TEDxBeaconStreet
Norman Spack: How I help transgender teens become who they want to be
Norman Spek (Norman Spack): Kako pomažem transrodnim tinejdžerima da postanu ono što žele
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Pubertet je nelagodan period za gotovo svakoga, ali za transpolne tinejdžere može biti noćna mora, dok preko noći izrastaju u tela u kojima im nije prijatno. U ovom govoru od srca, endokrinolog Norman Spek priča ličnu priču o tome kako je postao jedan od nekolicine doktora u SAD-u koji leče meloletnike terapijom zamene hormona. Sprečavajući efekte puberteta, Spek daje transpolnim tinejdžerima vreme koje im je potrebno. (Snimljeno na TEDxBeaconStreet).
Norman Spack - Endocrinologist
At Boston's Children Hospital, endocrinologist Norman Spack treats transgender teens to delay the effects of puberty. Full bio
At Boston's Children Hospital, endocrinologist Norman Spack treats transgender teens to delay the effects of puberty. Full bio
Double-click the English transcript below to play the video.
00:12
I want you all to think
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Hoću da razmislite
00:16
about the third word that was ever said
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o trećoj reči koja je ikada izgovorena
00:20
about you,
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u vezi vas,
00:23
or if you were delivering,
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ili ako ste se porađali,
00:26
about the person you were delivering.
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o osobi koju ste rodili.
00:31
And you can all mouth it if you want
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Možete je promrmljati ako hoćete
00:34
or say it out loud.
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ili je naglas izgovoriti.
00:35
It was, the first two were, "It's a ..."
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To je, prve dve su bile: "Dobili ste..."
00:44
Well, it shows you that
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Ukazuje vam da
00:46
I also deal with issues where there's
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se bavim i pitanjima gde
00:47
not certainty of whether it's a girl or a boy,
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nema pouzdanosti
da li je neko devojčica ili dečak,
da li je neko devojčica ili dečak,
00:50
so the mixed answer was very appropriate.
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tako da je mešovit odgovor
bio vrlo prikladan.
bio vrlo prikladan.
00:54
Of course, now the answer often comes
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Naravno, danas odgovor često dolazi
00:56
not at birth but at the ultrasound,
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ne na rođenju već na ultrazvuku,
00:58
unless the prospective parents choose
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osim ukoliko
potencijalni roditelji odaberu
potencijalni roditelji odaberu
01:01
to be surprised like we all were.
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da budu iznenađeni kao što smo mi bili.
01:05
But I want you to think about what it is
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Ali želim da razmislite o tome šta je to
01:08
that leads to that statement
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što dovodi do te izjave
01:12
on the third word,
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treće reči,
01:14
because the third word
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jer treća reč
01:17
is a description of your sex,
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je opis vašeg pola,
01:24
and by that I mean,
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i time podrazumevam,
01:27
made by a description of your genitals.
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nastala od opisa vaših genitalija.
01:32
Now, as a pediatric endocrinologist,
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Kao pedijatar endokrinolog,
01:35
I used to be very, very involved,
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bio sam veoma, veoma uključen,
01:37
and still somewhat am,
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i donekle još uvek jesam,
01:39
in cases in which
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u slučajevima u kojima
01:42
there are mismatches
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postoji nesklad
01:44
in the externals
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spoljašnjosti
01:47
or between the externals and the internals,
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ili između spoljašnjosti i unutrašnjosti,
01:51
and we literally have to figure out
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i bukvalno moramo da otkrijemo
01:56
what is the description of your sex.
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koji je opis vašeg pola.
02:00
But there is nothing that is definable
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Ali ne postoji ništa što je definišuće
02:02
at the time of birth
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u vreme rođenja
02:05
that would define you,
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što bi vas odredilo,
02:09
and when I talk about definition,
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a kada govorim o određivanju,
02:11
I'm talking about your sexual orientation.
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govorim o vašoj seksualnoj orijentaciji.
02:18
We don't say, "It's a gay boy."
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Ne kažemo: "Dobili ste gej sina."
02:23
"A lesbian girl."
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"Devojčicu lezbejku."
02:26
Those situations don't really define themselves
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Te okolnosti se ne određuju
02:29
more until the second decade of life.
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do druge decenije života.
02:33
Nor do they define your gender,
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Niti određuju vaš pol,
02:38
which, as different from your anatomic sex,
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koji, kao različit u odnosu na
vaš anatomski pol,
vaš anatomski pol,
02:42
describes your self-concept.
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opisuje vaš self-koncept.
02:45
Do you see yourself
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Da li vidite sebe
02:47
as a male or female
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kao muškarca ili ženu
02:51
or somewhere in the spectrum in between?
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ili negde između u spektrumu?
02:56
That sometimes shows up
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To se nekada javlja
03:01
in the first decade of life,
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u prvoj deceniji života,
03:04
but it can be very confusing for parents
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ali može biti vrlo zbunjujuće za roditelje
03:08
because it is quite normative
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jer je prilično normativno
03:11
for children to act in a cross-gender play and way,
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da se deca poigravaju
međupolnim igrama i načinima,
međupolnim igrama i načinima,
03:17
and that in fact there are studies that show
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i zapravo postoje studije koje pokazuju
03:19
that even 80 percent of children
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da čak 80 procenata dece
03:22
who act in that fashion
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koja se ponašaju na taj način
03:25
will not persist in wanting to be
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neće nastojati da budu
03:30
the opposite gender
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suprotnog pola
03:32
at the time when puberty begins.
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u vreme otpočinjanja puberteta.
03:36
But at the time that puberty begins,
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Ali u vreme kada pubertet počne,
03:42
that means between about age 10 to 12 in girls,
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to znači između uzrasta
od 10 do 12 godina kod devojčica,
od 10 do 12 godina kod devojčica,
03:45
12 to 14 in boys,
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12 do 14 kod dečaka,
03:49
with breast budding
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sa grudima koje pupe
03:50
or two to three times increase in the gonads
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ili dva do tri puta uvećanja gonada
03:54
in the case of genetic males,
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u slučaju genetskih muškaraca,
03:57
by that particular point, the child who says
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do te određene tačke, dete koje kaže
04:00
they are in the absolute wrong body
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da je u apsolutno pogrešnom telu
04:05
is almost certain to be transgender
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će gotovo sigurno biti transpolno
04:09
and is extremely unlikely to change those feelings,
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i izuzetno je malo verovatno
da će promeniti ta osećanja,
da će promeniti ta osećanja,
04:16
no matter how anybody tries reparative therapy
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bez obzira na to
koliko pokušava reparativnu terapiju
koliko pokušava reparativnu terapiju
04:20
or any other noxious things.
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ili bilo koju drugu neprijatnu stvar.
04:24
Now this is relatively rare,
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Ovo je relativno retko,
04:27
so I had relatively little
personal experience with this,
personal experience with this,
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tako da sam imao relativno malo
ličnog iskustva sa ovim,
ličnog iskustva sa ovim,
04:30
and my experience was more typical
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i moje iskustvo je bilo tipičnije
04:33
only because I had an adolescent practice.
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samo zato što sam imao
adolescentsku kliniku.
adolescentsku kliniku.
04:35
And I saw someone age 24,
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I video sam nekoga sa 24 godine,
04:37
went through Harvard, genetically female,
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prošao Harvard, genetski žensko,
04:39
went through Harvard with three male roommates
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prošao Harvard sa tri muška cimera
04:41
who knew the whole story,
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koji su znali celu priču,
04:43
a registrar who always listed his name
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beležnik koji je uvek unosio njegovo ime
04:46
on course lists as a male name,
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na listi kursa kao muško ime,
04:48
and came to me after graduating saying, "Help me.
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i došao kod mene nakon diplomiranja
govoreći: "Pomozite mi.
govoreći: "Pomozite mi.
04:53
I know you know a lot of endocrinology."
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Znam da znate puno o endokrinologiji."
04:55
And indeed I've treated a lot of people
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I zaista sam lečio mnogo ljudi
04:57
who were born without gonads.
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koji su rođeni bez gonada.
04:59
This wasn't rocket science.
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To nije bila nuklearna fizika.
05:01
But I made a deal with him:
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Ali sam se nagodio sa njim:
05:02
I'll treat you if you teach me.
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Lečiću te ako me naučiš.
05:05
And so he did.
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I tako me je naučio.
05:08
And what an education I got
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Kakvu sam samo edukaciju dobio
05:10
from taking care of all the members
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brinući o svim članovima
05:12
of his support group.
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njegove grupe podrške.
05:15
And then I got really confused,
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A onda sam se zaista zbunio,
05:17
because I thought it was relatively easy at that age
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jer sam mislio
da je relativno lako u tim godinama
da je relativno lako u tim godinama
05:20
to just give people the hormones
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jednostavno dati ljudima hormone
05:22
of the gender in which they were affirming,
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pola u kome su se afirmisali,
05:26
but then my patient married,
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ali onda se moj pacijent venčao,
05:29
and he married a woman
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i venčao se sa ženom
05:32
who had been born as a male,
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koja je rođena kao muškarac,
05:34
had married as a male, had two children,
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venčala se kao muškarac,
imala dva deteta,
imala dva deteta,
05:37
then went through a transition into female,
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zatim prošla kroz prelazak u ženu,
05:43
and now this delightful female
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i sada je ova zanosna žena
05:48
was attached to my male patient,
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bila vezana za mog muškog pacijenta,
05:52
in fact got legally married because they showed up
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u stvari, oni su se zakonski venčali
jer su se pojavili
jer su se pojavili
kao muškarac i žena, i ko bi rekao?
05:54
as a man and a woman, and who knew?
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05:56
Right? (Laughter)
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Zar ne? (Smeh)
05:59
And while I was confused about,
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I dok sam bio zauzet u vezi:
06:03
does this make so-and-so gay?
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da li je ovo manje-više gej?
06:05
Does this make so-and-so straight?
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Da li je manje-više strejt?
06:07
I was getting sexual orientation
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Pomešao sam seksualnu orijentaciju
06:10
confused with gender identity.
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sa polnim identitetom.
06:13
And my patient said to me,
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Pacijent mi je rekao:
06:15
"Look, look, look.
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"Vidi, vidi, vidi.
06:17
If you just think of the following, you'll get it right:
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Ako prosto ovako razmišljaš,
shvatićeš kako treba:
shvatićeš kako treba:
06:20
Sexual orientation is who you go to bed with;
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seksualna orijentacija je
sa kim ideš u krevet;
sa kim ideš u krevet;
06:23
gender identity is who you go to bed as."
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polni identitet je kakav ideš u krevet."
06:29
And I subsequently learned from the many adults --
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I naknadno sam naučio
od mnogo odraslih -
od mnogo odraslih -
06:32
I took care of about 200 adults —
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zbrinuo sam oko 200 odraslih -
06:34
I learned from them
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naučio sam od njih
06:36
that if I didn't look, peek as to who
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da ako ne gledam, ne gvirim ko je
06:39
their partner was in the waiting room,
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njihov partner u čekaonici,
06:41
I would never be able to guess
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nikada neću moći da pogodim
06:43
better than chance
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bolje od čiste slučajnosti
06:45
whether they were gay, straight, bi,
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da li su gej, strejt, bi,
06:47
or asexual in their affirmed gender.
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ili aseksualni u svom afirmisanom polu.
06:51
In other words,
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Drugim rečima,
06:52
one thing has absolutely nothing to do
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jedno nije imalo apsolutno nikakve veze
06:55
with the other.
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sa drugim.
06:57
And the data show it.
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I podaci to pokazuju.
06:59
Now, as I took care of the 200 adults,
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Dok sam se starao o 200 odraslih osoba,
07:04
I found it extremely painful.
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smatrao sam to izuzetno bolnim.
07:06
These people were -- many of them
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Ovi ljudi - mnogi od njih
07:09
had to give up so much of their lives.
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su morali da da odustanu
od mnogo toga u svojim životima.
od mnogo toga u svojim životima.
07:13
Sometimes their parents would reject them,
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Dešavalo se da ih roditelji odbace,
07:16
siblings, their own children,
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braća i sestre, sopstvena deca,
zatim bi im njihov bračni partner
pred razvodom
pred razvodom
07:18
and then their divorcing spouse
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07:20
would forbid them from seeing their children.
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zabranio da viđaju decu.
07:24
It was so awful, but why did they do it
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Bilo je užasno, ali zašto su to činili
07:27
at 40 and 50?
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u 40-im i 50-im godinama?
07:30
Because they felt they had to affirm themselves
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Jer su osećali da moraju da se afirmišu
07:34
before they would kill themselves.
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da se ne bi ubili.
07:37
And indeed, the rate of suicide
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I zaista, stopa samoubistava
07:39
among untreated transgendered people
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među transrodnim ljudima
bez primljenog tretmana
bez primljenog tretmana
07:43
is among the highest in the world.
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je među najvišima na svetu.
07:46
So what to do?
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Šta činiti?
07:49
I was intrigued in going to a conference
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Bio sam zaintrigiran
otišavši na konferenciju
otišavši na konferenciju
07:52
in Holland, where they are experts in this,
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u Holandiji, gde su stručnjaci za ovo,
07:54
and saw the most remarkable thing.
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i video sam vrlo neobičnu stvar.
07:58
They were treating young adolescents
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Lečili su adolescente
08:01
after giving them the most intense
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nakon što su im zadali najintenzivnije
08:04
psychometric testing of gender,
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psihometrijske testove pola,
08:07
and they were treating them by blocking
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i lečili su ih blokiranjem
08:09
the puberty that they didn't want.
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puberteta koji nisu želeli.
08:11
Because basically, kids look about the same,
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Jer u suštini, deca slično izgledaju,
08:14
each sex, until they go through puberty,
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svaki pol, dok ne prođu kroz pubertet,
08:17
at which point, if you feel you're in the wrong sex,
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u kom trenutku,
ako mislite da ste pogrešnog pola,
ako mislite da ste pogrešnog pola,
08:20
you feel like Pinocchio becoming a donkey.
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osećate se kao Pinokio
koji se pretvara u magarca.
koji se pretvara u magarca.
08:23
The fantasy that you had that your body will change
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Fantazija koju ste imali
da će se vaše telo promeniti
da će se vaše telo promeniti
08:26
to be who you want it to be with puberty
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i da ćete postati
ono što želite u pubertetu
ono što želite u pubertetu
08:28
actually is nullified by the puberty you get.
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zapravo se poništava pubertetom.
08:33
And they fall apart.
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I raspadaju se.
08:36
So that's why putting the puberty on hold—
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Zato odlaganje puberteta -
08:39
Why on hold? You can't just give them
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zašto odlaganje?
Ne možete im prosto dati
Ne možete im prosto dati
08:41
the opposite hormones that young.
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suprotne hormone tako mladima.
08:43
They'll end up stunted in growth,
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Završiće zakržljali rastom,
08:45
and you think you can have
a meaningful conversation
a meaningful conversation
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i zar mislite da možete imati
smisleni razgovor
smisleni razgovor
08:48
about the fertility effects of such treatment
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o efektima takvog tretmana na plodnost
08:50
with a 10-year-old girl, a 12-year-old boy?
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sa devojčicom od 10 godina,
dečakom od 12 godina?
dečakom od 12 godina?
08:54
So this buys time in the diagnostic process
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Zato ovo kupuje vreme
u dijagnostičkom procesu
u dijagnostičkom procesu
08:56
for four or five years
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na četiri ili pet godina
08:58
so that they can work it out,
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tako da mogu da reše problem,
09:01
they can have more and more testing,
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mogu da obave dosta testiranja,
09:04
they can live without feeling their bodies
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mogu da žive bez osećaja da njihova tela
09:06
are running away from them.
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beže od njih.
09:08
And then, in a program they call 12-16-18,
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A zatim, u programu
koji nazivaju 12-16-18,
koji nazivaju 12-16-18,
09:12
around age 12 is when they
give the blocking hormones,
give the blocking hormones,
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oko 12. godine daju blokirajuće hormone,
09:17
and then at age 16 with retesting,
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u 16. godini ponovo testiraju,
09:19
they requalify.
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budu prekvalifikovani.
09:21
Now remember, the blocking
hormones are reversible,
hormones are reversible,
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Setite se, blokirajući hormoni
se mogu preinačiti,
se mogu preinačiti,
09:25
but when you give the hormones of the opposite sex,
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ali kada date hormone suprotnog pola,
09:28
you now start spouting breasts and facial hair
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počinju da rastu grudi i dlake na licu
09:30
and voice, depending on what you're using,
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2102
i glas, u zavisnosti od toga
šta koristite,
šta koristite,
09:32
and those effects are permanent
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i ti efekti su trajni
09:35
or require surgery to remove
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2078
ili zahtevaju hirurgiju za otklanjanje
09:37
or electrolysis,
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ili elektrolizu,
09:38
and you can never really affect the voice.
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a nikada ne možete zaista uticati na glas.
09:40
So this is serious, and this is 15-, 16-year-old stuff.
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4299
Tako da je ovo ozbiljno,
to se tiče osobe od 15, 16 godina.
to se tiče osobe od 15, 16 godina.
09:45
And then at 18, they're eligible for surgery,
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A zatim u 18. godini,
postaju podesni za operaciju,
postaju podesni za operaciju,
09:48
and while there's no good surgery
for females to males genitally,
for females to males genitally,
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4335
i dok nema dobre operacije
za pretvaranje ženskih genitalija u muške,
za pretvaranje ženskih genitalija u muške,
09:52
the male-to-female surgery
has fooled gynecologists.
has fooled gynecologists.
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operacija muškarca u ženu
zna prevariti ginekologe.
zna prevariti ginekologe.
09:57
That's how good it can be.
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Toliko dobro može biti.
10:00
So I looked at how the patients were doing,
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Posmatrao sam kako su pacijenti,
10:03
and I looked at patients who
just looked like everybody else,
just looked like everybody else,
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3010
i posmatrao sam pacijente
koji su izgledali kao bilo ko drugi,
koji su izgledali kao bilo ko drugi,
10:06
except they were pubertally delayed.
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594990
2439
osim što im je odložen pubertet.
10:09
But once they gave them the hormones
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2059
Ali čim bi im dali hormone
10:11
consistent with the gender they affirm,
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2511
u skladu sa polom u kome se afirmišu,
10:13
they look beautiful.
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601999
1978
izgledali su prelepo.
10:15
They look normal. They had normal heights.
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3766
Izgledaju normalno.
Imali su normalnu visinu.
Imali su normalnu visinu.
10:19
You would never be able to pick them out
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2233
Nikada ne biste bili u stanju da ih uočite
10:21
in a crowd.
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2595
u gomili.
Tako da sam u tom trenutku
odlučio da ću raditi ovo.
odlučio da ću raditi ovo.
10:24
So at that point, I decided I'm going to do this.
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10:26
This is really where the pediatric
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2575
Ovde zaista domen
pedijatrijske endokrinologije
dolazi do izražaja,
dolazi do izražaja,
10:29
endocrine realm comes in,
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617502
1988
10:31
because in fact, if you're going to deal with it
202
619490
1981
jer zapravo, ako ćete se baviti
10:33
in kids age 10-12, 10-14,
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2681
decom uzrasta 10-12, 10-14 godina,
10:36
that's pediatric endocrinology.
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3282
to je pedijatrijska endokrinologija.
10:39
So I brought some kids in,
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3779
Izveo sam nekoliko klinaca,
10:43
and this now became the standard of care,
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2657
a to je sada postalo standard lečenja,
10:45
and Children's Hospital was behind it.
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2757
i Dečija bolnica ga je podržala.
10:48
By my showing them the kids before and after,
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4441
Mojim pokazivanjem dece pre i posle,
ljudi koji nikada nisu primili tretman
10:53
people who never got treated
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1349
10:54
and people who wished to be treated,
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2528
i ljudi koji su želeli da dobiju tretman,
10:56
and pictures of the Dutch,
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3146
i slike Holanđana,
prišli su mi i rekli:
11:00
they came to me and said,
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1129
11:01
"You've got to do something for these kids."
213
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1991
"Moraš nešto da učiniš za ovu decu."
11:03
Well, where were these kids before?
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3307
Pa gde su ta deca bila ranije?
11:06
They were out there suffering, is where they were.
215
654518
3154
Bila su tamo negde i patila, tamo su bila.
11:09
So we started a program in 2007.
216
657672
6311
Tako smo započeli program
2007. godine.
2007. godine.
11:15
It became the first program of its kind --
217
663983
2152
Postao je prvi program te vrste -
11:18
but it's really of the Dutch kind --
218
666135
2598
ali je zapravo kao holandski -
11:20
in North America.
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668733
2141
u Severnoj Americi.
11:22
And since then, we have 160 patients.
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4197
I od tada, imamo 160 pacijenata.
11:27
Did they come from Afghanistan? No.
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3277
Da li su došli iz Avganistana? Ne.
11:30
They came, 75 percent of them came
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3273
Došli su, 75 procenata je došlo
11:33
from within 150 miles of Boston.
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681621
5068
sa udaljenosti do 240 km od Bostona.
11:38
And some came from England.
224
686689
3397
A neki su došli iz Engleske.
11:42
Jackie had been abused in the Midlands, in England.
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690086
3819
Džeki je bila zlostavljana
u Midlendsu, u Engleskoj.
u Midlendsu, u Engleskoj.
11:45
She's 12 years old there,
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693905
2015
Imala je 12 godina tamo,
11:47
she was living as a girl
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1353
živela je kao devojčica
11:49
but she was being beaten up.
228
697273
2152
ali su je prebijali.
11:51
It was a horror show.
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699425
1053
Bio je to horor.
11:52
They had to homeschool her.
230
700478
1996
Morali su da je školuju kod kuće.
11:54
And the reason the British were coming was
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702474
2749
A razlog zbog kojeg
su Britanci dolazili je taj
su Britanci dolazili je taj
11:57
because they would not treat anybody
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705223
3365
što oni ne pružaju tretman nikome
12:00
with anything under age 16,
233
708588
1940
ispod uzrasta od 16 godina,
12:02
which means they were consigning them
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710528
1788
što znači da su ih osudili
12:04
to an adult body, no matter what happened,
235
712316
3468
na telo odrasle osobe,
bez obzira na to šta se dogodi,
bez obzira na to šta se dogodi,
12:07
even if they tested them well.
236
715784
2024
čak i ako su ih dobro testirali.
12:09
Jackie, on top of it, was,
237
717808
2368
Džeki je, povrh svega,
12:12
by virtue of skeletal markings,
238
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2575
usled obeležja skeleta,
12:14
destined to be six feet five.
239
722751
4087
predodređena da bude visoka 196 cm.
12:18
And yet, she had just begun
240
726838
1971
A ipak, upravo je otpočela
12:20
a male puberty.
241
728809
2155
muški pubertet.
12:22
Well, I did something a little bit innovative,
242
730964
3445
Uradio sam nešto malčice inovativno,
12:26
because I do know hormones,
243
734409
1950
jer poznajem hormone,
12:28
and that estrogen is much more potent
244
736359
2070
i znam da je estrogen mnogo delotvorniji
12:30
in closing epiphyses, the growth plates,
245
738429
3706
u zatvaranju epifiza, ploča rasta,
12:34
and stopping growth, than testosterone is.
246
742135
3317
i zaustavljanju rasta, od testosterona.
12:37
So we blocked her testosterone
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745452
2386
Zato smo blokirali njen testosteron
12:39
with a blocking hormone,
248
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2558
blokirajućim hormonom,
12:42
but we added estrogen, not at 16, but at 13.
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750396
4339
ali smo dodali estrogen,
ne u 16. godini, već u 13.
ne u 16. godini, već u 13.
12:46
And so here she is at 16, on the left.
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754735
3518
I evo nje ovde u 16. godini,
sa leve strane.
sa leve strane.
12:50
And on her 16th birthday, she went to Thailand,
251
758253
2001
Na svoj 16. rođendan, otišla je u Tajland,
12:52
where they would do a genital plastic surgery.
252
760254
2143
gde će obaviti
plastičnu operaciju genitalija.
plastičnu operaciju genitalija.
12:54
They will do it at 18 now.
253
762397
1900
Sada to rade sa 18 godina.
12:56
And she ended up 5'11"
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764297
2864
I na kraju je dostigla 180 cm,
12:59
but more than that, she has normal breast size,
255
767161
3307
štaviše, ima grudi normalne veličine,
13:02
because by blocking testosterone,
256
770468
2263
jer blokiranjem testosterona,
13:04
every one of our patients
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772731
1630
svaki naš pacijent
13:06
has normal breast size
258
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1875
ima grudi normalne veličine
13:08
if they get to us at the appropriate age, not too late.
259
776236
4175
ako dođu kod nas u odgovarajućem
uzrastu, ne previše kasno.
uzrastu, ne previše kasno.
13:12
And on the far right, there she is.
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2280
A evo nje skroz na desnoj strani.
13:14
She went public,
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1715
Izašla je u javnost,
13:16
semifinalist in the Miss England competition.
262
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3082
polufinalista u izboru za Mis Engleske.
13:20
The judges debated as to, can they do this?
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3232
Sudije su debatovale o tome
da li to može tako.
da li to može tako.
13:24
Can they make her —
264
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1868
Da li mogu da je proglase -
13:25
And one of them quipped, I'm told,
265
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2291
a jedan od njih se našalio, rekli su mi:
13:28
"But she has more natural self
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2055
"Ali ona ima više prirodnosti
13:30
than half the other contestants."
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798214
1925
od polovine ostalih učesnica."
13:32
(Laughter)
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800139
1967
(Smeh)
13:34
And some of them have been rearranged a little bit,
269
802106
4216
Neke od njih su malo preuređene,
13:38
but it's all her DNA.
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806322
3312
ali to je sve njena DNK.
13:41
And she's become a remarkable spokeswoman.
271
809634
3313
I postala je izuzetna govornica.
13:44
And she was offered contracts as a model,
272
812947
4010
Ponuđeni su joj ugovori kao modelu,
u tom trenutku me je zadirkivala,
rekla je:
rekla je:
13:48
at which point she teased me, where she said,
273
816957
1843
13:50
"You know, I might have had a better chance
274
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2080
"Znaš, možda bih imala veće šanse
13:52
as a model if you'd made me six feet one."
275
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2727
kao model da si učinio da imam 196 cm."
13:55
Go figure. (Laughter)
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4453
Pa sad vi vidite. (Smeh)
14:00
So this picture, I think, says it all.
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3653
Ova slika, po meni, sve govori.
14:03
It really says it all.
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1747
Stvarno sve govori.
14:05
These are Nicole and brother Jonas,
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3851
Ovo su Nikol i brat Džonas,
14:09
identical twin boys,
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2816
identični dečaci blizanci,
14:12
and proven to be identical,
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2569
i dokazano identični,
14:14
in which Nicole had affirmed herself
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2490
gde se Nikol afirmisala
14:17
as a girl as early as age three.
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845186
2230
kao devojčica na ranom uzrastu
od tri godine.
od tri godine.
14:19
At age seven, they changed her name,
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2501
U sedmoj godini, promenili su njeno ime,
14:21
and came to me at the very beginnings
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849917
3213
i došli kod mene na samom početku
muškog puberteta.
14:25
of a male puberty.
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1646
Možete da zamislite posmatrajući Džonas
14:26
Now you can imagine looking at Jonas
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1568
14:28
at only 14 that male puberty
288
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1758
sa svega 14 godina da muški pubertet
14:30
is early in this family,
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2517
rano dolazi u ovoj porodici,
14:32
because he looks more like a 16-year-old,
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2251
jer on izgleda više kao da ima 16 godina,
14:34
but it makes the point all the more
291
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1840
ali to još više ističe poentu
14:36
why you have to be conscious
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1657
zašto morate biti svesni toga
14:38
of where the patient is.
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866367
1952
gde se pacijent nalazi.
14:40
Nicole has done pubertal blockade in here,
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3960
Nikol je obavila
pubertetsku blokadu ovde,
pubertetsku blokadu ovde,
14:44
and Jonas is just going -- biologic control.
295
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3793
a Džonas će upravo - biološka kontrola.
14:48
This is what Nicole would look like
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1538
Ovako bi Nikol izgledala
14:49
if we weren't doing what we were doing.
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2180
da nismo uradili ono što smo uradili.
14:51
He's got a prominent Adam's apple.
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2392
On ima izraženu Adamovu jabučicu.
14:54
He's got angular bones to the face, a mustache,
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3707
Ima četvrtaste kosti lica, brkove,
i možete videti
da postoji razlika u visini
da postoji razlika u visini
14:57
and you can see there's a height difference
300
885889
1520
14:59
because he's gone through
301
887409
1300
jer je prošao kroz
15:00
a growth spurt that she won't get.
302
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2040
ubrzani rast kroz koji ona neće.
15:02
Now Nicole is on estrogen.
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1881
Nikol je sada na estrogenu.
15:04
She has a bit of a form to her.
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3289
Ima pomalo oblina.
15:07
This family went to the White House last spring
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895919
3307
Ova porodica je išla u Belu kuću
prošlog proleća
prošlog proleća
15:11
because of their work
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899226
2621
zbog njihovog rada
15:13
in overturning an anti-discrimination,
307
901847
3398
na preokretu antidiskriminacije,
15:17
there was a bill that would block
308
905245
2841
postojao je predlog zakona
koji bi sprečavao
koji bi sprečavao
15:20
the right of transgender people in Maine
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908086
2257
prava transrodnih ljudi u Mejnu
15:22
to use public bathrooms,
310
910343
1679
da koriste javna kupatila,
15:24
and it looked like the bill was going to pass,
311
912022
3123
i izgledalo je da će ovaj predlog proći,
15:27
and that would have been a problem,
312
915145
1377
a to bi bilo problem,
15:28
but Nicole went personally
to every legislator in Maine
to every legislator in Maine
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916522
3611
ali je Nikol lično išla
kod svakog zakonodavca u Mejnu
kod svakog zakonodavca u Mejnu
15:32
and said, "I can do this.
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920133
2074
i rekla: "Mogu ovo.
15:34
If they see me, they'll understand
315
922207
1951
Ako me vide, razumeće
15:36
why I'm no threat in the lady's room,
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2063
zašto nisam pretnja u ženskom toaletu,
15:38
but I can be threatened in the men's room."
317
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2337
ali mogu biti ugrožena u muškom toaletu."
15:40
And then they finally got it.
318
928558
3438
I tada su konačno shvatili.
15:43
So where do we go from here?
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931996
3020
Kuda odavde?
15:47
Well, we still have a ways to go
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2390
Pa, još uvek ima stvari koje treba uraditi
15:49
in terms of anti-discrimination.
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937406
1623
u vezi antidiskriminacije.
15:51
There are only 17 states that have
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939029
1415
Samo 17 država imaju
15:52
an anti-discrimination law
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940444
2062
antidiskriminacioni zakon
15:54
against discrimination in housing,
324
942506
2950
protiv diskriminacije stanovanja,
15:57
employment, public accommodation,
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2813
zapošljavanja, javnih usluga,
16:00
only 17 states, and five of them are in New England.
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948269
3294
samo 17 država,
a pet od njih su u Novoj Engleskoj.
a pet od njih su u Novoj Engleskoj.
16:03
We need less expensive drugs.
327
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1791
Potrebni su nam jeftiniji lekovi.
16:05
They cost a fortune.
328
953354
1433
Koštaju čitavo bogatstvo.
16:06
And we need to get this condition
329
954787
2176
I moramo da uklonimo ovo stanje
16:08
out of the DSM.
330
956963
2037
iz DSM-a.
16:11
It is as much a psychiatric disease
331
959000
2609
To je psihijatrijski poremećaj
isto koliko je i
isto koliko je i
16:13
as being gay and lesbian,
332
961609
1805
biti gej i lezbejka,
16:15
and that went out the window in 1973,
333
963414
2961
a to je ukinuto 1973,
16:18
and the whole world changed.
334
966375
1842
i ceo svet se promenio.
16:20
And this isn't going to break anybody's budget.
335
968217
2734
Ovo neće da poremeti ničiji budžet.
16:22
This is not that common.
336
970951
2116
Ovo nije toliko učestalo.
16:25
But the risks of not doing anything for them
337
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4638
Ali rizici od nečinjenja ničega za njih
16:29
not only puts all of them at risk
338
977705
4211
stavljaju ne samo sve njih pod rizik
16:33
of losing their lives to suicide,
339
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2457
od gubitka života zbog samoubistva,
16:36
but it also says something about
340
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2697
već takođe govori nešto o tome
16:39
whether we are a truly inclusive society.
341
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3791
da li smo zaista inkluzivno društvo.
16:42
Thank you.
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2569
Hvala vam.
16:45
(Applause)
343
993430
2566
(Aplauz)
ABOUT THE SPEAKER
Norman Spack - EndocrinologistAt Boston's Children Hospital, endocrinologist Norman Spack treats transgender teens to delay the effects of puberty.
Why you should listen
Norman Spack is a pediatric endocrinologist at Boston's Children Hospital and the co-founder of the hospital's Gender Management Service clinic. Created in 2007, the clinic remains one of the few in the world that treats minors with hormone replacement therapy.
Spack began working with college-aged transgender patients professionally in 1985, but found that once patients had reached adulthood, it was extremely difficult to treat their sexually mature bodies using hormone therapy. When parents of transgender children began seeking him out through online support groups, Spack started to think about possible treatments for patients in their youth, before puberty has permanently changed their bodies. Since then Spack has spoken widely on pediatric hormone therapy and has campaigned for law reform in several states to protect transgender people against hate crimes and discrimination.
Norman Spack | Speaker | TED.com