TEDxBeaconStreet
Norman Spack: How I help transgender teens become who they want to be
Norman Spack: Kako pomažem transrodnim tinejdžerima da postanu osobe koje žele biti
Filmed:
Readability: 3.8
1,359,735 views
Pubertet je nezgodno razdoblje skoro za svakoga, no za transrodne tinejdžere može biti i noćna mora, budući im se tijelo gotovo preko noći mijenja, a oni se u njemu ne osjećaju ugodno. U iskrenom govoru, endokrinolog Norman Spack je ispričao osobnu priču o tome kako je postao jedan od svega nekoliko liječnika u SAD-u, koji maloljetnike liječi zamjenskom hormonalnom terapijom. Odbijajući učinke puberteta, Spack daje transrodnim tinejdžerima vrijeme 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
0
763
3648
Želim da svi razmislite
00:16
about the third word that was ever said
1
4411
4329
o trećoj riječi koja je
ikada izgovorena o vama,
ikada izgovorena o vama,
00:20
about you,
2
8740
2842
00:23
or if you were delivering,
3
11582
3056
ili, ako ste se porađali,
00:26
about the person you were delivering.
4
14638
5158
o osobi koju ste rodili.
00:31
And you can all mouth it if you want
5
19796
2281
Možete je promrmljati ako želite,
ili je naglas izgovoriti.
ili je naglas izgovoriti.
00:34
or say it out loud.
6
22077
1570
00:35
It was, the first two were, "It's a ..."
7
23647
5948
To je, prve dvije su bile: "Dobili ste ..."
Publika: Djevojčicu. Dječaka.
(Smijeh)
00:44
Well, it shows you that
8
32268
1737
To vam pokazuje
00:46
I also deal with issues where there's
9
34005
1930
da se bavim i pitanjima gdje nije sigurno,
00:47
not certainty of whether it's a girl or a boy,
10
35935
2773
radi li se o djevojčici ili dječaku,
00:50
so the mixed answer was very appropriate.
11
38708
3305
tako da je mješovit odgovor
bio vrlo prikladan.
bio vrlo prikladan.
00:54
Of course, now the answer often comes
12
42013
2444
Naravno, danas odgovor često dolazi
ne na porodu, već na ultrazvuku,
ne na porodu, već na ultrazvuku,
00:56
not at birth but at the ultrasound,
13
44457
2406
00:58
unless the prospective parents choose
14
46863
2938
osim ako budući roditelji odaberu
da budu iznenađeni,
da budu iznenađeni,
01:01
to be surprised like we all were.
15
49801
3707
kao što smo mi bili.
01:05
But I want you to think about what it is
16
53508
2960
No, želim da razmislite o tome što je to
što dovodi do te izjave,
što dovodi do te izjave,
01:08
that leads to that statement
17
56468
4454
do te treće riječi,
01:12
on the third word,
18
60922
1677
01:14
because the third word
19
62599
2501
jer je treća riječ
01:17
is a description of your sex,
20
65100
7759
opis vašeg spola.
01:24
and by that I mean,
21
72859
2575
A pod time podrazumijevam,
01:27
made by a description of your genitals.
22
75434
4907
da je nastala prema opisu
vaših genitalija.
vaših genitalija.
01:32
Now, as a pediatric endocrinologist,
23
80341
2863
Kao pedijatar endokrinolog,
01:35
I used to be very, very involved,
24
83204
2390
bio sam veoma uključen,
i donekle još jesam,
i donekle još jesam,
01:37
and still somewhat am,
25
85594
1881
01:39
in cases in which
26
87475
2817
u slučajevima gdje postoje
nepodudarnosti u vanjštini,
nepodudarnosti u vanjštini,
01:42
there are mismatches
27
90292
2583
01:44
in the externals
28
92875
2440
ili između vanjštine i nutrine
01:47
or between the externals and the internals,
29
95315
3993
01:51
and we literally have to figure out
30
99308
4800
i doslovno moramo otkriti
01:56
what is the description of your sex.
31
104108
4094
koji je opis vašeg spola.
02:00
But there is nothing that is definable
32
108202
2478
Ali ne postoji ništa
što je određeno u vrijeme rođenja,
što je određeno u vrijeme rođenja,
02:02
at the time of birth
33
110680
3245
a što bi vas definiralo.
02:05
that would define you,
34
113925
3997
02:09
and when I talk about definition,
35
117922
2046
A kada govorim o određivanju,
02:11
I'm talking about your sexual orientation.
36
119968
6303
govorim o vašoj spolnoj orijentaciji.
02:18
We don't say, "It's a gay boy."
37
126271
5450
Ne kažemo: "Dobili ste gay sina."
Ili "Djevojčicu lezbijku."
02:23
"A lesbian girl."
38
131721
2650
02:26
Those situations don't really define themselves
39
134371
3609
Te situacije zapravo se
ne preciziraju
ne preciziraju
02:29
more until the second decade of life.
40
137980
3691
do drugog desetljeća života,
02:33
Nor do they define your gender,
41
141671
4981
niti određuju vaš spol,
02:38
which, as different from your anatomic sex,
42
146652
3612
koji, za razliku od anatomskog spola,
02:42
describes your self-concept.
43
150264
3380
opisuje vas same;
02:45
Do you see yourself
44
153644
1938
vidite li sebe kao muškarca ili ženu,
02:47
as a male or female
45
155582
3488
02:51
or somewhere in the spectrum in between?
46
159070
5617
ili negdje između unutar spektra?
To se nekada javlja
02:56
That sometimes shows up
47
164687
4981
03:01
in the first decade of life,
48
169668
3080
u prvom desetljeću života
03:04
but it can be very confusing for parents
49
172748
3557
i može biti vrlo zbunjujuće za roditelje,
03:08
because it is quite normative
50
176305
3138
jer je prilično uobičajeno kod djece
03:11
for children to act in a cross-gender play and way,
51
179443
6063
da se poigravaju
međuspolnim igrama i načinima
međuspolnim igrama i načinima
03:17
and that in fact there are studies that show
52
185506
2162
i, zapravo, postoje studije koje pokazuju
03:19
that even 80 percent of children
53
187668
3047
da čak 80% djece
koja se ponašaju na taj način,
koja se ponašaju na taj način,
03:22
who act in that fashion
54
190715
2484
03:25
will not persist in wanting to be
55
193199
5030
neće biti uporni u nastojanju
da budu suprotnog spola
da budu suprotnog spola
03:30
the opposite gender
56
198229
2233
03:32
at the time when puberty begins.
57
200462
3932
kada uđu u pubertet.
03:36
But at the time that puberty begins,
58
204394
5713
Ali, u vrijeme kada pubertet počne,
03:42
that means between about age 10 to 12 in girls,
59
210107
3567
to znači u dobi od 10 do 12 godina
kod djevojčica, 12 do 14 kod dječaka,
kod djevojčica, 12 do 14 kod dječaka,
03:45
12 to 14 in boys,
60
213674
3382
03:49
with breast budding
61
217056
1644
s rastom grudi,
03:50
or two to three times increase in the gonads
62
218700
3898
odnosno povećanja
spolnih žlijezda 2-3 puta
spolnih žlijezda 2-3 puta
03:54
in the case of genetic males,
63
222598
2912
kod muškog spola,
03:57
by that particular point, the child who says
64
225510
3382
do te određene točke,
dijete koje kaže da je
u apsolutno pogrešnom tijelu,
u apsolutno pogrešnom tijelu,
04:00
they are in the absolute wrong body
65
228892
4408
04:05
is almost certain to be transgender
66
233300
3712
gotovo sigurno će biti transrodno
04:09
and is extremely unlikely to change those feelings,
67
237012
6991
i izuzetno je malo vjerojatno
da će promijeniti te osjećaje,
da će promijeniti te osjećaje,
04:16
no matter how anybody tries reparative therapy
68
244003
4667
bez obzira na ičije pokušaje
reparativne terapije,
reparativne terapije,
04:20
or any other noxious things.
69
248670
3990
ili bilo čega drugog što je štetno.
04:24
Now this is relatively rare,
70
252660
2444
Ovo je relativno rijetko,
04:27
so I had relatively little
personal experience with this,
personal experience with this,
71
255104
3525
tako da sam s ovim imao
relativno malo osobnog iskustva.
relativno malo osobnog iskustva.
04:30
and my experience was more typical
72
258629
2575
I moje iskustvo je bilo tipičnije
04:33
only because I had an adolescent practice.
73
261204
2402
samo zato što sam imao
adolescentsku kliniku
adolescentsku kliniku
04:35
And I saw someone age 24,
74
263606
1863
i vidio sam nekoga od 24 godine,
genetski ženska osoba,
završila Harvard s tri muška cimera,
završila Harvard s tri muška cimera,
04:37
went through Harvard, genetically female,
75
265469
2471
04:39
went through Harvard with three male roommates
76
267940
1714
04:41
who knew the whole story,
77
269654
1535
koji su znali cijelu priču,
04:43
a registrar who always listed his name
78
271189
3693
osoba koja je uvijek unosila njegovo ime
na listi predavanja kao muško ime,
na listi predavanja kao muško ime,
04:46
on course lists as a male name,
79
274882
2108
04:48
and came to me after graduating saying, "Help me.
80
276990
4720
i tako je došao k meni nakon diplomiranja
govoreći: "Pomozite mi.
Znam da znate puno o endokrinologiji."
Znam da znate puno o endokrinologiji."
04:53
I know you know a lot of endocrinology."
81
281710
2091
04:55
And indeed I've treated a lot of people
82
283801
2144
I zaista sam liječio mnogo ljudi
koji su rođeni bez spolnih žlijezda.
koji su rođeni bez spolnih žlijezda.
04:57
who were born without gonads.
83
285945
1393
04:59
This wasn't rocket science.
84
287338
1710
Nije to bila nuklearna fizika.
05:01
But I made a deal with him:
85
289048
1744
Ali sam se nagodio sa njim:
05:02
I'll treat you if you teach me.
86
290792
2808
"Liječit ću te ako me podučiš."
05:05
And so he did.
87
293600
3360
To je i učinio.
05:08
And what an education I got
88
296960
1811
I što sam samo sve naučio,
05:10
from taking care of all the members
89
298771
1679
brinući o svim članovima
njegove grupe za podršku.
njegove grupe za podršku.
05:12
of his support group.
90
300450
2812
05:15
And then I got really confused,
91
303262
2622
A onda sam se zaista zbunio,
05:17
because I thought it was relatively easy at that age
92
305884
2608
jer sam mislio da je
relativno lako u tim godinama
relativno lako u tim godinama
05:20
to just give people the hormones
93
308492
1630
samo dati ljudima hormone
05:22
of the gender in which they were affirming,
94
310122
4299
onog spola kojeg potvrđuju.
05:26
but then my patient married,
95
314421
3210
No, onda se moj pacijent vjenčao,
05:29
and he married a woman
96
317631
2768
i to ženom koja je rođena kao muškarac,
05:32
who had been born as a male,
97
320399
1696
05:34
had married as a male, had two children,
98
322095
3698
vjenčala se kao muškarac,
imala dva djeteta,
imala dva djeteta,
05:37
then went through a transition into female,
99
325793
5390
a zatim prošla kroz promjenu spola u ženu.
05:43
and now this delightful female
100
331183
5277
Sada je ova divna žena
05:48
was attached to my male patient,
101
336460
3787
bila vezana za mog muškog pacijenta,
zapravo, zakonski su se vjenčali,
zapravo, zakonski su se vjenčali,
05:52
in fact got legally married because they showed up
102
340247
2737
jer su se pojavili kao muškarac i žena
i tko bi uopće znao, zar ne?
i tko bi uopće znao, zar ne?
05:54
as a man and a woman, and who knew?
103
342984
1576
05:56
Right? (Laughter)
104
344560
3106
(Smijeh)
05:59
And while I was confused about,
105
347666
3714
Bio sam zbunjen --
06:03
does this make so-and-so gay?
106
351380
2416
"Čini li ovo tu osobu gej?
06:05
Does this make so-and-so straight?
107
353796
1888
Čini li ovo tu osobu hetero?"
06:07
I was getting sexual orientation
108
355684
2463
Pomiješao sam seksualnu orijentaciju
sa spolnim identitetom.
sa spolnim identitetom.
06:10
confused with gender identity.
109
358147
3035
06:13
And my patient said to me,
110
361182
2487
Pacijent mi je rekao:
06:15
"Look, look, look.
111
363669
1665
"Vidi, vidi, vidi.
Ako samo ovako razmišljaš,
shvatit ćeš kako treba:
shvatit ćeš kako treba:
06:17
If you just think of the following, you'll get it right:
112
365334
3229
06:20
Sexual orientation is who you go to bed with;
113
368563
3266
Seksualna orijentacija znači
s kim ideš u krevet.
s kim ideš u krevet.
06:23
gender identity is who you go to bed as."
114
371829
5828
Spolni identitet znači
kakav ideš u krevet."
kakav ideš u krevet."
(Smijeh)
06:29
And I subsequently learned from the many adults --
115
377657
2686
Naknadno sam naučio od brojnih odraslih,
06:32
I took care of about 200 adults —
116
380343
2546
zbrinuo sam oko 200 odraslih,
06:34
I learned from them
117
382889
2059
naučio sam od njih
da ako ne gledam tko je
npr. njihov partner u čekaonici,
npr. njihov partner u čekaonici,
06:36
that if I didn't look, peek as to who
118
384948
2105
06:39
their partner was in the waiting room,
119
387053
2310
06:41
I would never be able to guess
120
389363
2212
samo pukom slučajnošću bih mogao pogoditi
06:43
better than chance
121
391575
1470
06:45
whether they were gay, straight, bi,
122
393045
2928
jesu li gej, hetero, bi, ili aseksualci
06:47
or asexual in their affirmed gender.
123
395973
3688
u svom izjašnjavanju.
Drugim riječima,
06:51
In other words,
124
399661
1315
jedno nije imalo apsolutno
nikakve veze sa drugim.
nikakve veze sa drugim.
06:52
one thing has absolutely nothing to do
125
400976
2784
06:55
with the other.
126
403760
1601
06:57
And the data show it.
127
405361
2345
I podaci to pokazuju.
06:59
Now, as I took care of the 200 adults,
128
407706
4534
Brinući se o 200 odraslih osoba,
07:04
I found it extremely painful.
129
412240
2345
smatrao sam to izuzetno bolnim.
07:06
These people were -- many of them
130
414585
3030
Ti ljudi, mnogi od njih,
07:09
had to give up so much of their lives.
131
417615
4207
morali su odustati
od mnogo toga u svojim životima.
od mnogo toga u svojim životima.
07:13
Sometimes their parents would reject them,
132
421822
2652
Ponekad bi ih roditelji odbacili,
07:16
siblings, their own children,
133
424474
2322
braća i sestre, vlastita djeca,
07:18
and then their divorcing spouse
134
426796
1781
a njihov bi im bračni partner u razvodu
07:20
would forbid them from seeing their children.
135
428577
3977
zabranio viđati vlastitu djecu.
07:24
It was so awful, but why did they do it
136
432554
3340
Bilo je užasno,
ali zašto su to činili
u 40-im i 50-im godinama?
u 40-im i 50-im godinama?
07:27
at 40 and 50?
137
435894
2408
Jer su osjećali da se moraju
izjasniti, potvrditi,
izjasniti, potvrditi,
07:30
Because they felt they had to affirm themselves
138
438302
4520
07:34
before they would kill themselves.
139
442822
2356
kako si ne bi oduzeli život.
07:37
And indeed, the rate of suicide
140
445178
2604
I zaista, stopa samoubojstava među
transrodnim osobama bez tretmana
transrodnim osobama bez tretmana
07:39
among untreated transgendered people
141
447782
3541
među najvišima je u svijetu.
07:43
is among the highest in the world.
142
451323
3434
07:46
So what to do?
143
454757
2343
I što učiniti?
Bio sam zaintrigiran,
otišavši na konferenciju u Nizozemsku,
otišavši na konferenciju u Nizozemsku,
07:49
I was intrigued in going to a conference
144
457100
3070
07:52
in Holland, where they are experts in this,
145
460170
2605
kako stoje stručnjaci po ovom pitanju
07:54
and saw the most remarkable thing.
146
462775
3788
i vidio nešto zaista vrijedno pažnje.
07:58
They were treating young adolescents
147
466563
3352
Liječili su adolescente
nakon što su im dali najintenzivnije
psihometrijske testove spola
psihometrijske testove spola
08:01
after giving them the most intense
148
469915
2613
08:04
psychometric testing of gender,
149
472528
3078
08:07
and they were treating them by blocking
150
475606
1817
i liječili su ih blokiranjem
puberteta kojeg nisu željeli.
puberteta kojeg nisu željeli.
08:09
the puberty that they didn't want.
151
477423
2560
08:11
Because basically, kids look about the same,
152
479983
2854
Jer u biti, djeca izgledaju skoro jednako,
08:14
each sex, until they go through puberty,
153
482837
2649
oba spola, sve dok ne prođu kroz pubertet,
08:17
at which point, if you feel you're in the wrong sex,
154
485486
2972
kada, ako osjećate da ste pogrešnog spola,
08:20
you feel like Pinocchio becoming a donkey.
155
488458
3042
osjećate 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
156
491500
2623
Maštanje koje ste imali
da će vam se tijelo promijeniti
da će vam se tijelo promijeniti
08:26
to be who you want it to be with puberty
157
494123
2693
u ono kakvo vi želite, kroz pubertet,
08:28
actually is nullified by the puberty you get.
158
496816
4739
zapravo se pubertetom poništava.
08:33
And they fall apart.
159
501555
3325
I tada se oni raspadnu.
08:36
So that's why putting the puberty on hold—
160
504880
2585
Zato odlaganje puberteta --
zašto odlaganje?
zašto odlaganje?
08:39
Why on hold? You can't just give them
161
507465
2404
Ne možete im samo dati hormone
suprotnog spola tako mladima.
suprotnog spola tako mladima.
08:41
the opposite hormones that young.
162
509869
1733
08:43
They'll end up stunted in growth,
163
511602
2017
Zakržljat će rastom,
08:45
and you think you can have
a meaningful conversation
a meaningful conversation
164
513619
2588
a mislite da možete voditi
smisleni razgovor
smisleni razgovor
08:48
about the fertility effects of such treatment
165
516207
2340
o utjecaju takvog tretmana na plodnost,
08:50
with a 10-year-old girl, a 12-year-old boy?
166
518547
4037
s djevojčicom od 10 godina,
ili dječakom od 12 godina?
ili dječakom od 12 godina?
08:54
So this buys time in the diagnostic process
167
522584
2309
Zato ovo kupuje vrijeme
u dijagnostičkom procesu
u dijagnostičkom procesu
08:56
for four or five years
168
524893
1852
na četiri ili pet godina,
08:58
so that they can work it out,
169
526745
3058
kako bi oni to riješili.
09:01
they can have more and more testing,
170
529803
2677
Oni mogu obaviti dosta testiranja,
mogu živjeti bez osjećaja
da ih njihova tijela napuštaju.
da ih njihova tijela napuštaju.
09:04
they can live without feeling their bodies
171
532480
2050
09:06
are running away from them.
172
534530
1634
09:08
And then, in a program they call 12-16-18,
173
536164
4182
A zatim, u programu kojeg zovu 12-16-18,
09:12
around age 12 is when they
give the blocking hormones,
give the blocking hormones,
174
540346
4873
oko 12. godine počinju im davati
hormone blokatore,
hormone blokatore,
09:17
and then at age 16 with retesting,
175
545219
2658
a sa 16 godina, ponovnim testiranjem,
09:19
they requalify.
176
547877
2112
smiju primiti --
09:21
Now remember, the blocking
hormones are reversible,
hormones are reversible,
177
549989
3205
zapamtite, hormoni blokatori
mogu imati i suprotan učinak,
mogu imati i suprotan učinak,
09:25
but when you give the hormones of the opposite sex,
178
553194
2923
no kada dajete hormone suprotnog spola,
09:28
you now start spouting breasts and facial hair
179
556117
2633
počinju rasti grudi i dlačice na licu,
glas se mijenja,
glas se mijenja,
09:30
and voice, depending on what you're using,
180
558750
2102
ovisno o tome što koristite
09:32
and those effects are permanent
181
560852
2270
i ti učinci su trajni,
09:35
or require surgery to remove
182
563122
2078
ili je potrebna operacija za otklanjanje,
09:37
or electrolysis,
183
565200
1221
ili elektroliza,
09:38
and you can never really affect the voice.
184
566421
2370
a nikada ne možete
zaista utjecati na glas.
zaista utjecati na glas.
09:40
So this is serious, and this is 15-, 16-year-old stuff.
185
568791
4299
I zato 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,
186
573090
3163
A onda u 18. godini mogu ići na operaciju.
09:48
and while there's no good surgery
for females to males genitally,
for females to males genitally,
187
576253
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.
188
580588
4771
operacija muškarca u ženu
zna prevariti ginekologe.
zna prevariti ginekologe.
09:57
That's how good it can be.
189
585359
2761
Toliko dobro može biti izvedena.
Promatrao sam kako su pacijenti
10:00
So I looked at how the patients were doing,
190
588120
3860
10:03
and I looked at patients who
just looked like everybody else,
just looked like everybody else,
191
591980
3010
i promatrao sam pacijente
koji su izgledali poput svih ostalih,
koji su izgledali poput svih ostalih,
osim što im je pubertet odgođen.
10:06
except they were pubertally delayed.
192
594990
2439
10:09
But once they gave them the hormones
193
597429
2059
No, jednom kada su im se dali hormoni,
10:11
consistent with the gender they affirm,
194
599488
2511
u skladu sa spolom kojeg potvrđuju,
10:13
they look beautiful.
195
601999
1978
izgledali su prelijepo.
10:15
They look normal. They had normal heights.
196
603977
3766
Izgledaju normalno.
Normalne su visine.
10:19
You would never be able to pick them out
197
607743
2233
Nikada ih ne biste mogli
prepoznati u masi.
prepoznati u masi.
10:21
in a crowd.
198
609976
2595
Tada sam odlučio da ću to učiniti.
10:24
So at that point, I decided I'm going to do this.
199
612571
2356
10:26
This is really where the pediatric
200
614927
2575
Ovo je zaista područje
pedijatrijske endokrinologije,
pedijatrijske endokrinologije,
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
jer, zapravo, ako ćete se baviti time
kod djece dobi između 10 i 14 godina,
kod djece dobi između 10 i 14 godina,
10:33
in kids age 10-12, 10-14,
203
621471
2681
10:36
that's pediatric endocrinology.
204
624152
3282
to je pedijatrijska endokrinologija.
I tako sam uveo u to nekoliko klinaca
10:39
So I brought some kids in,
205
627434
3779
10:43
and this now became the standard of care,
206
631213
2657
i to je sada postao standard liječenja
10:45
and Children's Hospital was behind it.
207
633870
2757
i bostonska dječja bolnica ga je podržala.
10:48
By my showing them the kids before and after,
208
636627
4441
Pokazujući im djecu prije i poslije,
10:53
people who never got treated
209
641068
1349
ljudi koji nikada nisu primili tretman
i ljudi koji su željeli primiti tretman,
i ljudi koji su željeli primiti tretman,
10:54
and people who wished to be treated,
210
642417
2528
te slike Nizozemaca --
10:56
and pictures of the Dutch,
211
644945
3146
prišli su mi i rekli,
11:00
they came to me and said,
212
648091
1129
11:01
"You've got to do something for these kids."
213
649220
1991
"Moraš nešto učiniti za te klince."
11:03
Well, where were these kids before?
214
651211
3307
Ali, gdje su ti klinci bili do sada?
11:06
They were out there suffering, is where they were.
215
654518
3154
Bili su tamo negdje vani i patili,
eto gdje su bili.
eto gdje su bili.
11:09
So we started a program in 2007.
216
657672
6311
I tako smo 2007. započeli program.
11:15
It became the first program of its kind --
217
663983
2152
Bio je to prvi program takve vrste,
11:18
but it's really of the Dutch kind --
218
666135
2598
ali je, zapravo, bio nizozemski --
11:20
in North America.
219
668733
2141
u Sjevernoj Americi.
11:22
And since then, we have 160 patients.
220
670874
4197
I od tada imamo 160 pacijenata.
11:27
Did they come from Afghanistan? No.
221
675071
3277
Jesu li došli iz Afganistana? Ne.
11:30
They came, 75 percent of them came
222
678348
3273
75% njih došlo je iz kruga
unutar 240 km od Bostona.
unutar 240 km od Bostona.
11:33
from within 150 miles of Boston.
223
681621
5068
11:38
And some came from England.
224
686689
3397
I neki iz Engleske.
11:42
Jackie had been abused in the Midlands, in England.
225
690086
3819
Jackie je bila zlostavljana
u Midlandu, u Engleskoj.
u Midlandu, u Engleskoj.
11:45
She's 12 years old there,
226
693905
2015
Ovdje je imala 12 godina,
11:47
she was living as a girl
227
695920
1353
živjela je kao djevojčica,
11:49
but she was being beaten up.
228
697273
2152
no počeli su je premlaćivati.
11:51
It was a horror show.
229
699425
1053
Bio je to užas, morala se
obrazovati kod kuće.
obrazovati kod kuće.
11:52
They had to homeschool her.
230
700478
1996
11:54
And the reason the British were coming was
231
702474
2749
A razlog zašto su Britanci dolazili je,
to što nisu liječili nikoga
ničim ispod 16. godine,
ničim ispod 16. godine,
11:57
because they would not treat anybody
232
705223
3365
12:00
with anything under age 16,
233
708588
1940
12:02
which means they were consigning them
234
710528
1788
što znači da su ih osudili
na tijelo odrasle osobe,
na tijelo odrasle osobe,
12:04
to an adult body, no matter what happened,
235
712316
3468
bez obzira što 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
Jackie je, uz sve to,
uslijed koštanih markera,
uslijed koštanih markera,
12:12
by virtue of skeletal markings,
238
720176
2575
12:14
destined to be six feet five.
239
722751
4087
bila predodređena na visinu
od preko 180 cm.
od preko 180 cm.
12:18
And yet, she had just begun
240
726838
1971
A ipak, upravo je
ušla u muški pubertet.
ušla u muški pubertet.
12:20
a male puberty.
241
728809
2155
Učinio sam nešto inovativno,
12:22
Well, I did something a little bit innovative,
242
730964
3445
12:26
because I do know hormones,
243
734409
1950
budući poznajem hormone
12:28
and that estrogen is much more potent
244
736359
2070
i znam da je estrogen mnogo jači
12:30
in closing epiphyses, the growth plates,
245
738429
3706
u zatvaranju epifize, važne za rast,
12:34
and stopping growth, than testosterone is.
246
742135
3317
te kod zaustavljanja rasta,
od testosterona.
od testosterona.
12:37
So we blocked her testosterone
247
745452
2386
Zato smo joj blokirali testosteron
hormonom blokatorom,
hormonom blokatorom,
12:39
with a blocking hormone,
248
747838
2558
12:42
but we added estrogen, not at 16, but at 13.
249
750396
4339
ali smo dodali estrogen,
ne u 16., već u 13. godini.
ne u 16., već u 13. godini.
12:46
And so here she is at 16, on the left.
250
754735
3518
I ovdje je ona sa 16 godina,
na lijevoj strani.
na lijevoj strani.
Na svoj 16. rođendan otišla je na Tajland,
12:50
And on her 16th birthday, she went to Thailand,
251
758253
2001
12:52
where they would do a genital plastic surgery.
252
760254
2143
gde će joj izvesti
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"
254
764297
2864
I na kraju je dostigla oko 160 cm.
12:59
but more than that, she has normal breast size,
255
767161
3307
Osim toga, ima grudi uobičajene veličine,
13:02
because by blocking testosterone,
256
770468
2263
jer blokiranjem testosterona,
13:04
every one of our patients
257
772731
1630
svaki naš pacijent
ima grudi uobičajene veličine
ima grudi uobičajene veličine
13:06
has normal breast size
258
774361
1875
13:08
if they get to us at the appropriate age, not too late.
259
776236
4175
ako nam dođu u prikladnoj dobi,
ne prekasno.
13:12
And on the far right, there she is.
260
780411
2280
Ovdje desno je ona.
13:14
She went public,
261
782691
1715
Izašla je u javnost --
polufinalistica za Miss Engleske.
polufinalistica za Miss Engleske.
13:16
semifinalist in the Miss England competition.
262
784406
3082
13:20
The judges debated as to, can they do this?
263
788768
3232
Žiri je raspravljao može li to tako?
13:24
Can they make her —
264
792000
1868
A jedan od njih se našalio,
pričali su mi:
pričali su mi:
13:25
And one of them quipped, I'm told,
265
793868
2291
13:28
"But she has more natural self
266
796159
2055
"Ali ona ima više prirodnosti
od polovine ostalih natjecateljica."
od polovine ostalih natjecateljica."
13:30
than half the other contestants."
267
798214
1925
13:32
(Laughter)
268
800139
1967
(Smijeh)
13:34
And some of them have been rearranged a little bit,
269
802106
4216
Neke od njih su bile i malo dorađene,
13:38
but it's all her DNA.
270
806322
3312
ali kod nje je sve u njenoj DNK.
13:41
And she's become a remarkable spokeswoman.
271
809634
3313
I postala je izuzetna glasnogovornica.
13:44
And she was offered contracts as a model,
272
812947
4010
Ponuđeni su joj ugovori kao modelu,
13:48
at which point she teased me, where she said,
273
816957
1843
u tom trenutku me je zadirkivala,
13:50
"You know, I might have had a better chance
274
818800
2080
"Znaš, možda bih imala
veće šanse kao model,
veće šanse kao model,
13:52
as a model if you'd made me six feet one."
275
820880
2727
da si me učinio visokom oko180 cm."
(Smijeh)
13:55
Go figure. (Laughter)
276
823607
4453
Pa sada vi vidite.
Dakle, mislim da ova slika sve govori.
14:00
So this picture, I think, says it all.
277
828060
3653
14:03
It really says it all.
278
831713
1747
Zaista sve govori.
14:05
These are Nicole and brother Jonas,
279
833460
3851
Ovo su Nicole i brat Jonas,
14:09
identical twin boys,
280
837311
2816
identični blizanci, dječaci,
14:12
and proven to be identical,
281
840127
2569
i dokazano identični.
14:14
in which Nicole had affirmed herself
282
842696
2490
Nicole se u dobi od tri godine
potvrdila kao djevojčica.
potvrdila kao djevojčica.
14:17
as a girl as early as age three.
283
845186
2230
14:19
At age seven, they changed her name,
284
847416
2501
U sedmoj godini promijenili su joj ime
14:21
and came to me at the very beginnings
285
849917
3213
te došli k meni odmah
na početku muškog puberteta.
na početku muškog puberteta.
14:25
of a male puberty.
286
853130
1646
14:26
Now you can imagine looking at Jonas
287
854776
1568
Možete zamisliti, promatrajući
Jonasa sa samo 14 godina,
Jonasa sa samo 14 godina,
14:28
at only 14 that male puberty
288
856344
1758
da muški pubertet
rano dolazi u ovu obitelj,
rano dolazi u ovu obitelj,
14:30
is early in this family,
289
858102
2517
jer on izgleda više kao 16-godišnjak.
14:32
because he looks more like a 16-year-old,
290
860619
2251
14:34
but it makes the point all the more
291
862870
1840
Zato je još važnije
14:36
why you have to be conscious
292
864710
1657
zašto trebate biti svjesni toga
gdje se pacijent nalazi.
gdje se pacijent nalazi.
14:38
of where the patient is.
293
866367
1952
14:40
Nicole has done pubertal blockade in here,
294
868319
3960
Nicole je obavila
pubertetsku blokadu ovdje,
pubertetsku blokadu ovdje,
14:44
and Jonas is just going -- biologic control.
295
872279
3793
a Jonas upravo prolazi biološku kontrolu.
14:48
This is what Nicole would look like
296
876072
1538
Ovako bi Nicole izgledala,
14:49
if we weren't doing what we were doing.
297
877610
2180
da nismo učinili sve što smo učinili.
14:51
He's got a prominent Adam's apple.
298
879790
2392
Ima izraženu Adamovu jabučicu.
14:54
He's got angular bones to the face, a mustache,
299
882182
3707
Ima četvrtaste kosti lica, brkove,
14:57
and you can see there's a height difference
300
885889
1520
a vidite i razliku u visini,
14:59
because he's gone through
301
887409
1300
jer je on prošao kroz
ubrzani rast kroz koji ona neće.
ubrzani rast kroz koji ona neće.
15:00
a growth spurt that she won't get.
302
888709
2040
15:02
Now Nicole is on estrogen.
303
890749
1881
Nicole je sada na estrogenu.
Poprima određenu formu.
15:04
She has a bit of a form to her.
304
892630
3289
Ova obitelj je bila
u Bijeloj kući prošlo proljeće,
u Bijeloj kući prošlo proljeće,
15:07
This family went to the White House last spring
305
895919
3307
15:11
because of their work
306
899226
2621
zbog svog rada na antidiskriminaciji --
15:13
in overturning an anti-discrimination,
307
901847
3398
15:17
there was a bill that would block
308
905245
2841
postojao je prijedlog zakona
koji bi sprečavao
koji bi sprečavao
pravo transrodnih osoba u državi Maine
na korištenje javnih WC-a
na korištenje javnih WC-a
15:20
the right of transgender people in Maine
309
908086
2257
15:22
to use public bathrooms,
310
910343
1679
15:24
and it looked like the bill was going to pass,
311
912022
3123
i izgledalo je da će zakon biti izglasan,
a to bi bio problem,
15:27
and that would have been a problem,
312
915145
1377
15:28
but Nicole went personally
to every legislator in Maine
to every legislator in Maine
313
916522
3611
no Nicole je osobno išla
svakom zakonodavcu u Mainu
svakom zakonodavcu u Mainu
15:32
and said, "I can do this.
314
920133
2074
i rekla, "Ja to mogu.
15:34
If they see me, they'll understand
315
922207
1951
Ako me vide, razumjet će
15:36
why I'm no threat in the lady's room,
316
924158
2063
zašto nisam prijetnja u ženskom WC-u,
15:38
but I can be threatened in the men's room."
317
926221
2337
no mogli bi mi prijetiti u muškom."
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?
319
931996
3020
I kamo sada dalje?
15:47
Well, we still have a ways to go
320
935016
2390
Pa, još uvijek ima dosta toga za učiniti
po pitanju antidiskriminacije.
po pitanju antidiskriminacije.
15:49
in terms of anti-discrimination.
321
937406
1623
15:51
There are only 17 states that have
322
939029
1415
Samo je 17 država koje imaju
antidiskriminacijski zakon
antidiskriminacijski zakon
15:52
an anti-discrimination law
323
940444
2062
15:54
against discrimination in housing,
324
942506
2950
protiv diskriminacije stanovanja,
zapošljavanja, javnih usluga.
15:57
employment, public accommodation,
325
945456
2813
16:00
only 17 states, and five of them are in New England.
326
948269
3294
Samo njih 17, a pet od njih
je u Novoj Engleskoj.
je u Novoj Engleskoj.
Potrebni su nam jeftiniji lijekovi.
16:03
We need less expensive drugs.
327
951563
1791
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 ukloniti ovo stanje
iz DSM klasiifikacije.
iz DSM klasiifikacije.
16:08
out of the DSM.
330
956963
2037
16:11
It is as much a psychiatric disease
331
959000
2609
To je psihijatrijski poremećaj
koliko je i biti gej ili lezbijka,
koliko je i biti gej ili lezbijka,
16:13
as being gay and lesbian,
332
961609
1805
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 cijeli svijet se promijenio.
16:20
And this isn't going to break anybody's budget.
335
968217
2734
I ovo neće utjecati na 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
973067
4638
Ali, ne čineći ništa za njih,
16:29
not only puts all of them at risk
338
977705
4211
ne samo da ih sve izlaže riziku
od gubitka života zbog samoubojstva,
od gubitka života zbog samoubojstva,
16:33
of losing their lives to suicide,
339
981916
2457
16:36
but it also says something about
340
984373
2697
već i govori nešto o tome
jesmo li zaista inkluzivno društvo.
jesmo li zaista inkluzivno društvo.
16:39
whether we are a truly inclusive society.
341
987070
3791
Hvala.
16:42
Thank you.
342
990861
2569
(Pljesak)
16:45
(Applause)
343
993430
2566
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