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Norman Spack: How I help transgender teens become who they want to be
我是如何帮助变性的青少年成为他们想做的人: How I help transgender teens become who they want to be
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Readability: 3.8
1,359,735 views
青春期对每个人都几乎是一个尴尬的时期。但对变性的青少年来说可以是个噩梦，当他们在一夜之间进入他们自己感觉不喜欢的身体的时候。在一个感动的谈话里，内分泌专家诺曼.斯巴克说出了为少年们用荷尔蒙做替换治疗的一些个体的故事。通过延缓关闭青春期，斯巴克给了变性青少年所需要的时间。
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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我要你们都想想
00:16
about the third word that was ever said
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别人说到你的时候
说的第三个字。
00:20
about you,
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00:23
or if you were delivering,
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或者如果你正在生孩子，
00:26
about the person you were delivering.
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就是说到这个孩子时的第三个字。
00:31
And you can all mouth it if you want
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你可以不出声地说，
00:34
or say it out loud.
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也可以大声地说出来。
00:35
It was, the first two were, "It's a ..."
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头两个字是：“是。。。个。。。”
00:44
Well, it shows you that
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你看，
00:46
I also deal with issues where there's
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我处理的病例中还有
00:47
not certainty of whether it's a girl or a boy,
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不能确定是男孩还是女孩的情况，
00:50
so the mixed answer was very appropriate.
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所以说刚才混合型的答案是很合适的。
00:54
Of course, now the answer often comes
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当然，现在谜底经常
00:56
not at birth but at the ultrasound,
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是在做超声波而不是
出生的时候就揭晓了，
出生的时候就揭晓了，
00:58
unless the prospective parents choose
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除非准父母们选择
01:01
to be surprised like we all were.
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和我们那会儿一样等待一个惊喜。
01:05
But I want you to think about what it is
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不过我希望你们想一想
是什么决定刚才那句话里
01:08
that leads to that statement
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01:12
on the third word,
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第三个字是什么。
01:14
because the third word
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因为第三个字
01:17
is a description of your sex,
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描述的是你的性征，
01:24
and by that I mean,
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我的意思是
01:27
made by a description of your genitals.
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实际上描述的是你的外生殖器。
01:32
Now, as a pediatric endocrinologist,
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作为一个儿童内分泌专家，
01:35
I used to be very, very involved,
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我曾经治过的很多病人，
01:37
and still somewhat am,
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现在有时我也治一些这类病人，
01:39
in cases in which
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是那些
01:42
there are mismatches
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外部结构之间不一致，
01:44
in the externals
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01:47
or between the externals and the internals,
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或着外部和内部器官不符的孩子，
01:51
and we literally have to figure out
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这种情况下我们真的得研究一下
01:56
what is the description of your sex.
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你的性征是什么。
02:00
But there is nothing that is definable
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但是出生的时候没有什么能够
02:02
at the time of birth
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02:05
that would define you,
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定义你，
02:09
and when I talk about definition,
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这里定义我指的，
02:11
I'm talking about your sexual orientation.
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是你的性取向。
02:18
We don't say, "It's a gay boy."
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我们不说，“这是一个同性恋男孩。”
02:23
"A lesbian girl."
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“同性恋女孩。”
02:26
Those situations don't really define themselves
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这些情况
要到十几岁才能显现出来。
02:29
more until the second decade of life.
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02:33
Nor do they define your gender,
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出生时也无法定义你的性别，
02:38
which, as different from your anatomic sex,
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和你的身体性征不同的是，
02:42
describes your self-concept.
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这里我指的是你的自我概念。
02:45
Do you see yourself
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你把自己
02:47
as a male or female
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看作是男还是女，
02:51
or somewhere in the spectrum in between?
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还是有点介于两者之间?
02:56
That sometimes shows up
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这些有时候会在
03:01
in the first decade of life,
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十岁以前显现出来。
03:04
but it can be very confusing for parents
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但是做父母的会难以确定，
03:08
because it is quite normative
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因为正常情况下，
03:11
for children to act in a cross-gender play and way,
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儿童们也会表现出跨性别的行为。
03:17
and that in fact there are studies that show
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实际上有些研究显示，
03:19
that even 80 percent of children
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百分之八十
03:22
who act in that fashion
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有这种行为表现的儿童
03:25
will not persist in wanting to be
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到青春期开始的时候，
不会坚持想要变成另一性别。
03:30
the opposite gender
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03:32
at the time when puberty begins.
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03:36
But at the time that puberty begins,
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但当他们青春期开始的时候，
03:42
that means between about age 10 to 12 in girls,
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也就是女孩在10到12岁之间
03:45
12 to 14 in boys,
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男孩在12岁到14岁之间，
03:49
with breast budding
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胸部开始隆起
03:50
or two to three times increase in the gonads
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或者男性的话，
性腺增大了两到三倍的时候，
性腺增大了两到三倍的时候，
03:54
in the case of genetic males,
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03:57
by that particular point, the child who says
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到这个时候，如果一个孩子说
04:00
they are in the absolute wrong body
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自己是生在一个错误的身体里，
04:05
is almost certain to be transgender
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那就几乎可以肯定是个变性人了。
04:09
and is extremely unlikely to change those feelings,
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而且他们几乎没有可能改变这种感觉，
04:16
no matter how anybody tries reparative therapy
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不管别人如何试图治疗他们，
04:20
or any other noxious things.
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或者采用其他不善的手段。
04:24
Now this is relatively rare,
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这种情况相当罕见，
04:27
so I had relatively little
personal experience with this,
personal experience with this,
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所以我个人在这方面的经验不多。
04:30
and my experience was more typical
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我的经验比较典型，
04:33
only because I had an adolescent practice.
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仅仅是因为我给青少年看病。
04:35
And I saw someone age 24,
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一个病人24岁，
04:37
went through Harvard, genetically female,
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遗传上来说是女性，
04:39
went through Harvard with three male roommates
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跟三个男室友一同上完哈佛，
04:41
who knew the whole story,
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他们完全清楚是怎么回事。
04:43
a registrar who always listed his name
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注册时在课表上
04:46
on course lists as a male name,
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他总是填上一个男性的名字。
04:48
and came to me after graduating saying, "Help me.
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毕业后他来找我，说，“帮帮我，
04:53
I know you know a lot of endocrinology."
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我知道内分泌学你很在行。”
04:55
And indeed I've treated a lot of people
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的确我治疗过很多
04:57
who were born without gonads.
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天生没有性腺的人。
04:59
This wasn't rocket science.
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这又不是什么火箭科学。
05:01
But I made a deal with him:
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但我跟他达成了一个协议：
05:02
I'll treat you if you teach me.
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我可以给你治疗，但你要教我。
05:05
And so he did.
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他教了我。
05:08
And what an education I got
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我真是接受了一场非同一般的教育，
05:10
from taking care of all the members
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就是通过治疗他的支持小组里的成员
05:12
of his support group.
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05:15
And then I got really confused,
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但是然后我又有些糊涂了
05:17
because I thought it was relatively easy at that age
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我原以为治疗那么年轻的人
应该比较容易，
应该比较容易，
05:20
to just give people the hormones
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只需要给他们使用
05:22
of the gender in which they were affirming,
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他们自己确认的性别的激素就可以了。
05:26
but then my patient married,
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但是后来我的病人结婚了，
05:29
and he married a woman
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他娶的这位女士，
05:32
who had been born as a male,
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出生的时候是个男的，
05:34
had married as a male, had two children,
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作为男人结过婚，有两个孩子，
05:37
then went through a transition into female,
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然后变成了女的。
05:43
and now this delightful female
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现在这位可爱的女士，
05:48
was attached to my male patient,
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跟我的男性病人在一起，
05:52
in fact got legally married because they showed up
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事实上他们已经合法结婚了，
05:54
as a man and a woman, and who knew?
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因为他们是一男一女。谁知道呢？
05:56
Right? (Laughter)
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对吧？（笑声）
05:59
And while I was confused about,
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我糊涂的是，
06:03
does this make so-and-so gay?
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这样谁和谁是不是同性恋了呢？
06:05
Does this make so-and-so straight?
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还是异性恋呢？
06:07
I was getting sexual orientation
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我把性取向
06:10
confused with gender identity.
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跟性别认同混淆了。
06:13
And my patient said to me,
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我的病人跟我说，
06:15
"Look, look, look.
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“看，
06:17
If you just think of the following, you'll get it right:
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只要这么想就不会错了：
06:20
Sexual orientation is who you go to bed with;
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性取向是你和男的还是女的上床，
06:23
gender identity is who you go to bed as."
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而性别认同是你作为
男的还是女的上床。“
男的还是女的上床。“
06:29
And I subsequently learned from the many adults --
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我随后从很多成年人那里得知－－
06:32
I took care of about 200 adults —
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我看过大约200个成年人--
06:34
I learned from them
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我从他们那里得知
06:36
that if I didn't look, peek as to who
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如果我不看，不偷偷地瞧一下
06:39
their partner was in the waiting room,
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侯诊室里他们的伴侣是谁，
06:41
I would never be able to guess
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我永远也不可能猜出，
06:43
better than chance
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至少不可能比随机猜测更可靠地知道，
06:45
whether they were gay, straight, bi,
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他们在自己确认的性别中是
06:47
or asexual in their affirmed gender.
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同性恋，异性恋，双性恋，
还是无性恋。
还是无性恋。
06:51
In other words,
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换句话说，
06:52
one thing has absolutely nothing to do
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这两件事完全没有任何关系。
06:55
with the other.
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06:57
And the data show it.
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研究数据也证明这一点。
06:59
Now, as I took care of the 200 adults,
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我治疗这200个成年人时，
07:04
I found it extremely painful.
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发现这是一件非常痛苦的事。
07:06
These people were -- many of them
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这些人，他们中很多人，
07:09
had to give up so much of their lives.
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不得不放弃生活中的很大一部分。
07:13
Sometimes their parents would reject them,
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有时候他们被父母，
07:16
siblings, their own children,
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兄弟姐妹，或者亲生的子女所拒绝，
07:18
and then their divorcing spouse
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还有他们闹离婚的配偶
07:20
would forbid them from seeing their children.
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会禁止他们去探望自己的孩子。
07:24
It was so awful, but why did they do it
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既然这么痛苦，为什么他们
07:27
at 40 and 50?
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到了四五十岁还要做呢？
07:30
Because they felt they had to affirm themselves
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因为他们觉得他们必须肯定自己，
07:34
before they would kill themselves.
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不然就只有自杀了。
07:37
And indeed, the rate of suicide
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的确，
07:39
among untreated transgendered people
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未接受治疗的变性人的自杀率
07:43
is among the highest in the world.
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在世界上是最高的。
07:46
So what to do?
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那么该做什么呢？
07:49
I was intrigued in going to a conference
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我去荷兰参加过一个很有意思的会议，
07:52
in Holland, where they are experts in this,
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他们那儿是这方面的专家，
07:54
and saw the most remarkable thing.
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我在那里看到了最不同寻常的事情。
07:58
They were treating young adolescents
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他们
对青少年进行非常严密的
08:01
after giving them the most intense
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08:04
psychometric testing of gender,
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关于性别的心理计量测试，然后进行治疗。
08:07
and they were treating them by blocking
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他们治疗的方法是阻止
08:09
the puberty that they didn't want.
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他们不想要的青春期。
08:11
Because basically, kids look about the same,
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因为小孩子看起来基本一样，
08:14
each sex, until they go through puberty,
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不管什么性别，
直到他们经过了青春期。
直到他们经过了青春期。
08:17
at which point, if you feel you're in the wrong sex,
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那时候如果你觉得自己的性别不对，
08:20
you feel like Pinocchio becoming a donkey.
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你会觉得就像匹诺曹变成驴子一样。
08:23
The fantasy that you had that your body will change
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你幻想你的身体发育成
08:26
to be who you want it to be with puberty
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你想要的样子，
08:28
actually is nullified by the puberty you get.
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可这个幻想却恰恰会因为青春期的发育而破灭。
08:33
And they fall apart.
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他们会因此而崩溃。
08:36
So that's why putting the puberty on hold—
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那就是为什么要让青春期暂停。
08:39
Why on hold? You can't just give them
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为什么是暂停呢？因为你不能
08:41
the opposite hormones that young.
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给那么小的孩子用相反性别的激素，
08:43
They'll end up stunted in growth,
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那会使他们停止生长。
08:45
and you think you can have
a meaningful conversation
a meaningful conversation
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而且你觉得有可能跟他们说明白
08:48
about the fertility effects of such treatment
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激素治疗对生育能力的影响吗？
08:50
with a 10-year-old girl, a 12-year-old boy?
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他们是才10岁的女孩，或12岁的男孩。
08:54
So this buys time in the diagnostic process
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这样，就可以为诊断过程多争取到
08:56
for four or five years
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四到五年的时间。
08:58
so that they can work it out,
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这样可以更加确定，
09:01
they can have more and more testing,
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可以做更多的测试，
09:04
they can live without feeling their bodies
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他们可以不用感觉
09:06
are running away from them.
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自己的身体正背离他们。
09:08
And then, in a program they call 12-16-18,
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然后，在一个叫做12-16-18的项目中，
09:12
around age 12 is when they
give the blocking hormones,
give the blocking hormones,
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12岁时他们接受阻断激素，
09:17
and then at age 16 with retesting,
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16岁时被重新测试，
09:19
they requalify.
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确认他们符合条件。
09:21
Now remember, the blocking
hormones are reversible,
hormones are reversible,
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请记住，阻断激素是可逆转的，
09:25
but when you give the hormones of the opposite sex,
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但是一旦使用了相反性别的激素，
09:28
you now start spouting breasts and facial hair
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就开始了乳房的发育，胡须的生长，
09:30
and voice, depending on what you're using,
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或声音的变化，取决于你用的是什么了。
09:32
and those effects are permanent
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那些效果是永久性的，
09:35
or require surgery to remove
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只能通过手术
或者是电蚀的方法来去除，
09:37
or electrolysis,
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09:38
and you can never really affect the voice.
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而且你几乎不可能真正改变声音。
09:40
So this is serious, and this is 15-, 16-year-old stuff.
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4299
所以这在十五六岁时是很重要的。
09:45
And then at 18, they're eligible for surgery,
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3163
到了十八岁，他们就可以接受手术了。
09:48
and while there's no good surgery
for females to males genitally,
for females to males genitally,
187
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4335
虽然女性转男性外生殖器方面
还没有什么好的手术疗法，
还没有什么好的手术疗法，
09:52
the male-to-female surgery
has fooled gynecologists.
has fooled gynecologists.
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男转女的手术已经可以
瞒过妇科专家了。
瞒过妇科专家了。
09:57
That's how good it can be.
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2761
可以做到这种程度。
10:00
So I looked at how the patients were doing,
190
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3860
我就想看看病人们怎样了，
10:03
and I looked at patients who
just looked like everybody else,
just looked like everybody else,
191
591980
3010
我发现他们和别人没什么两样，
10:06
except they were pubertally delayed.
192
594990
2439
只是青春期被延迟了。
10:09
But once they gave them the hormones
193
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2059
但是一旦给他们用上
10:11
consistent with the gender they affirm,
194
599488
2511
和他们确认的性别相符的激素，
10:13
they look beautiful.
195
601999
1978
他们看起来那么漂亮。
10:15
They look normal. They had normal heights.
196
603977
3766
他们看起来完全正常，身高也正常。
10:19
You would never be able to pick them out
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2233
你永远也不可能
10:21
in a crowd.
198
609976
2595
在人群里把他们挑出来。
10:24
So at that point, I decided I'm going to do this.
199
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2356
于是，我决定我也要这样做。
10:26
This is really where the pediatric
200
614927
2575
这是真正需要用到
儿童内分泌学的地方，
10:29
endocrine realm comes in,
201
617502
1988
10:31
because in fact, if you're going to deal with it
202
619490
1981
因为如果治疗的是
10:33
in kids age 10-12, 10-14,
203
621471
2681
10到12岁，10到14岁的孩子，
10:36
that's pediatric endocrinology.
204
624152
3282
那就是儿童内分泌学的范畴。
10:39
So I brought some kids in,
205
627434
3779
于是我找了些孩子来。
10:43
and this now became the standard of care,
206
631213
2657
现在这些已纳入标准护理方案，
10:45
and Children's Hospital was behind it.
207
633870
2757
是由儿童医院发起的。
10:48
By my showing them the kids before and after,
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636627
4441
当我给他们看治疗前后的孩子们，
10:53
people who never got treated
209
641068
1349
从没有接受治疗的人
10:54
and people who wished to be treated,
210
642417
2528
和那些想要接受治疗的人，
10:56
and pictures of the Dutch,
211
644945
3146
还有一些荷兰人的照片后，
11:00
they came to me and said,
212
648091
1129
他们来对我说，
11:01
"You've got to do something for these kids."
213
649220
1991
“你必须为这些孩子做些什么。”
11:03
Well, where were these kids before?
214
651211
3307
那么， 这些孩子以前在哪里呢？
11:06
They were out there suffering, is where they were.
215
654518
3154
他们就生活在痛苦之中。
11:09
So we started a program in 2007.
216
657672
6311
在2007年我们开展了一个项目
11:15
It became the first program of its kind --
217
663983
2152
它是第一个这类的项目，
11:18
but it's really of the Dutch kind --
218
666135
2598
不过它实际上就是荷兰的项目
11:20
in North America.
219
668733
2141
搬到北美来。
11:22
And since then, we have 160 patients.
220
670874
4197
从那以后，我们有了160个病人。
11:27
Did they come from Afghanistan? No.
221
675071
3277
他们来自阿富汗吗？不是。
11:30
They came, 75 percent of them came
222
678348
3273
百分之七十五的人来自
11:33
from within 150 miles of Boston.
223
681621
5068
波士顿周围150英哩（约240公里）
以内的地方。
以内的地方。
11:38
And some came from England.
224
686689
3397
有些来自英国。
11:42
Jackie had been abused in the Midlands, in England.
225
690086
3819
杰姬在英国的米德兰被虐待过。
11:45
She's 12 years old there,
226
693905
2015
12岁的时候，
11:47
she was living as a girl
227
695920
1353
她像个女孩一样地生活，
11:49
but she was being beaten up.
228
697273
2152
但是因此而被打。
11:51
It was a horror show.
229
699425
1053
非常可怕。
11:52
They had to homeschool her.
230
700478
1996
他们只能在家里教她读书。
11:54
And the reason the British were coming was
231
702474
2749
而英国人来这儿是因为
11:57
because they would not treat anybody
232
705223
3365
他们不给任何
12:00
with anything under age 16,
233
708588
1940
16岁以下的孩子们任何治疗。
12:02
which means they were consigning them
234
710528
1788
这意味着他们被迫接受
他们不想要的成人身体，
他们不想要的成人身体，
12:04
to an adult body, no matter what happened,
235
712316
3468
不管发生了什么，
12:07
even if they tested them well.
236
715784
2024
也不管他们是不是做了很好的检查。
12:09
Jackie, on top of it, was,
237
717808
2368
对杰姬来说，除此之外，
12:12
by virtue of skeletal markings,
238
720176
2575
按照骨骼标记，
12:14
destined to be six feet five.
239
722751
4087
她是注定要长到六呎五吋
（约1米95）的。
（约1米95）的。
12:18
And yet, she had just begun
240
726838
1971
而且，她刚刚开始了
12:20
a male puberty.
241
728809
2155
男性的青春期。
12:22
Well, I did something a little bit innovative,
242
730964
3445
我做了一点儿创新，
12:26
because I do know hormones,
243
734409
1950
因为我我确实对激素知道得比较多，
12:28
and that estrogen is much more potent
244
736359
2070
雌激素
12:30
in closing epiphyses, the growth plates,
245
738429
3706
对于关闭骨骼生长节，
12:34
and stopping growth, than testosterone is.
246
742135
3317
抑制生长比雄激素更有效。
12:37
So we blocked her testosterone
247
745452
2386
所以我们
12:39
with a blocking hormone,
248
747838
2558
用了一种阻断激素来抑制她的雄激素，
12:42
but we added estrogen, not at 16, but at 13.
249
750396
4339
但我们在她13岁，而不是16岁时
就加上了雌激素。
就加上了雌激素。
12:46
And so here she is at 16, on the left.
250
754735
3518
这是左边是她，16岁。
12:50
And on her 16th birthday, she went to Thailand,
251
758253
2001
她16岁生日的时候去了泰国，
12:52
where they would do a genital plastic surgery.
252
760254
2143
做了外生殖器整形手术。
12:54
They will do it at 18 now.
253
762397
1900
他们现在只给18岁的人做了。
12:56
And she ended up 5'11"
254
764297
2864
她最后长到5呎11吋（约1米80）高。
12:59
but more than that, she has normal breast size,
255
767161
3307
但是另外，她胸部发育得大小正常。
13:02
because by blocking testosterone,
256
770468
2263
因为阻断了雄激素，
13:04
every one of our patients
257
772731
1630
我们的每一个病人
13:06
has normal breast size
258
774361
1875
胸部大小都正常，
13:08
if they get to us at the appropriate age, not too late.
259
776236
4175
前提是他们在合适的年龄来找我们，
而不是太晚。
而不是太晚。
13:12
And on the far right, there she is.
260
780411
2280
最右边的是她。
13:14
She went public,
261
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1715
她公开了自己的身份，
13:16
semifinalist in the Miss England competition.
262
784406
3082
进入了英国小姐竞赛的半决赛。
13:20
The judges debated as to, can they do this?
263
788768
3232
裁判们就能不能这么做起了争议。
13:24
Can they make her —
264
792000
1868
可以选她吗？
13:25
And one of them quipped, I'm told,
265
793868
2291
我听说其中的一位打趣说，
13:28
"But she has more natural self
266
796159
2055
“但是她比很多其他的选手
13:30
than half the other contestants."
267
798214
1925
更具有自然美。“
13:32
(Laughter)
268
800139
1967
（笑声）
13:34
And some of them have been rearranged a little bit,
269
802106
4216
虽然某些部分重新安排了一下，
13:38
but it's all her DNA.
270
806322
3312
但还都是她的DNA。
13:41
And she's become a remarkable spokeswoman.
271
809634
3313
她现在是一个了不起的发言人。
13:44
And she was offered contracts as a model,
272
812947
4010
有人请她签约做模特儿，
13:48
at which point she teased me, where she said,
273
816957
1843
她就这事跟我开玩笑说：
13:50
"You know, I might have had a better chance
274
818800
2080
“如果你让我长到6呎1吋
（约1米85），
（约1米85），
13:52
as a model if you'd made me six feet one."
275
820880
2727
可能更有助于我的模特生涯。“
13:55
Go figure. (Laughter)
276
823607
4453
（笑声）
14:00
So this picture, I think, says it all.
277
828060
3653
那么这张照片，我认为，说明了一切。
14:03
It really says it all.
278
831713
1747
真的。
14:05
These are Nicole and brother Jonas,
279
833460
3851
这是妮可和她兄弟琼那斯。
14:09
identical twin boys,
280
837311
2816
同卵的孪生兄弟，
14:12
and proven to be identical,
281
840127
2569
而且经过证明是同卵的。
14:14
in which Nicole had affirmed herself
282
842696
2490
妮可认定自己是女孩，
14:17
as a girl as early as age three.
283
845186
2230
是早在她三岁的时候。
14:19
At age seven, they changed her name,
284
847416
2501
7岁时，他们为她改了名字，
14:21
and came to me at the very beginnings
285
849917
3213
而且在她刚刚开始男性青春期的时候
14:25
of a male puberty.
286
853130
1646
就来找我了。
14:26
Now you can imagine looking at Jonas
287
854776
1568
看看琼那斯14岁的样子，
14:28
at only 14 that male puberty
288
856344
1758
你就能想到
14:30
is early in this family,
289
858102
2517
他们家男性青春期开始得比较早，
14:32
because he looks more like a 16-year-old,
290
860619
2251
因为他看起来好像16岁。
14:34
but it makes the point all the more
291
862870
1840
这就更说明
14:36
why you have to be conscious
292
864710
1657
为什么你需要意识到
14:38
of where the patient is.
293
866367
1952
你的病人处在什么阶段。
14:40
Nicole has done pubertal blockade in here,
294
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3960
妮可接受了青春期阻断，
14:44
and Jonas is just going -- biologic control.
295
872279
3793
而琼那斯正在经过青春期－
这是最好的生物学对照。
这是最好的生物学对照。
14:48
This is what Nicole would look like
296
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1538
妮可本来会长成这样子，
14:49
if we weren't doing what we were doing.
297
877610
2180
如果我们没给她用药的话。
14:51
He's got a prominent Adam's apple.
298
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2392
他已经有一个明显的喉结
14:54
He's got angular bones to the face, a mustache,
299
882182
3707
面部的骨骼出现了棱角，还长了胡子。
14:57
and you can see there's a height difference
300
885889
1520
还可以看到他们的身高也不一样，
14:59
because he's gone through
301
887409
1300
因为他经过了一段快速生长期，
15:00
a growth spurt that she won't get.
302
888709
2040
而她不会有这段时期了。
15:02
Now Nicole is on estrogen.
303
890749
1881
现在妮可在用雌激素，
15:04
She has a bit of a form to her.
304
892630
3289
她已经开始发育出女性的形体。
15:07
This family went to the White House last spring
305
895919
3307
他们一家去年春季去了白宫
15:11
because of their work
306
899226
2621
因为他们在
15:13
in overturning an anti-discrimination,
307
901847
3398
逆转一条歧视法律中的贡献。
15:17
there was a bill that would block
308
905245
2841
缅因州有一个法案
15:20
the right of transgender people in Maine
309
908086
2257
要禁止变性人
15:22
to use public bathrooms,
310
910343
1679
使用公共卫生间。
15:24
and it looked like the bill was going to pass,
311
912022
3123
看起来那个法案要通过了，
15:27
and that would have been a problem,
312
915145
1377
那就会很成问题。
15:28
but Nicole went personally
to every legislator in Maine
to every legislator in Maine
313
916522
3611
但妮可在缅因访问了每一位立法人。
15:32
and said, "I can do this.
314
920133
2074
她说，“我能做到的。
15:34
If they see me, they'll understand
315
922207
1951
如果他们看到我，他们会明白
15:36
why I'm no threat in the lady's room,
316
924158
2063
为什么我在女卫生间不构成什么威胁，
15:38
but I can be threatened in the men's room."
317
926221
2337
而我在男卫生间会受到威胁。“
15:40
And then they finally got it.
318
928558
3438
他们最终理解了。
15:43
So where do we go from here?
319
931996
3020
现在我们还要做什么呢？
15:47
Well, we still have a ways to go
320
935016
2390
在反歧视方面
15:49
in terms of anti-discrimination.
321
937406
1623
我们还有很长一段路要走。
15:51
There are only 17 states that have
322
939029
1415
现在只有17个州有
15:52
an anti-discrimination law
323
940444
2062
反歧视法律，
15:54
against discrimination in housing,
324
942506
2950
禁止在房屋居住
15:57
employment, public accommodation,
325
945456
2813
就业，公共场合歧视变性人。
16:00
only 17 states, and five of them are in New England.
326
948269
3294
只有17个州，其中五个是在新英格兰地区。
16:03
We need less expensive drugs.
327
951563
1791
我们需要便宜一些的药物，
16:05
They cost a fortune.
328
953354
1433
现在这些药非常昂贵。
16:06
And we need to get this condition
329
954787
2176
而且我们要把这类病
16:08
out of the DSM.
330
956963
2037
从DSM（《精神疾病诊断与统计手册》）里排除。
16:11
It is as much a psychiatric disease
331
959000
2609
它如果是精神疾病，
16:13
as being gay and lesbian,
332
961609
1805
那同性恋也是了，
16:15
and that went out the window in 1973,
333
963414
2961
可是1973年同性恋就不再被认为是了，
16:18
and the whole world changed.
334
966375
1842
随之全世界都改变了。
16:20
And this isn't going to break anybody's budget.
335
968217
2734
这不会导致任何人入不敷出；
16:22
This is not that common.
336
970951
2116
因为这种情况并不常见。
16:25
But the risks of not doing anything for them
337
973067
4638
但是如果我们什么也不做，
16:29
not only puts all of them at risk
338
977705
4211
不仅是让他们都处于
16:33
of losing their lives to suicide,
339
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2457
自杀而失去生命的危险之中，
16:36
but it also says something about
340
984373
2697
而且也让人怀疑
16:39
whether we are a truly inclusive society.
341
987070
3791
我们是否是一个真正包容的社会。
16:42
Thank you.
342
990861
2569
谢谢。
16:45
(Applause)
343
993430
2566
（掌声）
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