据报道,没有手术技术是变性人生殖器性别确认手术(GAS)的最佳选择。尽管在选择手术技术时,患者的偏好是核心,没有研究评估这一因素.
调查变性人对生殖器GAS的优先考虑和偏好。
从2015年11月到2016年3月,54名被诊断为性别烦躁不安的变性人被要求转诊到Sahlgrenska大学医院讨论治疗步骤(手术和激素治疗),以完成关于GAS可实现的不同属性的问卷。如性和泌尿功能和外观。47名患者(87%)完成了问卷。年龄从18岁到52岁(平均=26岁,SD=7.4年)。在面试的时候,没有患者接受生殖器GAS治疗.
已完成问卷的答案。
76%的患者认为自己是男性,24%的人写了其他术语,比如“主要是男性,\"\"性别间\"和\"非二进制。性别认同对患者对两个问题的偏好产生了重大影响:阴道切除的重要性和阴茎在男性更衣室等地方可以通过的重要性。这些项目对于将自己识别为男性的患者更为重要。要求的最重要的属性是保持性高潮能力和触觉。最不重要的属性是切除阴道,接着是人类物质的阴茎,最小的疤痕,和大小。站立时排尿的能力被一些人认为是高优先级的,而另一些人则认为是低优先级的。所有答案的范围从“不重要”到“必须”。“
这一系列患者在性别认同和对生殖器GAS的偏好方面表现出了相当大的异质性,这支持了对几种技术的需求。必须准确地告知患者不同的技术及其特定的益处和局限性,以做出明智的选择。JacobssonJ,AndréassonM,KölbyL,etal.关于女性对男性性别确认生殖器手术的患者优先事项-瑞典47例患者的初步研究。JSexMed2017;14:857-864。
No surgical technique is reported to be the best option for gender-affirmation surgery (GAS) of the genitalia in transmen. Although patients\' preferences are central when choosing a surgical technique, no studies have evaluated this factor.
To investigate transmen\'s priorities and preferences regarding GAS of the genitalia.
From November 2015 to March 2016, 54 transmen with the diagnosis of gender dysphoria who were referred to Sahlgrenska University Hospital for discussion of therapeutic steps (surgery and hormonal treatments) were asked to complete a questionnaire on different attributes achievable with GAS, such as sexual and urinary function and appearance. Forty-seven patients (87%) completed the questionnaire. Age ranged from 18 to 52 years (mean = 26 years, SD = 7.4 years). At the time of interview, no patient had undergone GAS of the genitalia.
Answers to completed questionnaires.
Seventy-six percent of patients identified themselves as male, and 24% wrote other terms such as \"mostly male,\" \"inter-gender\" and \"non-binary.\" Gender identity had a significant impact on patients\' preferences for two questions: the importance of vaginal removal and the importance of having a penis that would be passable in places such as male dressing rooms. These items were more important to patients identifying themselves as male. The most important attributes requested were preserved orgasm ability and tactile sensation. The least important attribute was removal of the vagina, followed by having a penis of human material, minimal scarring, and size. The ability to urinate while standing was considered a high priority by some and a low priority by others. All answers ranged from \"unimportant\" to \"imperative.\"
This series of patients demonstrates a considerable heterogeneity among transmen in their gender identity and preferences regarding GAS of the genitalia, which supports the need for several techniques. Patients must be accurately informed on the different techniques and their specific benefits and limitations to make an informed choice. Jacobsson J, Andréasson M, Kölby L, et al. Patients\' Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia-A Pilot
Study of 47 Patients in Sweden. J Sex Med 2017;14:857-864.