Iindaba

UCarly ubuyele eLouisiana ukuya kubukela imuvi kunye nentombi yakhe kwaye bahlale phantsi.Kwakusentwasahlobo ka-2017, kwaye malunga neeveki ezimbini ngaphambili, uCarly, ibhinqa elineminyaka engama-34 ubudala, uye wafumana i-vaginoplasty: inkqubo eyenziwa ngamanye amaxesha emva kokwenzakala okanye umhlaza, kodwa rhoqo kukhathalelo olunxulumene notshintsho.UCarly wakhetha ugqirha, uDkt Kathy Rumer, ojongene neenkqubo zokuqinisekisa ngokwesini kwindawo yasePhiladelphia.
Baye ba-Skype kwiinyanga ezikhokelela kuqhaqho, kodwa abazange badibane nomntu phambi kotyando.UCarly uthe watyelela ngokufutshane ugqirha ngaphambi kokuba atyhalelwe kwigumbi lokusebenza, kodwa akazange aphinde ambone uDkt Rumer ngexesha leentsuku ezintathu zokuchacha esibhedlele.Kwiveki emva koqhaqho, umongikazi wamfakela idinga lokulandelela.
Emva kokubuyela ekhaya kwifilimu ethi "Louisiana", uCarly wajonga ngakumbi kwi-vulva yakhe entsha.Nangona uninzi lweeveki ezimbini emva kokuhlinzwa lubonakala lungathandeki, uCarly wothuka xa wafumana “iqhekeza elikhulu lesikhumba esifileyo elilingana nobhontsi,” watsho.Ngentsasa elandelayo, watsalela umnxeba kwinombolo yongxamiseko awayeyinikiwe waza wathumela i-imeyile kwiofisi kaGqr. Rumer.NgoMvulo, iofisi yacebisa uCarly ukuba athumele i-imeyile imifanekiso yemimandla yengxaki ukuze oogqirha bahlolisise.Kwiintsuku ezimbalwa kamva, uCarly nonina bathi beva kugqirha owayesekhefini baza baxelela uCarly ukuba wayengenanto yokukhathazeka ngayo.UGqr. Rumer wathi umama wakhe, ugqirha wotyando osele esidla umhlala-phantsi, unokulusika ulusu olujingayo ukuba luyaqhubeka luba buhlungu.
Esi siphakamiso sothusa uCarly nonina.Uthe amalungu akhe angasese anuka “kubi” kwaye i-labia yakhe yajijeka inomaleko obhityileyo wolusu.Kwiveki emva kokuthetha noDkt. Rumer, uCarly wathi waya kwi-gynecologist yendawo, esoyika waza wathatha uCarly kwisibhedlele sase-Oshner Baptist eNew Orleans ukwenzela utyando olungxamisekileyo.Inxalenye yeCarly's vagina yachatshazelwa yi-necrotizing fasciitis, usulelo oluyingozi kuyo nayiphi na imisebenzi.Oku kudla ngokubangela ukulahleka kwezicubu kwindawo eyosulelekileyo.
I-Carly yayiqhutywe liqela loogqirha, akukho namnye kubo owayenamava nge-post-op vulva okanye i-vagina-post-op yangasese ihluke kancinci kwi-cisgender.Wachitha iintsuku ezimbini kwigumbi labagula kakhulu kunye neentsuku ezintlanu zizonke esibhedlele.Bobabini kunye nonina bathi iifowuni ezininzi ezivela kumama kaCarly kunye ne-OB / GYN yakhe kwiofisi kaDkt Rumer ayizange iphendule ngeli xesha.
Xa befumana impendulo kwiofisi kaDkt Rumer - i-mess yolawulo kunye neerekhodi zeCarly - ugqirha wayecatshukiswa kukuba uCarly akazange acwangcise indiza eya ePhiladelphia ukuze oogqirha balungise ingxaki.Ngokutsho kukaCarly nonina, uGqr. Rumer wabafowunela nomama kaCarly wathi: “Ndikhumbula ndisiva ngaloo mini,” watsho uCarly, owayeyivile loo ncoko.“UGqr.URumer uthe, “Ndilandele izikhokelo ze-WPATH zokunyanga isigulana sam.Ukuba ucinga ukuba ungenza ngcono, kutheni ungamniki ubufazi?”
UGqr. Rumer wayebhekiselele kwi-World Professional Association for Transgender Health (WPATH), ephuhlisa izikhokelo kunye neendlela ezifanelekileyo zempilo ye-transgender emhlabeni jikelele.Umbutho osebenza njengomgcini-sango osebenzayo unemithetho engqongqo evumela izigulane ukuba zenze utyando olunxulumene notshintsho, kodwa aluyilawuli ngokucacileyo umkhuba wokwenza ezi nkqubo.Izigulana ezinokwenzeka njengeCarly ngokusisiseko zizodwa xa kufikwa ekufumaneni ugqirha wotyando.
UGqr. Rumer ngugqirha onamava: uye waqhuba umsebenzi wakhe ukususela ngo-2007, uye waphatha izigulane ze-transgender ukususela ngo-2016, kwaye wenza ukuya kwii-400 iinkqubo zokuqinisekisa ngokwesini ngonyaka, kubandakanywa ukucwangciswa kobuso, ukunyuswa kwebele kunye ne-GRS.Kwi-2018, uDkt Rumer wabonakala kwi-documentary ye-NBC malunga nokuguqulwa komfundi wekholeji.Ngokutsho kwewebhusayithi yakhe, ungomnye wabagqirha abambalwa abaqinisekisiweyo bebhodi yeplastiki yabasetyhini kwindawo yesithathu ye-Philadelphia, ilungu le-American Academy of Orthopedic Surgery, kunye nomlawuli wotyando lweplastiki kwiKholeji yaseFiladelphia ye-Osteopathic Medicine (PCOM) .kunye noBudlelwane kuTyando oluHlaziyayo.Ube lilungu le-WPATH ukususela ngo-2010. (Ukubhengezwa ngokupheleleyo: Ndineengcebiso zokuhlinzwa kunye noDkt. Rumer nge-Skype ekupheleni kukaSeptemba 2017, kodwa ekugqibeleni ndagqiba ekubeni ndibone ugqirha ohlukeneyo.)
Izigulane ezininzi eziza kuGqr. Rumer ukwenzela utyando lwe-hip zanelisekile ziziphumo.Kodwa kwabo bangonelisekanga ziinkqubo zabo ezandleni zikaGqr. Rumer okanye abanye, kunzima ukuphendula ngendlela enentsingiselo kwizikhalazo zabo.Kwilizwe elinezopolitiko eliphezulu lotyando oluqinisekisa isini, kunokuba nzima ukufumana iimpendulo kwimibuzo malunga nokhathalelo oluqhelekileyo.Abameli bachaza iindlela ezahlukeneyo zotyando kunye "namaziko e-transgender agqwesileyo" ajongwa zizibhedlele zasekhaya kunye neebhodi zonyango zikarhulumente.Iiofisi zinokwahluka kakhulu xa kufikwa kwi-ratio yesigulane ukuya kugqirha kunye noluphi uqeqesho oluthile logqirha otyandayo.
Xa oku kwenzeka, kunokuba nzima ukuthetha ngomcimbi onjalo wangasese - uCarly wabuza igama elibi ngenxa yokwesaba ukuziphindezela kwaye wabonisa esidlangalaleni umcimbi onjalo wobuqu kumajelo eendaba.Ukuthetha ngexesha apho abantu abambalwa banokufikelela kukhathalelo lwezonyango emva kokuba amava abuhlungu angasetyenziswa ngabasebenzi be-anti-transgender okanye atolikwe ngabaxhasi njengenyathelo elibuyela umva.
Amazwi kaCarly afakwe kwiiforamu ezichasene ne-transgender xa ebhala malunga namava akhe kunye noDkt Rumer kwibhodi yemiyalezo ukuze alumkise ezinye izigulane ezinokwenzeka.Isikhalazo sakhe kwiSebe lasePennsylvania leMicimbi yobuNgcali kunye neMicimbi yezoMsebenzi asizange sibangele nasiphi na isenzo esisemthethweni.U-Izebhele udlan' indlebe nabanye abantu abane abathi baneengxaki kwiinkqubo ezenziwa nguGqr. Rumer, ukusuka kwizityholo zokungakhathalelwa kakuhle emva kokhathalelo ukuya kwizakhiwo zelungu lobufazi ezibangele ukuba baqaqanjelwe kakhulu, okanye i-vulvas engakhange ibonakale ichanekile ngokwe-anatomically.Ingxaki.Ukongezelela, ukususela ngo-2016, kukho iisuti ezine ezingalunganga ezichasene noogqirha kwimiba efanayo, yonke into ephelile kwi-arbitration ngaphandle kwenkundla.Ngo-2018, iBhodi yezoNyango yasePennsylvania yanxibelelana nogqirha wotyando emva kokuba elinye iqela labantu abatshintshe isini ababembonile ethetha kwinkomfa yamayeza e-transgender bafaka isikhalazo sokuba ugqirha uye waxoka ngamazinga empumelelo, kodwa akukho sohlwayo sithathiweyo.
Njengoko uGqr. Rumer wabhala kwiwebhusayithi yakhe waza waxoxa enkundleni, kubonakala ngathi ezi ngxaki zibe ziziphumo zokungathotyelwa kwemiyalelo yasemva kokusebenza kweofisi yakhe, okanye inxalenye yeengozi ezifanelekileyo zayo nayiphi na inkqubo enjalo.Kodwa xa u-Izebhele waya kuGqr. Rumer noluhlu oluneenkcukacha lwemibuzo kunye neengxelo zesigulane, safumana impendulo kwigqwetha.Ngo-Epreli, amagqwetha kaGqr. Rumer azama ukundibizela kwityala elingahambelaniyo nelinye icala, efuna ukuba ndinikezele “onke amanqaku, ii-imeyile, amaxwebhu kunye nophando” olunxulumene nebali.Ngaphambi nje kokuba ipapashwe, uGqr. Rumer kwakhona akavumanga ukuphawula kwaye, ngamagqwetha akhe, wagrogrisa ngokufaka u-Izebhele kwisimangalo sakhe sokunyeliswa.
Amava ezi zigulana kunye nobunzima ekufumaneni uncedo zazingadibaniswanga nogqirha omnye.Njengoko imfuno ye-GRS ikhula, kunokubakho inkxalabo enkulu ngakumbi: Ngaphandle kwendlela yokunika ingxelo ezinikeleyo kwizigulana ezichaphazelekayo okanye i-arhente enoxanduva lokulawula iinkcukacha zokhathalelo lonikezelo-zinkonzo, izigulane ezifuna ezi nkqubo ziya kuthintelwa.akukho siqinisekiso somgangatho wenkonzo ekungeneni, kwaye akucaci ukuba uqhubela phambili njani ukuba abanelisekanga ngeziphumo.
Ngelixa naluphi na utyando, ngakumbi kwezona ndawo zibuthathaka kakhulu zomzimba, luza nemingcipheko, i-GRS ayibeki mngcipheko kwabasetyhini abagqithisayo.Ngokutsho kophononongo lwe-2018, ipesenti yabantu abaguquguqukayo abagqiba ukuzisola nge-vaginoplasty malunga neepesenti ze-1, ngaphantsi komyinge wotyando lwamadolo.Enyanisweni, esona sizathu siqhelekileyo sokuzisola ngotyando sisiphumo esibi.
Indlela yanamhlanje ye-vaginoplasty yaphuhliswa eYurophu kwiminyaka eyi-100 eyadlulayo kwaye ibisenziwa e-USA ubuncinci iminyaka engama-50 edlulileyo.Ngo-1979, iYunivesithi yaseJohns Hopkins yayeka ukunika iGRS ngenxa yezizathu zopolitiko, nangona yayisesinye sezibhedlele eziphambili eUnited States ukuphuhlisa lo mkhuba.Ezinye izibhedlele ezininzi zalandela, kwaye iSebe lezeMpilo kunye neeNkonzo zoLuntu zayivala i-Medicare ekuhlawuleni inkqubo ngo-1981, nto leyo eyabangela ukuba iinkampani ezininzi ze-inshorensi zingabandakanyi ngokucacileyo i-transgender-related coverage kwizicwangciso ze-inshorensi yangasese kungekudala emva koko.
Ngenxa yoko, iingcali ezimbalwa e-US zibonelela ngotyando lomzimba olusezantsi konke konke, ukunceda iqela elincinci lezigulane ezikwaziyo ukuthenga utyando.Uninzi lwabantu be-transgender baphoqeleka ukuba bahlawule utyando oluphuma ngaphandle kwepokotho kude kube yi-2014, xa ulawulo luka-Obama lubuyisela i-Medicare coverage yokuqinisekiswa kwezesini kunye nokukhutshwa kwe-inshurensi evaliweyo kwi-2016. zikwazi ukuhlawulela ezi nkqubo nge-inshurensi okanye nge-Medicaid, kwaye ezinye izibhedlele zingxamele ukuhlangabezana nemfuno engekapheli.
Nangona kunjalo, iinkqubo ezinjalo zibiza kakhulu: i-vaginoplasty ixabisa malunga ne-25,000 yeedola.Uphononongo luka-2018 ngabaphandi beYunivesithi yaseHarvard kunye neYunivesithi yaseJohns Hopkins bafumanisa ukuba phakathi kwe-2000 kunye ne-2014, inani le-transgender verification surgering linyuke kakhulu, kunye nenani elikhulayo labo likhuselwe ngasese okanye lihlawulwe yi-Medicaid.“Njengoko ugutyulo lwezi nkqubo lusanda, kuya kuba njalo nemfuneko yoogqirha botyando abanobuchule,” baqukumbela ngelithi abaphandi.Kodwa kukho imithetho embalwa esemgangathweni malunga nokuba kuthetha ukuthini "ukufaneleka", kwaye ezinye iindawo zonyango zinefuthe kwinguqu yesini.kwingxaki.Oogqirha botyando banika ingxelo kumaziko ahlukeneyo kwaye uqeqesho lwe-GRS lunokususela kuqwalaselo lweveki kunye nogqirha wotyando odumileyo ukuya kwinkqubo yokufunda iminyaka emininzi.Akukho zixhobo ezizimeleyo ezifumanekayo kwizigulane ukufumana idatha malunga namazinga obunzima botyando.Ngokuqhelekileyo, izigulane zithembele kuphela kwidatha ebonelelwe ngoogqirha ngokwabo.
Ngelixa abantu abangenakubalwa baye baxhamla kwi-GRS coverage, enye impembelelo engalindelekanga ibe yinto eyenziwa yi-San Francisco-based gender surgeon uDkt.esibhedlele ngexesha elimisiweyo, kwaye bangabulawa yingxaki eyoyikisayo, okanye baphinde bangeniswe esibhedlele izihlandlo ezininzi,” utshilo, “yindlela abalinganisa ngayo impumelelo.”babe "ngababoneleli abakhethiweyo" ngokutsala izigulane ezitsha ekusebenzeni kwazo ngokusekelwe kwezi metrics.
Ngo-Meyi 2018, izigulane ze-192 emva kokusebenza kwe-transgender zabhala ileta evulekileyo kwi-WPATH evakalisa ezinye iinkxalabo malunga nenkqubo yangoku apho oogqirha botyando banikezela ngezigulane ezinobuncwane "utyando lwamahhala okanye oluphantsi kweendleko zokufumana izinga lengxaki kunye neengcebiso zangaphambili".iimpapasho zemfundo kunye nokuthetha esidlangalaleni malunga namava otyando, utyando lokulinga ngaphandle kwemvume enolwazi, ulwazi lwezonyango olungachanekanga olunikezelwa kwizigulane, kunye nokungonelanga emva kokhathalelo lwezigulane.
"Kusekho ukungalingani phakathi kwemfuno kunye nenani labantu abaqeqeshwe kwezi nkqubo," kusho uDkt. Lauren Schechter, umongameli okhethiweyo we-American Society of Gender Surgeons.“Ngokuqinisekileyo injongo yethu kukufundisa abantu abaninzi ukuze abantu kungabikho mfuneko yokuba bahambe, ubuncinane kwiindawo eziphambili… Ngoko ke kukho ukulibaziseka phakathi kokufundisa abantu ngokufanelekileyo nokusungula amaziko amaziko [kunye] nezibhedlele.”
Ukunciphisa ukulibaziseka ukuhlangabezana nemfuno ekhulayo yeenkqubo zokuqinisekisa isini kudla ngokuthetha ukunciphisa amathuba oqeqesho oluxabisekileyo kwizibhedlele kunye noogqirha botyando."Ngokusisiseko, amanyathelo amabini ukuya phambili kunye nesinyathelo esinye emva," utshilo uJamison Green, owayengumongameli we-WPATH kunye nomlawuli okhoyo wezonxibelelwano, wotyando lotyando.Ukuthatha inyathelo umva, wathi, abanye oogqirha botyando banokukhetha ukuqeqeshwa phantsi kwezona meko zinzima: “Abajoyini i-WPATH.Abazivumeli ukuba bafundiswe.Emva koko bathi, "Ewe, ngoku ndiyazi ukuba mandenze ntoni."Njengomnye ugqirha wotyando ongaziwa ocatshulwe kuphando luka-2017: “Umntu uya kubantu abanamagama ahloniphekileyo;bafunda kangangeveki baze baqalise.akukho semthethweni kwaphela!”
Ukutshintsha izicwangciso ze-inshorensi kunye nemithetho elawula iinkampani ze-inshorensi zase-US kuthetha ukuba abantu abatshintshe isini bahlala befuna iinkqubo ezinjalo kuba besoyika ukuba i-inshurensi inokutshintsha imithetho yabo yokhuseleko xa behlola oogqirha abanokubakho.Ukhuseleko lwe-inshurensi luhlala luchaza apho izigulana zifumana khona ukhathalelo, njengoDanielle, umfazi oneminyaka engama-42 ubudala ohlala ePortland, e-Oregon kwaye oxhomekeke kwiMedicaid.Kwimeko yakhe, olunye utyando lokuqinisekisa isini lugutyungelwe yinkqubo yeMedicaid yelizwe, kodwa ngo-2015, uDanielle waziva enesidingo sokwenza oko ngokukhawuleza njengoko ukhathalelo lwezonyango lwabantu abatshintshe isini lwaba yinjongo yezopolitiko yaseRiphabhlikhi.
"Ndicinge ngaphambi kokuba sibe nomongameli waseRiphabhlikhi, kufuneka ndibe nelungu lobufazi," uxelele u-Izebhele kudliwanondlebe lwasentwasahlobo ka-2018.Xa iMedicaid imthumela ePortland ukuba ayokubona uGqr Daniel Dougie, wamxelela ukuba wayesisigulana sakhe se-12 se-transvaginoplasty.Wathi akuvuka kwi-anesthesia, waxelelwa ukuba utyando lwaluza kuthatha ixesha eliphindwe kabini kuba kwakunzima ukuvula amalungu angasese.
Nangona wayesithi iziphumo zakhe zokubonwayo nezezivamvo zazintle, amava kaDanielle esibhedlele ashiya okuninzi.“Akukho mntu kule wadi oyaziyo indlela yokujongana nokwenzakala kwabantu,” utshilo.Uthe waziva elahliwe kwaye wakhawuleza ukuya kunceda emva kwenkqubo ende nehlaselayo.U-Jezebel wathetha nabanye abaguli bakaGqr. Dougie, kwaye ekugqibeleni bafaka isikhalazo esisemthethweni esibhedlele.Ngelixa izikhalazo zikaDaniella zazimalunga namava akhe okhathalelo lwe-post-op esibhedlele, abanye bajamelana neengxaki ezinzulu, kuquka i-fistula kunye nokungabikho komchamo emva kokuhlinzwa.Ngokutsho komthombo onolwazi ngeengxoxo zeqela nesibhedlele, eli qela likholelwa ukuba isibhedlele sinezinga eliphezulu lokuxakeka kunezinye izibhedlele ezinikezela ngeenkqubo ezifanayo.
Ekuphenduleni imibuzo emininzi ye-Jezebel, uDkt Dougie uthe isibhedlele asibandakanyi ukusebenzisana okuthe ngqo kunye nezigulane ngenxa yemithetho yangasese, kodwa yavuma ukuba abasebenzi bathetha ngokubanzi kunye nezigulane ze-transgender.“Sithathe inxaxheba kwiindibano ezininzi zobuso ngobuso nabantu kunye namaqela ekuhambeni kwexesha.Ezi ntlanganiso ziqhubekile kwaze kwaba yilapho kuvunyelwana malunga neenkxalabo zesigulane zangoku, iinjongo zeengxoxo zafikelelwa, kwaye isicwangciso sokuthintela ukuphindaphinda saphuhliswa, "uDkt Dugi wabhala nge-imeyile.
Ngokukodwa, isibhedlele siye saseka iKomiti yeeNgcebiso zoLuntu lwe-transgender yendawo kunye nabantu abangahambelaniyo ngokwesini ababonisana nabasebenzi kunye nolawulo lweNkqubo yezeMpilo ye-OHSU Transgender, iMicimbi yezigulane kunye nabanye abachaphazelekayo.
UDkt Dougie wazisa u-Jesabel ukuba iingxaki zotyando esibhedlele zazibekwe iliso kwaye zisetyenziselwa ukuphucula iziphumo, kunye namazinga eengxaki ezihambelanayo okanye ezidlula iziphumo ezipapashiweyo ezivela kwezinye iingcali zotyando.“Oogqirha bethu botyando bazabalazela ukugqwesa, kodwa ngamanye amaxesha kubakho iingxaki,” utshilo."Bonke oogqirha be-OHSU benza uphononongo lwangaphakathi rhoqo lweziphumo zabo zonyango kunye notyando ngokugula kunye neentlanganiso zokufa eziququzelelwa ngumlawuli wesebe ngalinye lomgangatho."
UGqr Dugi uqaphele ukuba iinkxalabo zabasebenzi malunga nomgangatho wokhathalelo kunye neziphumo ziphakanyiselwe kwinkqubo yokuphononongwa koontanga enokudluliselwa kwiibhodi zokuphonononga iziko."Onke amaziko ezonyango alandela lo mgangatho kwaye anqunywe ngamaqumrhu agunyazisiweyo kazwelonke," watsho.
Ngelixa izigulane ze-OSHU zixubusha ukuguqulwa okunokwenzeka kunye nokulawulwa kwezibhedlele, ezinye zezigulane zikaDkt Rumer zangaphambili zahamba ubude obugqithiseleyo.Ngexesha lika-2018, abane ababekade bezizigulane zotyando bafaka amatyala ahlukeneyo enkundleni yeSithili saseMpuma sasePennsylvania.Ngamnye kubo wayemelwe yinkampani yamagqwetha efanayo kwaye bathi umsebenzi kaGqr. Rumer wenziwa kakubi kumatyala abo kangangokuba abamangali (bonke abantu baseNew York) bafuna utyando oluhlaziyiweyo kwiNtaba yeSinayi.
Ngamnye wabamangali uchaze ukucutha kunye nomonakalo kwi-urethra yabo, i-vaginal canal, kunye ne-labia, kunye ne-clitoral hoods, kunye ne-clitoral hoods, imiba eyaziwa ngokuba "umonakalo osisigxina" ukuze abamangali "bangaze babe nomsebenzi wesondo kwakhona."
Amatyala, achaza "ukuthotywa" kunye "nokwenzakala okukhulu kwengqondo" okubangelwa ngumsebenzi kaGqr. Rumer, ekuqaleni kwabiza ukuthethwa kwetyala, kodwa ekugqibeleni kwathunyelwa kulamlo lwangasese ngokuzithandela.Kwimeko enye, amagqwetha anenjongo yokumangalela uGqr. Jess Ting, ugqirha wotyando kunye noprofesa weyeza ogqwesileyo kwi-GRS eNtabeni yeSinayi, ngokwe-memo yangaphambi kokuvavanywa.Kulindeleke ukuba angqine ukuba nasemva kotyando oluthathu, umsebenzi kaGqr. Rumer awuzange uvumele abamangali ukuba "bafezekise i-orgasm okanye ukwaneliseka ngokwesondo ngaphandle kwentlungu", kunye nokusombulula ezinye iingxaki ezibalulekileyo, kuquka "i-clitoris enkulu ngaphandle kwekhaka le-clitoral" kunye neenwele. akukho clitoris.isuswe ngokuchanekileyo.
UGqr.“Sonke sineengxaki kwaye izinto azisoloko zihamba ngendlela esifuna ngayo.Xa ubona umzekelo weziphumo ezibonisa ukuba ugqirha usenokungafikeleli kumgangatho wokunyamekela, uye uzive ufuna ukuthetha.”
Kwisishwankathelo sangaphambi kovavanyo olufakwe ngasekupheleni kukaFebruwari, ngaphambi kokuba ityala liye kulamlo, amagqwetha kaGqr Rumer athi ugqirha akazange angakhathali, akazange aphambuke kumgangatho wokhathalelo, kwaye ingxaki yesigulana "yingxaki eyaziwayo. ”"[c] I-Vaginoplasty.Isikhalazo sikwachaza ukuba isigulane "asizange sisebenze ngelixa siphathwa nguDkt. Rumer" kwaye i-47 ubudala ayizange ichaze iingxaki ezinkulu de kube ngaphezu konyaka emva kokuhlinzwa.Iinkcukacha zenkqubo yolamlo kunye neziphumo zayo zikhutshwe azizange zenziwe esidlangalaleni, v. Rumer Akukho namnye kubamangali kwityala lobugqirha ophendule kwizicelo ezininzi zodliwano-ndlebe.
UGqr. Dean wathi: “Njengogqirha, akukho mntu uthanda iisuti ezingafanelekanga.“Esi sisihloko esingathandekiyo kum njengommangalelwa wezenzo ezigwenxa.Sele ndiyithethile loo nto, ndivakalelwa kukuba njengabasebenzi kulo mmandla mncinane kakhulu, kufuneka sizinyamekele kwaye sigcine imilinganiselo.”
U-Jezabel uqhagamshelane noogqirha abaninzi abaziwayo besini ukubuza ukuba zingaphi izigulana zangaphambili zikaRumer ezenziwe kwakhona ukulungisa iziphumo zakhe.Okuqondakalayo kunqabile ukuphawula, kodwa abantu abathathu, abacele ukuba bangachongwa, balandele ngaphezulu kwezigulane ezingama-50 ezaziqale zanxibelelana noGqr Rumer we-GRS ukusukela ngo-2016.
"Sonke sifuna ukuba abantu abagqithisayo babe neendlela ezininzi zokuhlinzwa, kwaye senza konke esinako ukufundisa nokukhuthaza iziphumo ezingcono," utshilo uGqr Bowers, ugqirha wotyando olusekelwe eSan Francisco.iingxaki zotyando, umsindo kunye nobutshaba kubakhalazi, ukungabikho kokufumaneka okanye ukuphendula.Wongezelela ngelithi uGqr. Rumer “kwaye uyabuqonda ubuthathaka babaguli abafuna utyando olunoogqirha abambalwa ngokwentelekiso.””
UHannah Simpson, umfazi oneminyaka engama-34 ubudala ovela eNew York, wathi emva kweeveki ezimbini emva kokufumana i-GRS kunye noDkt Rumer ehlobo lika-2014, waqaphela ukuba i-vulva yakhe yaqala ukubonakala i-asymmetrical kwaye iinxalenye zayo zibomvu kakhulu.kwaye idumbile.Nangona uGqr. Rumer waqinisekisa ukuba yonke into yayilungile, uSimpson wavelisa i-necrosis ye-vulva.
USimpson, owayefundela ubugqirha ngelo xesha, wachaza i-vulva yakhe entsha: i-clitoris egogekileyo “eyayicala-nye” kunye nelabia “eyayikhangeleka ngakumbi njengeqhuma kuneeflaphu ezimbini.”U-Simpson wayenezinye iingxaki, kuquka neenwele zelungu lobufazi ukuba oogqirha bathembisa ukususa kunye nokubekwa okungaqhelekanga kwe-urethra yakhe.Ukongeza, uGqr. Rumer washiya izicubu ezongezelelweyo malunga nomnyango welungu lobufazi, nto leyo eyenza ukuba i-dilation ingakhululeki, utshilo uSimpson.Ngomhla olandelayo, kwaye emva koko kwi-imeyile elandelayo ukuba uSimpson ekwabelwana ngayo no-Izebhele, uGqr. Rumer watyhola ulusu olufileyo kwi-Depends Simpson pair ukuba uSimpson wayeyinxibile kakhulu esibhedlele, apho uSimpson waqwalasela ingxaki yokuphepha.UGqr. Rumer akazange avume ukuphendula imibuzo kaIzebhele ngendlela awasinyanga ngayo esi sigulana okanye nasiphi na esinye isigulana.
I-Necrosis efana ne-Simpson's necrosis yingozi kunye nayo nayiphi na i-vaginoplasty kwaye inokubangelwa ukunxiba iimpahla zangaphantsi ezixinene kakhulu kumanqanaba okuqala okubuyisela emva kokuhlinzwa, nangona kunokuba nzima ukukhomba unobangela ochanekileyo kule meko, uSchechter uthe.usulelo kumguli.“Usulelo, i-tissue necrosis, i-suture dehiscence - konke oku kwenzeka nangaluphi na utyando,” utshilo.U-Schecter waphawula ukuba ukuhamba emva kokuhlinzwa kunye nendawo engcolileyo okanye engakhuselekanga ekhaya kunokukhokelela kwiingxaki, kodwa ekugqibeleni ugqirha kufuneka acebise isigulane kwaye aqinisekise ukuba le miba yengozi iyancitshiswa.
Utyando lwesibini kunye nogqirha owahlukileyo aluzange luphumelele ekubuyiseleni umsebenzi wokuqala kaGqr.Ngokwezibalo zakhe, ngoku uye wadibana noogqirha botyando abangama-36 ukuba bakhe amalungu akhe angasese.La mava amtyhafisa kumsebenzi wobugqirha waza wayeka ukulandela isidanga sakhe sobugqirha.Akazange asebenzise nayiphi na indlela esesikweni yokufaka izikhalazo, esoyikela ukuba oko kwakuya kunciphisa amathuba okuba ngomnye ugqirha wotyando othabathele kuye ityala.
Izikhalazo zikaSimpson ngomsebenzi kaGqr. Rumer ziyafana nezo zabanye abaguli ababethetha noJezebhele.“Bendisoloko ndilumkisa abantu ukuba bangahambi noRumer,” utshilo u-Amber Rose, oneminyaka engama-28 ubudala ongengomntwana waseBoston.Kwi-2014, baya kuDkt. Rumer ukuhlinzwa kwe-hip ngenxa yazo zonke iinketho ezinikezelwa yisicwangciso somshuwalense wabazali babo, ugqirha wayenexesha elifutshane lokulinda.
Uqhaqho lukaRose aluhambanga njengoko bekucwangcisiwe."URumer ushiye izicubu ezininzi ze-erectile phantsi kwe-labia minora yam, enokuba yingxaki," kusho uRoss.“Yayingajongeki njenge vulva.”Kwanabanye oogqirha, bathi, “ubuncinane kanye bazama ukufaka umnwe kumchamo wam ngenxa yokuba wawungabonakali.
URoss wathi uGqr. Rumer akazange akhe i-clitoral hood, eshiya i-clitoris yabo ivuleke ngokupheleleyo ukuze ivuselelwe.Kwakhona, indlela kaRumer yokususa iinwele ayiphumelelanga kwaye yashiya inwele ngaphakathi kwilabia kodwa hayi kumjelo welungu lobufazi ngokwawo.Bathi: “Wayemana eqokelela incindi nomchamo, yaye wayenuka kangangokuba ndade ndoyika kunyaka wokuqala de ndafumanisa ukuba akufunekanga kubekho nwele apho.
Ngokutsho kukaRoss, kwiminyaka emithandathu kamva, abakavuyi ukusebenza kwabo kwaye banenkxalabo yokuba uGqr Rumer usebenza kubantu abatshintshe isini.Kodwa bathi ukukhungatheka kwabo kukwavela kwiingxaki zenkqubo kunye neenkqubo: ukunqongophala koogqirha be-GRS kunye noluhlu olude lokulinda, oku kuthetha ukuba abantu abafana nabo banokukhetha okumbalwa kunye nolwazi olwaneleyo kugqirha wotyando.
Utyando lwempundu kubantu abatshintshe isini kunye nabantu abatshintshe isini luninzi kwaye lufuna ubuchule botyando lweplastiki, i-urology kunye ne-gynecology.Nganye kula macandelo anekomiti ezimeleyo enoxanduva lokuvunywa.Iinzame zakutsha nje zokulinganisa ijiko lokufunda le-vaginoplasty licebisa ukuba iinkqubo ezingama-40 ziyafuneka ukuze ufunde ngokupheleleyo obu buchule.Ngaphandle kobudlelwane obuvunyiweyo okanye izikhokelo zokuqeqeshelwa umsebenzi kwi-WPATH okanye nakweliphi na elinye iqumrhu lobuchwephesha, izigulane kuya kufuneka ziqhube uluhlu olubanzi lwemigangatho yotyando ubomi bazo bonke.
Izibhedlele ezizimeleyo ekugqibeleni zinoxanduva lokumisela ukuba ngubani ogunyazisiweyo ukwenza iinkqubo ezithile kumaziko azo.UGqr Schechter uxelele u-Jezabel ukuba iibhodi zezibhedlele zifuna ukuba oogqirha baqinisekise ubuncinane enye yeebhodi zonyango ze-30 kulo lonke ilizwe, kwaye banokuba nemigangatho eyahlukeneyo yoqeqesho oluncinci kwabo banakho utyando.Kodwa ngokukaWPATH's Greene, akukho bhodi yezonyango eqinisekisa ngokuthe ngqo oogqirha botyando ukuba benze utyando olungqamene nesini: “Bendikhathaza oogqirha botyando ukuba bafumane abantu abanjengoMbutho woTyando lwePlastiki ukuba bazame ukufumanisa indlela yokwenza olu hlobo lotyando. uqeqesho.njengenxalenye yoviwo lwebhodi ukuze ufumane isiqinisekiso,” utshilo."Kuba ngoku, ukuze kuthethwe, aziqinisekiswanga ngezifo ezithile."
Okwangoku, i-American Society of Plastic Surgeons ibamba isatifikethi sebhodi jikelele kodwa ayijongani ngokuthe ngqo kwiinkqubo ezinxulumene nesondo, oku kuthetha ukuba oogqirha abadibeneyo akufanele bahlangabezane nemigangatho ethile yoqeqesho ukwenza utyando lwangasese kwizigulane ze-transgender.UGreen uthe esi sisakhiwo seziko esingafanelanga imisebenzi yangoku.“Ngoku sinoogqirha botyando, iingcali zesibeleko kunye noogqirha botyando oluncinane ababandakanyekayo ekwakhiweni ngokutsha kwamalungu angasese.Ngoko kunzima kakhulu kunangaphambili,” utshilo."Kodwa akukho bhodi ikulungeleyo ukuyamkela loo nto."
Ukuzalisa isithuba, oogqirha abafana noDkt Schechter kunye nabanye abajongene nokunyamekela ngokwesini baye bahlanganisana ukuze balwele inkqubo yemfundo esemgangathweni kwizibhedlele ezifuna ukungena kwintsimi.Kwi-2017, uDkt Schechter wabhala inqaku kwi-Journal ye-Sexual Medicine echaza ezinye zezona mfuno zincinci zoqeqesho lwabagqirha bexesha elizayo.
Ngokwengxelo, oogqirha botyando abenza utyando lokuqinisekiswa ngokwesondo kufuneka bafumane uqeqesho olubanzi, kubandakanywa neesemina, iiseshoni zase-ofisini, iiseshoni zokunyamekela izandla kunye nasemva kokuhlinzwa, kunye nophuhliso oluqhubekayo lobuchwephesha.Ngelixa ezi zindululo ziza kuphucula umgangatho wemfundo kwilizwe liphela, zihlala zingavolontiya kwizibhedlele noogqirha botyando.Imibutho engenzi ngeniso efana ne-WPATH iye yazama ukuhlangabezana neemfuno zoqeqesho kodwa ayikwazanga ukwenza utshintsho lwenkqubo ngokwayo.Umbutho uqhuba uqeqesho lwayo lotyando, olwaqala ngexesha likaMongameli weGreen ukusuka kwi-2014 ukuya kwi-2016. Kodwa kwintlangano efana ne-WPATH, iindleko zoqeqesho zinokuthintela, kwaye zihlala zikhethwa kwaye zikhululekile koogqirha abafuna ngokwenene ukwenza umsebenzi wabo.
Abanye, njengabacebisi abasebenza kumaziko ononophelo oluphambili lwe-LGBT, bancedisa izigulana ezinotyando lokuqinisekisa ngokwesini, kwaye ngo-2018 baququzelele ileta evulekileyo ye-WPATH ecebisa imodeli "yeziko lokugqwesa" apho i-inshurensi kunye nemibutho yobuchwephesha basebenza kunye, ukuqinisekisa kuphela i-inshurensi ehlawulweyo. .oogqirha botyando abaqeqeshwe kwiinkqubo ezikhethekileyo.(Umzekelo, uthi, ujongene neengxaki ezifanayo kwi-bariatric operation ekuqaleni kwe-2000s, ukubonelela ngedatha yesiphumo esithile kunye nezithintelo zokuqinisa utyando xa ujongene neengxaki ezifanayo.) U-Blasdel uphawula ukuba ngelixa amanye amaziko ezonyango sele eqalise ukuzibiza ngokuthi "i-transgender". iziko lokugqwesa”, “Okwangoku akukho miqathango ekufuneka ilandelwe ngugqirha wotyando okanye iziko ukuze lifumane esi sihloko.