GenderDysphoria.fyi/public/tw/diagnoses.md

---
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 Other countries have their own local standards, but they're all either very similar or a lot more outdated.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。