Nūhou

Ua hoʻi hou ʻo Carly i Louisiana e nānā i kahi kiʻiʻoniʻoni me kāna hoaaloha a noho i hope.ʻO ia i ka pūnāwai o 2017, a ma kahi o ʻelua pule ma mua, ua hana ʻo Carly, he wahine trans 34 makahiki, i kahi vaginoplasty: kahi hana i hana ʻia i kekahi manawa ma hope o ka hōʻeha a i ʻole ka maʻi kanesa, akā ʻo ka mea pinepine no ka mālama pili i ka hoʻololi.Ua koho ʻo Carly i kahi kauka lapaʻau, ʻo Kauka Kathy Rumer, ka mea loea i nā kaʻina hana hōʻoia kāne ma ka wahi o Philadelphia.
Skyped lākou i nā mahina ma mua o ke ʻoki ʻana, akā ʻaʻole i hui kino ma mua o ke kaʻina.Ua ʻōlelo ʻo Carly ua kipa pōkole ʻo ia i ke kauka ma mua o ka hoʻokuke ʻia ʻana i loko o ka lumi hana, akā ʻaʻole ʻo ia i ʻike hou iā Kauka Rumer i loko o kona mau lā ʻekolu o ka hoʻōla ʻana i ka haukapila.I hoʻokahi pule ma hope o ka hana ʻana, ua hoʻopaʻa ʻia ke kahu hānai iā ia no kahi manawa e hahai ai.
Ma hope o ka hoʻi ʻana i ka home mai ka kiʻiʻoniʻoni "Louisiana", ua nānā ʻo Carly i kāna vulva hou.ʻOiai ke nānā aku nei ka hapa nui o nā vulvas postoperative ʻelua pule, ua pīhoihoi ʻo Carly i ka wā i ʻike ai ʻo ia "he ʻāpana nui o ka ʻili make e like me ka nui o ka manamana lima," wahi āna.I ke kakahiaka aʻe, ua kāhea ʻo ia i ka helu pilikia i hāʻawi ʻia a hoʻouna i leka uila i ke keʻena o Kauka Rumer.Ma ka Pōʻakahi, ua aʻo ke keʻena iā Carly e leka uila i nā kiʻi o nā wahi pilikia no nā kauka lapaʻau e nānā.I kekahi mau lā ma hope mai, ua ʻōlelo ʻo Carly a me kona makuahine ua lohe lākou mai kahi kauka e hoʻomaha ana a haʻi iā Carly ʻaʻohe ona mea e hopohopo ai.Ua ʻōlelo ʻo Kauka Rumer, hiki i kona makuahine, he kauka lapaʻau hoʻomaha, ke ʻoki i ka ʻili e kau ana inā hoʻomau ka ʻeha.
Ua hoʻokūhoihoi ʻo Carly a me kona makuahine i kēia manaʻo.Ua ʻōlelo ʻo ia ua ʻala "ʻino" kona mau ʻōpū a ua haʻalulu kona labia me kahi ʻili lahilahi.I hoʻokahi pule ma hope o ke kamaʻilio ʻana me Kauka Rumer, ua ʻōlelo ʻo Carly ua hele ʻo ia i ka gynecologist kūloko, nāna i hopohopo a lawe iā Carly i ka Halemai ʻo Oshner Baptist ma New Orleans no ka hōʻoki pilikia.Ua hoʻopilikia ʻia kekahi hapa o ka ʻōpū o Carly e ka necrotizing fasciitis, kahi maʻi weliweli i kekahi hana.Hoʻopau pinepine kēia i ka nalo ʻana o ka ʻiʻo ma ka wahi i maʻi ʻia.
Ua hoʻohana ʻia ʻo Carly e kekahi hui kauka, ʻaʻohe o lākou i ʻike i ka vulva post-op a i ʻole vagina—he ʻokoʻa ka maʻi post-op mai ka cisgender.Ua noho ʻo ia i ʻelua lā i loko o ka hale mālama koʻikoʻi a he ʻelima mau lā ma ka haukapila.Ua ʻōlelo ʻo ia a me kona makuahine he nui nā kelepona mai ka makuahine o Carly a me kāna OB/GYN i ke keʻena o Kauka Rumer ʻaʻole i pane ʻia i kēia manawa.
I ka loaʻa ʻana o ka pane mai ke keʻena ʻo Kauka Rumer - he ʻano hoʻomalu me nā moʻolelo a Carly - ua huhū ke kauka ʻokiʻoki ʻaʻole i hoʻonohonoho ʻo Carly i kahi lele i Philadelphia no nā kauka e hoʻoponopono i ka pilikia.Wahi a Carly a me kona makuahine, ua paʻi ʻo Kauka Rumer iā lāua ma ke kelepona me ka makuahine o Carly: "Ke hoʻomanaʻo maopopo nei au i koʻu lohe ʻana i kēlā lā," wahi a Carly, ka mea hiki ke lohe i ke kamaʻilio ʻana.“Ua haʻi aku ʻo Dr.Ua ʻōlelo ʻo Rumer, "Ua hahai au i nā alakaʻi WPATH no ka mālama ʻana i koʻu maʻi.Inā manaʻo ʻoe hiki iā ʻoe ke hana maikaʻi aʻe, no ke aha e hāʻawi ʻole ai iā ia i kahi vagina?
Ua ʻōlelo ʻo Kauka Rumer i ka World Professional Association for Transgender Health (WPATH), nāna e hoʻomohala i nā alakaʻi a me nā hana maikaʻi loa no ke olakino transgender a puni ka honua.ʻO kahi hui e hana nei ma ke ʻano he kiaʻi puka ikaika he mau lula koʻikoʻi e ʻae ana i nā poʻe maʻi e hana i ke kaʻina hana e pili ana i ka hoʻololi ʻana, akā ʻaʻole ia e mālama pono i ka hana o ka hana ʻana i kēia mau kaʻina hana.ʻO nā maʻi maʻi like ʻole e like me Carly ma o lākou iho i ka wā e loaʻa ai ke kauka no ka ʻoki.
He kauka lapaʻau akamai ʻo Kauka Rumer: ua holo ʻo ia i kāna hana ponoʻī mai ka makahiki 2007, ua mālama ʻo ia i nā maʻi transgender mai 2016, a hana i nā kaʻina hana hoʻopaʻa kāne 400 i kēlā me kēia makahiki, me ka hoʻomaʻamaʻa wahine maka, ka hoʻonui ʻana i ka umauma a me ka GRS.Ma 2018, ua hōʻike ʻia ʻo Dr. Rumer i kahi palapala NBC e pili ana i ka hoʻololi ʻana o kahi haumāna kulanui.Wahi a kāna pūnaewele, ʻo ia kekahi o nā kauka lapaʻau wahine i hōʻoia ʻia e ka papa ma ka mokuʻāina ʻekolu o Philadelphia, he lālā o ka American Academy of Orthopedic Surgery, a me ke alakaʻi o ka ʻoki kino ma ka Philadelphia College of Osteopathic Medicine (PCOM) .a me ka Hui i ka ʻoki ʻana hou.He lālā ʻo ia no WPATH mai ka makahiki 2010. (Full disclosure: I have a surgical consultation with Dr. Rumer via Skype ma ka pau ʻana o Kepakemapa 2017, akā ua hoʻoholo hope e ʻike i kahi kauka lapaʻau ʻē aʻe.)
Nui nā poʻe maʻi e hele mai iā Kauka Rumer no ka ʻoki ʻāʻī ʻana i nā hopena.Akā no ka poʻe i ʻoluʻolu ʻole i kā lākou kaʻina hana ma ka lima o Kauka Rumer a i ʻole nā ​​​​mea ʻē aʻe, he paʻakikī ke pane kūpono i kā lākou hoʻopiʻi.I loko o ka honua politicized o ka hōʻoia ʻana i ke kāne, hiki ke paʻakikī ke loaʻa nā pane i nā nīnau e pili ana i ka mālama maʻamau.Hōʻike ka poʻe kākoʻo i nā hana ʻokiʻoki like ʻole a me nā "transgender centers of excellence" i mālama ʻia e nā haukapila kūloko a me nā papa lapaʻau aupuni.Hiki i nā keʻena ke hoʻololi nui i ka wā e pili ana i ka ratio o ka maʻi-i-kauka a me ka hoʻomaʻamaʻa kūikawā i loaʻa i ke kauka.
Ke hana ʻia kēia, hiki ke paʻakikī ke kamaʻilio e pili ana i kahi pilikia pilikino - ua noi ʻo Carly i kahi pseudonym no ka makaʻu i ka hoʻopaʻi ʻana a kuhikuhi i ka lehulehu i kahi pilikia pilikino i ka media.Ma ke kamaʻilio ʻana i kahi manawa liʻiliʻi ka poʻe i loaʻa i ka mālama olakino ma hope o kahi ʻike traumatic hiki ke hoʻohana ʻia e nā mea hoʻoikaika anti-transgender a i ʻole e unuhi ʻia e nā mea kākoʻo ma ke ʻano he pae hope.
Ua paʻi ʻia nā ʻōlelo a Carly ma nā ʻaha kūkā anti-transgender i kona wā i hoʻopuka ai e pili ana i kona ʻike me Kauka Rumer ma kahi papa leka e aʻo aku i nā maʻi ʻē aʻe.ʻO kāna hoʻopiʻi ʻana i ka Pennsylvania Department of Professional and Vocational Affairs, ʻaʻole ia i hopena i kekahi hana mana.Ua nīnauele ʻo Iezebela i ʻehā mau kānaka ʻē aʻe e ʻōlelo ana he pilikia ko lākou me nā kaʻina hana a Kauka Rumer i hana ai, mai nā ʻōlelo hoʻopiʻi ʻana i ka mālama pono ʻole ʻana a hiki i nā hale ʻokoʻa i hōʻeha iā lākou i ka ʻeha nui, a i ʻole nā ​​vulvas i ʻike ʻole ʻia.Pilikia.Eia kekahi, mai ka makahiki 2016, ua hoʻopiʻi hewa ʻia i nā kauka no nā pilikia like, a ua pau ia mau mea ma waho o ka ʻaha hoʻokolokolo.I ka makahiki 2018, ua hoʻopili ka Papa Lapaʻau o Pennsylvania i ke kauka ma hope o kekahi pūʻulu o ka poʻe transgender i ʻike iā ia e kamaʻilio ana ma kahi hālāwai kūkā e pili ana i ka lāʻau lapaʻau transgender i hoʻopiʻi i ka hoʻopiʻi ʻana ua hoʻopunipuni ke kauka i nā helu kūleʻa, akā ʻaʻohe hana hoʻopaʻi.
E like me kā Kauka Rumer i kākau ai ma kāna pūnaewele a hoʻopaʻapaʻa i ka ʻaha hoʻokolokolo, me he mea lā ʻo kēia mau pilikia ka hopena o ka mālama ʻole ʻana i nā ʻōlelo aʻoaʻo a kāna keʻena ma hope o ka hana ʻana, a i ʻole kekahi hapa o nā pilikia kūpono o kēlā me kēia kaʻina hana.Akā, i ka wā i hele aku ai ʻo Iezebela iā Kauka Rumer me kahi papa inoa kikoʻī o nā nīnau a me nā ʻōlelo hoʻomanawanui, ua loaʻa iā mākou kahi pane mai ka loio.I ʻApelila, ua hoʻāʻo nā loio o Kauka Rumer e hoʻopiʻi iaʻu ma kahi hihia libel pili ʻole, me ke koi ʻana e hāʻawi wau i "nā memo āpau, nā leka uila, nā palapala, a me nā noiʻi" pili i ka moʻolelo.Ma mua koke o ka hoʻolaha ʻana, ua hōʻole hou ʻo Kauka Rumer i ka ʻōlelo ʻana a, ma o kāna mau loio, ua hoʻoweliweli ʻo ia e hoʻohui iā Iezebela i kāna hihia hōʻino.
ʻAʻole pili kēia mau mea maʻi a me nā pilikia i ka loaʻa ʻana o ke kōkua me kahi kauka hoʻokahi.Ke ulu nei ka noi no GRS, hiki ke hopohopo nui aʻe: Me ka ʻole o kahi ʻano hōʻike hoʻolaʻa no nā maʻi i hoʻopilikia ʻia a i ʻole kahi ʻoihana i hana ʻia me ka hoʻoponopono ʻana i nā kikoʻī o ka mālama transaffirmative, e ālai ʻia nā poʻe maʻi e ʻimi nei i kēia mau kaʻina hana.ʻaʻohe mea hōʻoiaʻiʻo o ka maikaʻi o ka lawelawe ma ka hoʻopaʻa inoa ʻana, a ʻaʻole maopopo pehea e neʻe ai i mua inā hauʻoli lākou i nā hopena.
ʻOiai ʻo ka ʻoki ʻana, ʻoi aku ka nui o nā ʻāpana koʻikoʻi o ke kino, hele mai me nā pilikia, ʻaʻole pilikia ka GRS i nā wahine transgender.Wahi a kahi noiʻi 2018, ʻo ka pākēneka o ka poʻe transgender e mihi ana i ka vaginoplasty ma kahi o 1 pakeneka, ma lalo o ka awelika no nā ʻoki kuli.ʻO ka ʻoiaʻiʻo, ʻo ke kumu maʻamau o ka mihi ʻana i ka hana ʻana he hopena maikaʻi ʻole.
Ua hoʻomohala ʻia ka ʻenehana hou o ka vaginoplasty ma ʻEulopa ma mua o 100 mau makahiki i hala a ua hoʻomaʻamaʻa ʻia ma USA no nā makahiki he 50 i hala.I ka makahiki 1979, ua ho'ōki ke Kulanui o Johns Hopkins i ka hāʻawi ʻana i ka GRS no nā kumu politika, ʻoiai ʻo ia kekahi o nā haukapila alakaʻi ma ʻAmelika Hui Pū ʻIa e hoʻomohala i ka hana.He nui nā halemai ʻē aʻe i hahai, a ua pāpā ke Keʻena ʻOihana Ola a me nā lawelawe kanaka i ka Medicare mai ka uhi ʻana i ke kaʻina hana ma 1981, e koi ana i ka hapa nui o nā ʻinikua e hoʻokaʻawale i ka uhi pili transgender mai nā hoʻolālā ʻinikua pilikino ma hope koke iho.
ʻO ka hopena, he liʻiliʻi ka poʻe loea i ka US e hāʻawi i ka ʻoki kino haʻahaʻa loa, e lawelawe ana i ka pūʻulu liʻiliʻi o nā maʻi i hiki ke kūʻai maoli i ka ʻoki.Ua koi ʻia ka hapa nui o ka poʻe transgender e uku no ka ʻoki ʻana i waho o ka ʻeke a hiki i ka makahiki 2014, i ka wā i hoʻihoʻi hou ai ke aupuni ʻo Obama i ka uhi Medicare no ka hōʻoia ʻana i ke kāne kāne a me ka pāpā ʻana i ka hoʻokaʻawale ʻia ʻana o ka ʻinikua no nā ʻoki transgender i ka makahiki 2016. hiki iā ʻoe ke uku no kēia mau kaʻina hana ma o ka ʻinikua a i ʻole Medicaid, a ke holo wikiwiki nei kekahi mau haukapila e hoʻokō i ka koi pent-up.
Eia nō naʻe, ʻoi aku ke kumukūʻai o ia mau kaʻina hana: ʻo ke kumukūʻai o ka vaginoplasty ma kahi o $25,000.Ua ʻike ʻia kahi noiʻi 2018 e nā mea noiʻi ma ke Kulanui ʻo Harvard a me ke Kulanui ʻo Johns Hopkins ma waena o 2000 a me 2014, ua hoʻonui nui ʻia ka nui o nā hōʻoia transgender hōʻoia, me ka piʻi nui ʻana o lākou i hōʻoia pilikino a uku ʻia e Medicaid."I ka piʻi ʻana o ka uhi ʻana o kēia mau kaʻina hana, pēlā nō ka pono o nā kauka lapaʻau akamai," i hoʻopau ai nā mea noiʻi.Akā he liʻiliʻi nā lula e pili ana i ke ʻano o ka "kūpono", a me nā wahi ʻē aʻe o ka ʻoihana lapaʻau e hoʻololi i ka wahine.ma ka pilikia.Hiki ke hōʻike ʻia nā kauā i nā ʻoihana like ʻole a me ka hoʻomaʻamaʻa GRS mai ka nānā ʻana i hoʻokahi pule me kahi kauka lapaʻau kaulana a i kahi papahana hoʻonaʻauao makahiki.ʻAʻohe kumu kūʻokoʻa i loaʻa i nā poʻe maʻi e kiʻi i ka ʻikepili e pili ana i ka nui o ka hoʻopiʻi ʻana.ʻO ka manawa pinepine, hilinaʻi wale nā ​​​​mea maʻi i ka ʻikepili i hāʻawi ʻia e nā kauka lapaʻau ponoʻī.
ʻOiai he nui ka poʻe i pōmaikaʻi mai ka uhi ʻana o GRS, hoʻokahi hopena ʻaoʻao i manaʻo ʻole ʻia ʻo ia ka mea i kapa ʻia e ke kauka lapaʻau wahine ma Kapalakiko ʻo Dr. Marcy Bowers he moʻomeheu "aloha".halemai i loko o ka manawa i hāʻawi ʻia, a ʻaʻole e make i kekahi complication weliweli, a i ʻole hoʻi hou ʻia i ka haukapila i nā manawa he nui," wahi āna, "ʻo ia ke ʻano o kā lākou ana ʻana i ka kūleʻa."lilo i "mea hoʻolako i makemake ʻia" ma ka huki ʻana i nā maʻi hou i kā lākou hana ma muli o kēia mau ana.
Ma Mei 2018, 192 mau mea maʻi transgender postoperative i kākau i kahi leka wehe iā WPATH e hōʻike ana i kekahi mau hopohopo e pili ana i ka ʻōnaehana o kēia manawa kahi e hāʻawi ai nā kauka lapaʻau i nā mea maʻi i kaupalena ʻia i ka waiwai "ʻoki manuahi a haʻahaʻa haʻahaʻa e kiʻi i ka helu hoʻopiʻi me ka ʻōlelo aʻo mua".nā hoʻolaha hoʻonaʻauao a me ka haʻi ʻana i ka lehulehu e pili ana i ka ʻike ʻokiʻoki, ke ʻoki hoʻokolohua me ka ʻole o ka ʻae ʻia, ka ʻike lapaʻau kūpono ʻole i hāʻawi ʻia i nā maʻi, a me ka mālama pono ʻole ʻana i nā maʻi.
"Aia nō ka ʻokoʻa ma waena o ka noi a me ka nui o nā poʻe i aʻo ʻia i kēia mau kaʻina hana," wahi a Kauka Lauren Schechter, ka pelekikena koho o ka American Society of Gender Surgeons.“ʻOiaʻiʻo kā mākou pahuhopu e hoʻonaʻauao i nā poʻe hou aʻe i ʻole e hele ka poʻe, ma ka liʻiliʻi ma nā wahi koʻikoʻi… No laila, aia kekahi lohi ma waena o ka hoʻonaʻauao kūpono ʻana i ka poʻe a me ka hoʻomaka ʻana i nā kikowaena kula [a me] nā halemai.”
ʻO ka hōʻemi ʻana i nā lohi e hoʻokō i ka ulu nui ʻana o nā kaʻina hana hōʻoia i ke kāne e hōʻemi pinepine i nā manawa hoʻomaʻamaʻa koʻikoʻi no nā haukapila a me nā kauka."ʻO ke kumu, ʻelua mau ʻanuʻu i mua a hoʻokahi ʻanuʻu i hope," i ʻōlelo ai ʻo Jamison Green, ka pelekikena mua o WPATH a me ke alakaʻi o nā kamaʻilio o kēia manawa, no ka piʻi ʻana o ka hana.Ke hoʻi nei i hope, ʻōlelo ʻo ia, hiki i kekahi mau kauka lapaʻau ke koho e hoʻomaʻamaʻa ma lalo o nā kūlana paʻakikī: "ʻAʻole lākou e hui pū me WPATH.ʻAʻole lākou e ʻae iā lākou iho e aʻo ʻia.a laila ʻōlelo lākou, "ʻAe, ʻike wau i ka mea e hana ai."E like me ka ʻōlelo ʻana a kekahi kauka lapaʻau inoa ʻole i ka makahiki 2017: “Hele kekahi i nā poʻe me nā inoa hanohano;aʻo lākou no hoʻokahi pule a laila hoʻomaka lākou e hana.pono ʻole loa!”
ʻO ka hoʻololi ʻana i nā hoʻolālā ʻinikua a me nā kānāwai e pili ana i nā ʻoihana ʻinikua ʻAmelika, ʻo ia ka mea e ʻimi pinepine ka poʻe transgender i nā kaʻina hana no ka makaʻu e hoʻololi paha nā mea hoʻolale i kā lākou mau lula i ka wā e nānā ai i nā kauka lapaʻau.Hoʻopuka pinepine ka ʻinikua i kahi e mālama ai nā maʻi, e like me Danielle, he wahine trans 42 ona makahiki e noho ana ma Portland, Oregon a hilinaʻi iā Medicaid.Ma kona moku'āina, ua uhi 'ia kekahi mau hana hō'oia i ke kāne e ka papahana Medicaid o ka moku'āina, akā i ka makahiki 2015, ua mana'o 'o Danielle i ka pono e hana i ka hikiwawe loa no ka lilo 'ana o ka mālama 'ana i ka po'e transgender i pahuhopu politika Repubalika.
"Ua manaʻo wau ma mua o ka loaʻa ʻana o kahi pelekikena Repubalika, pono wau e loaʻa i kahi vagina," i haʻi aku ai ʻo ia iā Iezebel i kahi hālāwai ninaninau 2018.I ka wā i hoʻouna aku ai ʻo Medicaid iā ia i Portland e ʻike iā Kauka Daniel Dougie, haʻi ʻo ia iā ia ʻo kāna maʻi transvaginoplasty 12th.I kona ala ʻana mai ka maʻi maʻi maʻi, ua haʻi ʻia ʻo ia e ʻoi aku ka lōʻihi o ka hana ʻana no ka paʻakikī o ka wehe ʻana o kona ʻōpū.
ʻOiai ua ʻōlelo ʻo ia he maikaʻi kāna mau hopena ʻike a me ka naʻau, ʻo ka ʻike o Danielle i ka haukapila i waiho nui i ka makemake."ʻAʻohe mea o kēia papa i ʻike pehea e hana ai i nā ʻeha o nā kānaka," wahi āna.Ua ʻōlelo ʻo ia ua haʻalele ʻo ia a wikiwiki ʻo ia e kōkua ma hope o kahi kaʻina hana lōʻihi a invasive.Ua kamaʻilio ʻo Iezebela i kekahi o nā maʻi ʻē aʻe o Kauka Dougie, a ua hui pū lākou i kahi hoʻopiʻi kūhelu i ka haukapila.ʻOiai ʻo nā hoʻopiʻi a Daniella e pili ana i kona ʻike i ka mālama post-op i ka haukapila, ua hakakā kekahi me nā pilikia koʻikoʻi, e pili ana i nā fistulas a me ka urinary incontinence ma hope o ke ʻoki ʻana.Wahi a kahi kumu i kamaʻāina i nā kūkākūkā o ka hui me ka haukapila, manaʻo ka hui he ʻoi aku ka nui o ka pilikia o ka haukapila ma mua o nā halemai ʻē aʻe e hāʻawi ana i nā kaʻina hana like.
Ma ka paneʻana i kekahi mau nīnau a Iezebela, ua'ōleloʻo Dr. Dougie,ʻaʻole i komo ka haukapila i nā pilina kūikawā me nā maʻi ma muli o nā kānāwai pilikino, akā ua hoʻomaopopoʻo ia ua kamaʻilio nui nā limahana me nā maʻi transgender."Ua komo mākou i kekahi mau hālāwai alo a me nā kānaka a me nā hui i ka manawa.Ua hoʻomauʻia kēia mau hālāwai a hiki i ka loaʻaʻana o kaʻaelike e pili ana i nā manaʻo maʻi o kēia manawa, ua hoʻokōʻia nā pahuhopu o nā kūkākūkāʻana, a ua kūkuluʻia kahi hoʻolālā pale hou, "i kākauʻo Dr. Dugi i ka leka uila.
Ma keʻano kūikawā, ua hoʻokumu ka haukapila i Kōmike Aʻoaʻo Kaiāulu o nā transgender kūloko a me nā kāne like ʻole e kūkākūkā me nā limahana a me ka hoʻokele o ka OHSU Transgender Health Program, Patient Affairs, a me nā mea kuleana ʻē aʻe.
Ua haʻi aku ʻo Kauka Dougie iā Jesabel ua nānā ʻia a hoʻohana ʻia nā pilikia ʻokiʻoki ma ka haukapila no ka hoʻomaikaʻi ʻana i nā hopena, me nā helu hoʻopiʻi e kūlike a ʻoi aku paha i nā hopena i paʻi ʻia mai nā kauka lapaʻau kūikawā ʻē aʻe."Ke hoʻoikaika nei kā mākou mau kauka lapaʻau no ka maikaʻi, akā i kekahi manawa aia nā pilikia," wahi āna."Hōʻike nā kauka OHSU āpau i nā loiloi kūloko o kā lākou hopena lapaʻau a me nā hopena ma o nā hālāwai maʻi a me ka make i hoʻonohonoho ʻia e ka luna o kēlā me kēia keʻena o ka maikaʻi."
Ua ʻike ʻo Dr Dugi ua hāpai ʻia nā hopohopo o nā limahana e pili ana i ka maikaʻi o ka mālama a me nā hopena i kahi kaʻina loiloi peer a laila hiki ke hāʻawi ʻia i nā papa loiloi ʻoihana."ʻO nā keʻena olakino āpau e hahai i kēia maʻamau a ua hoʻoholo ʻia e nā kino accreditation aupuni," wahi āna.
ʻOiai ua kūkākūkā nā poʻe maʻi OSHU i nā hoʻoponopono kūpono me ka mālama ʻana i ka haukapila, ua hele kekahi o nā maʻi mua o Kauka Rumer i kahi lōʻihi loa.I ka makahiki 2018, ʻehā mau maʻi maʻi o ke kauka lapaʻau i hoʻopiʻi i nā hoʻopiʻi hewa i ka ʻaha no ka ʻĀpana Hikina o Pennsylvania.Ua hōʻike ʻia kēlā me kēia o lākou e ka keʻena loio hoʻokahi a ua ʻōlelo ʻo Kauka Rumer ua hana ʻino loa i kā lākou mau hihia i makemake ai ka poʻe hoʻopiʻi (nā New Yorkers āpau) i kahi ʻoki hoʻoponopono hou ma ka mauna Sinai.
Ua wehewehe kēlā me kēia o nā mea hoʻopiʻi i ka hōʻemi a me ka hōʻino ʻana i ko lākou urethra, canal vaginal, a me ka labia, a me nā puʻupuʻu clitoral bulging a i ʻole deformed, nā pilikia i kapa ʻia ʻo "ka pōʻino mau" i hiki ʻole ai i ka poʻe hoʻopiʻi ke "hiki ke hana hou i ka moekolohe."
ʻO nā hoʻopiʻi hoʻopiʻi, e wehewehe ana i ka "hoʻohaʻahaʻa" a me ka "trauma psychological koʻikoʻi" i hoʻokumu ʻia e ka hana a Kauka Rumer, ua kāhea mua ʻia no ka hoʻokolokolo jure, akā ua hāʻawi ʻia i ka hoʻokolokolo pilikino.I kekahi hihia, ua manaʻo nā loio e hoʻopiʻi iā Kauka Jess Ting, he kauka lapaʻau a he kauka lapaʻau kūikawā i ka GRS ma Mount Sinai, e like me ka memo pretryal.Manaʻo ʻia ʻo ia e hōʻike ʻoiai ma hope o ʻekolu mau ʻoki ʻana, ʻaʻole i ʻae ka hana a Kauka Rumer i ka poʻe hoʻopiʻi e "loaʻa i ka orgasm a i ʻole ka ʻoluʻolu o ka wahine me ka ʻole o ka ʻeha", a me ka hoʻoponopono ʻana i nā pilikia koʻikoʻi ʻē aʻe, e like me ka "clitoris oversized me ka pale ʻole o ka clitoral" a me ka lauoho. ʻaʻohe clitoris.wehe pono.
"Ma ke ʻano he kauka lapaʻau, hiki iaʻu ke haʻi aku iā ʻoe he hopena maikaʻi ʻole kēlā me kēia kauka," wahi a Kauka Ding Jezebel.“Loaʻa iā mākou nā pilikia a ʻaʻole hele mau nā mea e like me kā mākou makemake.Ke ʻike ʻoe i kahi hiʻohiʻona o nā hopena e hōʻike ana ʻaʻole i kūpono ke kauka lapaʻau i ke kūlana o ka mālama ʻana, manaʻo ʻoe i ka pono e ʻōlelo. "
I loko o kahi pōkole mua o ka hoʻokolokolo i waiho ʻia ma ka hopena o Pepeluali, ma mua o ka hele ʻana o ka hihia i ka hoʻokolokolo ʻana, ua ʻōlelo nā loio o Kauka Rumer ʻaʻole i hoʻohalahala ka mea lapaʻau, ʻaʻole i haʻalele i ke kūlana mālama, a ʻo ka pilikia o ka mea maʻi he "pilikia i ʻike ʻia. ”“[c] Vaginoplasty.ʻO ka hoʻopiʻi hoʻi e ʻōlelo nei ʻo ka mea maʻi "ʻaʻole i hana i ka wā i mālama ʻia e Dr. Rumer" a ʻaʻole i hōʻike ka 47 makahiki i nā pilikia nui a hiki i hoʻokahi makahiki ma hope o ka hana.ʻAʻole i hoʻolaha ʻia nā kikoʻī o ke kaʻina arbitration a me kāna mau hopena, v. Rumer ʻAʻohe o nā mea hoʻopiʻi i ka hihia kauka i pane i nā noi he nui no ka ninaninau.
"Ma ke ʻano he kauka, ʻaʻohe mea makemake i nā hoʻopiʻi hewa," wahi a Kauka Dean.“He kumuhana ʻoluʻolu loa kēia iaʻu ma ke ʻano he mea hoʻopiʻi no ka hana hewa.I ka ʻōlelo ʻana i kēlā, manaʻo wau ma ke ʻano he mau loea i kēia wahi liʻiliʻi hou, pono mākou e mālama iā mākou iho a mālama i nā kūlana. "
Ua hoʻopili ʻo Iezabel i kekahi mau kauka lapaʻau kaulana kaulana e nīnau i ka nui o nā mea maʻi mua o Rumer i hana hou ʻia e hoʻoponopono i kāna mau ʻike.Ua hōʻole ka hapa nui i ka ʻōlelo, akā ʻo nā poʻe ʻekolu, i noi ʻaʻole e ʻike ʻia, ua hahai ma mua o 50 mau maʻi i hoʻopili mua iā Kauka Rumer no GRS mai 2016.
"Makemake mākou a pau e loaʻa i nā poʻe transgender nā koho hou aʻe no ka ʻoki ʻana, a ke hana nei mākou i nā mea āpau e hiki ai ke hoʻonaʻauao a hoʻolaha i nā hopena maikaʻi aʻe," wahi a Kauka Bowers, kahi kauka lapaʻau wahine ma Kapalakiko.nā pilikia o ke kaʻina hana, ka huhū a me ka huhū i ka poʻe hoʻopiʻi, nele i ka loaʻa a i ʻole ke kuleana.Ua hoʻohui ʻo ia ʻo Kauka Rumer "hoʻomaopopo pū i ka nāwaliwali o nā poʻe maʻi e makemake nui nei no ka ʻoki ʻana me nā kaukaʻi liʻiliʻi."”
Ua ʻōlelo ʻo Hannah Simpson, he wahine transgender 34 makahiki mai New York, ʻelua pule ma hope o ka hana ʻana i ka GRS me Dr. Rumer i ke kauwela o 2014, ua ʻike ʻo ia ua hoʻomaka kona ʻano like ʻole a ʻulaʻula loa.a pehu.ʻOiai ʻo ka ʻōlelo hōʻoia a Kauka Rumer ua maikaʻi nā mea a pau, ua hoʻomohala ʻo Simpson i ka necrosis o ka vulva.
ʻO Simpson, ka mea e aʻo ana i ka lāʻau lapaʻau i kēlā manawa, ua wehewehe ʻo ia i kāna vulva hou: he clitoris deformed i "ʻaoʻao hoʻokahi" a me kahi labia "ua ʻoi aku ka like me ka puʻu ma mua o ʻelua mau flaps."Ua loaʻa iā Simpson kekahi mau pilikia ʻē aʻe, ʻo ia hoʻi ka lauoho vaginal i hoʻohiki ʻia e nā kauka lapaʻau e wehe a me ke kau ʻana o kāna urethra.Eia kekahi, ua haʻalele ʻo Kauka Rumer i nā ʻiʻo ʻē aʻe a puni ka puka o ka ʻōpū, kahi i hōʻoluʻolu ʻole ai ka dilation, wahi a Simpson.Ma kekahi lā ma hope mai, a laila ma ka leka uila a Simpson i hui pū me Iezebela, ua hoʻopiʻi ʻo Kauka Rumer i ka ʻili make ma luna o kahi pālua Depends Simpson i ʻaʻahu ʻia ʻo Simpson i ka haukapila, a ua manaʻo ʻo Simpson he pilikia evasion.Ua hōʻole ʻo Kauka Rumer i ka pane ʻana i nā nīnau a Iezebela e pili ana i kāna hana ʻana i kēia maʻi a i ʻole kekahi maʻi ʻē aʻe.
ʻO ka necrosis e like me Simpson's necrosis he pilikia me kekahi vaginoplasty a hiki ke kumu ma muli o ke komo ʻana i ke kapa komo paʻa loa i ka wā mua o ka hoʻihoʻi postoperative, ʻoiai hiki ke paʻakikī ke kuhikuhi i ke kumu kūpono i kēia kūlana, wahi a Schechter.nā maʻi i loko o ka mea maʻi."ʻO ka maʻi maʻi, ka necrosis tissue, ka suture dehiscence - hiki kēia mau mea me kekahi hana," wahi āna.Ua ʻike ʻo Schecter ʻo ka huakaʻi postoperative a me kahi kaiapuni home lepo a palekana ʻole hiki ke alakaʻi i nā hoʻopiʻi, akā ʻo ka mea hope loa e aʻo aku ke kauka i ka mea maʻi a hōʻoia e hōʻemi ʻia kēia mau mea pilikia.
ʻAʻole i kūleʻa ka lua o ka hana ʻana me kahi kauka lapaʻau ʻē aʻe i ka hoʻihoʻi ʻana i ka hana mua a Kauka Rumer a ua alakaʻi ʻia i nā pilikia ʻē aʻe, a ʻaʻole i loaʻa iā Simpson kahi clitoris.Ma kāna helu ponoʻī, ua kūkākūkā ʻo ia i nā kauka lapaʻau 36 e hana hou i kāna mau ʻōpū.Ua hoʻohilahila kēia ʻike iā ia ma ka ʻoihana lapaʻau a ua hoʻōki ʻo ia i ka ʻimi ʻana i kāna kēkelē lapaʻau.ʻAʻole ʻo ia i hoʻohana i kekahi ʻano kumu no ka waiho ʻana i nā hoʻopiʻi, me ka hopohopo e hōʻemi kēia i ka hiki ke lawe ʻia e kekahi kauka lapaʻau ʻē aʻe i kāna hihia.
ʻO nā hoʻopiʻi a Simpson e pili ana i ka hana a Kauka Rumer e like me nā mea maʻi ʻē aʻe i kamaʻilio me Iezebela."Ua aʻo mau au i ka poʻe e haʻalele iā Rumer," wahi a Amber Rose, he 28 makahiki ʻaʻole binary mai Boston.I ka makahiki 2014, ua hele lākou iā Kauka Rumer no ka hōʻoki ʻana i ka ʻūhā ma muli o nā koho a pau i hāʻawi ʻia e ka hoʻolālā ʻinikua o ko lākou mau mākua, ʻo ke kauā ka manawa kali pōkole loa.
ʻAʻole i holo ka hana a Rose e like me ka mea i hoʻolālā ʻia."Ua haʻalele ʻo Rumer i ka nui o ka erectile ma lalo o koʻu labia minora, hiki ke pilikia," wahi a Ross."ʻAʻole like ia me ka vulva."ʻO nā kauka ʻē aʻe, ʻōlelo lākou, "i hoʻokahi manawa i hoʻāʻo e hoʻokomo i kahi manamana lima i loko o koʻu urethra no ka mea ʻaʻole maopopo."
Ua ʻōlelo ʻo Ross ʻaʻole i kūkulu ʻo Kauka Rumer i kahi puʻupuʻu clitoral, e waiho ana i kā lākou clitoris e hāmama loa no ka hoʻoulu ʻana.Eia kekahi, ʻaʻole i hāʻule ke ʻano o ka wehe ʻana i ka lauoho a Rumer a waiho ʻia kekahi lauoho i loko o ka labia akā ʻaʻole i loko o ke awāwa."Ua hoʻomau ʻo ia i nā mea huna a me ka mimi, a ua pilau ʻo ia a makaʻu wau iā ia no ka makahiki mua," wahi a lākou, "a hiki i koʻu ʻike ʻana ʻaʻole he lauoho i loko."
Wahi a Ross, ʻeono makahiki ma hope mai, ʻaʻole hauʻoli lākou i kā lākou hana ʻana a ke hopohopo nei lākou e hana ʻo Kauka Rumer i ka poʻe transgender.Akā ke ʻōlelo nei lākou ʻo kā lākou huhū no nā pilikia ʻōnaehana me nā kaʻina hana: kahi hemahema o nā kauka GRS a me nā papa inoa kali lōʻihi, ʻo ia ka poʻe e like me lākou he liʻiliʻi nā koho e koho ai a ʻaʻole lawa ka ʻike no ke kauka.
He multidisciplinary ka ʻoki ʻana o ka ʻūhā no ka poʻe transgender a me ka poʻe transgender a koi i ka ʻike i ka ʻoki plastik, urology a me ka gynecology.He kōmike kūʻokoʻa ko kēlā me kēia o kēia mau aʻo ʻana no ka ʻae ʻana.ʻO nā hoʻāʻo hou e hoʻohālikelike i ka curve aʻo vaginoplasty e hōʻike ana he 40 mau kaʻina hana e pono ai ke aʻo piha i ka ʻenehana.Me ka ʻole o ka launa ʻana a i ʻole nā ​​alakaʻi alakaʻi aʻoaʻo mai WPATH a i ʻole kekahi kino ʻoihana ʻē aʻe, pono nā maʻi e hoʻokō i nā kūlana o ke kaʻina hana no ke koena o ko lākou ola.
ʻO nā halemai hoʻokahi ke kuleana no ka hoʻoholo ʻana i ka mea i ʻae ʻia e hana i kekahi mau kaʻina hana i kā lākou mau hale.Ua haʻi ʻo Kauka Schechter iā Iezabel e koi maʻamau nā papa o ka haukapila e hōʻoia ʻia e nā mea lapaʻau ma kahi liʻiliʻi e hoʻokahi o nā papa lapaʻau ʻoi aku ma mua o 30 a puni ka ʻāina, a loaʻa paha i nā kūlana hoʻomaʻamaʻa haʻahaʻa liʻiliʻi no nā kauka lapaʻau.Akā, e like me ka WPATH's Greene, ʻaʻohe papa lapaʻau e hōʻoia i nā kauka lapaʻau hoʻokahi e hana i ke ʻoki ʻana i ke kāne: hoʻonaʻauao.ma ke ʻano he ʻāpana o ka hoʻokolokolo papa i hiki iā ʻoe ke hōʻoia ʻia, "wahi āna."No ka mea, i kēia manawa, ʻaʻole lākou i hōʻoia ʻia no nā maʻi kūikawā."
I kēia manawa, paʻa i ka American Society of Plastic Surgeons ka palapala hōʻoia o ka papa maʻamau akā ʻaʻole ia e pili pono i nā kaʻina hana pili i ka wahine, ʻo ia hoʻi, ʻaʻole pono nā kauka lapaʻau pili e hoʻokō i kekahi mau kūlana hoʻomaʻamaʻa no ka hana ʻana i ke kaʻina genital i nā maʻi transgender.Ua ʻōlelo ʻo Green, he ʻano hoʻolālā kēia i kūpono ʻole i nā hana o kēia manawa."I kēia manawa ua loaʻa iā mākou nā urologists, gynecologists a me nā microsurgeons like ʻole e pili ana i ka hana hou ʻana o ke kino.No laila ʻoi aku ka paʻakikī ma mua o ka wā ma mua, "wahi āna."Akā ʻaʻohe papa i mākaukau e ʻae i kēlā."
No ka hoʻopihaʻana i ka hakahaka, ua hui pū nā kauka e like me Dr. Schechter a me nā mea'ē aʻe iʻike i ka mālamaʻana i ke kāne e hakakā no kahi papahana hoʻonaʻauao kūpono no nā halemai e nānā ana e komo i ke kahua.I ka makahiki 2017, ua kākau pū ʻo Dr. Schechter i kahi ʻatikala ma ka Journal of Sexual Medicine e hōʻike ana i kekahi o nā koi hoʻomaʻamaʻa haʻahaʻa no nā kauka lapaʻau e hiki mai ana.
Wahi a ka hōʻike, pono e hoʻomaʻamaʻa nui nā kauka lapaʻau e hoʻokō i ka hoʻopaʻa ʻana i ka wahine, e komo pū me nā seminars, nā keʻena i loko o ke keʻena, nā lima lima a me nā hana mālama postoperative, a me ka hoʻomohala ʻana i ka ʻoihana.ʻOiai e hoʻomaikaʻi kēia mau ʻōlelo aʻoaʻo i ka maikaʻi o ka hoʻonaʻauao ma ka ʻāina, e noho mau lākou no nā haukapila a me nā kauka lapaʻau.ʻO nā hui waiwai ʻole e like me WPATH ua hoʻāʻo maʻamau e hoʻokō i nā pono hoʻomaʻamaʻa akā ʻaʻole hiki iā lākou ke hoʻololi i nā ʻōnaehana ma o lākou iho.Ke alakaʻi nei ka hui i kāna hoʻomaʻamaʻa hoʻomaʻamaʻa ponoʻī, i hoʻomaka i ka wā o ka pelekikena o Green mai 2014 a 2016. Akā no kahi hui e like me WPATH, hiki ke pāpā ʻia ke kumukūʻai o ka hoʻomaʻamaʻa ʻana, a waiho ʻia ke koho a manuahi ʻole no nā kauka lapaʻau makemake maoli e hana i kā lākou hana.
ʻO kekahi, e like me nā kākā'ōlelo e hana ana i nā kikowaena mālama mua LGBT, kōkua i nā poʻe maʻi me ka hōʻoia ʻana i ke kāne, a ma 2018 i hoʻonohonoho i kahi leka wehe WPATH e hōʻike ana i kahi kumu hoʻohālike "center of excellence" kahi e hana pū ai nā mea hoʻolako a me nā hui ʻoihana, e hōʻoiaʻiʻo i ka ʻinikua uku wale nō. .nā kauka lapaʻau i aʻo ʻia i nā papahana kūikawā.(ʻO ke kumu hoʻohālike, e ʻōlelo ana ʻo ia, ua hoʻoponopono i nā pilikia like ʻole i ka hana bariatric i ka 2000s mua, e hāʻawi ana i ka ʻikepili hopena kikoʻī a me ka hoʻopaʻa ʻana i nā kaohi i ka wā e kū ana i nā pilikia like.) Ua ʻōlelo ʻo Blasdel ʻoiai ua hoʻomaka kekahi mau keʻena olakino e kapa iā lākou iho he "transgender. kikowaena o ka maikaʻi", "I kēia manawa ʻaʻohe kumu e pono ai ke kaukaʻi a i ʻole ke kula e hālāwai ai no ka loaʻa ʻana o kēia poʻo inoa.