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2018.10.09

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2018.11.15

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#性別議題

跨性別 Transgender


簡介 Introduction

跨性別是指性別認同或表達與生理性別不同的人,但這是與性傾向無關。所謂性別認同是指個人對自己的性別身份及角色的認同,性別已不再局限於二元對立的男與女之間,而是一個性別光譜包括了無性別者、流性別者、雙性別者等。另一方面,性別表達是指自己表現的性別氣質,從行為舉止、興趣、化妝妝打扮等反映自己偏好的性別氣質,變裝者及偽娘就是常見例子。 對於他們的性別認同及表達,傳統心理及精神醫療體制大多診斷他們為性別認同障礙,需要進行強制的更正治療。近年,有關的診斷的準確性及界定都有所改變,將跨性別人士與性別不安的精神症患者分開 ( 香港性文化學會 , 2017) ,好讓精神病患者得到確切的治療及復康外,亦讓跨性別人士擺脫精神病的標籤,得到合理的心理評估以取得不同程序及類型的醫療介入。不少跨性別人士會以醫學手段進行不同的手術及治療,例如荷爾蒙、性別重置手術以及其他外科或重塑手術,從生理性別轉換到自己認同的性別角色 (McCann & Sharek, 2016) 。「跨仔」則指由女轉為男的男性,而「跨女」指由女轉為男的女性。 跨性別人士往往受到傳統文化及宗教所批評及壓迫,他們由確認自己的性別認同、向家人及他人「出櫃」甚至從外表到身體的性別轉換,這個過程不但在心理上做成種種不安及負面的情緒,家人、學校、職場的暴力及不公平對待令他們在社會及財政上邊緣化 ( 莫坤菱 , 2018) ,甚至社會上的醫療體制及法律體制的接納及支持亦是很有限 (White & Jaclyn, 2015) 。雖說如此,性少眾的社會運動亦將跨性別社群包括在內,爭取社會確認跨性別的存在,無需強制跨性別人士要接受性別重置手術以取得其性別身份及平等權利,例如身份証的登記、婚姻及使用男性或女性的福利等 ( 早安 , 2017) 。

Transgender implies a person whose gender identity or gender expression differs from their assigned sex at birth. However, being transgender is not related to sexual orientation. Gender identity is defined as a sense of own gender. Instead of gender binary categorizing people as men or women, gender is interpreted as a spectrum including agender, genderfluid, pangender and etc. For gender expression, such terms focus on the cultural context on how people make use of their behaviors and manners, interest, make up and appearances to express their preferred gender roles. Cross-dresser, drag king/queen for examples. Regarding their gender identity and expression, traditional psychosis system tended to diagnose them as gender identity disorder which require forced treatment to rectify their preferences. Nowadays, the accuracy of such diagnosis and classification are being questioned. Such shift facilitates better diagnosis and adequate treatment for those who have mental illness ( 香港性文化學會 , 2017). On the other hand, transgender people can access proper psychological assessment for different level and types of medical intervention for sex change such as hormone therapy, sex reassignment therapy and other surgical reconstruction procedure (McCann & Sharek,2016). The terms "trans-masculine" means male who transitioned from female to male and "trans-feminine" means female who transitioned from male to female. Transgender people often being criticized and oppressed by traditional culture and religion. From they recognize their gender identity, “coming out” to their families and others, making changes from appearance to physical body, they bear great distress and negative emotions in such a rocky journey ( 莫坤菱 , 2018). Violence and unequal treatment from family, schools and workplace marginalized them socially and financially (White & Jaclyn, 2015). The society and government provide limited recognition and support for them. Having said that, LGBT social movement includes transgender community in the hope of raising more recognition and equal rights of transgender people. Transgender people should have their gender identity recognized without compulsory requirement of undergoing sex reassignment treatment. For example, the gender registered in identity card, equal rights for male/female as well as marriage ( 早安 , 2017).

作者/Author: Carmen K.M. Yau

新聞及政府資訊 News&Government Information

陳穎思 、 林家儀. (2016). 跨性別,難得一廁. 大學線.
香港大學在校園設立「性別友善洗手間」,文中亦訪問兩位男跨女跨性別人士,她們的轉變引致同學對她的冷漠疏遠,受訪者對使用殘疾人士廁所各有看法,有受訪者認為學校如不接納她使用女廁,是不承認她的女性身份,剝奪她使用女廁的權益;亦有受訪者認為能使用殘疾人士廁所總好過甚麼都沒有。記者曾向兩位受訪者學校查問,但只以官腔回應;而平機會則鼓勵校方設立性別友善洗手間,減少跨性別人士使用洗手間出現尷尬。
引文
莫坤菱. (2018). 逾半跨性別人士曾受家暴  六成想自殺:傷害多來自最親的人. 明周.
跨性別資源中心的調查發現接近半數的跨性別者曾受父母及親密伴侶暴力對待,而超過六成的受訪者,曾面對暴力,包括言語、虐打、辱罵和冷戰。中心亦關注跨性別人士的情緒健康,除了暴力引發他們有自殺的衝動,另一個主要原因是身份迷失、經濟壓力和漫長變性過程。中心提出「性別承認法」,強化家庭及性別意識教育,減少大眾對跨性別人士的歧視。
引文
香港性文化學會. (2017). BBC跨性別兒童紀錄片掀爭議. 香港性文化學會.
文中討論跨性別運動主張「肯定式」(affirmative approach),鼓勵跨性別兒童的感受,不應使用「更正治療」,反而盡早變性以免他們自殘。另一方面,跨性別運動活躍份子擔心此主張令大眾對性別焦慮產生誤解,在兒童未達可以深思熟慮的能力前便過早進行性別重置手術,有礙確診及治療兒童性別焦慮問題。
引文
早安. (2017, 2017-09-29, September 29). 性別承認@香港. 獨立媒體.
文中簡述香港 現時仍 偏向以 「病理化」角度去了解 跨性別人士,即使 主流媒體亦很少尊重他們 的性別身份認同及私隱,甚至 將 他們 標籤化及 病理化成 「患有性別認同障礙」 。此外, 跨性別人士如需獲得 性別承認 (如: 要 更改身分證上的性別資料)), 必須接受整項性別重置手術。 性別承認制度雖被評批而各國不一,但應本著 尊重跨性別人士對身體的自主權,不應將 性別重置手術作為 必要條件。文中總結性別承認制度並不是性小眾的事,而是社會大眾尊重及認同的性別課題。
引文
BBC. (2017, 2017-07-31, December 23). 性別認同:跨性別人士權益會弱化女性權益?. BBC NEWS 中文.
文中表示英國政府有意修訂方案,將更改法定性別的程序「去醫療化」,讓跨性別人士自行選擇性別,不需提供醫學證明以使用女性的設施,例如婦女庇護所、女更衣室等,文中提及網上及不少倡議者談及有關影響女性權益及安全的說法。
引文

影視作品 Movie and TV Series

Hooper, T. (2015). The Danish Girl.
A fictitious love story loosely inspired by the lives of Danish artists Lili Elbe and Gerda Wegener. Lili and Gerda's marriage and work evolve as they navigate Lili's groundbreaking journey as a transgender pioneer.
引文
孫明希. (2018). 女人就是女人.
世界公民協會製作一部關於真實的跨性別故事,教導人們跨性別女性雖然脆弱受盡欺凌,其實也只是普通人,應該受到所有人的愛和尊重,讓社會大眾對跨性別女性有正確了解,去除一向以來的負面標籤。
引文
新田真三 、 中野亮平. (2018). 女子的生活.
從鄉下來到城市的美纪是個跨性別人士,生理上是男性,但從小就追求以可愛女孩的身份生活,外表更是華麗漂亮的女生,但她對男人並沒有興趣,只會喜歡女生。後來他遇到舊同學後藤,因意外要被逼住在一起,美紀的日常生活令朋友吃驚,但她依然能肯定自己,勇敢地生活。
引文
鍾嘉慧. (2017). 我要跨過界. 香港故事-邊緣探戈.
天生女兒身的阿Sho (梁儷覺)走過一段對自身性別疑惑的青春歲月,由中學穿著中性服飾到大學編寫一個關於「性別認同」的劇本,再次加深對自己的認識,決定開展找回自己的經歷,包括精神及心理評估、藥物治療及外科手術。然而,他憂慮的是以一個跨性別人士的身份生活,會否影響工作及人際關係。
引文

學術文章 Academic Papers

McCann, E. & Sharek, D. (2016). Mental health needs of people who identify as transgender: A review of the literature. Archives of Psychiatric Nursing, 30(2), 280–285.
This review highlights the specific needs of mental health services in the transgender population by studying 10 selected papers from 217 comprehensively searched papers in 2014 from social sciences databases. Results identified existing barriers of mental health services against transgender people including accessing suitable consultation and treatment, responsiveness of doctors and nurses, support from family as well as development of potential services on mental health.
引文
Sven C. Mueller,  et al. (2017). Transgender research in the 21st century: A selective critical review from a neurocognitive perspective. American Journal of Psychiatry, 174(12), 1155–1162.
This review covers the psychological distress and mental health issues of transgender people in the hope of addressing their needs and care in transition to preferred gender. Although anxiety and depression are common in the pre- and post-transition, 40% of the literature pointed out that they are still prevalent to self-injuries and suicide due to their autistic traits.
引文
White Hughto, J. M. et al. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine, 147, 222–231.
This review integrated researches on transgender stigma across different domains such as employment and healthcare. These stigma create barriers agianst transgender people to access to reasonable physical and mental health. Social ecological model is applied to illustrate how stigma operates in individual, interpersonal and structural levels. It is important to have multi-level stigma prevention and coping intervention to tackle social stigma against transgender people in the hope of raise the health equality for transgender population.
引文

書籍 Books

Ekins, R. & King, D. (2006). The transgender phenomenon.
Based on over twenty years of fieldwork, research and archive work with transgender community around the world, this book covers the evolution of transgender as a phenomenon with comprehensive overview of the diversity of transgender nowadays and marks a conceptual framework on making sense of the interaction of women, men and those who may not identify with either male or female.
引文
Girshick, L. (2008). Transgender voices: Beyond women and men (pp. 1–213).
This book covers 150 extensive interviews with gender diverse people to share their experience in coming out, exploring their gender identity and sexual orientation as well as relationship with others and their partners. In sociology perspective, the society creates a sense of control and surveillance of people with gender diversities such as segregating bathrooms in gender.
引文
Hines, S. (2007). TransForming gender: Transgender practices of identity, intimacy and care.
This book provides studies on transgender practice of intimacy and care as well as marks the study on transgender identity formation. It covers several key approaches including anthropology, sociology as well as cultural, contemporary gender and sexuality studies. This book addresses the changing government policy on transgender citizenship. Extensive interviews with transgender people were conducted to examine the impacts of these social policy shift on their identity formation, intimate relationships and practice of care in the near future.
引文
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