2021年经济学人 我是男还是女,这是个问题(1)

Gender¹ medicine

性别医学

Second thoughts

三思

Doubts are growing about therapy for gender-dysphoric children

对于性别焦虑症儿童的治疗方法，人们的质疑越来越多

Gender medicine was once an obscure specialty². Patients with gender dysphoria were typically middle-aged³ men wishing to live as women. Things are different now. First, there are many more patients. Referrals to a specialist clinic attached to the Free University of Amsterdam rose 20- fold between 1980 and 2015. The Gender Identity Development Service (GIDS), England and Wales's only paediatric gender clinic, sees 30 times more people than a decade ago. The patients have changed, too. Most are now female and in their teens. Many are treated with drugs to block the onset⁴ of puberty. These are often followed by hormones⁵ to promote development of physical characteristics of the opposite sex, as part of an approach called affirmation therapy.

性别医学曾经是一个不起眼的专业。性别焦虑症患者通常是希望像女性一样生活的中年男性。现在情况不同了。首先，病人更多了。从1980年到2015年，到阿姆斯特丹自由大学的一家附属专家诊所就诊的人数增加了20倍。性别认同发展服务(GIDS)是英格兰和威尔士唯一的一家儿科性别诊所，就诊人数是10年前的30倍。患者也发生了变化，现在大多数都是十几岁的女性。许多人用药物来阻止青春期的开始，通常伴随着用荷尔蒙来促进异性身体特征的发展，是“肯定疗法”的一种。

Last June, though, Finland revised its guidelines to prefer psychological treatment to drugs. In September Britain launched a top-down review of the field. In December the High Court of England and Wales ruled that under-16s were unlikely to be able to consent meaningfully to taking puberty blockers, leading GIDS to suspend new referrals, though a subsequent ruling held that parents could consent on their children's behalf. On April 6th Arkansas passed laws that make prescribing puberty blockers and cross-sex hormones to children illegal. Also in April the Astrid Lindgren Children's Hospital in Stockholm, a part of the Karolinska Institute, announced that it would stop prescribing puberty blockers and cross-sex hormones to those under 18, except in clinical trials.

然而，去年6月，芬兰修订了其指导方针，将心理治疗置于药物之上。9月，英国对该领域展开了一项自上而下的审查。去年12月，英格兰和威尔士高等法院裁定，16岁以下的青少年不太可能有意义地同意服用青春期阻滞药，这导致GIDS暂停了新的转诊，尽管随后的裁决认为父母可以代表孩子同意。4月6日，阿肯色州通过了一项法律，规定给儿童开青春期阻断剂和跨性别激素是非法的。同样在4月，斯德哥尔摩的阿斯特里德·林德格伦儿童医院(隶属于卡罗林斯卡研究所)宣布，除临床试验外，将停止给18岁以下儿童开青春期阻断剂和跨性别激素的处方。

Those sceptical of affirmation therapy point out two problems. Evidence is lacking, and what exists is not reassuring⁶. A reviewby Sweden's health authorities in2019 found little research, mostly of poor quality. Britain's National Institute for Health and Care Excellence⁷ found that puberty blockers did little to dispel⁸ gender dysphoria or improve patients' mental health (though they do not make such feelings worse). Moreover, existing studies suggest that, without intervention⁹, most children with gender dysphoria end up reconciled to their natal¹⁰ sex as adults.

那些对“肯定疗法”持怀疑态度的人指出了两个问题。缺乏证据，现有的证据也不可靠。瑞典卫生当局2019年的一项评估发现，针对这方面的研究极少，而且研究质量差。英国国家健康和卓越保健研究所发现，青春期阻断剂对消除性别焦虑或改善患者的心理健康没有什么作用(尽管不会让患者感觉更焦虑)。此外，现有的研究表明，如果不进行干预，大多数患有性别焦虑症的儿童最终会在成年后接受他们的出生性别。

1 gender   

n.（生理上的）性，（名词、代词等的）性

参考例句：

• French differs from English in having gender for all nouns.法语不同于英语，所有的名词都有性。
• Women are sometimes denied opportunities solely because of their gender.妇女有时仅仅因为性别而无法获得种种机会。

2 specialty   

n.(speciality)特性，特质；专业，专长

参考例句：

• Shell carvings are a specialty of the town.贝雕是该城的特产。
• His specialty is English literature.他的专业是英国文学。

3 middle-aged   

adj.中年的

参考例句：

• I noticed two middle-aged passengers.我注意到两个中年乘客。
• The new skin balm was welcome by middle-aged women.这种新护肤香膏受到了中年妇女的欢迎。

4 onset   

n.进攻，袭击，开始，突然开始

参考例句：

• The drug must be taken from the onset of the infection.这种药必须在感染的最初期就开始服用。
• Our troops withstood the onset of the enemy.我们的部队抵挡住了敌人的进攻。

5 hormones   

n. 荷尔蒙，激素 名词hormone的复数形式

参考例句：

• This hormone interacts closely with other hormones in the body. 这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
• The adrenals produce a large per cent of a man's sex hormones. 肾上腺分泌人体的大部分性激素。

6 reassuring   

a.使人消除恐惧和疑虑的，使人放心的

参考例句：

• He gave her a reassuring pat on the shoulder. 他轻拍了一下她的肩膀让她放心。
• With a reassuring pat on her arm, he left. 他鼓励地拍了拍她的手臂就离开了。

7 excellence   

n.优秀，杰出，(pl.)优点，美德

参考例句：

• His art has reached a high degree of excellence.他的艺术已达到炉火纯青的地步。
• My performance is far below excellence.我的表演离优秀还差得远呢。

8 dispel   

vt.驱走，驱散，消除

参考例句：

• I tried in vain to dispel her misgivings.我试图消除她的疑虑，但没有成功。
• We hope the programme will dispel certain misconceptions about the disease.我们希望这个节目能消除对这种疾病的一些误解。

9 intervention   

n.介入，干涉，干预

参考例句：

• The government's intervention in this dispute will not help.政府对这场争论的干预不会起作用。
• Many people felt he would be hostile to the idea of foreign intervention.许多人觉得他会反对外来干预。

10 natal   

adj.出生的，先天的

参考例句：

• Many music-lovers make pilgrimages to Mozart's natal place.很多爱好音乐的人去访问莫扎特的出生地。
• Since natal day,characters possess the visual elements such as dots and strokes.文字从诞生开始便具有了点画这样的视觉元素。