GenderDysphoria.fyi/public/tw/physical-dysphoria.md

---
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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---

<!-- # 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：

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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。