Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.
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DOI：
10.1080/26895269.2022.2100644
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发表时间：
2022
影响因子：
4.6
通讯作者：
Arcelus, J.
中科院分区：
文献类型：
--
作者：
Coleman, E.;Radix, A. E.;Bouman, W. P.;Brown, G. R.;de Vries, A. L. C.;Deutsch, M. B.;Ettner, R.;Fraser, L.;Goodman, M.;Green, J.;Hancock, A. B.;Johnson, T. W.;Karasic, D. H.;Knudson, G. A.;Leibowitz, S. F.;Meyer-Bahlburg, H. F. L.;Monstrey, S. J.;Motmans, J.;Nahata, L.;Nieder, T. O.;Reisner, S. L.;Richards, C.;Schechter, L. S.;Tangpricha, V;TisheInnan, A. C.;Van Trotsenburg, M. A. A.;Winter, S.;Ducheny, K.;Adams, N. J.;Adrian, T. M.;Allen, L. R.;Azul, D.;Bagga, H.;Basar, K.;Bathory, D. S.;Belinky, J. J.;Berli, J. U.;Bluebond-Langner, R. O.;Bouman, M-B;Bowers, M. L.;Brassard, P. J.;Byrne, J.;Capitan, L.;Cargill, C. J.;Carswell, J. M.;Chang, S. C.;Chelvakumar, G.;Corneil, T.;Dalke, K. B.;De Cuypere, G.;de Vries, E.;Den Heijer, M.;Devor, A. H.;Dhejne, C.;D'Marco, A.;Edmiston, E. K.;Edwards-Leeper, L.;Ehrbar, R.;Ehrensaft, D.;Eisfeld, J.;Elaut, E.;Erickson-Schroth, L.;Feldman, J. L.;Fisher, A. D.;Garcia, M. M.;Gijs, L.;Green, S. E.;Hall, B. P.;Hardy, T. L. D.;Irwig, M. S.;Jacobs, L. A.;Janssen, A. C.;Johnson, K.;Klink, D. T.;Kreukels, B. P. C.;Kuper, L. E.;Kvach, E. J.;Malouf, M. A.;Massey, R.;Mazur, T.;McLachlan, C.;Morrison, S. D.;Mosser, S. W.;Neira, P. M.;Nygren, U.;Oates, J. M.;Obedin-Maliver, J.;Pagkalos, G.;Patton, J.;Phanuphak, N.;Rachlin, K.;Reed, T.;Rider, G. N.;Ristori, J.;Robbins-Cherry, S.;Roberts, S. A.;Rodriguez-Wallberg, K. A.;Rosenthal, S. M.;Sabir, K.;Safer, J. D.;Scheim, A., I;Seal, L. J.;Sehoole, T. J.;Spencer, K.;St Amand, C.;Steensma, T. D.;Strang, J. F.;Taylor, G. B.;Tilleman, K.;T'Sjoen, G. G.;Vala, L. N.;Van Mello, N. M.;Veale, J. F.;Vencill, J. A.;Vincent, B.;Wesp, L. M.;West, M. A.;Arcelus, J.
关键词：
背景：跨性别医疗保健是一个快速发展的跨学科领域。在过去十年中，寻求支持和性别肯定医疗的跨性别和性别多样性（TGD）人群的数量和知名度出现了前所未有的增长，同时该领域的科学文献也大幅增加。世界跨性别健康专业协会（WPATH）是一个国际性的多学科专业协会，其使命是促进基于证据的护理，教育，研究，公共政策和尊重跨性别健康。WPATH的主要职能之一是通过护理标准（SOC）促进TGD人群的最高标准医疗保健。SOC最初于1979年开发，最后一个版本（SOC-7）于2012年发布。鉴于越来越多的科学证据，WPATH委托制定了新版本的护理标准，即SOC-8。目的：SOC-8的总体目标是为医疗保健专业人员（HCP）提供临床指导，以帮助TGD患者获得安全有效的途径，以实现与性别自我的持久个人舒适感，旨在优化他们的整体身体健康，心理健康和自我实现。方法：SOC-8是基于跨性别健康方面的最佳科学和专家专业共识。国际专业人员和利益攸关方被选为SOC-8委员会成员。建议声明是根据独立系统文献综述（如可用）、背景综述和专家意见得出的数据制定的。建议的分级是基于支持干预措施的现有证据、对风险和危害的讨论以及在不同背景和国家环境下的可行性和可接受性。结果：作为SOC-8的一部分，共制定了18个章节。它们包含为TGD患者提供护理和治疗的卫生保健专业人员的建议。每项建议后面都附有解释性案文，并附有相关参考资料。与跨性别健康有关的一般领域在术语、全球适用性、人口估计和教育等章节中有所介绍。为TGD人群的不同人群开发的章节包括成人，青少年，儿童，非二元，太监和双性个体的评估，以及生活在机构环境中的人。最后，与性别肯定治疗有关的章节是激素治疗，手术和术后护理，语音和沟通，初级保健，生殖健康，性健康和心理健康。结论：SOC-8指南旨在灵活地满足全球TGD人群的不同医疗保健需求。这些标准虽然具有适应性，但为促进最佳保健提供了标准，并为治疗经历性别不一致的人提供了指导。与SOC的所有先前版本一样，本文件中规定的性别肯定医疗干预标准是临床指南;个别医疗保健专业人员和项目可以在与TGD人员协商后修改这些标准。
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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