---
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