Izindaba

UCarly usanda kubuyela e-Louisiana ukuyobuka ifilimu nentombi yakhe futhi bahlale phansi.Kwakusentwasahlobo ka-2017, futhi cishe emasontweni amabili ngaphambili, uCarly, owesifazane oneminyaka engu-34 ubudala, wayenziwe i-vaginoplasty: inqubo ngezinye izikhathi eyenziwa ngemva kokulimala noma umdlavuza, kodwa ngokuvamile ukunakekelwa okuhlobene noshintsho.UCarly wakhetha udokotela ohlinzayo, uDkt. Kathy Rumer, ochwepheshe bezinqubo zokuqinisekisa ubulili endaweni yasePhiladelphia.
Basebenzisa iSkype ezinyangeni ezingaphambi kokuhlinzwa, kodwa abakaze bahlangane mathupha ngaphambi kokuhlinzwa.UCarly uthe uvakashele udokotela kafushane ngaphambi kokuba aphushelwe egunjini lokuhlinza, kodwa akazange aphinde ambone uDkt. Rumer phakathi nezinsuku ezintathu zokululama esibhedlela.Ngemva kwesonto ehlinziwe, umhlengikazi wamfakela isikhathi sokulandelela.
Ngemva kokubuyela ekhaya evela ku-movie ethi "Louisiana", uCarly wabukisisa i-vulva yakhe entsha.Nakuba iningi lama-vulvas ngemva kokuhlinzwa elinamasonto amabili libukeka lingathandeki, uCarly washaqeka lapho ethola “isiqephu esikhulu sesikhumba esifile esingangesithupha,” esho.Ngakusasa ekuseni, washayela inombolo yezimo eziphuthumayo eyayinikeziwe wayesethumela i-imeyili ehhovisi likaDkt. Rumer.NgoMsombuluko, ihhovisi leluleke uCarly ukuthi athumele i-imeyili izithombe zezindawo ezinezinkinga ukuze odokotela abahlinzayo babuyekeze.Ezinsukwini ezimbalwa kamuva, uCarly nonina bathi bezwa kudokotela owayeseholidini futhi batshela uCarly ukuthi akukho okwakumelwe akhathazeke ngakho.UDkt. Rumer uthe unina, ongudokotela ohlinzayo osewathatha umhlalaphansi, wayengasivula isikhumba esilengayo uma siqhubeka nokuba buhlungu.
Lesi siphakamiso sashaqisa uCarly nonina.Uthe isitho sakhe sangasese sinuka “kubi” kanti isilembu sakhe sicwiliswe isikhumba esincanyana.Ngemva kwesonto ekhulume noDkt. Rumer, uCarly wathi waya kudokotela wabesifazane wendawo, owashaywa uvalo wayisa uCarly esibhedlela i-Oshner Baptist eNew Orleans ukuze ayohlinzwa isimo esiphuthumayo.Ingxenye yesitho sangasese sikaCarly yathinteka yi-necrotizing fasciitis, ukutheleleka okuyingozi kunoma yikuphi ukuhlinzwa.Lokhu kuvame ukudala ukulahleka kwezicubu endaweni ethelelekile.
I-Carly yahlinzwa ithimba lodokotela, akekho noyedwa kubo owayenolwazi nge-post-op vulva noma i-vagina-izitho zangasese ze-post-op zihluke kancane kune-cisgender.Wahlala izinsuku ezimbili egunjini labagula kakhulu nezinsuku ezinhlanu esesibhedlela.Bobabili yena nomama wakhe bathi izingcingo eziningi ezivela kumama kaCarly kanye no-OB/GYN wakhe eziya ehhovisi likaDkt. Rumer bezingaphendulwanga ngalesi sikhathi.
Lapho bethola impendulo evela ehhovisi likaDkt. Rumer - isiphithiphithi sokuphatha esinamarekhodi kaCarly - udokotela ohlinzayo wayecasulwe ukuthi uCarly akazange ahlele indiza eya ePhiladelphia ukuze odokotela balungise inkinga.NgokukaCarly nonina, uDkt. Rumer wabaphendula ocingweni nomama kaCarly: “Ngikhumbula kahle ngezwa ngalolo suku,” kusho uCarly, okungenzeka wayizwa ingxoxo.“UDkt.URumer uthe, “Ngalandela imihlahlandlela ye-WPATH yokwelapha isiguli sami.Uma ucabanga ukuthi ungenza kangcono, kungani ungamniki isitho sangasese sowesifazane?”
UDkt. Rumer wayebhekise ku-World Professional Association for Transgender Health (WPATH), ethuthukisa imihlahlandlela nezindlela ezingcono kakhulu zempilo yabantu abashintsha ubulili emhlabeni wonke.Inhlangano esebenza njengonogada besango osebenzayo inemithetho eqinile evumela iziguli ukuthi zihlinzwe okuhlobene noshintsho, kodwa ayilawuli ngokucacile umkhuba wokwenza lezi zinqubo.Iziguli ezingaba khona njengoCarly ngokuyisisekelo zizimele zodwa uma kuziwa ekutholeni udokotela ozohlinzwa.
UDkt. Rumer ungudokotela ohlinzayo onolwazi olunzulu: uye waqhuba umsebenzi wakhe kusukela ngo-2007, ubelokhu elapha iziguli ezishintsha ubulili kusukela ngo-2016, futhi wenza izinqubo zokuqinisekisa ubulili ezifika ku-400 minyaka yonke, okuhlanganisa ukwenza ubuso besifazane, ukukhuliswa kwebele kanye ne-GRS.Ngo-2018, uDkt. Rumer uvele kudokhumentari ye-NBC mayelana noshintsho lomfundi wasekolishi.Ngokusho kwewebhusayithi yakhe, ungomunye wodokotela abahlinzayo bepulasitiki besifazane abambalwa abagunyazwe yibhodi endaweni yase-Philadelphia, oyilungu le-American Academy of Orthopedic Surgery, kanye nomqondisi wokuhlinzwa kwepulasitiki e-Philadelphia College of Osteopathic Medicine (PCOM) .kanye Nokuhlanganyela Ekuhlinzeni Okwakha Kabusha.Ube yilungu le-WPATH kusukela ngo-2010. (Ukudalulwa okuphelele: Ngibe nokubonisana noDkt. Rumer ngokuhlinzwa nge-Skype ekupheleni kukaSepthemba 2017, kodwa ekugcineni nginqume ukubona udokotela ohlinzayo ohlukile.)
Iziguli eziningi eziza kuDkt. Rumer zizohlinzwa inqulu zanelisekile ngemiphumela.Kodwa kulabo abangenelisekile ngezinqubo zabo ezandleni zikaDkt. Rumer noma abanye, kunzima ukuphendula ngendlela enengqondo ezikhalweni zabo.Emhlabeni onepolitiki enkulu yokuhlinzwa okuqinisekisa ubulili, kungaba nzima ukuthola izimpendulo zemibuzo emayelana nokunakekelwa okujwayelekile.Abameli bachaza izinqubo ezihlukahlukene zokuhlinza kanye “nezikhungo ze-transgender of excellence” eziqondiswa izibhedlela zendawo kanye namabhodi kahulumeni wezokwelapha.Amahhovisi angahluka kakhulu uma kuziwa ekulinganisweni kwesiguli nodokotela nokuthi yikuphi ukuqeqeshwa okuthile udokotela ohlinzayo anakho.
Uma lokhu kwenzeka, kungase kube nzima ukukhuluma ngodaba olunjalo oluyimfihlo - uCarly wacela igama-mbumbulu ngenxa yokwesaba ukuphindiselela futhi waveza obala udaba olunjalo lomuntu siqu kwabezindaba.Ukukhuluma ngesikhathi lapho abantu abambalwa bethola usizo lwezokwelapha ngemva kokuhlangenwe nakho okubuhlungu kungasetshenziswa izishoshovu ezimelene nobulili noma kuhunyushwe abameli njengesinyathelo sokuhlehla.
Amazwi kaCarly afakwe ezinkundleni eziphikisana nobulili ngesikhathi ebhala mayelana nolwazi lwakhe noDkt. Rumer ebhodini lemiyalezo ukuze axwayise ezinye iziguli ezingaba khona.Isikhalazo sakhe eMnyangweni Wezindaba Zomsebenzi Nomsebenzi wasePennsylvania asizange siholele kunoma yisiphi isenzo esisemthethweni.U-Jezebel uxoxisane nabanye abantu abane abathi babenezinkinga ngezinqubo ezenziwa uDkt. Rumer, kusukela ezinsolweni zokunganakekeli kahle kuya ezinhlakeni zesitho sangasese sowesifazane ezazibazwise ubuhlungu obukhulu, noma ama-vulvas ayengabonakali elungile ngokomzimba.Inkinga.Ngaphezu kwalokho, kusukela ngo-2016, kube namacala amane okungafaneleki ngokumelene nodokotela ezindabeni ezifanayo, zonke eziphelele ekuxazululeni ngaphandle kwenkantolo.Ngo-2018, i-Medical Board yasePennsylvania yaxhumana nodokotela ohlinzayo ngemuva kokuba elinye iqembu labantu abashintsha ubulili ebelimbonile ekhuluma engqungqutheleni yezokwelapha ezishintsha ubulili lifake isimangalo sokuthi udokotela wenza amanga amanani empumelelo, kodwa akuthathwanga zinyathelo zokuqondiswa kwezigwegwe.
Njengoba uDkt. Rumer abhala kusizindalwazi sakhe futhi ephikisana naye enkantolo, kubonakala sengathi lezi zinkinga zaziwumphumela wokungathobeli imiyalelo yehhovisi lakhe ngemva kokuhlinzwa, noma ingxenye yezingozi ezinengqondo zanoma iyiphi inqubo enjalo.Kodwa lapho uJezebel eya kuDkt. Rumer nohlu oluningiliziwe lwemibuzo nezitatimende zesiguli, sathola impendulo kummeli.Ngo-April, abameli bakaDkt. Rumer bazama ukungibizela ecaleni elingahlobene nendebe, befuna ukuba nginikeze “wonke amanothi, ama-imeyili, imibhalo, kanye nocwaningo” oluhlobene nendaba.Ngaphambi nje kokuba kushicilelwe, uDkt. Rumer waphinda wenqaba ukuphawula futhi, esebenzisa abameli bakhe, wasabisa ngokufaka u-Jezebel ecaleni lakhe lokudicilela phansi isithunzi.
Okuhlangenwe nakho kwalezi ziguli nobunzima ekutholeni usizo akuzange kuhlanganiswe nodokotela oyedwa.Njengoba isidingo se-GRS sikhula, kungase kube nokukhathazeka okukhulu nakakhulu: Ngaphandle kwendlela yokubika ezinikele yeziguli ezithintekile noma i-ejensi enikezwe umsebenzi wokulawula imininingwane yokunakekelwa kwe-transaffirmative, iziguli ezifuna lezi zinqubo zizovinjelwa.asikho isiqinisekiso sekhwalithi yesevisi lapho kungena, futhi akucaci ukuthi kufanele siqhubeke kanjani phambili uma bengajabule ngemiphumela.
Nakuba noma yikuphi ukuhlinzwa, ikakhulukazi ezingxenyeni ezibucayi kakhulu zomzimba, kuza nezingozi, i-GRS ayibeki engcupheni kwabesifazane abashintsha ubulili.Ngokusho kocwaningo luka-2018, iphesenti labantu abashintsha ubulili abagcina bezisola nge-vaginoplasty cishe ngamaphesenti angu-1, ngaphansi kwesilinganiso sokuhlinzwa kwamadolo.Eqinisweni, isizathu esivame kakhulu sokuzisola ngokuhlinzwa siwumphumela omubi.
Indlela yesimanje ye-vaginoplasty yathuthukiswa eYurophu eminyakeni eyi-100 edlule futhi ibisetshenziswa e-USA okungenani iminyaka engama-50 edlule.Ngo-1979, i-Johns Hopkins University yayeka ukunikeza i-GRS ngezizathu zezombusazwe, nakuba kwakungesinye sezibhedlela ezihamba phambili e-United States ukuthuthukisa lo mkhuba.Ezinye izibhedlela eziningi zalandela okufanayo, futhi uMnyango Wezempilo Nezinkonzo Zabantu wavimbela i-Medicare ukuthi ihlanganise le nqubo ngo-1981, okwenza izinkampani eziningi zomshwalense zikhiphe ngokusobala ukuhlinzekwa okuhlobene nokushintsha kobulili ezinhlelweni zomshwalense wangasese ngemva nje kwalokho.
Ngenxa yalokho, ochwepheshe abambalwa e-US bahlinzeka ngokuhlinzwa okuphansi komzimba, ukusiza iqembu elincane leziguli ezingakwazi ukukhokhela ukuhlinzwa.Iningi labantu abashintsha ubulili baphoqeleka ukuthi bakhokhele ukuhlinzwa ngaphandle kwephaketheni kuze kube ngu-2014, lapho abaphathi baka-Obama bebuyisela ukuhlinzekwa kwe-Medicare ngokuhlinzwa kokuqinisekiswa kobulili futhi bavimbela ukukhishwa komshwalense ngokuhlinzwa kwe-transgender ngo-2016. Uma izinqubomgomo zenkathi ka-Obama seziphasisiwe, abantu abaningi abashintsha ubulili bazo. bakwazi ukukhokhela lezi zinqubo ngomshwalense noma nge-Medicaid, futhi ezinye izibhedlela ziphuthuma ukuhlangabezana nesidingo esilindile.
Nokho, izinqubo ezinjalo ziyabiza: i-vaginoplasty ibiza cishe u-$25,000.Ucwaningo lwango-2018 olwenziwa abacwaningi base-Harvard University kanye nase-Johns Hopkins University luthole ukuthi phakathi kuka-2000 no-2014, isibalo sokuhlinzwa kokuqinisekiswa kwe-transgender sanda kakhulu, nenani elikhulayo labo abafakwe umshwalense wangasese noma abakhokhelwa yi-Medicaid.“Njengoba ukufakwa kwalezi zinqubo kwanda, sizoba nesidingo sodokotela abanekhono,” kuphetha abacwaningi.Kodwa kunemithetho embalwa emisiwe mayelana nokuthi kusho ukuthini “abaqeqeshiwe,” futhi ezinye izindawo zomsebenzi wezokwelapha zinethonya ekushintsheni kobulili.enkingeni.Odokotela abahlinzayo babika ezikhungweni ezihlukahlukene futhi ukuqeqeshwa kwe-GRS kungasukela ekuqaphelisweni kwesonto nodokotela ohlinzayo owaziwayo kuye ohlelweni lokufunda iminyaka eminingi.Azikho izinsiza ezizimele ezitholakalayo zeziguli ukuze zithole idatha ngezilinganiso zezinkinga zokuhlinzwa.Ngokuvamile, iziguli zithembele kuphela emininingwaneni enikezwa odokotela abahlinzayo ngokwabo.
Nakuba abantu abaningi bezuze ekufakweni kwe-GRS, umphumela owodwa ongahlosiwe kube yilokho udokotela ohlinzayo ngokobulili osekelwe e-San Francisco uDkt. Marcy Bowers akubiza ngokuthi isiko “lokuvalelisa”.esibhedlela ngesikhathi esinikeziwe, futhi bangabulawa izinkinga ezimbi kakhulu, noma baphinde bangeniswe esibhedlela izikhathi eziningi,” kusho yena, “yileyo ndlela abalinganisa ngayo impumelelo.”babe "abahlinzeki abakhethwayo" ngokuheha ngempumelelo iziguli ezintsha emisebenzini yazo ngokusekelwe kulawa mamethrikhi.
Ngo-May 2018, iziguli ezingu-192 ze-postoperative transgender zabhala incwadi evulekile eya ku-WPATH ezwakalisa ukukhathazeka okuthile mayelana nesistimu yamanje lapho odokotela abahlinzayo benikeza iziguli ezinomkhawulo wezinsiza "ukuhlinzwa kwamahhala noma okuphansi ukuze zithole isilinganiso senkinga ngokululekwa kwangaphambi kokuhlinzwa".izincwadi zemfundo kanye nokukhuluma esidlangalaleni mayelana nolwazi lokuhlinzwa, ukuhlinzwa kokuhlolwa ngaphandle kwemvume enolwazi, ulwazi lwezokwelapha olunganembile olunikezwa iziguli, kanye nokunakekelwa okunganele kweziguli.
"Kusenokungalingani phakathi kwesidingo kanye nenani labantu abaqeqeshwe kulezi zinqubo," kusho uDkt. Lauren Schechter, umongameli okhethiwe we-American Society of Gender Surgeons.“Yebo umgomo wethu uwukufundisa abantu abaningi ukuze abantu bangadingi ukuhamba, okungenani ezindaweni ezibalulekile… Ngakho-ke kukhona nokubambezeleka phakathi kokufundisa abantu ngendlela efanele kanye nokwethula izikhungo zezikhungo [kanye] nezibhedlela.”
Ukunciphisa ukubambezeleka ukuze kuhlangatshezwane nesidingo esikhulayo sezinqubo zokuqinisekisa ubulili ngokuvamile kusho ukunciphisa amathuba okuqeqeshwa abalulekile ezibhedlela nodokotela abahlinzayo."Eqinisweni, izinyathelo ezimbili eziya phambili kanye nesinyathelo esisodwa emuva," kusho uJamison Green, owayengumongameli we-WPATH kanye nomqondisi wamanje wezokuxhumana, mayelana nokuhlinzwa kokuhlinzwa.Ethatha isinyathelo emuva, wathi, abanye odokotela abahlinzayo bangase bakhethe ukuqeqeshwa ngaphansi kwezimo ezinzima kakhulu: “Abajoyini i-WPATH.Abakuvumeli ukufundiswa.Bese bethi, “O yebo, manje sengiyazi okufanele ngenze.”Njengomunye udokotela ohlinzayo ongaziwa ocashunwe ocwaningweni lwango-2017: “Othile uya kubantu abanamagama ahlonishwayo;bafunda isonto lonke bese beqala ukukwenza.asikho neze ukuziphatha okuhle!”
Ukushintsha izinhlelo zomshwalense kanye nemithetho elawula izinkampani zomshwalense zase-US kusho ukuthi abantu abashintsha ubulili bavame ukufuna izinqubo ezinjalo ngenxa yokwesaba ukuthi abomshwalense bangase bashintshe imithetho yabo yokuhlinzeka lapho behlola odokotela abangakwazi ukuhlinza.Ukuhlinzekwa komshwalense kuvame ukusho ukuthi iziguli zithola kuphi ukunakekelwa, njengoDanielle, owesifazane oneminyaka engu-42 ubudala ohlala ePortland, e-Oregon futhi othembele ku-Medicaid.Esifundeni sakhe, okunye ukuhlinzwa okuqinisekisa ubulili kufakwa uhlelo lukahulumeni lweMedicaid, kodwa ngonyaka ka-2015, uDanielle wabona kunesidingo sokwenza lokho ngokushesha njengoba ukunakekelwa kwezokwelapha kwabantu abashintsha ubulili kwaba umgomo wezepolitiki waseRiphabhulikhi.
"Bengicabanga ngaphambi kokuthi sibe nomongameli waseRiphabhlikhi, ngidinga isitho sangasese sowesifazane," etshela u-Jezebel engxoxweni yasentwasahlobo ka-2018.Ngenkathi iMedicaid imthumela ePortland ukuthi ayobona uDkt. Daniel Dougie, wamtshela ukuthi uyisiguli sakhe se-12 se-transvaginoplasty.Kuthe uma evuka lapho okulaliswe khona izinzwa, watshelwa ukuthi ukuhlinzwa kuzothatha isikhathi esiphindwe kabili ngenxa yokuthi isitho sakhe sangasese bekunzima ukusivula.
Nakuba ayethi imiphumela yakhe yokubona nezinzwa yayimihle, okuhlangenwe nakho kukaDanielle esibhedlela kwashiya okuningi okufiselekayo.“Akekho kule wadi obengazi ukuthi kwenziwa kanjani ngokulimala kwabantu,” kusho yena.Uthe wazizwa elahliwe waphuthuma ukuyosiza ngemuva kwenqubo ende futhi ehlaselayo.U-Jezebel wakhuluma nedlanzana lezinye iziguli zikaDkt. Dougie, futhi ndawonye bagcina befake isikhalazo esisemthethweni esibhedlela.Nakuba izikhalo zikaDaniella zazimayelana nokuhlangenwe nakho kwakhe kokunakekelwa kwe-post-op esibhedlela, abanye babezabalaza nezinkinga ezinkulu, kuhlanganise ne-fistula nokungakwazi ukuzibamba umchamo ngemva kokuhlinzwa.Ngokusho komthombo owazi kahle izingxoxo zaleli qembu nesibhedlela, leli qembu likholelwa ukuthi lesi sibhedlela sinezinkinga eziningi kakhulu kunezinye izibhedlela ezenza imigudu efanayo.
Ephendula imibuzo eminingi kaJezebel, uDkt. Dougie uthe isibhedlela asihlanganyeli ekusebenzelaneni okuqondile neziguli ngenxa yemithetho yobumfihlo, kodwa wavuma ukuthi abasebenzi bakhulume kakhulu neziguli ezishintsha ubulili.“Sibambe iqhaza emihlanganweni eminingi yobuso nobuso nabantu namaqembu ngokuhamba kwesikhathi.Le mihlangano yaqhubeka kwaze kwaba yilapho kufinyelelwa khona ukuvumelana mayelana nokukhathazeka kwamanje kwesiguli, imigomo yezingxoxo yafinyelelwa, futhi kwasungulwa uhlelo lokuvimbela ukubuyela emuva, "uDkt. Dugi wabhala ku-imeyili.
Ngokukhethekile, isibhedlela sisungule iKomidi Lokweluleka Lomphakathi labantu abashintsha ubulili kanye nabantu abangavumelani nobulili abaxhumana nabasebenzi nabaphathi boHlelo Lwezempilo Lwe-OHSU Transgender, Indaba Yesiguli, nabanye ababambiqhaza.
UDkt. Dougie wazisa u-Jesabel ukuthi izinkinga zokuhlinzwa esibhedlela zaziqashwe futhi zisetshenziselwa ukuthuthukisa imiphumela, ngezinga lezinkinga elihambisanayo noma elidlula imiphumela eshicilelwe evela kwabanye odokotela abahlinzayo abangochwepheshe.“Odokotela bethu abahlinzayo balwela ukwenza kahle, kodwa kwesinye isikhathi kuba nezinkinga,” kusho yena."Bonke odokotela be-OHSU benza ukubuyekezwa kwangaphakathi njalo kwemiphumela yabo yezokwelapha kanye nokuhlinzwa ngemihlangano yokugula nokufa ehlanganiswe umqondisi wekhwalithi womnyango ngamunye."
UDkt Dugi waphawula ukuthi ukukhathazeka kwabasebenzi mayelana nekhwalithi yokunakekelwa kanye nemiphumela sekuphakanyiswe ohlelweni lokubuyekezwa kontanga okungabe sekudluliselwa emabhodini okubuyekeza ezikhungo."Zonke izikhungo zezokwelapha zilandela leli zinga futhi zinqunywa yizinhlangano ezigunyazwe zikazwelonke," esho.
Ngenkathi iziguli ze-OSHU zixoxisana ngezinguquko ezingase zibe khona nabaphathi besibhedlela, ezinye zeziguli zangaphambili zikaDkt. Rumer zahamba ubude obukhulu kakhulu.Ngo-2018, iziguli ezine zangaphambili zikadokotela ohlinzayo zafaka amacala ahlukene okungafaneleki enkantolo yeSifunda Esisempumalanga sasePennsylvania.Ngamunye wayemelwe inkampani efanayo yabameli futhi athi umsebenzi kaDkt. Rumer wawenziwa kabi kakhulu emacaleni abo kangangokuthi abamangali (bonke baseNew York) babedinga ukuhlinzwa okubukeziwe eMount Sinai.
Ummangali ngamunye uchaze ukuncishiswa kanye nokulimala ku-urethra, umsele wesitho sangasese sowesifazane, kanye ne-labia, kanye nama-clitoral hood aqhumile noma akhubazekile, izindaba ezaziwa ngokuthi "umonakalo waphakade" kangangokuthi abamangali "abasakwazi ukuba nomsebenzi wocansi futhi."
Amacala, achaza “ihlazo” kanye “nokuhlukunyezwa okukhulu kwengqondo” okubangelwe umsebenzi kaDkt. Rumer, ekuqaleni ayefuna ukuqulwa kwecala lamajaji, kodwa agcina edluliselwe ekuxazululeni kokuzithandela kwangasese.Kwesinye isigameko, abameli bahlose ukumangalela uDkt. Jess Ting, udokotela ohlinzayo kanye noprofesa wezokwelapha osebenza ngokukhethekile e-GRS eNtabeni iSinayi, ngokusho kwememo ngaphambi kokuqulwa kwecala.Kulindeleke ukuthi afakaze ukuthi ngisho nangemva kokuhlinzwa kathathu, umsebenzi kaDkt. Rumer awuzange uvumele abamangali ukuba “bafinyelele i-orgasm noma ukwaneliseka ngokocansi ngaphandle kobuhlungu”, kanye nokuxazulula ezinye izinkinga ezibalulekile, ezihlanganisa “i-clitoris enkulu ngaphandle kwesihlangu se-clitoral” nezinwele. akukho clitoris.isuswe ngendlela efanele.
“Njengodokotela ohlinzayo, ngingakutshela ukuthi bonke odokotela abahlinzayo banemiphumela emibi,” kusho uDkt. Ding Jezebel.“Sonke sinezinkinga futhi izinto azihambi ngendlela esifisa ngayo.Lapho ubona iphethini yemiphumela esikisela ukuthi udokotela ohlinzayo angase angabi sezingeni lokunakekelwa, uzizwa unesidingo sokukhuluma.”
Embikweni wangaphambi kokuqulwa kwecala owafakwa ngasekupheleni kukaFebhuwari, ngaphambi kokuba icala liye ekuxazululeni, abameli bakaDkt. Rumer baphikisa ngokuthi udokotela ohlinzayo wayengeyena ubudedengu, akazange aphambuke ezingeni lokunakekelwa, nokuthi inkinga yesiguli “iyinkinga eyaziwayo. ”"[c] I-Vaginoplasty.Isikhalo siphinde sithi isiguli “asizange sisebenze ngesikhathi selashwa uDkt. Rumer” nokuthi oneminyaka engu-47 ubudala akazange abike izinkinga ezinkulu kwaze kwaba ngaphezu konyaka ngemva kokuhlinzwa.Imininingwane yenqubo yokulamula kanye nemiphumela yayo ayizange ikhishwe esidlangalaleni, v. Rumer Akekho kubamangali ecaleni lodokotela ophendule izicelo eziningi zenhlolokhono.
“Njengodokotela, akekho othanda amasudi angalungile,” kusho uDkt. Dean.“Lesi yisihloko esingesihle kimina njengommangalelwa wokungenzi kahle.Sengikushilo lokho, nginomuzwa wokuthi njengabasebenzi kule ndawo encane kakhulu entsha, kudingeka sizinakekele futhi silondoloze izindinganiso.”
U-Jezabel uxhumane nodokotela abahlinzayo bobulili abambalwa abaziwayo ukuze abuze ukuthi zingaki iziguli zangaphambili zikaRumer eziphinde zahlinzwa ukuze kulungiswe lokho akutholile.Ngokuqondakalayo abaningi benqabile ukuphawula, kodwa laba bantu abathathu, abacele ukungadalulwa, balandele iziguli ezingaphezu kuka-50 ezaziqale zathintana noDkt. Rumer we-GRS kusukela ngo-2016.
"Sonke sifuna abantu abashintsha ubulili babe nezinketho eziningi zokuhlinzwa, futhi senza konke esingakwenza ukufundisa nokukhuthaza imiphumela engcono," kusho uDkt. Bowers, udokotela ohlinzayo wobulili osekelwe eSan Francisco.izinkinga zokuhlinzwa, intukuthelo kanye nobutha kubamangali, ukungabi khona noma ukuziphendulela.Wanezela ukuthi uDkt. Rumer “uyabuqonda futhi ubungozi beziguli ezilangazelela ukuhlinzwa nodokotela abahlinzayo abambalwa uma kuqhathaniswa.””
U-Hannah Simpson, owesifazane oneminyaka engu-34 ubudala waseNew York, wathi ngemva kwamasonto amabili e-GRS noDkt. Rumer ehlobo lika-2014, wabona ukuthi i-vulva yakhe yaqala ukubukeka i-asymmetrical futhi izingxenye zayo zibomvu kakhulu.futhi evuvukele.Naphezu kokuqinisekisa kukaDkt. Rumer ukuthi konke kuhamba kahle, uSimpson waba necrosis ye-vulva.
USimpson, owayefundela ubudokotela ngaleso sikhathi, wachaza ingquza yakhe entsha: i-clitoris ekhubazekile “eyayinohlangothi olulodwa” kanye ne-labia “eyayibukeka njengeqhubu kunezicucu ezimbili.”U-Simpson uphinde waba nezinye izinkinga, kuhlanganise nezinwele zesitho sangasese sowesifazane odokotela abahlinzayo abathembisa ukuzisusa kanye nokubekwa ngendlela eyinqaba komgudu wakhe womchamo.Ngaphezu kwalokho, uDkt. Rumer ushiye izicubu ezengeziwe eduze komnyango wesitho sangasese sowesifazane, okwenze ukuvuleka kungakhululeki kakhulu, kusho uSimpson.Ngosuku olwalandela, futhi ku-imeyili eyalandela uSimpson awabelana ngayo no-Jezebel, uDkt. Rumer wasola isikhumba esifile ku-Depends Simpson pair ukuthi uSimpson wayeyigqoke kakhulu esibhedlela, uSimpson abheka inkinga yokubalekela.UDkt. Rumer wenqaba ukuphendula imibuzo kaJezebeli mayelana nendlela asiphatha ngayo lesi siguli noma esinye isiguli.
I-Necrosis efana ne-Simpson's necrosis iyingozi nganoma iyiphi i-vaginoplasty futhi ingabangelwa ukugqoka izingubo zangaphansi ezimpintsha kakhulu ezigabeni zokuqala zokululama ngemuva kokuhlinzwa, nakuba kungase kube nzima ukukhomba imbangela yangempela kulesi simo, kusho uSchechter.izifo esigulini."Ukutheleleka, i-tissue necrosis, i-suture dehiscence - konke lokhu kwenzeka nganoma yikuphi ukuhlinzwa," esho.U-Schecter waphawula ukuthi ukuhamba ngemva kokuhlinzwa kanye nendawo yasekhaya engcolile noma engaphephile nakho kungaholela ezinkingeni, kodwa ekugcineni udokotela ohlinzayo kufanele eluleke isiguli futhi aqinisekise ukuthi lezi zici eziyingozi ziyancishiswa.
Ukuhlinzwa kwesibili nodokotela ohlinzayo ohlukile akuphumelelanga ukubuyisela umsebenzi wokuqala kaDkt. Rumer kwaze kwaholela kwezinye izinkinga, futhi uSimpson wayengenayo i-clitoris.Ngokwezibalo zakhe, manje usexhumane nodokotela abahlinzayo abangu-36 ukuze bakhe kabusha isitho sakhe sangasese.Lokhu okuhlangenwe nakho kwamdumaza emsebenzini wezokwelapha futhi wayeka ukuqhubeka neziqu zakhe zobudokotela.Akazange asebenzise noma yiziphi izindlela ezingokomthetho zokufaka izikhalazo, esaba ukuthi lokhu kwakuzonciphisa amathuba okuba omunye udokotela ohlinzayo athathele udaba lwakhe.
Izikhalo zikaSimpson ngomsebenzi kaDkt. Rumer ziyefana nezabanye ababeyiziguli ezakhuluma noJezebel."Bengihlale ngixwayisa abantu ukuthi bahlukane noRumer," kusho u-Amber Rose, oneminyaka engu-28 ubudala ongeyena kanambambili waseBoston.Ngo-2014, baya kuDkt. Rumer ukuze bahlinzwe inqulu ngenxa yazo zonke izinketho ezinikezwa uhlelo lomshwalense wabazali babo, udokotela ohlinzayo wayenesikhathi esifushane sokulinda.
Ukuhlinzwa kukaRose akuzange kuhambe ngendlela ayehlele ngayo."U-Rumer ushiye izicubu eziningi ze-erectile ngaphansi kwe-labia minora yami, okungase kube inkinga," kusho uRoss.“Bekungabukeki njenge vulva.”Ngisho nabanye odokotela, bathi, “okungenani bake bazama ukungifaka umunwe emthonjeni wami womchamo ngenxa yokuthi kwakungabonakali.
URoss uthe uDkt. Rumer akazange akhe i-clitoral hood, eshiya i-clitoris yabo ivuleke ngokuphelele ukuze ishukunyiswe.Futhi, indlela kaRumer yokususa izinwele yehlulekile futhi yashiya ezinye izinwele ngaphakathi kwe-labia kodwa hhayi kumsele wesitho sangasese sowesifazane ngokwawo.“Wayelokhu enqwabelanisa umchamo nomchamo, futhi wanuka kangangokuba ngangesaba ngonyaka wokuqala,” basho, “ngaze ngabona ukuthi akufanele kube noboya lapho.
NgokukaRoss, eminyakeni eyisithupha kamuva, abakagculiseki ngokusebenza kwabo futhi bakhathazekile ngokuthi uDkt. Rumer uhlinza abantu abashintsha ubulili.Kodwa bathi ukukhungatheka kwabo nakho kubangelwa izinkinga zesistimu ngezinqubo: ukushoda kodokotela be-GRS nohlu olude lokulinda, okusho ukuthi abantu abafana nabo banezinketho ezimbalwa abangakhetha kuzo futhi abanalo ulwazi olwanele lukadokotela ohlinzayo.
Ukuhlinza izinqe kubantu abashintsha ubulili kanye nabantu abashintsha ubulili kuyimisebenzi eminingi futhi kudinga ubuchwepheshe ekuhlinzeni ngepulasitiki, i-urology kanye ne-gynecology.Ngayinye yale mikhakha inekomiti elizimele elibhekele ukugunyazwa.Imizamo yakamuva yokulinganisa ijika lokufunda le-vaginoplasty iphakamisa ukuthi izinqubo ezingama-40 ziyadingeka ukuze ufunde ngokugcwele le nqubo.Ngaphandle kwemihlahlandlela yobudlelwane egunyaziwe noma yokufundela umsebenzi evela ku-WPATH nanoma yimuphi omunye umgwamanda wochwepheshe, iziguli kuyodingeka zibhekane nezinhlobo eziningi zezindinganiso zokuhlinzwa impilo yazo yonke.
Izibhedlela ngazinye ekugcineni zinomthwalo wemfanelo wokunquma ukuthi ubani ogunyaziwe ukwenza izinqubo ezithile ezikhungweni zazo.UDkt. Schechter utshele u-Jezabel ukuthi amabhodi ezibhedlela ngokuvamile adinga ukuthi odokotela abahlinzayo bagunyazwe okungenani yibhodi elilodwa lamabhodi ezokwelapha angaphezu kuka-30 ezweni lonke, futhi angase abe nezindinganiso ezihlukile zokuqeqesha odokotela abangaba khona.Kodwa ngokusho kukaGreene we-WPATH, alikho ibhodi lezokwelapha eligunyaza ngokukhethekile odokotela abahlinzayo ukuba benze ukuhlinzwa okuqondene nobulili: “Bengilokhu ngikhathaza odokotela abahlinzayo ukuze bathole imiphakathi efana neNhlangano Yokuhlinza Ngepulasitiki ukuzama ukuthola ukuthi lolu hlobo lwenziwa kanjani. ukuqeqeshwa.njengengxenye yokuhlolwa kwebhodi ukuze ukwazi ukuthola izitifiketi,” usho kanje."Ngoba manje, ngomqondo ongokomfanekiso, azigunyaziwe izifo ezithile."
Njengamanje, i-American Society of Plastic Surgeons inesitifiketi sebhodi elijwayelekile kodwa ayisebenzi ngokuqondile ngezinqubo ezihlobene nobulili, okusho ukuthi odokotela abahlinzayo abathintekayo akudingeki bahlangabezane nezindinganiso ezithile zokuqeqesha ukuze benze ukuhlinzwa kwezitho zangasese ezigulini ezishintsha ubulili.UGreen uthe lolu wuhlaka lwesikhungo olungafanele ukwenza imisebenzi yamanje.“Manje sesinabo odokotela bomchamo, odokotela bezifo zabesifazane kanye nodokotela abancane abahlukahlukene abahlanganyela ekwakhiweni kabusha kwezitho zangasese.Ngakho sekunzima kakhulu kunakuqala,” usho kanje."Kodwa alikho ibhodi elikulungele ukwamukela lokho."
Ukuze bavale lesi sikhala, odokotela abanjengoDkt. Schechter nabanye abasebenza ngokukhethekile ekunakekelweni kobulili baye bahlangana ukuze balwele uhlelo lwemfundo olusezingeni eliphezulu lwezibhedlela ezifuna ukungena kulo mkhakha.Ngo-2017, uDkt. Schechter wabhala ngokuhlanganyela isihloko ku-Journal of Sexual Medicine echaza ezinye zezidingo ezincane zokuqeqesha odokotela abahlinzayo besikhathi esizayo.
Ngokombiko, odokotela abahlinzayo abenza ukuhlinzwa kokuqinisekisa ubulili kumele bathole ukuqeqeshwa okubanzi, okuhlanganisa izingqungquthela, izikhathi zasehhovisi, izikhathi zokunakekelwa kwezandla kanye nangemuva kokuhlinzwa, kanye nokuthuthukiswa kochwepheshe okuqhubekayo.Nakuba lezi zincomo zizothuthukisa izinga lemfundo ezweni lonke, zihlala ngokuzithandela ezibhedlela nodokotela abahlinzayo.Izinhlangano ezingenzi nzuzo njenge-WPATH bezilokhu zizama ukuhlangabezana nezidingo zokuqeqeshwa kodwa azikwazanga ukwenza izinguquko zesistimu ngokwazo.Le nhlangano iqhuba ukuqeqeshwa kwayo kokuhlinza, okwaqala ngesikhathi sobumongameli bukaGreen kusukela ngo-2014 kuya ku-2016. Kodwa enhlanganweni efana ne-WPATH, izindleko zokuqeqeshwa zinganqanda, futhi zihlala zizikhethela futhi zikhululekile kodokotela abahlinzayo abafuna ngempela ukwenza umsebenzi wabo.
Abanye, njengabeluleki abasebenza ezikhungweni zokunakekela eziyinhloko ze-LGBT, basiza iziguli ngokuhlinzwa okuqinisekisa ubulili, kwathi ngo-2018 bahlela incwadi evulekile ye-WPATH encoma imodeli "yesikhungo sokuvelela" lapho izinkampani zomshuwalense nezinhlangano eziqeqeshiwe zisebenza ndawonye, ​​ukuze kuqinisekiswe umshwalense okhokhelwayo kuphela. .odokotela abahlinzayo abaqeqeshwe ezinhlelweni ezikhethekile.(Uthi, imodeli, ibhekane nezinkinga ezifanayo ekuhlinzeni i-bariatric ekuqaleni kwawo-2000, inikeze idatha ethile yemiphumela kanye nemingcele eqinile yokuhlinzwa lapho ibhekene nezinkinga ezifanayo.) U-Blasdel uphawula ukuthi nakuba ezinye izikhungo zezokwelapha zisanda kuqala ukuzibiza ngokuthi "i-transgender". isikhungo sobuhle”, “Okwamanje azikho izindlela udokotela ohlinzayo noma isikhungo okufanele sihlangabezane nazo ukuze sithole lesi sihloko.