---
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。