但隨著時間的推移，這可能會變得越來越困難。
<!-- ##### Clear Ejaculate -->
##### 透明的精液
<!-- The majority of the liquid that makes up ejaculate originates in the prostate. It is a completely clear fluid, with a slimy texture. The white color and stickiness that is usually attributed to male ejaculate is caused by semen and seminal fluid from the testicles. The production of both semen and seminal fluid is a product of testicle function, so as the testicles shut down (either because of anti-androgens or from estrogen dominance), these fluids halt, leaving only the prostate fluid. -->
組成精液的大部分液體都來自前列腺。它是一種完全透明的液體，質地黏稠。通常被認為是男性精液的白色和黏性是由睪丸中的精子和精液引起的。精子和精液的產生都是睪丸功能的產物，因此隨著睪丸停止運作（由於抗雄激素或雌激素佔優勢），這些液體會停止，只剩下前列腺液。
<!-- Some people lose even that, and stop having any emissions at all during orgasm. -->
有些人甚至連前列腺液都失去了，在性高潮時根本沒有任何分泌物。
<!-- Needless to say, this comes with sterility. Contrary to what some sources report, this is NOT permanent, and many people have been able to restore testicle functionality by halting hormone therapy, either for detransition or for reproductive purposes. -->
不用說，這會導致不育。與一些資料來源的報導相反，這*不是*永久性的，許多人能夠透過停止激素治療來恢復睪丸的功能，無論是為了去轉變還是為了生育。
<!-- ##### Testicle Atrophy -->
##### 睪丸萎縮
<!-- Once the testes have stopped functioning, the cells start to atrophy, shrinking over time. This atrophy may be accompanied with pain, sometimes in the form of a soreness or a dull throbbing sensation, or sometimes as registering as little sparks of pain that travel along the perineal nerve from the testicles down to the rectum. -->
一旦睪丸停止運作，細胞就會開始萎縮，隨著時間的推移而縮小。這種萎縮可能伴隨著疼痛，有時表現為酸痛或鈍痛，有時表現為沿著會陰神經從睪丸到直腸的小小刺痛。
<!-- ### Sexual Changes -->
### 性方面的變化
<!-- Initial start of HRT may result in a total loss of sex drive as testosterone levels plummet. This can last 3-12 months, and, in some cases, doesn't return at all. Starting progesterone often serves as a catalyst for its return. If/when sex drive comes back, the new libido [may be a completely different experience](https://curvyandtrans.com/p/5BF1EA/libatious-libidos) that one may not recognize at first. -->
隨著睪固酮水平的急劇下降，開始 HRT 的初期可能會導致性慾完全喪失。這可能持續 3-12 個月，在某些情況下，根本不會恢復。開始服用黃體酮通常可以作為其恢復的催化劑。如果/當性慾恢復時，新的性慾[可能是一種完全不同的體驗](https://curvyandtrans.com/p/5BF1EA/libatious-libidos)（英文），一開始你可能認不出來。
<!-- ##### Heightened Erogenous Zones -->
##### 敏感帶增強
{!{
<div class="gutter flex">
<div class="card"><div class="card-body"><h4 class="card-title">人體敏感帶：</h4>
{{import '~/img'
images.erogenous
link='https://www.researchgate.net/publication/301509880_Topography_of_Human_Erogenous_Zones#pf19'
caption='Source: <a href=\"https://link.springer.com/article/10.1007/s10508-016-0745-z\">人體敏感帶分佈圖</a>（英文）'
}}
</div></div>
</div>
}!}
<!-- The entire body becomes more responsive to touch, and with that unlocks stronger erogenous zones. Breasts, abdomen, inner thighs, and neck, in particular, become more arousal-inducing. -->
整個身體對觸摸的反應變得更加敏感，隨之而來的是更強的敏感帶。乳房、腹部、大腿內側和頸部尤其更容易引起性興奮。
<!-- ##### Orgasm -->
##### 性高潮
<!-- Orgasm changes significantly, both in the way it builds and how it is experienced (see link above), but additionally, if one is lucky, they will gain the ability to become multi-orgasmic with no refractory period. The cost of this is that orgasm may become harder to achieve, and one has to re-learn how to reach it. It also becomes easier to reach with a partner, which may have been the opposite before. -->
性高潮會發生顯著變化，無論是在它的積累方式還是在體驗方式上（見上面的連結），但此外，如果一個人幸運的話，他們將獲得沒有不應期的多次性高潮的能力。這樣做的代價是性高潮可能變得更難達到，而且必須重新學習如何達到性高潮。與伴侶一起達到性高潮也變得更容易了，這在以前可能是相反的。
<!-- ##### Attraction -->
##### 吸引力
<!-- It is [not at all unheard of](https://www.them.us/story/sexual-attraction-after-transition) for a transgender person to experience a change in their sexual orientation with transition. This is almost always the result of the removal of self-imposed mental barriers, but hormone therapy often plays a role *in* that removal. In most cases this simply involves an expansion of ones attraction, from monosexual to bi/pansexual, but some people also discover that their attraction was largely rooted in self-interest and that their true attraction is reversed. -->
跨性別者在轉變過程中經歷性取向的改變[並不少見](https://www.them.us/story/sexual-attraction-after-transition)（英文）。這幾乎總是去除自我強加的心理障礙的結果，但激素治療通常在去除這些障礙的過程中起作用。在大多數情況下，這只是擴展了一個人的吸引力，從單性戀到雙性戀/泛性戀，但也有一些人發現，他們的吸引力很大程度上源於自身利益，而他們真正的吸引力是相反的。
<!-- ### Cyclical Period-like Symptoms -->
### 週期性類似經期症狀
<!-- Obviously, we do not mean blood flow; that would be ludicrous. Symptoms vary greatly (just as they do in cisgender women) and typically last for 2-4 days, repeating every 26-32 days (though some report experiencing it every two weeks). This happens independent of medication dosing schedules. The use of a period tracker app like Clue can reveal the pattern. -->
顯然，我們指的不是血液流動；那就太荒謬了。症狀變化很大（就像順性別女性一樣），通常持續 2-4 天，每 26-32 天重複一次（儘管有些人報告說每兩週經歷一次）。這與藥物劑量時間表無關。使用像 Clue 這樣的經期追蹤應用程式可以顯示這種模式。
<!-- - Cramping in the intestine and abdominal muscles, ranging from a slight flutter in the gut to strong painful spasms.
- Bloating and water retention
- Gas, diarrhea and other intestinal issues.
- Emotional instability, mood swings and irrational thoughts
- Heightened depression and dysmorphia
- Depersonalization or dissociation.
- Increased dysphoria
- Irritability (PMS)
- Muscle and joint aches and pains
- Breast engorgement and nipple tenderness
- Acne
- Fatigue
- Appetite changes and spontaneous cravings (see: chocolate cravings)
- Spontaneous shifts in libido
- Changes in genital odor -->
- 腸道和腹部肌肉痙攣，從輕微的腸道顫動到劇烈的疼痛性痙攣。
- 腹脹和水腫
- 脹氣、腹瀉和其他腸道問題。
- 情緒不穩定、情緒波動和非理性想法
- 抑鬱和身體畸形加劇
- 人格解體或現實解體。
- 性別不安加劇
- 易怒（經前症候群）
- 肌肉和關節疼痛
- 乳房腫脹和乳頭壓痛
- 粉刺
- 疲勞
- 食慾變化和自發性渴望（例如：巧克力渴望）
- 性慾的自發性變化
- 生殖器氣味的變化
<!-- No, there have not yet been studies on this yet, but it is reported by far, **far** too many individuals to be an anomaly (including by yours truly), and has been confirmed by multiple people's own doctors. There is also precedent of this happening with cisgender women who have had hysterectomies (I personally know two cisgender women who have cycles but do not menstruate, without any medical intervention). -->
不，目前還沒有關於這方面的研究，但有太多太多的人報告說這是一種異常現象（包括我自己），而且已經得到多位醫生證實。順性別女性在切除子宮後也會出現這種情況（我個人認識兩位順性別女性，她們有月經週期，但沒有月經，沒有任何醫療干預）。
<!-- Running on estrogen and progesterone activates a gene sequence which instructs the hypothalamus to attempt to cycle ovary and uterine behavior just as it does in female-assigned individuals, regardless of the absence of ovaries or a uterus. This cycle affects numerous organs and subsystems in the body, causing the release of a variety of different hormones and enzymes that can affect function and even behavior. -->
使用雌激素和黃體酮會激活一個基因序列，指示下視丘試圖像在女性指定個體中一樣循環卵巢和子宮的行為，而不管卵巢或子宮是否存在。這個週期會影響身體的許多器官和子系統，導致釋放各種不同的荷爾蒙和酶，這些荷爾蒙和酶會影響功能，甚至行為。
<!-- A more thorough explanation of this will be coming in a later update to the site. -->
關於這方面的更詳細的解釋將在網站的後續更新中提供。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "雄激素性第二青春期 101"
linkTitle: 雄激素性青春期
description: "男性化 HRT 的預期變化"
preBody: '_disclaimer'
siblings:
prev: /tw/hormones
prevCaption: 賀爾蒙
next: /tw/second-puberty-fem
nextCaption: 雌激素性第二青春期
classes:
- gdb
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- '1374054574579798016'
- '1374039857773875201'
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---
<!-- # Androgenic Second Puberty 101 -->
# 雄激素性第二青春期 101
<!-- ## What To Expect from Masculinizing HRT -->
## 男性化 HRT 的預期變化
<!-- This is a compilation of reported medical transition changes collected from testimonials of AFAB trans people taking testosterone hormone therapy. This information is gathered from social media and chat rooms. Yes, that means this is all anecdotal, but historically, most of transgender medical study is anecdotal because no one wants to fund transgender medical research. -->
這是從服用睪固酮激素療法的出生指定性別女性(AFAB)的跨性別者的證詞中收集的已報告的醫療轉變變化的彙編。這些資訊是從社交媒體和聊天室收集的。是的，這意味著這些都是軼事，但從歷史上看，大多數跨性別醫學研究都是軼事，因為沒有人願意資助跨性別醫學研究。
<!-- **Note that this is a list of _possible_ changes. There is no guarantee that every person on masculinizing HRT will experience all of these. Your age, genetics, medical history, degree of feminization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness — every body is different — and some things can take years to appear.** -->
**請注意，這是一個 _可能_ 發生的變化的清單。不能保證每個接受男性化 HRT 的人都會經歷所有這些變化。你的年齡、基因、病史、原生青春期的女性化程度以及激素療法方案都會對結果產生影響。也存在一定程度的隨機性——每個人的身體都是不同的——有些事情可能需要數年時間才會出現。**
<!-- ### Voice Drop -->
### 聲音低沉
<!-- Androgens cause the tissue that comprises the vocal cords to thicken and harden, permanently lowering the pitch of the voice. This is not a very fast change, but rather incremental over the first few years. Some people do not experience any voice change at all, it varies person to person. The change will not be drastic; if you are a soprano, you are not going to become a bass, but it could bring you down to a contralto or tenor. -->
雄激素會導致組成聲帶的組織變厚和變硬，從而永久降低聲音的音調。這不是一個很快的變化，而是在最初幾年中逐漸發生的。有些人根本沒有經歷任何聲音變化，這因人而異。變化不會很大；如果你是一個女高音，你不會變成男低音，但它可能會讓你降到女低音或男高音。
<!-- This does *not* mean that your voice will automatically become read as male. Pitch is only a piece of how people gender voice, and the way you speak plays a much larger role. Vocal training will be needed to amplify resonance and change speaking style. -->
這 *並不* 意味著你的聲音會自動被聽成男性。音調只是人們判斷聲音性別的一個方面，你說話的方式起著更大的作用。需要進行聲音訓練來放大共鳴並改變說話風格。
<!-- ### Changes in Body Temperature Placement -->
### 體溫分佈的變化
{!{ <div class="gutter">{{import '~/tweet' ids=[
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] tweets=meta.tweets className="hide-mentions" }}</div> }!}
<!-- Androgens encourage extra blood flow to the extremities, making them warmer. Because of this, men have cooler cores but warmer oral and surface level temperatures. You may see your basal body temperature increase. The net result is that you will *feel* warmer, and likely will not be able to layer clothing as much as previously possible. If you live in cold climates, exposing your calves can help to dissipate heat without chilling you too severely. -->
雄激素會促進血液流向四肢，使它們變暖。因此，男性的核心體溫較低，但口腔和表層體溫較高。你可能會看到你的基礎體溫升高。最終結果是你會感覺更暖和，而且可能無法像以前那樣穿很多層衣服。如果你生活在寒冷的氣候中，露出你的小腿有助於散熱，而不會讓你感到太冷。
<!-- This change often comes fairly early on; expect night sweats while your system gets used to it. -->
這種變化通常很早就會出現；在你的身體適應它的過程中，預計會出現盜汗。
<!-- ### Changes in Perspiration -->
### 排汗的變化
<!-- With the above shift in temperature distribution, this also results in a significant change in how one sweats. Sweat will pool on the head, back and armpits. You'll also likely sweat more often, so keep water handy. -->
隨著上述體溫分佈的變化，排汗的方式也會發生重大變化。汗水會積聚在頭部、背部和腋窩。你也可能更容易出汗，所以要隨時準備好水。
<!-- ### Body Odor -->
### 體味
<!-- Often one of the first things to change: sweat and general body odor will become much stronger, especially during exercise. The smell will take on a sour, muskier smell. Tends to even out over time. -->
通常是最先改變的事情之一：汗水和一般的體味會變得更強烈，尤其是在運動過程中。氣味會變成一種酸味、麝香味。隨著時間的推移，這種氣味往往會變得均勻。
<!-- ### Body Hair, Everywhere -->
### 體毛，無處不在
<!-- Androgens significantly increase the presence of body hair on the legs, groin, buttocks, chest, back, and arms. Hair will grow in thicker, longer, and darker. This will likely happen well before facial hair growth, which can take over a year to start. Rogaine/minoxidil can help with that, but be careful, as it is poisonous if ingested (especially to cats). -->
雄激素會顯著增加腿部、腹股溝、臀部、胸部、背部和手臂上的體毛。毛髮會變得更粗、更長、顏色更深。這很可能在臉上的毛髮生長之前很久就會發生，臉上的毛髮可能需要一年多的時間才會開始生長。落健/米諾地爾可以幫助解決這個問題，但要小心，因為如果攝入它是有毒的（尤其是對貓）。
<!-- ### Male Pattern Baldness -->
### 雄性禿
<!-- MPB is caused by [dihydrotestosterone](https://en.wikipedia.org/wiki/Dihydrotestosterone) (DHT), an androgen which metabolizes from Testosterone. Having more T in your body means more DHT can form, and the gene that contributes to MPB causes the hair follicles on the scalp to receive less blood, choking them out until the follicles die. There will likely be *some* loss of hair line eventually, no matter what, but if there is a history of baldness among the men in your family, then you can expect to see that as well. Again, minoxidil can help with this. -->
雄性禿(MPB)是由[二氫睪固酮](https://zh.wikipedia.org/wiki/%E5%8F%8C%E6%B0%A2%E7%9D%BE%E9%85%AE) (DHT) 引起的，DHT 是一種由睪固酮代謝而來的雄激素。體內有更多 T 意味著可以形成更多 DHT，導致雄性禿的基因會導致頭皮上的毛囊血液供應減少，使毛囊窒息，直到毛囊死亡。無論如何，最終髮際線都可能會 *有所* 後退，但如果你的家族中的男性有禿髮史，那麼你也可以預計會看到這種情況。同樣，米諾地爾可以幫助解決這個問題。
<!-- The synthetic androgen [nandrolone](https://en.wikipedia.org/wiki/Nandrolone) does not metabolize into DHT and may be a viable alternative in place of direct testosterone if hair loss is a concern. However, DHT is important for genital growth, so this is a double-edged sword. -->
合成雄激素[諾龍(nandrolone)](https://zh.wikipedia.org/wiki/19-%E5%8E%BB%E7%94%B2%E7%9D%BE%E9%85%AE)不會代謝成 DHT，如果擔心脫髮，它可以替代直接的睪固酮。然而，DHT 對生殖器的生長很重要，所以這是一把雙刃劍。
<!-- ### Thicker and Oilier Skin -->
### 更厚、更油的皮膚
<!-- Testosterone promotes the thickening and toughening of the epidermis, causing skin to become coarser. As estrogen levels fall, the body will produce less collagen. This causes the skin to become tougher and drier (especially in the knees and elbows). Veins on the hands, arms, and legs may become more pronounced, but not varicose. -->
睪固酮會促進表皮變厚和變硬，導致皮膚變得粗糙。隨著雌激素水平的下降，身體產生的膠原蛋白會減少。這會導致皮膚變得粗糙和乾燥（尤其是在膝蓋和手肘處）。手、手臂和腿上的靜脈可能會變得更明顯，但不會出現靜脈曲張。
<!-- Expect your face and scalp to become oilier. Acne is likely to be a problem, and not just on the face. This tends to be worst immediately after dosing. This will generally improve after the first few years. -->
預計你的臉和頭皮會變得更油。痤瘡(acne)很可能是一個問題，而且不只是在臉上。這往往在用藥後立即變得最嚴重。在最初幾年後，情況通常會有所改善。
<!-- ### Larger Hands / Feet -->
### 更大的手/腳
<!-- Over long periods of time (3-5 years) the hands may become tougher and more calloused. You may need to increase your ring size eventually. -->
隨著時間的推移 (3-5 年)，手可能會變得更硬、更長繭。你最終可能需要增加你的戒指尺寸。
<!-- Testosterone also causes ligaments and tendons to retain more water, altering their flexibility. Over time this can result in an increase in foot size as the arch of the foot lowers. -->
睪固酮還會導致韌帶和肌腱保留更多的水分，從而改變它們的靈活性。隨著時間的推移，隨著足弓的降低，這可能會導致腳的尺寸增加。
<!-- ### Thicker and Stronger Nails -->
### 更厚、更強壯的指甲
<!-- Both fingernails and toenails will grow thicker over time as keratin levels rise due to the presence of androgens. -->
隨著雄激素的出現，角蛋白水平升高，指甲和腳趾甲都會隨著時間的推移而變厚。
<!-- ### Increased Muscle Mass -->
### 增加肌肉量
<!-- Androgens stimulate muscle growth, which is why anabolic steroids (which are literally testosterone) are so common amongst bodybuilders. The body will naturally gain more muscle without even having to exercise, but *with* exercise there can be substantial gains, particularly in the arms and shoulders. Beware; you won't know your own strength at first. -->
雄激素會刺激肌肉生長，這就是為什麼合成代謝類固醇（實際上就是睪固酮）在健美運動員中如此普遍的原因。即使不運動，身體也會自然地增加肌肉，但 *透過* 運動，肌肉可以大幅增加，尤其是在手臂和肩膀上。注意：你一開始不會知道你自己的力量。
<!-- Added lean muscle in the upper body redefines the shoulder and neck line, creating a more masculine silhouette. It also improves the body's ability to process lipids, making weight loss easier. -->
上半身增加的肌肉會重新定義肩膀和頸部的線條，創造更男性化的輪廓。它還能提高身體處理脂質的能力，使減肥更容易。
<!-- ### Fat Redistribution -->
### 脂肪重新分佈
<!-- Where estrogen encourages the body to deposit fats into the thighs, buttocks, and hips, androgens encourage the body to deposit fats largely into the abdomen. Starting testosterone will encourage your body to follow the androgen pattern, so you can expect new weight to deposit into your belly, while weight loss will take away from all over. Fat in the breasts, thighs and buttocks will slowly shift away as muscle builds, but this may take a long time. -->
雌激素會促進身體將脂肪儲存在大腿、臀部和臀部，而雄激素則會促進身體將脂肪主要儲存在腹部。開始服用睪固酮會促使你的身體遵循雄激素模式，因此你可以預計新的脂肪會沉積到你的腹部，而減肥會使你的全身脂肪減少。隨著肌肉的增長，乳房、大腿和臀部的脂肪會慢慢消失，但這可能需要很長時間。
<!-- ### Facial Feature Changes -->
### 面部特徵的變化
<!-- Along with body fat migration, fat in the face also moves. The neck, chin and jawline will fill out while the lips and upper cheeks shrink. The color of the eyes may also change and become fainter in the long term, as testosterone causes the pigmentation in the iris to fade. -->
隨著體脂的遷移，臉部的脂肪也會移動。頸部、下巴和下顎線會變豐滿，而嘴唇和上臉頰會縮小。隨著時間的推移，眼睛的顏色也可能會改變，變得更淡，因為睪固酮會導致虹膜中的色素沉澱褪色。
<!-- This is an extremely subtle and slow moving process that takes years, and it is easy to think nothing is changing at all. The greatest shifts seem to happen in years 3 and 4. Take selfies to compare. -->
這是一個非常微妙且緩慢的過程，需要數年的時間，而且很容易認為什麼都沒有改變。最大的變化似乎發生在第 3 年和第 4 年。拍自拍照來對照。
<!-- ### Increased Tolerance of Caffeine, Alcohol, and/or Psychotropics -->
### 對咖啡因、酒精和/或精神藥物的耐受性增加
<!-- More mass means more blood to dilute chemicals into. Increasing testosterone also means a higher metabolic rate, increasing the speed at which toxins are removed from the bloodstream. -->
更大的體重意味著有更多的血液來稀釋化學物質。睪固酮的增加也意味著更高的代謝率，從而加快了毒素從血液中清除的速度。
<!-- ### Mental Changes -->
### 心理變化
<!-- As covered in the Biochemical Dysphoria section, brains can be wired for a certain hormone profile, and running on the wrong profile is like using a laptop with low batteries or an overheated processor. Starting HRT almost universally results in a cessation of depersonalization and derealization (DPDR) symptoms within the first two weeks. A mental fog lifts, and it becomes easier to concentrate on complex concepts (assuming you don't also have other mental processing difficulties such as ADHD). -->
正如生化不安一節中所述，大腦可以根據特定的荷爾蒙曲線連接，而使用錯誤的荷爾蒙曲線就像使用電池電量低或處理器過熱的筆電一樣。開始 HRT 幾乎普遍會導致在最初兩週內停止人格解體和現實解體 (DPDR) 症狀。大腦的迷霧消散了，更容易集中注意力思考複雜的概念（假設你沒有其他心理處理困難，例如注意力不足過動症(ADHD)）。
<!-- ##### ADHD -->
##### 注意力不足過動症 (ADHD)
<!-- If you have ADHD, there may be some changes in your symptoms. Androgens amplify [dopamine](https://en.wikipedia.org/wiki/Dopamine) receptor function, so increasing testosterone can improve the activation potential for dopamine in the brain. Dopamine is a key neurotransmitter in the behavior of [working memory](https://en.wikipedia.org/wiki/Working_memory), the short-term memory of the brain. More working memory means you may become less prone to distractions and have an easier time maintaining [cognitive load](https://en.wikipedia.org/wiki/Cognitive_load). -->
如果你患有注意力不足過動症，你的症狀可能會有一些變化。雄激素會放大[多巴胺](https://zh.wikipedia.org/wiki/%E5%A4%9A%E5%B7%B4%E8%83%BA)受體的功能，因此增加睪固酮可以提高大腦中多巴胺的激活潛力。多巴胺是[工作記憶](https://zh.wikipedia.org/wiki/%E5%B7%A5%E4%BD%9C%E8%AE%B0%E5%BF%86)（大腦的短期記憶）行為中的關鍵神經遞質。更多的工作記憶意味著你可能不太容易分心，更容易保持[認知負荷](https://zh.wikipedia.org/wiki/%E8%AA%8D%E7%9F%A5%E8%B2%A0%E8%8D%B7)。
<!-- *However*, estradiol encourages the production of dopamine, so as estrogen levels fall there will be less dopamine for the brain to work with. Your symptoms worsen, not improve. -->
*然而*，雌二醇會促進多巴胺的產生，因此隨著雌激素水平的下降，大腦中可用的多巴胺會減少。你的症狀會惡化，而不是改善。
<!-- ##### Emotional Expansion -->
##### 情緒擴張
<!-- The alleviation of DPDR almost universally is accompanied with a much broader capacity for emotion and emotional regulation. Emotions become somewhat more controllable and suppressible, less likely to overwhelm on the spot. *Please note: suppressing emotions is a very quick way to develop trauma.* -->
DPDR 的緩解幾乎普遍伴隨著更廣泛的情緒和情緒調節能力。情緒變得更容易控制和壓抑，不太可能當場爆發。*請注意：壓抑情緒是形成創傷的一個非常快速的方式。*
<!-- However, the ability to express them may become reduced. Some people lose the ability to cry after starting on testosterone, but this is *not* a universal experience and may be tied into how strong your T dose is. The reasons behind this aren't well known, although some studies have found that androgens alter function in parts of the brain connected to emotional processing. If you do lose the ability to cry, it may return in time as your brain becomes more acclimated and you come out of second puberty. -->
然而，表達情緒的能力可能會降低。有些人在開始服用睪固酮後會失去哭泣的能力，但這 *不是* 一種普遍的經歷，可能與你的 T 劑量強度有關。其背後的原因尚不清楚，儘管一些研究發現雄激素會改變大腦中與情緒處理相關部分的功能。如果你確實失去了哭泣的能力，隨著你的大腦更加適應，當你度過第二青春期，它可能會隨著時間的推移而恢復。
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<!-- Emotional deregulation occurs the most commonly before and immediately after dosing (injections or gel) and results in reduced patience and increased aggression. -->
情緒失調最常發生在用藥前和用藥後（注射或凝膠），並導致耐心降低和攻擊性增加。
<!-- ##### Increased Appetite / Eating Capacity -->
##### 食慾/進食能力增加
<!-- You are going to be hungry. Testosterone cranks the body's metabolism up significantly, and increased muscle mass means there is more to feed, so you will burn calories faster. -->
你會感到飢餓。睪固酮會顯著提高身體的新陳代謝，增加的肌肉量意味著需要更多的食物來維持，所以你會更快地燃燒卡路里。
<!-- ##### Sleep -->
##### 睡眠
<!-- Some people report problems with insomnia and having fewer memorable dreams. This is far from universal, however. -->
有些人報告有失眠和難以記住夢的問題。然而，這遠不是普遍現象。
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<!-- ##### Confidence -->
##### 自信
<!-- Testosterone is known to induce a strong sense of self-confidence in people. Problems seem less significant, self-esteem is stronger, fewer anxieties. Many people report a tendency to be more prone to spark arguments, and more willing to speak out in the face of conflict and self advocate. This does *not* mean more hostile or argumentative, but simply that one's tolerance for bullshit is lower. -->
眾所周知，睪固酮會讓人產生強烈的自信心。問題似乎不那麼重要了，自尊心更強了，焦慮也更少了。許多人表示，他們更容易引發爭論，更願意在面對衝突時表達自己的意見，並為自己辯護。這 *並不* 意味著更具敵意或更愛爭論，而只是意味著一個人對廢話的容忍度降低了。
<!-- ##### Extroversion -->
##### 外向性
<!-- It's extremely common for trans people of all types to find themselves much more sociable post-transition. This may simply be a result of no longer having to suppress large portions of their personality, but the aforementioned confidence also plays a role. -->
各種跨性別者在轉變後發現自己更善於交際是非常普遍的。這可能只是不再需要壓抑自己大部分個性的結果，但前面提到的自信也起著作用。
<!-- ### Genital Changes -->
### 生殖器變化
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<!-- All genitalia are constructed from the same tissues; they are merely organized differently during gestation. Much of the behavior of these tissues is regulated by the hormones one's body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions. Which means that when you add androgens, these tissues start acting like they are in the shape of a penis and scrotum, even when they aren't. -->
所有生殖器都是由相同的組織構成的；它們只是在妊娠期間的組織方式不同。這些組織的許多行為都受到一個人身體運作的荷爾蒙的調節。皮膚分泌物、質地、敏感性和勃起行為都是荷爾蒙的表達。這意味著，當你增加雄激素時，這些組織就會開始像陰莖和陰囊一樣活動，即使它們不是陰莖和陰囊。
<!-- ##### Bottom Growth -->
##### 下體生長
<!-- DHT (mentioned above) plays a critical role in the development of the erectile tissue within the genitals. As DHT levels rise with the increase in Testosterone, this will cause the Skene's gland (sometimes referred to as the female prostate) to swell. This will induce random erections within the clitoris, causing the erectile tissue to grow. The amount of growth varies from person to person, but 1-3 inches is common. -->
DHT（上文提到的）在生殖器內勃起組織的發育中起著關鍵作用。隨著睪固酮的增加，DHT 水平也會升高，這會導致斯基恩氏腺（有時稱為女性前列腺）腫脹。這會導致陰蒂內的隨機勃起，從而導致勃起組織生長。生長的程度因人而異，但 1-3 英寸(3-8 公分)很常見。
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<!-- The clitoral hood and labia will become drier and thicker over time, and the inner labia may also start to grow hair. Self lubrication may reduce substantially, and over time penetration may become painful. Use more lube to avoid tearing and bleeding. -->
隨著時間的推移，陰蒂包皮和陰唇會變得乾燥和變厚，小陰唇也可能開始長毛。自體潤滑可能會大大減少，隨著時間的推移，插入可能會變得疼痛。使用更多潤滑劑，以避免撕裂和出血。
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<!-- ##### Increased Emissions During Climax -->
##### 高潮時分泌物增加
<!-- With the swelling of the prostate comes more prostate fluid. If you weren't a squirter before, you may become one now. -->
隨著前列腺的腫脹，前列腺液也會增多。如果你以前不是潮吹者，你現在可能會變成潮吹者。
<!-- ##### Changes in Sensitivity and Response -->
##### 敏感性和反應的變化
<!-- Erogenous stimulation may become more focused on the head of the clitoris and in stroking of the shaft. -->
性感帶刺激可能會更集中在陰蒂頭部和陰莖的撫摸上。
<!-- ##### Atrophy -->
##### 萎縮
<!-- Vaginal and uterine atrophy often happens within the first five years, and a hysterectomy may become necessary. Signs of atrophy include a deep throbbing in the lower abdomen and painful cramping without other period symptoms, particularly following intercourse. Vaginal atrophy can be avoided through the use of the same vaginal dilators that AMAB trans people use following vaginoplasty. -->
陰道和子宮萎縮通常發生在最初五年內，可能需要進行子宮切除術。萎縮的跡象包括下腹部深部搏動性疼痛和沒有其他經期症狀的疼痛性痙攣，尤其是在性交後。透過使用與出生指定性別為男性(AMAB)的跨性別者在陰道成形術後使用的相同的陰道擴張器，可以避免陰道萎縮。
<!-- ##### Increased Sex Drive -->
##### 性慾增加
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<!-- Libido will almost certainly go through the roof for the first year or two, with the strongest effects immediately following dosing. You may find yourself more assertive during sex and more prone to being dominant and/or a top. -->
在最初的一兩年裡，性慾幾乎肯定會爆棚，在用藥後立即產生最強烈的效果。你可能會發現自己在性愛過程中更自信，更容易佔主導地位和/或成為上位。
<!-- ##### Orgasm -->
##### 性高潮
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<!-- The "shape" of one's orgasm can change. Rather than a cascade, it strikes like an explosion from the groin. -->
性高潮的「形態」可能會改變。它不是像瀑布一樣，而是像腹股溝的爆炸一樣襲來。
<!-- ##### Attraction -->
##### 吸引力
<!-- Testosterone has been shown to increase arousal from visual stimuli. As such, you may *notice* people of your sexual preference much quicker, especially if you are gynephilic (attracted to the feminine shape). -->
睪固酮已被證明可以增加視覺刺激引起的性興奮。因此，你可能會更快地 *注意到* 你性偏好的人，尤其是在你是女性戀(gynophilic)（被女性的體型所吸引）的情況下。
<!-- ### Cessation of Menstruation -->
### 月經停止
<!-- The increase of androgens within the body causes the hypothalamus to down-regulate production of the hormones which control the ovaries. This will reduce total estrogen available, and may halt ovulation. Without ovulation and with lower FSH levels, the uterus will be less inclined to build up and release a lining, causing the cessation of blood flow. -->
體內雄激素的增加會導致下視丘下調控制卵巢的荷爾蒙的產生。這會減少可用的雌激素總量，並可能停止排卵。沒有排卵且 FSH 水平較低，子宮就不太會積聚和釋放內膜，導致血液停止流動。
{!{ <div class="gutter">{{import '~/tweet' ids=[
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<!-- You may still experience other period symptoms, however, as the hypothalamus can continue to express other aspects of the monthly cycle. This can even continue following a total hysterectomy, although it is not common. -->
然而，你可能仍然會經歷其他經期症狀，因為下視丘可以繼續表達月經週期的其他方面。即使在完全切除子宮後，這種情況也可能繼續存在，儘管並不常見。
<!-- **This does *not* mean that you are infertile, however.** Ovulation can still occur even if you are not menstruating. Additionally, halting testosterone will make the old orbs wake up; they do not die. -->
**然而，這*並不*意味著你不孕。** 即使你沒有月經，仍然可能會排卵。此外，停止服用睪固酮會使舊的卵巢甦醒；它們不會死亡。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現：性慾不安"
linkTitle: "性慾不安"
description: "有的時候，雪茄並不想被抽。"
preBody: '_disclaimer'
siblings:
prev: /tw/societal-dysphoria
prevCaption: 社會不安
next: /tw/presentational-dysphoria
nextCaption: 表現不安
classes:
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---
# 性慾不安
<!-- Closely related to societal dysphoria is dysphoria centered around sexuality, sexual relationships, and the act of having sex. [Heteronormative](https://en.wikipedia.org/wiki/Heteronormativity) gender roles come loaded with the expectation that [AMABs will top and AFABs will bottom](https://en.wikipedia.org/wiki/Top,_bottom_and_versatile). These dynamics get reinforced by our popular media, by toxic masculinity, and especially by our pornography, even in *transgender* pornography (the bulk of trans/cis pornography involves the trans woman topping). Deviations from these roles often result in shame, both from partners and from peers. -->
與社會不安密切相關的是圍繞性慾、性關係和性行為的不安。[異性戀霸權](https://zh.wikipedia.org/wiki/%E5%BC%82%E6%80%A7%E6%81%8B%E6%9C%AC%E4%BD%8D)的性別角色預設了[出生指定男性(AMABs)扮演上位(top)，而出生指定女性(AFABs)會扮演下位(bottom)](https://zh.wikipedia.org/wiki/%E6%94%BB%E5%8F%97)。這些動態關係被我們的大眾媒體、有害的男子氣概，尤其色情作品所強化，即使在 *跨性別* 色情片中也是如此（大多數跨性別/順性別色情片都涉及跨性別女性扮演上位）。偏離這些角色通常會導致羞愧感，無論是來自伴侶還是同儕。
<!-- Of course, this is not an absolute by any means, and many heterosexual cis couples do find ways out of these molds, finding a new dynamic in their relationship, or engaging in kinks to satisfy desires. Some couples find they aren't sexually compatible at all and seek other partners. However, there are many, many external pressures discouraging this kind of self-awareness and discovery, and breaking away from those demands can be extremely difficult — even traumatic. This is particularly true when there is a background of conservatism or religious virtuism. -->
當然，這絕非絕對，許多異性戀順性別伴侶確實找到了擺脫這些模式的方法，在他們的關係中找到新的動態，或透過禁羈(kink)來滿足慾望。有些伴侶發現他們在性方面根本不相容，於是另尋伴侶。然而，有許多、許多外在壓力阻礙了這種自我覺察和探索，擺脫這些要求可能極其困難，甚至是創傷性的。在保守主義或宗教禁慾主義的背景下尤其如此。
<!-- Cisgender gay relationships shirk this by virtue of necessity, opening the doors for individuals to explore what role leaves them more fulfilled. Some gay couples have an established dominant/submissive dynamic, and they enter into the relationship with that already understood. Others resolve it by switching up which partner is dominant. Yet, gay relationships can still get caught up in these kinds of expectations in regards to [butch/femme](https://en.wikipedia.org/wiki/Butch_and_femme), [bear](https://en.wikipedia.org/wiki/Bear_(gay_culture)), and [twink](https://en.wikipedia.org/wiki/Twink_(gay_slang)) dynamics. -->
順性別同志關係由於必要性而避開了這一點，為個人探索哪個角色能讓他們更滿足開闢了道路。一些同志伴侶有既定的支配(dominant)/臣服(submissive)動態，他們在建立關係時就已經理解了這一點。另一些人則透過交換支配伴侶的角色來解決這個問題。然而，同志關係仍然會在[T/P](https://zh.wikipedia.org/wiki/%E9%A0%82%E5%BA%95)、[熊族](https://zh.wikipedia.org/wiki/%E7%86%8A%E6%97%8F)和[Twink](https://zh.wikipedia.org/wiki/Twink_(%E7%94%B7%E5%90%8C%E6%80%A7%E6%81%8B%E4%BF%9A%E8%AF%AD))的動態關係中被這些期望所困擾。
<!-- What does all this mean? Trans people who enter into perceptually heterosexual relationships pre-transition sometimes find themselves losing interest in sexual intercourse, as penetrative acts do not produce the fulfillment that they would expect. In extreme cases it can feel completely wrong and trigger panic. The sensations may feel pleasurable, but the experience is out of place, and the act itself feels forced. -->
這一切意味著什麼？在轉變前進入表面異性戀關係的跨性別者有時會發現他們對性交失去興趣，因為插入式性行為並未產生他們預期的滿足感。在極端情況下，它會讓人感到完全錯誤並引發恐慌。這些感覺可能令人愉悅，但體驗卻格格不入，而且性行為本身感覺很勉強。
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<!-- This can lead to one feeling less enthusiastic or even disinterested in sex, as half of what makes up sex drive is the mental context of the situation. Many trans people never even experience sex until adulthood, functionally operating as sex-averse due to how severely their dysphoria has shut down all sex drive. They may still perform for the sake of their partners, but not get as much enjoyment as they could, and even end up disconnecting from reality around them in order to accomplish the task. -->
這可能導致一個人對性行為缺乏熱情，甚至失去興趣，因為性衝動的構成有一半來自於情境的心理脈絡。許多跨性別者甚至直到成年後才經歷性行為，功能上如同性冷感，因為他們的不安嚴重地抑制了所有的性衝動。他們可能仍然為了伴侶而進行性行為，但卻無法獲得應有的享受，甚至最終為了完成這項任務而與周圍的現實斷線。
<!-- This dysphoria may be so significant that they find themselves taking a sexual identity that they don't actually connect with. It is not unheard of for a trans person to realize after coming out that they never actually felt a connection to the sexual orientation that they had identified with previously, but were instead using it as a way to feel less dysphoric in their sex lives. -->
這種性別不安可能非常嚴重，以至於他們發現自己採取了實際上並不認同的性傾向認同。跨性別者在出櫃後才意識到他們從未真正與先前認同的性傾向產生連結，而是將其作為一種在性生活中減少不安感的方式，這種情況並不少見。
<!-- Some trans women, for example, identified as gay men pre-transition out of a desire to have a partner that treats them like women during sex, but find themselves to actually be lesbians once that demand is lifted. Others may attempt to live as gay men, but find that the role doesn't fulfill them because they know their partners see them as men. -->
例如，一些跨性別女性在轉變前認同為男同志，是因為渴望擁有一個在性愛中像對待女性一樣對待她們的伴侶，但在這種需求解除後，她們發現自己實際上是女同志。其他人可能試圖以男同志的身分生活，但發現這個角色並不能滿足他們，因為他們知道他們的伴侶將他們視為男性。
<!-- # The Coercive Male Gaze -->
# 強迫性的男性凝視
<!-- æææ<div class="cw"><p><strong>Author's Note</strong>: This specific type of sexual dysphoria is difficult to explain in generalist terms, so I am going to take a departure here and write about this from my own personal experience. The following is presented from my perspective as a binary trans woman. As such, this may not be completely relatable to all trans people. My apologies.</p></div>æææ -->
æææ<div class="cw"><p><strong>作者註：</strong>這種類型的性慾不安難以用通俗的語言來解釋，所以我將在此偏離主題，並根據我個人的經驗來撰寫。以下內容是從我作為一名二元跨性別女性的角度提出的。因此，這可能並非所有跨性別者都能完全理解。在此致歉。</p></div>æææ
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<!-- There is a saying that is very well known in sapphic circles: "Do I want to be her, or be with her?" -->
在女同圈裡有一句很有名的話：「我是想成為她，還是想和她在一起？」
<!-- It can be hard to tell the difference between sexual attraction and envy, especially when you're a closeted trans teenager. Our entire society is built upon heterosexuality; it is simply the cultural default, to the point that even prepubescent children are barraged with messages about male to female attraction. Consequently, interest in aspects of the lives of the "opposite" sex is almost always immediately perceived as being sexual attraction. -->
要區分性吸引力和羨慕是很困難的，尤其當你是一個尚未出櫃的跨性別青少年時。我們的整個社會都建立在異性戀的基礎上；它簡直就是預設的文化，甚至連青春期前的孩子都被充斥著關於男性對女性吸引力的訊息。因此，對「異性」生活方面的興趣幾乎總是立即被視為性吸引力。
<!-- What is the result of this? Usually... shame. Trans children often internalize their view of their peers based on their true gender, and one does not objectify their equals. Thus the child is motivated to hide those interests out of a desire to not be seen engaging in that kind of sexual objectification. This is even further compounded if the child has been raised in a setting with very strict moral codes, such as in a conservative religious upbringing. -->
這會導致什麼結果？通常是……羞恥。跨性別兒童通常會根據他們真實的性別來內化他們對同儕的看法，而一個人不會物化與他們平等的人。因此，孩子會因為不想被看到參與這種性物化而隱藏這些興趣。如果孩子在道德規範非常嚴格的環境中長大，例如在保守的宗教教育中，這種情況會更加複雜。
<!-- Growing up as a closeted trans teen in an evangelical Christian household, I knew that if I was ever caught looking at women in what was seen as a sexual manner, I would be punished. I knew if I was ever found handling women's apparel, there would be a lot of very awkward questions which I was not prepared to answer. This posed a very serious problem for me, as someone with a strong fascination with women's apparel, particularly lingerie. -->
在一個福音派基督教家庭中，作为一个未出櫃的跨性別青少年長大，我知道如果我被發現以被視為性意味的方式看著女性，我會受到懲罰。我知道如果我被發現擺弄女性服裝，就會有很多我沒有準備好回答的非常尷尬的問題。這對我來說是一個非常嚴重的問題，因為我對女性服裝，尤其是內衣有著強烈的迷戀。
<!-- There is [a Simpsons clip where Moe Szyslak is put on a lie detector test](https://www.youtube.com/watch?v=iQGwrK_yDEg), and by the end of the test he has confessed that he will be spending the night ogling the women in the intimates section of the Sears catalog. The entire crux of the scene, and the source of the comedy, is the shame that is cast on Moe for engaging in this desperate act of objectification. I grew up knowing that this is how I would be perceived for my interest in women's clothing. -->
[辛普森家庭中有一段莫少蔥接受測謊的片段](https://www.youtube.com/watch?v=iQGwrK_yDEg)，在測試結束時，他承認他會整晚盯著西爾斯目錄中內衣區的女性。整個場景的關鍵，以及喜劇的來源，是莫伊因為沉迷於這種絕望的物化行為而蒙受的羞恥。我從小就知道，這就是我對女性服裝的興趣會被如何看待。
<!-- Out of shame and fear, I did everything I could to hide this passion, because I simply could not bear for someone to view me like the teenage boys who masturbate to any material they get their hands on. What made this fear even worse was that I *also believed* that my interest was sexual. -->
出於羞恥和恐懼，我盡我所能地隱藏這種熱情，因為我實在無法忍受別人把我視為那些對任何拿到手的材料都手淫的青少年男孩。讓我更害怕的是， *我也相信* 我的興趣是性的。
<!-- When you see the world through a duck shaped lens, everything looks vaguely like a duck. The only framework I had been given to understand my interest in women was through sexual desire, and thus every feminine interest I had became warped into a sexual desire. My wish to be a bride morphed into a bridal kink, my desire to have a child warped into an interest in pregnancy porn, and my own need to be a girl was redirected into a transformation fetish. -->
當你透過鴨子形狀的鏡片看世界時，一切看起來都隱約像鴨子。我被賦予的理解我對女性興趣的唯一框架是透過性慾，因此我所有的女性化興趣都變成了性慾。我希望成為新娘的願望變成了新娘癖好(bridal kink)，我希望擁有孩子的願望變成了對懷孕色情片的興趣，而我自己想成為女孩的需求則被轉化成了變身戀物癖。
<!-- But on top of all of this, I was *terrified* to be seen expressing legitimate sexual interest in other women. I had male friends who were notorious rubberneckers and slack-jawed gawkers; one of my former employers had an awful habit of leering at attractive women when we were out to lunch, which made me very uncomfortable to be seen with him. -->
但在這一切之上，我 *害怕* 被看到表達對其他女性的合法性興趣。我有一些男性朋友是臭名昭著的會轉頭看或是看到嘴巴關不起來的人；我以前的一個老闆有一個可怕的習慣，當我們出去吃午飯時，他會色瞇瞇地盯著有吸引力的女性，這讓我覺得和他一起出現很不舒服。
<!-- I could not stand to be associated with that male gaze. Even around the most beautiful women, I would avoid even looking at them, because I did not want to be seen as the kind of person that stares at women. I did not want to be seen as a predator. -->
我無法忍受與那種男性凝視聯繫在一起。即使在最美麗的女性身邊，我也會避免看著她們，因為我不想被視為那種盯著女性看的人。我不想被視為掠食者。
<!-- This is the coercive male gaze: [compulsory heterosexuality](https://en.wikipedia.org/wiki/Compulsory_heterosexuality) placed upon closeted trans women due to heteronormative ideologies — a cognitive dissonance that causes intense guilt and shame surrounding appreciation of one's peers and gendered interests. -->
這就是強迫性的男性凝視：由於異性戀霸權的意識形態，加諸於尚未出櫃的跨性別女性身上的[強制性異性戀](https://en.wikipedia.org/wiki/Compulsory_heterosexuality)，一種認知失調，導致對同性欣賞和性別興趣產生強烈的罪惡感和羞恥感。
<!-- Once you remove this male framework – once one is able to perceive themselves as female and accept these interests and observations as valid – that shame and guilt completely evaporates. Even when the interest is sapphic in nature and genuinely includes sexual desire, it is no longer tainted with this layer of objectification. I am able to appreciate the femininity and the beauty of my female peers without judgment, and I can compliment them without fearing being perceived as a creep or having my intentions misinterpreted. -->
一旦你移除這個男性框架——一旦一個人能夠將自己視為女性，並接受這些興趣和觀察是合理的——那種羞恥感和罪惡感就會完全消失。即使這種興趣是女同性戀性質的，並且真正包含性慾望，它也不再被這層物化所玷污。我能夠毫無批判地欣賞女性同儕的女性氣質和美麗，我可以讚美她們，而不必擔心被視為怪人或我的意圖被誤解。
<!-- It was a dysphoria I could not possibly have put into words until after it had finally been relieved. I was even more relieved as I began to integrate into queer women's spaces and came to realize that _women are exactly as thirsty as men are_; we're just (usually) much more respectful about it. It was a release of guilt that I didn't even know I was carrying. -->
這是一種不安，直到它最終得到緩解後，我才有可能用語言表達出來。當我開始融入酷兒女性的空間，並意識到 *女性和男性一樣渴望* 時，我更加釋然了；我們只是（通常）更尊重這一點。這是一種我甚至不知道自己背負的罪惡感的釋放。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: 性別不安的體現：社交不安"
linkTitle: "社交不安"
description: 代名詞、舊名，還有性別稱呼，天啊！"
preBody: '_disclaimer'
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prevCaption: 生化不安
next: /tw/societal-dysphoria
nextCaption: 社會不安
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<!-- # Social Dysphoria -->
# 社交不安
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> 當你與非常陽剛的男性互動時，你會感到緊張。你不太知道如何與他們進行對話，或者根本不想與他們對話。你感覺到他們期望你成為你不是的樣子。你默默地批評他們太「兄弟」或太「膚淺」。
>
> 在陌生的男性面前展現脆弱讓你感到害怕。在公共男廁時，你會感到焦慮。在健身房更衣室換衣服更是難以想像。你對這些空間沒有歸屬感。你非常擔心陌生的男性觀察你或你的身體。
>
> 你在肢體接觸方面很笨拙。你可能像大多數人一樣渴望觸碰，但你覺得自己幾乎完全無法溫暖地接受它。當你擁抱別人時，你的軀幹會讓你覺得「冒犯」到別人。(無論是什麼，他們都沒有注意到。)
>
> 你無法談論性、吸引力，或你應該被吸引的人的身體。即使有人徵求你的意見，你所有能說的話都讓你感到不受歡迎和不恰當，即使這些話從別人嘴裡說出來也沒問題。你會僵住。
>
> 你甚至難以對別人說出單純的讚美，例如「你看起來很棒！」你非常清楚，幾乎任何話從你口中說出來，聽起來都像是令人反感的性騷擾。你覺得你的關注是獨一無二、普遍不受歡迎的。
>
> 當一位被指定性別為女性的朋友表示不贊同時，你會感到崩潰。你會拼命想重新獲得她們的認可。你擔心自己會被認為是一個諂媚的「好人」，而你鄙視所有這種類型的人。你只是更加重視被指定性別為女性朋友的意見，原因你無法解釋。
<!-- All social gender dysphoria orbits around one central concept: "What gender do people believe me to be?" Social dysphoria is about how the outside world perceives you, how others address you, and how you are expected to address them. This applies differently prior to the trans person becoming self-aware of their own gender versus how social dysphoria is experienced after a trans awakening (cracking one's shell). -->
所有社交性別不安都圍繞著一個核心概念：「大家相信我是什麼性別？」社交不安關乎外界如何看待你、如何稱呼你，以及你被期望如何稱呼他人。在跨性別者意識到自己的性別之前和「破殼而出」（覺醒）之後，社交不安的表現方式有所不同。
<!-- While still in the dark, the only awareness is that something seems off about the way you interact with your interactions with other people. People of your assigned gender seem to interact with each other in ways that do not feel natural to you. Their behaviors and mannerisms feel strange and surprising, where interactions with individuals of your true gender feel easier. You relate to people closer to your own truth. -->
當還在黑暗中時，唯一的意識是與他人的互動方式似乎有些不對勁。與你被指定性別相同的人彼此互動的方式，對你來說並不自然。他們的行為舉止讓你感到奇怪和驚訝，而與你真實性別相同的人互動則更容易。你更容易與更接近你真實自我的人產生連結。
<!-- For example, an AMAB trans person may find themselves very uncomfortable in groups of men. They may feel out of place and struggle to fit in among their male peers. Masculine social interactions don't come naturally to them, and trying to emulate their male friends feels awkward. They may feel themselves drawn more to friendships with women, but become frustrated at the social and heterosexual dynamics that come into play between men and women, preventing them from forming platonic relationships. This is if women are willing to form friendships at all. They may find themselves deeply hurt when women shy away from them on principle. -->
例如，一個被出生時指定性別為男性(AMAB)的跨性別者可能會在男性群體中感到非常不自在。他們可能覺得格格不入，難以融入男性同儕之中。陽剛的社交互動對他們來說並非自然而然，試圖模仿男性朋友的行為會讓他們感到尷尬。他們可能會發現自己更容易被女性朋友吸引，但又會對男女之間的社會和異性戀互動感到沮喪，因為這阻礙了他們建立純友誼關係。這還得看女性是否願意與他們建立友誼。當女性原則上迴避他們時，他們可能會感到深深的傷害。
<!-- This feeling of wrongness intensifies as the person becomes more and more aware of their own incongruence, and upon realizing who they really are it takes on a new shape. For binary trans people this often may be about the intense need to be seen as your true gender, be it male or female. Some non-binary people experience this more as euphoria at being seen as neither male or female and thus only being referred to in ungendered ways, or from being read as different genders by different people in the same setting. Some experience intense euphoria when people are incapable of reading their gender and become confused. -->
隨著當事人越來越意識到自身的不一致，這種錯誤感會加劇，而在意識到自己真實身份後，這種感覺會呈現新的形態。對於二元性別的跨性別者來說，這通常意味著強烈地需要被視為他們真實的性別，無論是男性還是女性。一些非二元性別者則將此體驗為被視為非男非女的愉悅感，因此只會以非性別化的方式被稱呼，或者在同一場合被不同的人解讀為不同的性別。有些人則在人們無法辨識其性別而感到困惑時，體驗到強烈的愉悅感。
<!-- Social dysphoria is where pronouns and misgendering come into play; being addressed with a gendered pronoun such as she, he, him, or her which is not the pronoun that aligns with our gender is extremely discomforting. Granted, this is true for *all* people, including cisgender people, but where a cis person may be insulted by being misgendered, a trans person will feel hurt. It's like nails on a chalkboard, or steel wool across skin. Hearing the wrong pronoun is a reminder that the person you are talking to does not recognize you for the gender that you are. -->
社會性性別焦慮與代名詞和錯誤性別稱呼息息相關；被以與自身性別不符的性別化代名詞，例如他或她 (she, he, him, or her)，稱呼會極度令人不適。誠然，*所有人*都是如此，包括順性別者，但順性別者被錯誤性別稱呼可能會感到被冒犯，而跨性別者則會感到受傷。這就像指甲刮黑板，或鋼絲絨摩擦皮膚。聽到錯誤的代名詞提醒著你，與你交談的人沒有把你當成你所屬的性別。
<!-- Gender-neutral pronouns can also be unsettling for binary trans people if used in a way that make it clear the person is avoiding the pronoun that matches them. This often is an indication that a person has been read as being transgender, and the person addressing them doesn't know what pronouns they use. Asking their pronouns can resolve this situation immediately, but the paradox is that even in that scenario, having their pronouns asked may itself induce dysphoria around having been recognized as being trans. It is sort of a catch-22. -->
如果性別中立代名詞的使用方式明顯是在迴避與你相符的代名詞，那麼二元性別的跨性別者也會感到不安。這通常表明對方已被識別為跨性別者，而稱呼者不知道他們使用什麼代名詞。詢問他們的代名詞可以立即解決這種情況，但矛盾的是，即使在這種情況下，被詢問代名詞也可能因為被識別為跨性別者而引發性別焦慮。這有點像是一種兩難的局面，你需要先有工作經驗才能找到工作之類的。
<!-- Singular they can also be used maliciously when a transphobic individual refuses to use the correct pronoun, but knows they will get in trouble for using the wrong pronouns. Tone and intent matter a lot. -->
當一個恐跨者拒絕使用正確的代名詞，但又知道使用錯誤的代名詞會惹上麻煩時，他們也可能惡意使用單數they。語氣和意圖非常重要。
<!-- The same also applies to names. Being called by one's given name (deadname) instead of their chosen name can feel invalidating when done ignorantly, and downright dismissive when done intentionally. -->
名字也是如此。被用本名（舊名）而不是自選的名字稱呼，在無知的情況下會讓人感到不被認同，而在故意為之時則會讓人感到完全不被尊重。
<!-- It may also manifest as joy or embarrassment at being labeled as your true gender while still living as your assigned gender. Examples: -->
在仍然以指定性別生活時，被標記為真實性別也可能表現為喜悅或尷尬。例如：
<!-- - An AMAB person being labeled a girl, intending insult, but it causing them to blush rather than get angry.
- An AFAB person being called Sir, and feeling better for it. -->
- 一個出生時指定性別為男性(AMAB)的跨性別者被稱為小妹妹，意圖侮辱，卻讓他們臉紅而不是生氣。
- 一個出生時指定性別為女性(AFAB)的跨性別者被稱為先生，並因此感覺良好。
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<!-- The discomfort caused by social dysphoria can pressure a trans person to act and present in an exaggerated manner in order to try to convince the rest of the world that they really are who they say they are. Transfeminine people may concentrate on makeup and feminine clothes, and become quieter in order to seem more demure, speaking in a higher voice. Transmasculine people will lean on masculine clothing styles, stand taller, suppress displays of emotion, start speaking louder, and make their voices intentionally deeper. -->
社交不安造成的不適感會迫使跨性別者以誇張的方式行事和表現，試圖讓其他人相信他們真的是他們所說的那樣。跨性別女性可能會專注於化妝和女性服飾，並變得更安靜以表現得更端莊，用更高的聲調說話。跨性別男性則會傾向於男性化的服裝風格，站得更高，壓抑情緒的展現，開始大聲說話，並刻意壓低嗓音。
<!-- ### Physical vs Social Dysphoria -->
### 身體 vs 社交不安
<!-- Some physical traits which may cause discomfort all the time for some trans people may only manifest as a social dysphoria for others. For example, some people may only be self conscious about their physical appearance when it causes them to be misgendered or clocked (read as being trans), and feel completely comfortable when interacting in environments where they are always seen and treated as their true gender. -->
某些生理特徵可能會讓一些跨性別者一直感到不適，但對另一些人來說，這些特徵可能只會表現為社會性性別焦慮。例如，有些人可能只有在因為外貌而被錯誤性別稱呼或被識破（被看出是跨性別者）時，才會對自己的外貌感到在意，而在總是能被視為和對待為真實性別的環境中互動時，他們會感到完全自在。
<!-- I, myself, have no direct physical dysphoria around my voice; I actually really enjoy singing in my natal baritone, and when I am home with just my family I let my voice relax. When out in public, however, being able to speak in a feminine voice plays a critical role in my being seen as a woman by strangers, so I put a lot of effort into training it into a feminine sound. My feminine voice turns on the instant I answer the phone or leave the house, it isn't even a conscious thing. -->
我自己對我的聲音沒有直接的身體不安；我其實很喜歡用我原本的男中音唱歌，當我只和家人在家時，我會讓我的聲音放鬆。然而，在公共場合，能夠用女性的聲音說話，對我被陌生人視為女性至關重要，所以我花了很多精力訓練我的聲音，讓它聽起來更女性化。我只要一接電話或出門，就會立刻切換成女性化的聲音，這甚至不是有意識的行為。
<!-- ### "One of us!" -->
### "One of us!"
<!-- A very curious and surprisingly common phenomenon is that closeted trans people have a tendency to find each other without ever knowing they've done it. There's a funny pattern that I have heard duplicated over and over where one person in a friend group realizes they are transgender, starts to transition, and that inspires other members of the group to also realize they are trans and come out as well. -->
一個非常奇特且驚人普遍的現象是，尚未出櫃的跨性別者往往會互相吸引，卻從未意識到這一點。我聽過一個重複出現的有趣模式：一個朋友圈中的一個人意識到自己是跨性別者，開始轉變，這激勵了群體中的其他成員也意識到自己是跨性別者，並跟著出櫃。
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> @Whorrorer 我可以認識一個順性別女性一年，卻感覺和她沒有那麼親近。
>
> 我可以認識一個跨性別女性三個小時，卻感覺像認識她一輩子。
<!-- Trans people subconsciously tend to gravitate towards each other's friendships, both out of a need for peers who think and act the same as us without judgments, and due to a kinship of social ostracization. This is not exclusive to trans people, of course, and occurs with all types of queer people, but the way it has a rippling effect is quite powerful. It's very similar to the way an entire friend group will get married and have kids all in response to one member of the group initiating. -->
跨性別者會在潛意識中互相吸引成為朋友，一方面是出於對能理解彼此想法和行為、沒有批判的同儕的需求，另一方面則是由於共同的社會排斥經歷而產生的連結。當然，這並非跨性別者獨有，所有類型的酷兒族群都會發生這種情況，但它產生的漣漪效應相當強大。這與一個朋友圈中，所有成員都因為其中一人結婚生子而陸續仿效的情況非常相似。
<!-- Trans people often continue to self-select their groups post-transition as well, as we simply understand each other better than cis people can. There is an energy that occurs when a group of trans people get together in a location, the room becomes charged with camaraderie and commiseration. We all have so much in common in our histories, so many shared experiences, that (short of personality conflicts) we instantly bond together. -->
跨性別者即使在完成轉變後，也常常會繼續選擇自己的群體，因為我們就是比順性別者更了解彼此。當一群跨性別者聚集在一個地方時，會產生一種能量，整個空間充滿了友情和共鳴。我們的經歷中有太多共同點，太多共同的經驗，以至於（除了性格衝突之外）我們會立即建立起聯繫。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
title: "性別不安的體現: 社會不安"
linkTitle: "社會不安"
description: "因為角色就是角色，代價就是代價，扮演錯誤的角色是要付出沉重代價的。"
preBody: '_disclaimer'
siblings:
prev: /tw/social-dysphoria
prevCaption: 社交不安
next: /tw/sexual-dysphoria
nextCaption: 性慾不安
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---
<!-- # Societal Dysphoria -->
# 社會不安
<!-- Gender roles exist, and, as much as we may try to buck them and point out the sexism that exists, there will always be expectations placed on people for their gender. The strongest of these are in marital and parental roles; "Husband", "Wife", "Mother", "Father", these terms come with loads of baggage attached to them, and the wrong role, or even any role at all, can feel like a lead-lined straitjacket. You are given a whole book full of behaviors and actions, likes and dislikes, that you are just expected to fulfill, and if you fail to meet those requirements then you are seen as a bad spouse or a bad parent. -->
性別角色確實存在，無論我們多麼努力地反抗它們並指出存在的性別歧視，人們總是會面臨基於性別的期望。這些期望在婚姻和親子角色中表現得尤為強烈；「丈夫」、「妻子」、「母親」、「父親」，這些詞彙都帶有大量的包袱，扮演錯誤的角色，或者甚至扮演任何角色，都可能讓人感覺像是穿著鉛衣的緊身衣般難以喘息。你會被賦予一整本關於行為舉止、喜好厭惡的規範，而你被期望去履行它們，如果你沒有達到這些要求，你就會被視為一個糟糕的配偶或糟糕的父母。
<!-- An AFAB parent who gives birth may experience severe dysphoria around being labeled as a mother. The vast majority of resources for birth are *extremely* female-gendered, so just the very process of conceiving, carrying, and giving birth is exceptionally loaded with gender expectations. If you are pregnant then you are labeled a mom, regardless of how you actually feel about your role, and with that comes a whole load of assumptions — assumptions about caregiving, breastfeeding, and child-rearing. -->
出生時指定性別為女性(AFAB) 家長在生產後，可能會因為被貼上「母親」的標籤而經歷嚴重的不安感。絕大多數的生產資源都 *非常* 女性化，因此，從受孕、懷胎到分娩的整個過程都充滿了性別期望。如果你懷孕了，那麼你就會被貼上媽媽的標籤，無論你對自己的角色實際感受如何，伴隨而來的就是一大堆的臆測——關於照顧、母乳餵養和育兒的臆測。
<!-- [Cisgender-passing](https://en.wikipedia.org/wiki/Passing_(gender)) transfeminine individuals also run into this. If you are holding an infant or tending to a child then you are labeled a mom (unless the child is mixed race, in which case you're demoted to nanny, but that's a whole other topic). This can be validating, because it is a sign that you've been seen as a woman, but it can also be extremely *invalidating* when cis women start to talk about what they think are shared experiences with reproductive processes. -->
[順性別 pass](https://en.wikipedia.org/wiki/Passing_(gender)) 即使是看起來像順性別女性的跨性別女性也會遇到這種情況。如果你抱著一個嬰兒或照顧一個小孩，你就會被貼上媽媽的標籤（除非孩子是混血兒，在這種情況下你會被降級為保姆，但那是另一個話題）。這可能是一種肯定，因為這表明你已被視為女性，但當順性別女性開始談論她們認為與你共享的生殖過程經歷時，這也可能讓你感到極度 *不被認同*。
<!-- Some unexpected ways that societal dysphoria can appear are in the need to conform to the social standards of your true gender. For example, many trans women have stories about feeling the need to cover up their chest pre-transition out of an intrinsic sense of modesty. A discomfort at swimming topless is a common trait, even when there is no understanding of one's true self; something just knows. -->
社會不安也可能以一些意想不到的方式出現，例如需要符合真實性別的社會規範。舉例來說，許多跨性別女性都有這樣的經歷：在尚未變性之前，她們會感受到一種發自內心的需要遮蓋自己的胸部。即使在還不了解真實自我的情況下，對裸露上身游泳感到不適也是一種常見的特徵；某些東西就是本能地知道。
<!-- ### Shame -->
### 羞恥感
<!-- Failure to live up to these roles can manifest *intensely* as shame and humiliation. Growing up closeted and struggling to fit into common gender tropes often results in signs of disappointment from parents and peers who expected otherwise. A father may be disappointed that their AMAB child isn't willing to engage in sports or other masculine activities. Female peers may demonstrate disapproval of an AFAB teenager choosing to hang out with a male social circle. Teen boys may ostracize an AMAB trans person who doesn't join in with their humor. -->
未能符合這些角色的期望會 *強烈地* 表現為羞恥感和屈辱感。在封閉的環境中成長，並努力適應常見的性別刻板印象，往往會導致父母和同儕的失望，因為他們原本期待的是另一種樣子。一位父親可能會對出生指定性別男性(AMAB)的孩子不願意參加體育運動或其他男性化的活動感到失望。女性同儕可能會對一位出生指定性別女性(AFAB)的青少年選擇與男性社交圈相處表示不滿。青少年男孩可能會排斥一個不參與他們幽默的 AMAB 跨性別者。
<!-- These kinds of situations can lead to bullying and abuse, pushing the trans person to feel isolated, alone, and out of place. This sense of division then creates feelings of shame for failing to be the person everyone expects them to be. This then manifests as depression on top of other dysphoria, compounding their pain. -->
這類情況可能導致霸凌和虐待，使跨性別者感到孤立、孤獨和格格不入。這種分裂感會產生羞恥感，因為他們沒有成為大家期望的那個人。這種羞恥感接著會在其他不安之上表現為抑鬱，加劇他們的痛苦。
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<!-- The shame becomes especially intense at the moment of revealing themselves to be trans. Transphobic friends and family having negative (sometimes even violent) reactions to a trans person coming out of the closet converts that shame into extreme guilt and disgrace. An adult trans person in a marriage may feel a tremendous amount of remorse at upending their spouse's life by revealing themselves. They may expect reproach from their neighbors and peers, and fear how that will affect their spouse and/or children. -->
在揭露自己跨性別身份的那一刻，羞恥感會變得格外強烈。跨性別恐懼的朋友和家人對跨性別者出櫃的負面反應（有時甚至是暴力反應）會將這種羞恥感轉化為極度的內疚和恥辱。已婚的成年跨性別者可能會因為揭露自己的身份而打亂配偶的生活，因而感到極大的悔恨。他們可能會預期到鄰居和同儕的責備，並擔心這會如何影響他們的配偶和/或孩子。
<!-- This too is a form of gender dysphoria, as these influences would not have been felt if the person had been cisgender. -->
這也是一種性別不安，因為如果這個人是順性別者，就不會感受到這些影響。
<!-- The other way shame comes into play is in the systemic transphobia present in our society. Trans adults of today grew up watching transphobic media in their childhood. The transsexual obsession of the late 80s and early 90s was horrifically traumatic for trans kids of the time, watching all the adults and peers around them laugh and jeer at and be disgusted by people whom they not only identified with but strongly empathized with and looked up to. This shame sits with us for our entire lives; it is a fundamental reason for why so many trans people do not come out until their late 30s or later, because only when they reach mid-life are they able to overcome that shame. -->
羞恥感產生的另一種方式是我們社會中系統性的跨性別恐懼症。今天的跨性別成年人在童年時期都看過跨性別恐懼症的媒體內容。80 年代末和 90 年代初對變性的痴迷對於當時的跨性別兒童來說是一種可怕的創傷，他們看著周圍所有的成年人和同儕嘲笑、奚落和厭惡那些他們不僅認同，而且強烈同情和仰慕的人。這種羞恥感伴隨著我們一生；這是為什麼這麼多跨性別者直到 30 多歲後期或更晚才出櫃的根本原因，因為只有當他們到了中年，他們才能克服這種羞恥感。
<!-- Shame also tends to build up until it boils over into radical action. A very common aspect among trans people's histories are cycles where they will build up their presentation, fighting their feelings less and less, until suddenly they feel overcome with shame and purge everything, vowing to never pursue those feelings again. This pattern repeats over and over again. -->
羞恥感也往往會累積，直到爆發成激烈的行動。跨性別者經歷中一個非常普遍的方面是循環模式：他們會逐步建立自己的外在形象，越來越少壓抑自己的感受，直到突然感到被羞恥感淹沒，然後清除一切，發誓再也不去追求這些感受。這種模式會反覆出現。
<!-- ### Dating and Romantic Relationships -->
### 約會和戀愛關係
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] tweets=meta.tweets className="oneblock capped" }}</div> }!}
<!-- Societal dysphoria *strongly* comes into play with courtship rituals. Being forced into being the boyfriend or girlfriend when you are not a boy or a girl is extremely disorienting and often feels very unfair. AMABs may find themselves wishing *they* were the one being pampered, and AFABs may become uncomfortable with the amount of attention they receive from their prospective partners (beyond the discomfort that women experience, as this includes genuine attention, not just unwanted attention). The expectations placed on them by their partners to fill these courtship roles may feel like a heavy burden to bear. By contrast, dating as your true gender becomes euphoric. Buy a trans girl flowers and see how much she swoons. -->
社會不安在求偶儀式中 *強烈地* 發揮作用。當你不是男孩或女孩時，被迫成為男朋友或女朋友會讓人非常迷惘，而且常常感到很不公平。出生指定性別男性(AMAB)可能會希望被呵護的是 *他們*，而出生指定性別女性(AFAB)可能會因為潛在伴侶對他們的過多關注而感到不舒服（這超越了女性經歷的不適，因為這包含了真正的關注，而不僅僅是不必要的關注）。伴侶期望他們扮演這些求偶角色可能會讓他們感到沉重的負擔。相比之下，以真實的性別約會會讓人感到愉悅。買花送給一位跨性別女孩，看看她有多麼欣喜若狂。
<!-- A closeted trans person may feel so much pressure to conform to heterosexuality that they suppress their own instincts with regards to relationships and take on a performative role. Many a trans woman has attempted to play the role of a heterosexual husband to a wife, only to realize with transition that they would much prefer the role of the wife. They may not even be attracted to women. -->
一位尚未出櫃的跨性別者可能會感受到巨大的壓力，要他們順從異性戀的規範，以至於他們壓抑自己在人際關係方面的本能，並扮演一個矯飾的角色。許多跨性別女性曾試圖扮演異性戀丈夫的角色，卻在變性後意識到她們更喜歡妻子的角色。她們甚至可能根本不喜歡女性。
<!-- Beyond discomfort, many trans people realize that the dynamics of relationships that they have experienced simply did not fit the shape of how they appeared. Many trans people come to realize after transition that they had never actually dated like a cis person of their assigned gender, instead always having romantic relationships that fit their true orientation. Male to male and female to female relationships have completely different patterns from heterosexual relationships; different courtship rituals, different perceptions, different communication styles. Men relate differently to men than they do to women, and women to women differently than they do to men, even when they don't know they are men or women. -->
除了不適之外，許多跨性別者意識到，他們所經歷的關係動態根本不符合他們外在形象的樣貌。許多跨性別者在變性後才意識到，他們從未像順性別者那樣約會過，他們的戀愛關係總是符合他們真正的性傾向。男男關係和女女關係與異性戀關係有著完全不同的模式；不同的求偶儀式、不同的認知和不同的溝通方式。即使不知道自己是男性或女性，男性與男性的相處方式與與女性的相處方式不同，女性與女性的相處方式與與男性的相處方式也不同。
<!-- For example, I myself realized after coming out to my wife that all of my previous dating attempts had absolutely been sapphic in nature. My first order had always been to become good friends with them. Dates would never be labeled as dates because we would just sit and talk somewhere, hanging out together. Consequently, several of my relationships ended simply because I was too scared to make the first move out of destroying the friendship. I would spend half my waking day thinking about them and wanting to be around them, not out of sexual lust, but out of personal infatuation. My first girlfriend straight up told me on our first date that I was unlike any man she'd ever dated because I enjoyed talking instead of just trying to get physical. She broke up with me two months later because I wasn't as assertive as she wanted from a partner. -->
例如，我自己在向妻子出櫃後才意識到，我以前所有的約會嘗試都完全是女同性戀性質的。我的首要任務始終是與她們成為好朋友。約會從未被稱為約會，因為我們只是找個地方坐下來聊天，一起出去玩。因此，我的幾段戀情都以失敗告終，原因很簡單，我太害怕採取主動，怕破壞友誼。我會花一半醒著的時間想著她們，想要和她們在一起，不是出於性慾，而是出於個人的迷戀。我的第一個女朋友在我們的第一次約會時就直接告訴我，我不像她約會過的任何男人，因為我喜歡聊天，而不是只想著肢體接觸。兩個月後，她和我分手了，因為我不像她期望的伴侶那樣果斷。
<!-- These dynamics get even more complex for non-binary people, some of whom can at best describe their dating style as queer. Some struggle to identify what role they play in a relationship. Others take a specific role that is typically seen as a binary gendered role. Some non-binary people wish to be seen as a boyfriend/girlfriend even if they are not a boy/girl. Some want to play a role seen by society as neutral or consisting of aspects from both binary roles. -->
對於非二元性別者來說，這些動態更加複雜，他們中的一些人最多只能將自己的約會風格描述為酷兒。有些人難以確定自己在一段關係中扮演的角色。另一些人則扮演特定的角色，這些角色通常被視為二元性別角色。一些非二元性別者希望被視為男朋友/女朋友，即使他們不是男孩/女孩。有些人想要扮演一個在社會上被視為中性或包含兩種二元性別角色特徵的角色。

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
# title: "Treating Gender Dysphoria"
# description: "Transition is the cure."
title: "治療性別不安"
description: "轉變是良方。"
preBody: '_disclaimer'
siblings:
prev: /tw/diagnoses
prevCaption: 臨床診斷
next: /tw/causes
nextCaption: 性別不安的成因
classes:
- gdb
---
<!-- # How is Gender Dysphoria Treated? -->
# 性別不安如何治療？
<!-- Treatment options vary significantly depending on the individual person's needs. Every single transition is unique, and there is no one way to transition. This section is a list of possible pathways. -->
治療方案因個人需求而異。每一個轉變都是獨一無二的，沒有唯一的轉變方式。本節列出了一些可能的途徑。
<!-- ### Social Transition -->
### 社會轉變
<!-- In a phrase: coming out of the closet. This is simply announcing to the world that you are transgender. You announce that you wish to use a new name and/or new pronouns – or not; you may just wish for people to know that you are trans and do not actually identify with your assigned binary gender. For some non-binary people this may not even be a full step away from their assignment, since gender is a spectrum and there is such a thing as a "non-binary man" and a "non-binary woman". -->
一句話：出櫃。這只是向全世界宣佈你是跨性別者。你宣佈你希望使用一個新的名字和/或新的代詞——或者不；你可能只是希望人們知道你是跨性別者，並且實際上並不認同你被指定的二元性別。對於一些非二元性別者來說，這甚至可能不是完全脫離他們被指定的性別，因為性別是一個光譜，而且存在「非二元性別男性」和「非二元性別女性」這樣的概念。
<!-- A social transition is the act of stepping out of the closet, and it can relieve a lot of stress from the suppression of oneself. -->
社會轉變是步出衣櫃的行為，它可以減輕壓抑自我的許多壓力。
<!-- ### Legal Transition -->
### 法律轉變
<!-- This is the process of changing your legal documents to reflect your true gender. This may be through a legal name and gender change issued by a court, through a change of gender marker on an official ID, or through re-issuing of birth certificates and marriage licenses. -->
這是更改你的法律文件以反映你真實性別的過程。這可以透過法院發出的合法姓名和性別更改、官方身份證上的性別標記更改，或重新簽發出生證明和結婚證書來實現。
<!-- ### Presentational Transition -->
### 表現轉變
<!-- These are changes to how you style yourself, be it your clothes, your hair, or the use of makeup. Our society heavily genders all of these things, and switching presentation is both affirming to one's self and also sends cues to those around them about how they wish to be addressed. -->
這些是你改變自己風格的方式，無論是你的衣服、你的髮型，還是化妝。我們的社會重重地將所有這些東西都賦予了性別，而改變表現方式既是對自我的肯定，也是向周圍的人發出關於他們希望如何被稱呼的信號。
<!-- ### Medical Transition -->
### 醫療轉變
<!-- For adults, this is hormone replacement therapy and surgery. For adolescents, this often means puberty blockers until the teen is old enough to be certain of which gonadal hormone they want to have. For prepubescents, this is nothing. Let me repeat that again, since transphobes keep getting it wrong. -->
對於成年人來說，這是指賀爾蒙替代療法(HRT)和手術。對於青少年來說，這通常意味著使用青春期阻斷劑，直到青少年年齡足夠大，可以確定他們想要哪種性賀爾蒙。對於青春期前的兒童來說，這什麼都不算。讓我再重複一遍，因為跨性別恐懼症者總是搞錯。
<!-- ***PREPUBESCENT CHILDREN DO NOT MEDICALLY TRANSITION***. -->
***青春期前兒童不會進行醫療轉變***。
<!-- While the American Academy of Pediatrics [strongly encourages the validation and acceptance of transgender youth](https://pediatrics.aappublications.org/content/pediatrics/early/2018/09/13/peds.2018-2162.full.pdf), and the enabling of all other forms of transition, they explicitly do not support doctors beginning either hormone therapy or puberty blockers until a child has reached [Tanner stage 2](https://en.wikipedia.org/wiki/Tanner_scale). -->
雖然美國兒科學會[強烈鼓勵肯定和接納跨性別青少年](https://pediatrics.aappublications.org/content/pediatrics/early/2018/09/13/peds.2018-2162.full.pdf)（英文），並促成所有其他形式的轉變，但他們明確表示不支持醫生在兒童達到[坦納氏期第2期](https://zh.wikipedia.org/wiki/%E8%B0%AD%E7%BA%B3%E6%A0%87%E5%87%86)之前開始賀爾蒙治療或青春期阻斷劑。
<!-- Furthermore, no surgeon in the United States will perform a gender altering surgery on a minor (excluding intersex "corrections", which is a whole other problem outside the scope of this article). Very few children have strong enough features to be read as either male or female without clues provided through presentation. Allowing a child to change their hair and clothes is all that is needed for the child to be seen as male or female. -->
此外，美國沒有任何外科醫生會對未成年人進行性別重置手術（不包括雙性人「矯正」，這是本文範圍之外的另一個問題）。很少有兒童的容貌特徵足以在沒有透過表現方式提供的線索的情況下被視為男性或女性。允許孩子改變他們的髮型和衣服就足以讓孩子被視為男性或女性。
<!-- ### Hormonal Transition -->
### 賀爾蒙轉變
<!-- **Masculinizing hormone therapy** (female to male sexual characteristics) consists of the introduction of testosterone, usually via intramuscular injection or topical gel. The increase in total gonadal hormones typically causes a cessation of ovulation, which is the source of the majority of estrogen produced in the ovaries. -->
**雄性賀爾蒙療法** （女性到男性的性徵）包括引入睪固酮，通常透過肌肉注射或局部凝膠。性賀爾蒙總量的增加通常會導致排卵停止，而排卵是卵巢產生的雌激素的主要來源。
<!-- **Feminizing hormone therapy** (male to female sexual characteristics) consists of the introduction of estrogen, typically estradiol, via oral pills, patches, or regular injections (intramuscular or subcutaneous). The use of slow dispensing implants is also becoming more and more common. It is also common practice to prescribe an anti-androgen to block testosterone production or absorption. In the United States this is usually spironolactone, a blood pressure medication which has a testosterone blocking side-effect. Outside of the US, the most common drug is cyproterone acetate, an androgen receptor blocker, which is not available in the US. Doctors may also prescribe bicalutamide, which also blocks androgen receptors. However, some doctors may simply opt to use larger estradiol doses in order to cause the body to halt testosterone production. -->
**雌性賀爾蒙療法** （男性到女性的性徵）包括引入雌激素，通常是雌二醇，透過口服藥丸、貼片或定期注射（肌肉注射或皮下注射）。使用緩釋植入物也越來越普遍。通常的做法是開一種抗雄激素藥物來阻止睪固酮的產生或吸收。在美國，這通常是螺環固醇內酮(spironolactone)，一種具有阻斷睪固酮副作用的血壓藥物。在美國以外，最常用的藥物是醋酸環丙孕酮(cyproterone acetate, CPA)，一種雄激素受體阻斷劑，在美國沒有。醫生也可能開比卡魯胺(bicalutamide)，它也能阻斷雄激素受體。然而，一些醫生可能會選擇使用更大劑量的雌二醇，以使身體停止產生睪固酮。
<!-- **In adolescents**, puberty blockers may involve the above androgen blockers, or (if it is covered by insurance) the use of an antigonadotropic (a drug which blocks the hormones that cause the production of estrogen and androgen) such as leuprolide acetate (a shot delivered every few months) or histrelin acetate (an annual implant). -->
**在青少年中，** 青春期阻斷劑可能包括上述雄激素阻斷劑，或者（如果保險有給付）使用抗促性腺激素（一種阻斷導致雌激素和雄激素產生的激素的藥物），例如柳菩林(leuprolide)（每幾個月注射一次）或醋酸組胺瑞林(histrelin)（每年植入一次）。
<!-- ### Surgical Transition -->
### 手術轉變
<!-- Transgender surgeries are typically divided into three separate categories: -->
跨性別手術通常分為三個不同的類別：
<!-- **Bottom Surgery** (modifications to genitals): -->
**下半身手術**（生殖器改造）：
<!-- - Feminizing: -->
- 女性化：
<!-- - Orchiectomy (removal of the testicles)
- Scrotectomy (removal of scrotal tissue, following orchiectomy)
- Vaginoplasty (creation of a vaginal cavity)
- Vulvoplasty (creation of a vulva, with or without depth). -->
- 睪丸切除術(Orchiectomy)（移除睪丸）
- 陰囊切除術(Scrotectomy)（移除陰囊組織，在睪丸切除術之後）
- 陰道成形術(Vaginoplasty)（創造陰道腔）
- 外陰成形術(Vulvoplasty)（創造外陰，有或沒有深度）。
{!{ <div class="gutter"><div class="card"><div class="card-body"><h4 class="card-title">For Your Information</h4> }!}
<!-- A newly developing area of bottom surgery is in AMAB non-binary operations which attempt to perform vaginoplasty *without* the removal of the penis. This particular surgery is extremely experimental and has been performed less than a dozen times in the United States, but the outlook for the future is good. -->
下半身手術的一個新興領域是針對出生時指定性別為男性(AMAB)的非二元性別手術，該手術試圖在 *不移除* 陰莖的情況下進行陰道成形術。這種特殊的手術在美國還處於實驗階段，只進行了不到十幾次，但未來的展望是好的。
<!-- An additional option for non-binary bottom surgery is genital nullification surgery, which aims to completely remove the external genitalia, leaving only a urethral opening. -->
非二元性別下半身手術的另一個選擇是生殖器去除手術，其目的是完全移除外生殖器，只留下尿道口。
{!{ </div></div></div> }!}
<!-- - Masculinizing: -->
- 男性化：
<!-- - Hysterectomy (removal of uterus and cervix)
- Oophorectomy (removal of one or both ovaries)
- Vaginectomy (removal of vaginal cavity)
- Metoidioplasty (a process which turns the enlarged clitoris after hormone therapy into a penis)
- Phalloplasty (construction of a penis from skin grafting)
- Urethroplasty (extension of the urethral canal through the phallus)
- Scrotoplasty (use of labia majora and false testicles to construct a scrotum). -->
- 子宮切除術(Hysterectomy)（移除子宮和子宮頸）
- 卵巢切除術(Oophorectomy)（移除一個或兩個卵巢）
- 陰道切除術(Vaginectomy)（移除陰道腔）
- 陰蒂成形術(Metoidioplasty)（將激素治療後增大的陰蒂變成陰莖的過程）
- 陰莖成形術(Phalloplasty)（透過植皮來構造陰莖）
- 尿道成形術(Urethroplasty)（將尿道延伸穿過陰莖）
- 陰囊成形術(Scrotoplasty)（使用大陰唇和假睪丸來構造陰囊）。
<!-- Phalloplasty does not necessarily require previous hormone therapy, and while it is common to perform vaginectomy, urethroplasty, and phalloplasty at the same time, some surgeons can perform phalloplasty without vaginectomy or phalloplasty without urethroplasty. -->
陰莖成形術不一定需要事先進行激素治療，雖然通常同時進行陰道切除術、尿道成形術和陰莖成形術，但一些外科醫生可以在不進行陰道切除術的情況下進行陰莖成形術，或者在不進行尿道成形術的情況下進行陰莖成形術。
<!-- **Top Surgery** (modifications to the chest) -->
**上半身手術**（胸部改造）
<!-- - Feminizing: -->
- 女性化：
<!-- - Breast augmentation via fat transfer or implants. -->
- 透過脂肪移植或植體進行隆乳。
<!-- - Masculinizing: -->
- 男性化：
<!-- - Bilateral mastectomy (breast tissue removal) with chest reconstruction
- Breast reduction (some fat and breast tissue removal) -->
- 雙側乳房切除術(Bilateral mastectomy)（移除乳房組織）和胸部重建
- 縮胸術（移除一些脂肪和乳房組織）
<!-- **Facial Feminization / Masculinization Surgery** (modifications to the skull, cartilage, and skin on the face). -->
**面部女性化/男性化手術**（改造面部的顱骨、軟骨和皮膚）。
<!-- The younger a person is, the less they will need these surgeries, especially if they medically transition prior to the age of 20. -->
一個人越年輕，他們就越不需要這些手術，尤其是如果他們在 20 歲之前進行醫療轉變的話。
<!-- - Feminizing: -->
- 女性化：
<!-- - Forehead recontouring
- Eye socket recontouring
- Brow lift
- Hairline correction
- Blepharoplasty (lifting of eye bags)
- Rhinoplasty (reshaping of the nose)
- Cheek implants
- Lip lift
- Lip filling
- Jaw recontouring
- Tracheal shave (adam's apple reduction)
- Rhytidectomy (face lift) -->
- 額頭重塑
- 眼窩重塑
- 提眉
- 髮際線矯正
- 眼瞼成形術（提拉眼袋）
- 鼻整形術（重塑鼻子）
- 臉頰植入物
- 提唇
- 豐唇
- 下巴重塑
- 氣管刮鬍子（縮小喉結）
- 拉皮手術（面部提拉）
<!-- - Masculinizing: -->
- 男性化：
<!-- - Forehead augmentation
- Jaw augmentation
- Chin augmentation
- Tracheal augmentation (adam's apple enlargement) -->
- 額頭增高
- 下巴增大
- 下巴增大
- 氣管增大（增大喉結）
<!-- Other Trans Feminine Surgeries: -->
其他跨性別女性化手術：
<!-- - Brazilian Butt Lift: Fat from the belly is transplanted into the butt in order to increase hip to waist ratio.
- Voice Feminization Surgery: An incision is performed in the vocal cords in order to permanently raise the pitch.
- Cinderella Surgery: Bones in the foot are shortened in order to reduce foot size. EXTREMELY RISKY
- Shoulder Reduction: The collar bone is shortened to reduce the width of the shoulders. EXTREMELY RISKY -->
- 巴西提臀術：將腹部脂肪移植到臀部，以增加腰臀比。
- 聲音女性化手術：在聲帶上切開一個切口，以永久提高音調。
- 灰姑娘手術：縮短腳部的骨骼，以縮小腳的尺寸。風險極高
- 肩膀縮小術：縮短鎖骨以縮小肩膀的寬度。風險極高

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---
date: "2020-01-26T20:41:55.827Z"
lang: "tw"
# en:
# title: "What is Gender?"
# description: "How do we define the concept of Gender, and how does it differ from Sex?"
# zh-tw:
title: "性別是什麼？"
description: "我們如何定義性別的概念，以及如何與性區分？"
preBody: '_disclaimer'
siblings:
prev: /tw/
prevCaption: 簡介
next: /tw/history
nextCaption: 性別不安的歷史
classes:
- gdb
tweets:
- '1228717614630940672'
- '1439225913623781377'
---
# 性別是什麼？
{!{
<div class="gutter">
<blockquote>
<strong>性別 Gen·der</strong> - <em>名詞</em><br>
<!-- en:
The range of characteristics pertaining to, and differentiating between, femininity and masculinity. Depending on the context, these characteristics may include biological sex, sex-based social structures (i.e., gender roles), or gender identity (the personal sense of one's own gender).
zh-tw: -->
與女性氣質和男性氣質有關並區分兩者的一系列特質。根據具體上下文，這些特質可能包含生理性別、基於性別的社會結構（例如性別角色）或性別認同（對自我性別的感知）。
</blockquote>
</div>
}!}
<!-- en:
If you trace the etymology of the word to its Latin roots, gender simply means "type". The Norman French term **gendre** was in use in the 12th century to describe "the quality of being male or female."
zh-tw: -->
如果你追溯這個詞到拉丁語的根源，性別只是指「類型」。12世紀的諾曼法語中 **gendre** 用來描述「男性或女性的特質」。
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Many people attribute the term to psychologist John Money, who proposed using "gender" in 1955 to differentiate mental sex from physical sex. However, Money was not the first to do so. Cultural anthropologist [Margaret Mead](https://en.wikipedia.org/wiki/Margaret_Mead) used the term in 1949 in her book *Male and Female* to distinguish gendered behaviors and roles from biological sex. The American Journal of Psychology ([vol. 63, no. 2, 1950, pp. 312](https://www.jstor.org/stable/1418948)) described the book thusly:
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很多人認為心理學家約翰·曼尼（John Money）創造了「性別」這個詞，他在1955年提出用「性別」來區分心理上的性和身體上的性。然而曼尼並不是第一個這麼做的人。文化人類學家[瑪格麗特·米德](https://en.wikipedia.org/wiki/Margaret_Mead)在1949年的《兩性之間》(Male and Female)一書中使用這個詞來區分性別化的行為和角色與生理性別。《美國心理學期刊》（The American Journal of Psychology, [vol. 63, no. 2, 1950, pp. 312](https://www.jstor.org/stable/1418948)）這樣描述這本書：
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> A book, moreover, which gives beyond its premise; for it informs the reader upon **'gender' as well as upon 'sex,'** upon masculine and feminine roles as well as upon male and female and their reproductive functions.
>
> Margaret Mead moves from the specific delineation to the more general comparison of male and female in several communities, finally coming to an analysis of sex-patterns in our own midst and for our own time.
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> 這本書超越了其基本假設。告訴讀者**什麼是「性」，什麼是「性別」**，什麼是男性化的角色，什麼是女性化的角色，什麼是男女的生殖功能。
>
> 瑪格麗特·米德從特定的描繪移向更一般的比較，比較了幾個社群中的男性和女性，最後分析了我們自己時代的性模式。
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Human Sex (the adjective, not the verb) is broken down into three categories:
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人類的性（形容詞，不是動詞）分為三類：
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- **[Genotype](https://en.wikipedia.org/wiki/Genotype)**: The genetically-defined chromosomal kareotype of an organism (XX, XY, [and all variants thereof](https://twitter.com/sciencevet2/status/1035250518870900737?lang=en))
- **[Phenotype](https://en.wikipedia.org/wiki/Phenotype)**: The observable primary and secondary sexual characteristics (genitals, fat and muscle distribution, bone structure, etc.)
- **[Gender](https://en.wikipedia.org/wiki/Gender)**: The **un**observable sexual characteristics, the internal mental model of a person's own sex, and the way that they express it.
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- **[基因型 (Genotype)](https://zh.wikipedia.org/wiki/%E5%9F%BA%E5%9B%A0%E5%9E%8B)**：生物遺傳確定的染色體核型（XX、XY及[其它變體](https://twitter.com/sciencevet2/status/1035250518870900737?lang=en)）
- **[表現型 (Phenotype)](https://zh.wikipedia.org/wiki/%E8%A1%A8%E7%8F%BE%E5%9E%8B)**：可觀察到的主要和次要性徵（生殖器、脂肪和肌肉分布、骨骼結構等）
- **[性別 (Gender)](https://zh.wikipedia.org/wiki/%E7%A4%BE%E6%9C%83%E6%80%A7%E5%88%A5)**：**不**可見的性徵、一個人內在的性心理模式和性別表達。
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Any of these three aspects can fall into a position on a range of values. Your elementary school health class probably taught you that genotype is binary, either female (XX) or male (XY), when the reality is that there are a dozen other permutations that can occur within human beings.
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這三類中都受到觀念的桎梏。小學的健康課可能教過，基因型是二元的，如果不是女性（XX） 就是男性（XY），但現實中還有十幾種其他的排列組合存在人類之中。
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Likewise, many people believe that phenotype is also binary, but biology has recognized for hundreds of years that, when you plot out all sexual characteristics across a population, you actually end up with a bimodal distribution where the majority of the population falls within a percentile of two groups. This means that some people will, simply by nature of how life works, fall outside of the typical two piles. Many people fall in the middle, with characteristics of both sexes.
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同樣地，很多人認為表現型也是二元的，但生物學幾百年來一直認為，當你在整個人群中繪製所有性徵時，你實際上會得到一個雙峰分佈，其中大多數人落在兩組百分位數之間。這意味著有些人，僅僅是因為生活的運作方式，會落在兩個典型群體之外。許多人落在中間，具有兩性的特徵。
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Gender, however, is a lot more... esoteric. There are a lot of different ways in which people have attempted to illustrate the gender spectrum, but none have quite thoroughly captured it because the spectrum is itself a very abstract concept.
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性別，然而，更為...抽象。人們試圖描繪性別光譜的方式有很多種，但沒有一種完全捕捉到它，因為光譜本身就是一個非常抽象的概念。
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<div class="card-header"><strong>一些用來描述性別的方法</strong></div>
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<em>資料來源:</em>
[<a href="https://bahamutzero.tumblr.com/post/56838411871/gender-a-visual-guide-when-most-people-think-of">Tumblr</a>]
[<a href="http://www.transstudent.org/gender">TransStudent.org</a>]
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The short of it is: some people are very male, some people are very female. Some people feel no gender at all, some people feel both. Some are smack in the middle, some land along the edges. Some people oscillate all over the spectrum in unpredictable ways, changing like the wind. Only an individual can identify their own gender; no one else can dictate it for them.
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簡而言之：有些人非常男性化，有些人非常女性化。有些人根本沒有性別感，有些人兩者都有。有些人處於中間，有些人處於邊緣。有些人在光譜上不可預測地震盪，像風一樣變化。只有個人才能確定自己的性別；沒有人可以為他們決定性別。
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Gender is part social construct, part learned behaviors, and part biological processes which form very early in a person's life.
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性別是社會建構的一部分，是學習的行為，也是在一個人的生命早期形成的生物過程的一部分。
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Present evidence seems to suggest that a person's gender is established during gestation while the cerebral cortex of the brain is forming (more about that in the Causes of Gender Dysphoria section). This mental model then informs, at a subconscious level, what aspects of the gender spectrum a person will lean towards. It affects behavior, perceptions of the world, the way we experience attraction (separate from sexual orientation and hormonal influences) and how we bond with other people.
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目前的證據似乎表明，一個人的性別是在胎兒期間確立的，當大腦皮層形成時（關於這一點，請參見性別不安的成因章節）。這種心理模式然後在潛意識水平上告訴一個人會偏向性別光譜的哪些方面。它影響行為、對世界的感知、我們如何體驗吸引力（與性取向和荷爾蒙影響分開）以及我們如何與其他人建立關係。
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Gender also affects the expectations that the brain has for the environment it resides in (your body), and when that environment does not meet those expectations, the brain sends up warning alarms in the form of depression, depersonalization, derealization, and dissociation. These are the brain's subconscious ways of informing us that something is very wrong.
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性別也影響大腦對其所處環境（你的身體）的期望，當環境不符合這些期望時，大腦會通過憂鬱、失自我感、現實感喪失和解離的形式發出警報。這些是大腦潛意識地告訴我們有什麼地方出了嚴重問題。
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<strong>習性 Hab·i·tus</strong> - <em>名詞</em><br>
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Socially ingrained habits, skills, and dispositions. The way a person perceives and reacts to the world.
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社會上根深蒂固的習慣、技能和性格。一個人感知世界和對世界作出反應的方式。
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On the social side, gender involves our [habitus](https://en.wikipedia.org/wiki/Habitus_(sociology)): our presentation, our mannerisms and behaviors, how we communicate, how we react, what our expectations are from life, and the roles that we fulfill as we walk through life. The author Susan Stryker described habitus it in her book *[Transgender History](https://smile.amazon.com/Transgender-History-second-Todays-Revolution/dp/158005689X)*:
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在社會方面，性別涉及我們的[習性](https://zh.wikipedia.org/wiki/%E6%85%A3%E7%BF%92)：我們的表現、我們的舉止和行為、我們的溝通方式、我們的反應方式、我們對生活的期望以及我們在生活中扮演的角色。作者蘇珊·史崔克（Susan Stryker）在她的書《[跨性別歷史](https://smile.amazon.com/Transgender-History-second-Todays-Revolution/dp/158005689X)》中這樣描述習性：
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> A lot of habitus involves manipulating our secondary sex characteristics to communicate to others our own sense of who we feel we are---whether we sway our hips, talk with our hands, bulk up at the gym, grow out our hair, wearclothing with a neckline that emphasizes our cleavage, shave our armpits, allow stubble to be visible on our faces, or speak with a rising or falling inflection at the end of sentences. Often these ways of moving and styling have become so internalized that we think of them as natural even though---given that they are all things we've learned through observation and practice---they can be better understood as culturally acquired "second nature."
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> 眾多習性涉及操縱我們的次要性徵，向他人傳達我們對自己感覺的認知---無論是擺動臀部、肢體語言、在健身房增肌、留長頭髮、穿著領口突顯乳溝的衣服、刮腋毛、讓臉上的胡渣顯現，還是在句子結尾說話時帶有上揚或下降的語調。通常這些移動和造型方式已經內化到我們的思維中，我們認為它們是自然的，即使"考慮到這些都是我們通過觀察和練習學到的東西"它們更應該被理解為文化習得的「第二天性」。
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Indeed, these are all cultural factors: things which have developed within the population over time. Regardless of being essentially "made up", they are still strongly gendered and a person tends to connect to the gendered habitus of their internal self without even realizing they are doing it. When we are denied access to those social aspects, this results in discomfort with one's social position in life.
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事實上，這些都是文化因素：隨著時間的推移在人群中發展起來的東西。儘管基本上是「虛構的」，它們仍然具有強烈的性別特徵，一個人傾向於與自己內在自我的性別習性相連接，甚至沒有意識到自己在這樣做。當我們被剝奪了這些社會方面的接觸時，這將導致對自己在生活中的社會地位感到不適。
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John Money's experiments attempted to confirm his belief that gender is entirely a social construct, and that any child can be raised to believe themselves to be whatever they were taught to be. His experiment was a massive failure (see the Biochemical Dysphoria section). Gender does not change; every human is the same gender at 40 that they were at 4. What changes is our own personal understanding of our gender as we mature as individuals.
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約翰·曼尼的實驗試圖證實他的信念，即性別完全是一種社會建構，任何孩子都可以被教導相信自己是什麼。他的實驗是一次巨大的失敗（請參見生化不安章節）。性別不會改變；每個人在40歲時的性別與4歲時的性別是一樣的。改變的是我們對自己性別的個人理解，隨著我們作為個體的成熟而變化。
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These negative symptoms (depression, derealization, social discomfort) are the symptoms of Gender Dysphoria.
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這些負性症狀（憂鬱、現實感喪失、社交不適）是性別不安的症狀。
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What **Gender is *not*** is sexual orientation. We describe orientation using terms relative to one's gender (homosexual/heterosexual/bisexual, etc), but gender itself does not affect sexuality and sexuality has no role in gender.
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性別**不是**性取向(sexual orientation)。我們使用與一個人的性別相關的術語來描述性取向（同性戀(homosexual)/異性戀(heterosexual)/雙性戀等(bisexual)），但性別本身不影響性取向，性取向在性別中也沒有作用。
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## What does it mean to be Non-binary?
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## 非二元是什麼意思？
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Non-binary can basically be simplified as a lack of exclusive affinity to male or female. This may be a lack of affinity to either identity ([agender](https://gender.wikia.org/wiki/Agender)), a total affinity to both ([bi-gender](https://gender.wikia.org/wiki/Bigender)/), a balanced affinity to both ([androgyne](https://gender.fandom.com/wiki/Androgyne)), an affinity that changes from day to day ([genderfluid](https://gender.wikia.org/wiki/Genderfluid)), a partial affinity ([demigender](https://gender.wikia.org/wiki/Demigender)), or even an affinity to the entire gender spectrum at once ([pangender](https://gender.wikia.org/wiki/Pangender)).
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非二元基本上可以簡化為對男性或女性沒有排他性的親和力。這可能是對任一身份的親和力缺乏（[無性別(agender)](https://gender.wikia.org/wiki/Agender)），對兩者的完全親和力（[雙性別(bi-gender)](https://gender.fandom.com/wiki/Bigender)），對兩者的平衡親和力（[雌雄同體(androgyne)](https://gender.fandom.com/wiki/Androgyne)），每天都會變化的親和力（[性別流動(genderfluid)](https://gender.wikia.org/wiki/Genderfluid)），部分親和力（[半性別(demigender)](https://gender.wikia.org/wiki/Demigender)），甚至是對整個性別光譜的一次性親和力（[泛性別(pangender)](https://gender.wikia.org/wiki/Pangender)）。
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It could be an affinity to some aspects of a gender but not others. For example, a [demigirl](https://gender.wikia.org/wiki/Demigirl) could be someone assigned female at birth who only feels a partial connection to womanhood and femininity, or may be a male-assigned individual who is taking hormone therapy to relieve physical dysphoria, and has a female phenotype, but does not experience a strong connection to the social aspects of womanhood.
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這可能是對某些性別特徵的親和力，但不是對其他特徵。例如，一個[半女孩(demigirl)](https://gender.wikia.org/wiki/Demigirl)可能是一個出生時被指定為女性的人，只對女性和女性特質有部分聯繫，或者可能是一個被指定為男性的人，正在接受荷爾蒙治療以緩解生理性別不安，並且具有女性表現型，但不會對女性社會方面有強烈的聯繫。
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In generalist terms, this book will be describing gender in a sense of binary identities (male/female) vs non-binary identities, but this is purely for the sake of writing simplicity. Please know that the depth of gender experience and expression is far, far more complicated than this simple breakdown.
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總的來說，這本書將以二元身份（男性/女性）與非二元身份的意義來描述性別，但這僅僅是為了寫作的簡單性。請知道，性別經驗和表達的深度遠遠比這個簡單的分類複雜得多。