Amakuru

Carly yahise asubira i Louisiana kureba firime numukunzi we aricara.Hari mu mpeshyi ya 2017, kandi hashize ibyumweru bibiri mbere yaho, Carly, umukecuru w’imyaka 34 w’umugore w’inzibacyuho, yari yararwaye ibyara: inzira rimwe na rimwe ikorwa nyuma y’imvune cyangwa kanseri, ariko akenshi ikaba ari iyo kwita ku mpinduka.Carly yahisemo kubaga, Dr. Kathy Rumer, inzobere mu bikorwa byo kwemeza uburinganire mu gace ka Philadelphia.
Basimbutse mu mezi abanziriza kubagwa, ariko ntibigeze bahura imbonankubone mbere yo kubagwa.Carly yavuze ko yasuye muganga muri make mbere yo kumusunikwa mu cyumba cyo kubagamo, ariko ntiyongeye kubonana na Dr. Rumer mu minsi itatu yakize mu bitaro.Icyumweru kimwe nyuma yo kubagwa, umuforomokazi yamusabye kumukurikirana.
Nyuma yo gusubira mu rugo avuye muri filime “Louisiana”, Carly yarebye neza igituba cye gishya.Nubwo ibyumweru bibiri bimaze ibyumweru bibiri nyuma yo kubagwa bigaragara nabi, Carly yatunguwe no kubona “igice kinini cy'uruhu rwapfuye kingana n'urutoki”.Bukeye bwaho, yahamagaye nimero yihutirwa yatanzwe maze yohereza imeri ku biro bya Dr. Rumer.Ku wa mbere, ibiro byagiriye inama Carly kohereza imeri amashusho y’ibibazo by’abaganga babisubiramo.Nyuma y'iminsi mike, Carly na nyina bavuze ko bumvise umuganga wari mu biruhuko babwira Carly ko ntacyo afite cyo guhangayika.Muganga Rumer yavuze ko nyina, umuganga ubaga mu kiruhuko cy'izabukuru, ashobora gukingura uruhu rurenze niba bikomeje kubabaza.
Icyifuzo cyatunguye Carly na nyina.Yavuze ko imyanya ndangagitsina ye ihumura "mbi" kandi labia ye yagabanutse uruhu ruto.Icyumweru kimwe nyuma yo kuvugana na Dr. Rumer, Carly yavuze ko yagiye kwa muganga w’umugore w’umugore, agira ubwoba maze ajyana Carly mu bitaro by’Ababatisita ba Oshner muri New Orleans kugira ngo bamubaze byihutirwa.Igice cyigituba cya Carly cyatewe na nekrotizing fasciitis, indwara ishobora guteza akaga mubikorwa byose.Ibi akenshi bitera gutakaza tissue mubice byanduye.
Carly yabazwe n'itsinda ry'abaganga, nta n'umwe muri bo wigeze agira uburambe ku gitsina cya nyuma ya opa cyangwa igituba - imyanya ndangagitsina nyuma ya op itandukanye cyane n'iy'abandi.Yamaze iminsi ibiri mu gice cyita ku barwayi kandi iminsi itanu yose mu bitaro.We na nyina bombi bavuze ko guhamagarwa kwa nyina wa Carly na OB / GYN ku biro bya Dr. Rumer bitabaye icyo gihe.
Igihe babonaga igisubizo ku biro bya Dr. Rumer - akajagari k’ubuyobozi kanditseho Carly - umuganga ubaga yababajwe nuko Carly atigeze ateganya indege yerekeza i Philadelphia kugira ngo abaganga bakemure icyo kibazo.Nk’uko Carly na nyina babivuze, Dr. Rumer yabakubise kuri telefoni na nyina wa Carly ati: “Ndibuka neza ko numvise uwo munsi.” Carly, washoboraga kumva icyo kiganiro.“Dr.Rumer yagize ati: “Nakurikije amabwiriza ya WPATH yo kuvura umurwayi wanjye.Niba utekereza ko ushobora gukora neza, kuki utamuha igituba? ”
Dr. Rumer yavugaga ku ishyirahamwe ry’umwuga ku isi ryita ku buzima bw’imyororokere (WPATH), ritegura umurongo ngenderwaho n’uburyo bwiza bw’ubuzima bw’imyororokere ku isi.Ishirahamwe rikora nk'umuzamu ukora cyane rifite amategeko akomeye yemerera abarwayi kubagwa bijyanye ninzibacyuho, ariko ntigenzura neza imyitozo yo gukora ubu buryo.Abashobora kuba abarwayi nka Carly ahanini bonyine mugihe cyo gushaka umuganga wo kubaga.
Dr. Rumer ni umuganga ubaga ubunararibonye: yatangiye imyitozo ye kuva mu 2007, avura abarwayi bahindura ibitsina kuva mu 2016, kandi buri mwaka akora ibikorwa bigera kuri 400 byemeza uburinganire, harimo no mu maso h’umugore, kongera amabere na GRS.Muri 2018, Dr. Rumer yagaragaye muri documentaire ya NBC ivuga ku ihinduka ry’umunyeshuri wa kaminuza.Nk’uko urubuga rwe rubitangaza, ni umwe mu bantu bake bemejwe n’ubuyobozi bw’abagore babaga plasitike mu karere ka tri-leta ya Philadelphia, umwe mu bagize Ishuri Rikuru ry’Abanyamerika ry’ubuvuzi bw’amagufwa, akaba n’umuyobozi ushinzwe kubaga plastike mu ishuri rikuru ry’ubuvuzi rya Philadelphia (PCOM) .n'Ubusabane mu Kubaga Kwubaka.Yabaye umunyamuryango wa WPATH kuva mu 2010. (Kumenyekanisha byuzuye: Nagiranye inama yo kubaga na Dr. Rumer nkoresheje Skype mu mpera za Nzeri 2017, ariko amaherezo mfata icyemezo cyo kubonana n'undi muntu.)
Abarwayi benshi baza kwa Dr. Rumer kubaga ikibuno banyuzwe nibisubizo.Ariko kubatanyuzwe nibikorwa byabo na Dr. Rumer cyangwa abandi, biragoye gusubiza muburyo bunoze ibibazo byabo.Mw'isi ya politiki cyane yo kubaga ibitsina byemeza uburinganire, birashobora kugorana kubona ibisubizo kubibazo bijyanye n'ubuvuzi busanzwe.Abavoka basobanura ibikorwa bitandukanye byo kubaga hamwe na “transgender center of excellence” bigenzurwa n'ibitaro byaho ndetse n’ubuyobozi bwa leta.Ibiro birashobora gutandukana cyane mugihe kijyanye numubare wumurwayi-kwa muganga naya mahugurwa yihariye umuganga afite.
Iyo ibi bibaye, birashobora kugorana kuvuga kukibazo cyihariye - Carly yasabye izina ry'irihimbano kubera gutinya kwihorera maze agaragariza itangazamakuru ikibazo nk'iki bwite.Kuvuga mugihe abantu bake bafite ubuvuzi nyuma yuburambe bwihungabana bushobora gukoreshwa nabaharanira kurwanya transgender cyangwa bagasobanurwa nababunganira nkintambwe isubira inyuma.
Amagambo ya Carly yashyizwe ku mahuriro arwanya transgender ubwo yashyiraga ahagaragara ibyamubayeho na Dr. Rumer ku kibaho cy’ubutumwa kugira ngo aburire abandi barwayi.Ikirego cye mu ishami rya Pennsylvania rishinzwe imyuga n’imyuga ntacyo cyatanze ku mugaragaro.Jezebel yabajije abandi bantu bane bavuze ko bafite ibibazo bijyanye n’uburyo Dr. Rumer yakoze, kuva ku birego by’ubuvuzi bubi nyuma y’imyanya ndangagitsina yabatera ububabare bukabije, cyangwa igituba kidasa neza.Ikibazo.Byongeye kandi, kuva mu mwaka wa 2016, habaye imanza enye z’imikorere mibi y’abaganga ku bibazo bisa, byose bikaba byarangiye mu bukemurampaka hanze y’urukiko.Mu mwaka wa 2018, Ikigo cy’ubuvuzi cya Pennsylvania cyavuganye n’umuganga ubaga nyuma y’uko irindi tsinda ry’abantu bahinduye igitsina bamubonye avuga mu nama y’ubuvuzi bw’imyororokere batanze ikirego bavuga ko muganga yabeshye intsinzi, ariko nta gihano cyafashwe.
Nkuko Dr. Rumer yabyanditse ku rubuga rwe kandi akajya impaka mu rukiko, bisa nkaho bishoboka ko izo ngaruka zatewe no kutubahiriza amabwiriza y'ibiro bye nyuma yo kubagwa, cyangwa bimwe mu byago bishobora guterwa n'uburyo ubwo ari bwo bwose.Ariko igihe Yezebel yagiye kwa Dr. Rumer afite urutonde rurambuye rw'ibibazo n'amagambo y'abarwayi, twabonye igisubizo cya avoka.Muri Mata, abunganizi ba Dr. Rumer bagerageje kuntumiza mu rubanza rudafitanye isano, bansaba ko natanga “inyandiko zose, imeri, inyandiko, n'ubushakashatsi” bijyanye n'inkuru.Mbere gato yo gutangazwa, Dr. Rumer yongeye kwanga kugira icyo atangaza, abinyujije ku bamwunganira, avuga ko azongera Yezebeli mu kirego cye cyo gusebanya.
Inararibonye z'abarwayi n'ingorane zo kubona ubufasha ntabwo byari bifitanye isano na muganga umwe.Mugihe icyifuzo cya GRS kigenda cyiyongera, hashobora kubaho impungenge zikomeye: Hatabayeho uburyo bwihariye bwo gutanga raporo kubarwayi banduye cyangwa ikigo gishinzwe kugenzura amakuru arambuye yubuvuzi bwanduye, abarwayi bashaka ubwo buryo bazahagarikwa.nta garanti yubuziranenge bwa serivisi kuri cheque-in, kandi ntibisobanutse uburyo bwo gutera imbere niba batishimiye ibisubizo.
Mugihe kubagwa kwose, cyane cyane kubice byoroshye byumubiri, bizana ibyago, GRS ntabwo itera ibyago kubagore bahindura ibitsina.Nk’ubushakashatsi bwakozwe mu mwaka wa 2018, ijanisha ry’abantu bahindura ibitsina barangiza bakicuza vaginoplasti ni 1 ku ijana, munsi yikigereranyo cyo kubaga ivi.Mubyukuri, impamvu ikunze kwicuza kubagwa ni ingaruka mbi.
Tekiniki igezweho ya vaginoplasti yatejwe imbere i Burayi hashize imyaka irenga 100 kandi ikorerwa muri Amerika byibuze mu myaka 50 ishize.Mu 1979, kaminuza ya Johns Hopkins yahagaritse gutanga GRS kubera impamvu za politiki, nubwo yari imwe mu bitaro bikomeye muri Amerika biteza imbere iyo myitozo.Ibindi bitaro byinshi byakurikiranye, kandi ishami ry’ubuzima n’ibikorwa by’abantu ryabujije Medicare gukurikiza ubwo buryo mu 1981, bituma amasosiyete menshi y’ubwishingizi yirukana ku buryo bweruye ubwishingizi bw’uburinganire muri gahunda z’ubwishingizi bw’abikorera nyuma yaho gato.
Kubera iyo mpamvu, inzobere nke muri Amerika zitanga kubaga umubiri hasi na gato, zikorera itsinda rito ry’abarwayi bashobora rwose kubaga.Abantu benshi bahindura ibitsina bahatiwe kwishyura amafaranga yo kubagwa mu mufuka kugeza mu 2014, ubwo ubuyobozi bwa Obama bwagarukaga ubwisungane mu kwivuza bw’ubuvuzi bw’abagore kandi bukabuza ko hakurwaho ubwishingizi ku kubaga ababana bahuje ibitsina mu 2016. Politiki yo mu gihe cya Obama niyatorwa, abantu benshi bahindura ibitsina bazabikora. gushobora kwishyura ibyo bikorwa binyuze mu bwishingizi cyangwa Medicaid, kandi ibitaro bimwe byihutira kuzuza ibisabwa.
Nyamara, inzira nkizo zirazimvye: vaginoplasty igura amadorari 25.000.Ubushakashatsi bwakozwe mu mwaka wa 2018 n’abashakashatsi bo muri kaminuza ya Harvard na kaminuza ya Johns Hopkins bwerekanye ko hagati ya 2000 na 2014, umubare w’abaganga babaga barenga transgender wiyongereye ku buryo bugaragara, aho umubare wabo wiyongereye wishingiwe ku giti cyabo cyangwa ukishyurwa na Medicaid.Abashakashatsi bashoje bati: "Uko ibikorwa bigenda byiyongera, ni nako hazakenerwa abaganga babaga babishoboye."Ariko hariho amategeko make asanzwe yerekeye icyo "yujuje ibisabwa" bisobanura, kandi nizindi nzego zumwuga wubuvuzi zigira ingaruka ku ihinduka ry’uburinganire.ku kibazo.Abaganga babaga batanga raporo mubigo bitandukanye kandi amahugurwa ya GRS arashobora kuva mubyitegererezo byicyumweru hamwe nabaganga babaga bazwi kugeza kuri gahunda yimyaka myinshi yo kwitoza.Nta mutungo wigenga uhari kugirango abarwayi babone amakuru ku gipimo cyo kubaga.Akenshi, abarwayi bashingira gusa kumibare yatanzwe nabaganga ubwabo.
Mu gihe abantu batabarika bungukiwe no gukwirakwiza GRS, ingaruka imwe itateganijwe ni yo yabaye umuganga ubaga uburinganire ukomoka mu mujyi wa San Francisco, Dr. Marcy Bowers yita umuco “muraho”.ibitaro mu gihe cyagenwe, kandi ntibipfe bazize ingorane ziteye ubwoba, cyangwa ngo bongere kuba mu bitaro inshuro nyinshi, "niko bapima intsinzi."ube "abatanga ibyifuzo" mukureshya neza abarwayi bashya mubikorwa byabo bishingiye kuri ibi bipimo.
Muri Gicurasi 2018, abarwayi 192 bahinduye ibitsina nyuma yo kubagwa bandikiye WPATH ibaruwa ifunguye igaragaza impungenge zatewe na sisitemu iriho ubu aho abaganga batanga abarwayi badafite amikoro “kubagwa ku buntu cyangwa ku giciro gito kugira ngo babone igipimo cy’ingutu hamwe n’ubujyanama mbere yo gutangira”.ibitabo byigisha no kuvuga kumugaragaro uburambe bwo kubaga, kubaga ubushakashatsi utabanje kubiherwa uruhushya, amakuru yubuvuzi adahwitse ahabwa abarwayi, hamwe nubuvuzi budahagije kubarwayi.
Perezida watowe na Sosiyete y'Abanyamerika ishinzwe ubuvuzi bw’uburinganire, Dr. Lauren Schechter yagize ati: "Haracyari ubusumbane hagati y’ibisabwa n'umubare w'abantu bahuguwe muri ubwo buryo."Ati: "Nibyo koko intego yacu ni iyo kwigisha abantu benshi kugirango abantu batagomba gutembera, byibuze mu bice by'ingenzi… Hariho kandi gutinda hagati yo kwigisha abantu neza no gutangiza ibigo by'ibigo [n'ibitaro].”
Kugabanya ubukererwe kugirango uhuze ibyifuzo byiyongera kubikorwa byemeza uburinganire akenshi bisobanura kugabanya amahirwe yo guhugura ibitaro nabaganga.Jamison Green wahoze ari perezida wa WPATH akaba n'umuyobozi ushinzwe itumanaho muri iki gihe, yagize ati: "Ahanini, intambwe ebyiri zitera imbere n'intambwe imwe."Yateye intambwe inyuma, yavuze ko bamwe mu babaga bashobora guhitamo imyitozo mu bihe bigoye: “Ntabwo binjira muri WPATH.Ntibemerera kwigishwa.noneho baravuga bati: "Yego yego, ubu nzi icyo gukora."Nkuko umuganga umwe wo kubaga utazwi yabivuze mu bushakashatsi bwakozwe mu 2017: “Umuntu yagiye ku bantu bafite amazina akomeye;biga icyumweru hanyuma bagatangira kubikora.bidakwiye rwose! ”
Guhindura gahunda yubwishingizi namategeko agenga amasosiyete yubwishingizi yo muri Amerika bivuze ko abantu bahindura ibitsina akenshi bashakisha inzira nkizo batinya ko abishingizi bashobora guhindura amategeko yubwishingizi mugihe basuzumye abashobora kubaga.Ubwishingizi akenshi buteganya aho abarwayi bitaweho, nka Danielle, umukecuru w'imyaka 42 utuye Portland, Oregon kandi wishingikirije kuri Medicaid.Muri leta ye, bimwe mu bikorwa byo kubaga abemeza uburinganire bikubiye muri gahunda ya Leta ya Medicaid, ariko mu 2015, Danielle yumvise ko ari ngombwa kubikora vuba kuko ubuvuzi bw’abahuje ibitsina bwabaye intego ya politiki ya Repubulika.
Mu kiganiro yagiranye na Jezebel yagize ati: "Natekereje mbere yuko tugira perezida wa republika, nkeneye kugira igituba".Igihe Medicaid yamwohereje i Portland kureba Dr. Daniel Dougie, yamubwiye ko ari umurwayi wa 12 wa transvaginoplasti.Amaze kubyuka avuye muri anesteziya, bamubwiye ko kubagwa bizatwara inshuro ebyiri kuko imyanya ndangagitsina ye byari bigoye gufungura.
Nubwo yavuze ko ibisubizo bye n'amashusho ari byiza, uburambe bwa Danielle mu bitaro bwasize byinshi byifuzwa.Ati: “Nta muntu n'umwe wo muri iki cyumba wari uzi guhangana n'ibikomere by'abantu.”Yavuze ko yumva yataye kandi yihutiye kumufasha nyuma y’inzira ndende kandi itera.Jezebel yavuganye na benshi mu barwayi ba Dr. Dougie, maze bahuriza hamwe mu bitaro.Mu gihe ibirego bya Daniella byari bijyanye n'uburambe bwe bwo kwita ku bitaro nyuma yo kubagwa mu bitaro, abandi bahuye n'ibibazo bikomeye, birimo fistule ndetse no kutagira inkari nyuma yo kubagwa.Nk’uko amakuru aturuka mu bumenyi bwaganiriweho n’iri tsinda abitangaza, iryo tsinda ryizera ko ibitaro bifite umuvuduko mwinshi ugereranije n’ibindi bitaro bitanga inzira zisa.
Mu gusubiza ibibazo byinshi bya Jezebel, Dr. Dougie yavuze ko ibitaro bitagirana imikoranire yihariye n’abarwayi kubera amategeko y’ibanga, ariko akemera ko abakozi bavuganye cyane n’abarwayi bahindura ibitsina.Ati: “Twagiye mu nama nyinshi imbonankubone n'abantu ku giti cyabo n'amatsinda mu gihe runaka.Izi nama zarakomeje kugeza igihe habaye ubwumvikane ku bibazo by’abarwayi muri iki gihe, intego z’ibiganiro zagerwaho, hanashyirwaho gahunda yo gukumira indwara. ”Dr. Dugi yanditse kuri interineti.
By'umwihariko, ibitaro byashyizeho komite ngishwanama y’abaturage y’abahindura ibitsina n’abantu badahuje igitsina bagisha inama abakozi n’ubuyobozi bwa gahunda y’ubuzima ya OHSU, ibibazo by’abarwayi, n’abandi bafatanyabikorwa.
Muganga Dougie yamenyesheje Jesabel ko ibibazo byo kubaga ibitaro byakurikiranwe kandi bigakoreshwa mu kuzamura umusaruro, hamwe n’ibipimo by’ingutu bihuye cyangwa birenze ibisubizo byatangajwe n’abandi babaga babaga babaga.Ati: “Abaganga bacu babaga baharanira kuba indashyikirwa, ariko rimwe na rimwe hari ibibazo.”Ati: “Abaganga bose ba OHSU bakora isuzuma rihoraho ry'ubuvuzi bwabo no kubaga binyuze mu nama z’indwara n’impfu zahujwe n’umuyobozi w’ishami ry’ubuziranenge.”
Dr Dugi yavuze ko impungenge z’abakozi zerekeye ireme ry’ubuvuzi n’ibisubizo zagejejwe kuri gahunda yo gusuzuma urungano rushobora noneho gushyikirizwa akanama gashinzwe gusuzuma.Ati: “Ibigo nderabuzima byose bikurikiza aya mahame kandi bigenwa n'inzego zemewe z'igihugu”.
Mu gihe abarwayi ba OSHU baganiriye ku ivugurura rishoboka hamwe n’ubuyobozi bw’ibitaro, bamwe mu bahoze ari abarwayi ba Dr. Rumer bagiye kure cyane.Muri 2018, bane bahoze ari abarwayi babaga batanze ikirego cy’imikorere mibi mu rukiko mu Karere ka Pennsylvania.Bose bari bahagarariwe n’ikigo kimwe cy’amategeko kandi bavuga ko imirimo ya Dr. Rumer yakozwe nabi mu manza zabo ku buryo abarega (abanya New York bose) bakeneye kubagwa ku musozi wa Sinayi.
Buri wese mu barega yasobanuye kugabanuka no kwangirika kwa urethra, umuyoboro w’inda ibyara, na labia, ndetse no guturika cyangwa guhindura imiterere y’imitsi, ibibazo bizwi nk '“ibyangiritse burundu” ku buryo abarega “badashobora kongera gukora imibonano mpuzabitsina.”
Izi manza zisobanura “agasuzuguro” n '“ihungabana rikomeye ryo mu mutwe” ryatewe n'akazi ka Dr. Rumer, mu ntangiriro ryasabye ko habaho inteko y'abacamanza, ariko amaherezo yoherezwa mu bukemurampaka ku bushake.Mu rubanza rumwe, abanyamategeko barashaka kurega Dr. Jess Ting, umuganga ubaga akaba n'umwarimu w’ubuvuzi w’inzobere muri GRS ku musozi wa Sinayi, nk'uko byavuzwe mbere.Biteganijwe ko ahamya ko na nyuma yo kubagwa inshuro eshatu, umurimo wa Dr. Rumer utemereye abarega “kugera ku mibonano mpuzabitsina cyangwa kunyurwa mu mibonano mpuzabitsina nta bubabare”, ndetse no gukemura ibindi bibazo by’ingenzi, birimo “clitoris nini cyane idafite ingabo ikingira” n'umusatsi nta clitoris.yakuweho neza.
Dr. Ding Jezebel yagize ati: "Njyewe nk'umuganga ubaga, ndashobora kukubwira ko buri muntu ubaga afite ingaruka mbi."Ati: “Twese dufite ibibazo kandi ibintu ntabwo buri gihe bigenda uko dushaka.Iyo ubonye urugero rw'ibisubizo byerekana ko umuganga ubaga adashobora kuba yujuje ubuvuzi, uba ukeneye kuvuga. ”
Mu nyandiko ibanziriza iburanisha yatanzwe mu mpera za Gashyantare, mbere yuko urubanza rujya mu bukemurampaka, abunganira Dr. Rumer bavuze ko umuganga ubaga atirengagije, ko atateshutse ku rwego rw'ubuvuzi, kandi ko ikibazo cy'umurwayi ari “ingorane zemewe. ”“[C] Vaginoplasti.Ikirego kivuga kandi ko umurwayi “atakoze mu gihe yavuwe na Dr. Rumer” kandi ko uyu mugabo w'imyaka 47 atigeze atangaza ibibazo bikomeye kugeza mu gihe kirenga umwaka nyuma yo kubagwa.Ibisobanuro birambuye ku bukemurampaka n'ibisubizo byatanzwe ntibyashyizwe ahagaragara, aburana na Rumer Nta n'umwe mu barega mu rubanza rwa dogiteri wasubije ibyifuzo byinshi byabajijwe.
Dr. Dean yagize ati: "Nka muganga, nta muntu ukunda imyenda idahwitse."Ati: "Iyi ni ingingo itanyoroheye kuri njye nk'uregwa imyitwarire mibi.Tumaze kubivuga, ndumva ko nk'abakora imyitozo muri kariya gace gato cyane, tugomba kwiyitaho no gukomeza amahame. ”
Jezabel yavuganye n’abaganga benshi bazwiho kubaga uburinganire kugira ngo abaze umubare w’abahoze ari abarwayi ba Rumer bongeye kubagwa kugira ngo bakosore ibyo yabonye.Benshi birumvikana ko banze kugira icyo batangaza, ariko abantu batatu basabye ko batamenyekana, bakurikiranye abarwayi barenga 50 babanje kuvugana na Dr. Rumer muri GRS kuva mu 2016.
Dr. Bowers, umuganga ubaga uburinganire bw’umugore wa San Francisco yagize ati: "Twese twifuza ko abantu bahindura ibitsina bagira amahitamo menshi yo kubagwa, kandi dukora ibishoboka byose kugira ngo twigishe kandi duteze imbere umusaruro ushimishije."ibibazo byo kubaga, uburakari no kwanga abitotomba, kubura kuboneka cyangwa kubazwa.Yongeyeho ko Dr. Rumer “yumva kandi intege nke z'abarwayi bifuza kubagwa hamwe n'abaganga bake ugereranyije.””
Hannah Simpson, umukecuru w’imyaka 34 w’umugore ukomoka mu mujyi wa New York, yavuze ko nyuma y'ibyumweru bibiri nyuma yo gukorerwa GRS na Dr. Rumer mu mpeshyi ya 2014, yabonye ko igituba cye cyatangiye kugaragara nk’ibice bitukura cyane.akabyimba.Nubwo Dr. Rumer yijeje ko ibintu byose bimeze neza, Simpson yarwaye necrosis yigituba.
Simpson, wigaga ubuvuzi muri kiriya gihe, yasobanuye igituba cye gishya: clitoris yamugaye yari "uruhande rumwe" na labia "yasaga nkibibyimba kuruta ibibero bibiri."Simpson kandi yagize izindi ngorane, zirimo umusatsi wigituba ababaganga basezeranyije ko bazakuraho no gushyira urethra idasanzwe.Simpson yavuze ko kandi, Dr. Rumer yasize inyama ziyongera ku muryango w’igitereko, bigatuma kwaguka bitoroha cyane.Ku munsi wakurikiyeho, hanyuma kuri imeri yakurikiyeho Simpson yasangiye na Jezebel, Dr. Rumer yashinje uruhu rwapfuye ku mugabo wa Depends Simpson Simpson yari yambaye cyane mu bitaro, Simpson akaba yarabonaga ko ari ikibazo cyo guhunga.Muganga Rumer yanze gusubiza ibibazo bya Yezebeli bijyanye nuko yafashe uyu murwayi cyangwa undi murwayi uwo ari we wese.
Schechter yavuze ko Necrosis nka necrosis ya Simpson ishobora guteza akaga na vaginoplasti iyo ari yo yose kandi ishobora guterwa no kwambara imyenda y'imbere ikabije mu ntangiriro yo gukira nyuma yo kubagwa, nubwo bishobora kugorana kumenya impamvu nyayo muri iki kibazo.kwandura umurwayi.Ati: "Indwara, tissue necrosis, suture dehiscence - ibi byose bibaho nibikorwa byose".Schecter yavuze ko ingendo nyuma yo kubagwa hamwe n’ibidukikije byanduye cyangwa bidafite umutekano bishobora no gutera ibibazo, ariko amaherezo umuganga abaga agomba kugira inama umurwayi kandi akemeza ko izo ngaruka zishobora kugabanuka.
Igikorwa cya kabiri hamwe n’umuganga ubaga utandukanye nticyatsinzwe mu kugarura imirimo ya mbere ya Dr. Rumer ndetse byanateje ibindi bibazo, kandi Simpson ntabwo yari afite clitoris.Ukurikije imibare ye, ubu yagiye kugisha inama abaganga 36 kugira ngo bongere kubaka igitsina.Ubunararibonye bwamutengushye mu mwuga w'ubuvuzi areka gukomeza impamyabumenyi ye.Ntiyigeze akoresha uburyo ubwo ari bwo bwose bwo gutanga ibirego, atinya ko ibyo byagabanya amahirwe yo kuba undi muganga ubaga yakira ikibazo cye.
Ibirego bya Simpson kubyerekeye akazi ka Dr. Rumer bisa nibyabandi barwayi bahoze bavugana na Yezebeli.Amber Rose, ufite imyaka 28, utari binary ukomoka i Boston, yagize ati: "Nahoraga mburira abantu kwirinda Rumer."Muri 2014, bagiye kwa Dr. Rumer kubagwa ikibuno kubera inzira zose zitangwa na gahunda yubwishingizi bwababyeyi babo, umuganga yabaga afite igihe gito cyo gutegereza.
Igikorwa cya Rose nticyagenze nkuko byari byateganijwe.Ross yagize ati: "Ibihuha byasize ingirabuzimafatizo nyinshi munsi ya labia minora, bishobora kuba ikibazo."“Ntibyasaga n'igituba.”Ndetse n'abandi baganga, baravuze bati: "byibuze bigerageje gushyira urutoki muri urethra yanjye kuko bitagaragara."
Ross yavuze ko Dr. Rumer atigeze yubaka ingofero, kugira ngo imitsi yabo ifungurwe rwose.Nanone, uburyo bwo gukuraho umusatsi wa Rumer bwarananiranye kandi busiga umusatsi imbere muri labia ariko ntabwo biri mu muyoboro wigitereko ubwacyo.Bati: "Yakomeje kwegeranya ururenda n'inkari, nuko anuka cyane ku buryo natinyaga umwaka wa mbere, kugeza igihe namenyeye ko nta musatsi ugomba kuba uhari."
Nk’uko Ross abitangaza ngo nyuma yimyaka itandatu, baracyishimiye imikorere yabo kandi bafite impungenge ko Dr. Rumer akorera abantu bahindura ibitsina.Ariko bavuga ko gucika intege kwabo guturuka kubibazo bya sisitemu hamwe nuburyo bukoreshwa: kubura abaganga ba GRS na lisiti ndende yo gutegereza, bivuze ko abantu nkabo bafite amahitamo make yo guhitamo kandi atari amakuru ahagije kubaga.
Kubaga Buttock kubantu bahindura ibitsina naba transgender ni byinshi kandi bisaba ubuhanga mububiko bwa plastike, urologiya na ginecology.Buri somo rifite komite yigenga ishinzwe kwemererwa.Kugerageza kugerageza kugereranya ibyigisho bya vaginoplasty byerekana ko inzira 40 zisabwa kugirango wige neza tekinike.Hatabayeho gusabana byemewe cyangwa amabwiriza yo kwitoza kuva WPATH cyangwa urundi rwego rwumwuga, abarwayi bagomba gukurikiza amahame atandukanye yo kubaga ubuzima bwabo bwose.
Ibitaro bya buri muntu bifite inshingano zo kumenya uwemerewe gukora inzira runaka mubigo byabo.Dr. Schechter yabwiye Jezabel ko inama z’ibitaro zisaba ko abaganga bemezwa nibura n’imwe mu mbaho ​​zirenga 30 z’ubuvuzi mu gihugu hose, kandi ko bashobora kuba bafite amahame atandukanye yo guhugura abashobora kubaga.Nk’uko bivugwa na Greene wa WPATH, nta kibaho cy’ubuvuzi cyemeza mu buryo bwihariye abaganga babaga ku giti cyabo kubaga umwihariko w’uburinganire: “Nagiye mbona nabi abaganga babaga kugira ngo babone sosiyete nka Sosiyete ishinzwe ubuvuzi bwa Plastike kugira ngo ngerageze gushaka uko bakora ubu bwoko. amahugurwa.mu rwego rwo gukora ikizamini cy'inama kugira ngo ubone icyemezo ”.Ati: “Kubera ko ubu, mu yandi magambo, ntabwo bemerewe indwara zihariye.”
Kugeza ubu, Sosiyete y'Abanyamerika ishinzwe ubuvuzi bwa Plastike ifite icyemezo rusange cy’ubuyobozi ariko ntigire uruhare mu buryo bwerekeranye n’imibonano mpuzabitsina, bivuze ko abaganga babaga batagomba kubahiriza amahame amwe n'amwe yo guhugura kugira ngo babaze imyanya ndangagitsina ku barwayi bahindura ibitsina.Green yavuze ko iyi ari imiterere yinzego idakwiriye imirimo iriho.Ati: “Ubu dufite urologiste, ginecologiste na microsurgeons zitandukanye zigira uruhare mu kwiyubaka.Biragoye cyane kuruta mbere ”.“Ariko nta nama n'imwe yiteguye kubyemera.”
Kugira ngo icyuho cyuzure, abaganga nka Dr. Schechter n'abandi bazobereye mu kwita ku gitsina bishyize hamwe kugira ngo baharanire gahunda y’uburezi isanzwe ku bitaro bashaka kwinjira mu murima.Muri 2017, Dr. Schechter yanditse igitabo mu kinyamakuru cy’ubuvuzi bw’imibonano mpuzabitsina agaragaza bimwe mu bisabwa byibura amahugurwa azakenerwa kubaga ejo hazaza.
Nk’uko iyi raporo ibigaragaza, abaganga babaga abaganga babaga bagomba kwemeza imyitozo ngororamubiri bagomba guhugurwa cyane, harimo amahugurwa, amasomo yo mu biro, amasomo yo kwita ku ntoki na nyuma yo kubagwa, ndetse no gukomeza iterambere ry’umwuga.Mu gihe ibi byifuzo bizamura ireme ry’uburezi mu gihugu hose, bakomeza ku bushake ku bitaro by’abaganga n’abaganga.Imiryango idaharanira inyungu nka WPATH isanzwe igerageza guhaza ibikenewe mu mahugurwa ariko ntiyabasha guhindura sisitemu yonyine.Uyu muryango ukora imyitozo yawo yo kubaga, watangiye ku butegetsi bwa Green kuva muri 2014 kugeza 2016. Ariko ku muryango nka WPATH, ikiguzi cy'amahugurwa kirashobora kuba kibujijwe, kandi gikomeje guhitamo kandi ku buntu ku babaga bashaka gukora akazi kabo.
Bamwe, nk'abajyanama bakorera mu bigo nderabuzima bya LGBT, bafasha abarwayi babagwa bemeza uburinganire, maze mu 2018 bategura ibaruwa ifunguye ya WPATH isaba icyitegererezo cy’ikigo cy’indashyikirwa aho abishingizi n’imiryango yabigize umwuga bakorera, kugira ngo ubwishingizi bwishyuwe gusa .kubaga bahuguwe muri gahunda zihariye.(Avuga ko icyitegererezo, cyakemuye ibibazo nk'ibyo mu kubaga ibibari mu ntangiriro ya za 2000, bitanga amakuru yihariye kandi bigabanya uburyo bwo kubaga igihe bahuye n'ibibazo nk'ibyo.) Blasdel avuga ko mu gihe ibigo bimwe na bimwe by'ubuvuzi byatangiye kwiyita “transgender”. centre de excellence ”,“ Kugeza ubu nta ngingo ngenderwaho abaganga cyangwa ikigo bagomba kuba bujuje kugirango babone iyi nyito.