TEDxBeaconStreet
Norman Spack: How I help transgender teens become who they want to be
諾曼．史派克: 我是如何幫助跨性別青少年成為他們想變成的樣子
Filmed:
Readability: 3.8
1,359,735 views
青春期對每個人而言都意味著一個怪異的時期，但對跨性別青少年而言它像噩夢，因為一夕之間他們就要長成一副不適合的身軀。在這場打動人心的演說中，內分泌學家諾曼．史派克告訴我們，他如何成為美國少數以賀爾蒙治療青少年的醫生之一。藉由阻擋青春期所帶來的效應，史派克給了跨性別青少年足夠時間去適應一切。(拍攝於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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我希望大家回想一些：
00:16
about the third word that was ever said
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別人形容你那句話的第三個詞彙
00:20
about you,
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00:23
or if you were delivering,
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或如果你正在接生一個嬰兒
00:26
about the person you were delivering.
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你會如何形容這個孩子？
00:31
And you can all mouth it if you want
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請你把答案默念或者大聲說出來
00:34
or say it out loud.
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00:35
It was, the first two were, "It's a ..."
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最開頭兩個字是:Ta是...
（觀眾：男孩 ... 女孩 ...）
好吧，我這話使你知道
00:44
Well, it shows you that
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00:46
I also deal with issues where there's
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我也處理有關到底是
男孩或女孩的問題
男孩或女孩的問題
00:47
not certainty of whether it's a girl or a boy,
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00:50
so the mixed answer was very appropriate.
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所以我剛剛那樣的措辭十分得體
00:54
Of course, now the answer often comes
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當然，現在這問題的答案
00:56
not at birth but at the ultrasound,
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通常是在照射超音波時
而非出生時揭曉
而非出生時揭曉
00:58
unless the prospective parents choose
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除非未來的父母們像我們以前那樣
01:01
to be surprised like we all were.
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把驚喜留到孩子出生那天
才知道孩子的性別。
才知道孩子的性別。
01:05
But I want you to think about what it is
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但我希望你們想一想
01:08
that leads to that statement
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是什麼決定了
那第三個詞彙
01:12
on the third word,
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01:14
because the third word
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因為它
01:17
is a description of your sex,
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描述你的性別
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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它的判斷來自於你的生殖器
01:32
Now, as a pediatric endocrinologist,
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現在，身為一個小兒科內分泌學家
01:35
I used to be very, very involved,
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我曾經非常熱衷於研究 （現在也算是）
01:37
and still somewhat am,
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01:39
in cases in which
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關於種種通過生殖器的判斷會不會出錯
01:42
there are mismatches
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01:44
in the externals
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外觀上
01:47
or between the externals and the internals,
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或內外之間的性別不符合
01:51
and we literally have to figure out
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而我們實際上必須設法釐清
01:56
what is the description of your sex.
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什麼才能客觀描述你的性別
02:00
But there is nothing that is definable
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在出生那刻
02:02
at the time of birth
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我們實在難以定義你的性別。
02:05
that would define you,
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02:09
and when I talk about definition,
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而當我談及定義
02:11
I'm talking about your sexual orientation.
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我是在說你的性別取向
02:18
We don't say, "It's a gay boy."
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我們不說:他是個男同志男孩
02:23
"A lesbian girl."
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她是個女同志女孩
02:26
Those situations don't really define themselves
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這些情況還要等到
他們10幾歲之後才會出現。
他們10幾歲之後才會出現。
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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性取向也不能定義你的性別
02:38
which, as different from your anatomic sex,
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而這性別並不等同於解剖學上的
02:42
describes your self-concept.
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而是關乎你的自我意識
02:45
Do you see yourself
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你認為自己
02:47
as a male or female
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是男性或女性
02:51
or somewhere in the spectrum in between?
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或者在這之間徘徊
02:56
That sometimes shows up
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性別混淆有時發生在
03:01
in the first decade of life,
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孩子10歲以前
03:04
but it can be very confusing for parents
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卻會讓父母十分困惑
03:08
because it is quite normative
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因為一般而言
03:11
for children to act in a cross-gender play and way,
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孩童表現出跨性別的舉止
或遊戲方式是很正常的
或遊戲方式是很正常的
03:17
and that in fact there are studies that show
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且事實上有許多研究顯示
03:19
that even 80 percent of children
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只有八成的兒童
03:22
who act in that fashion
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在那樣的行為模式下
03:25
will not persist in wanting to be
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於青春期來臨時
03:30
the opposite gender
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不會想再扮演
03:32
at the time when puberty begins.
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其另外一種性別的角色
03:36
But at the time that puberty begins,
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青春期開始時
03:42
that means between about age 10 to 12 in girls,
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約當於女孩在10到12歲間
03:45
12 to 14 in boys,
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男孩在12到14歲間
03:49
with breast budding
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胸部開始發育
03:50
or two to three times increase in the gonads
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而在生理男性方面：
性腺會成長兩到三倍
性腺會成長兩到三倍
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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在那特定時間點
04:00
they are in the absolute wrong body
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聲稱自己處在錯誤身體裡的那些孩子
04:05
is almost certain to be transgender
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幾乎可以確定將會是跨性別的
04:09
and is extremely unlikely to change those feelings,
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且改變這樣想法的可能性極小
04:16
no matter how anybody tries reparative therapy
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無論任何人對他做修復療法
04:20
or any other noxious things.
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或其他任何有害的事
04:24
Now this is relatively rare,
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現在這種情況相對罕見
04:27
so I had relatively little
personal experience with this,
personal experience with this,
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所以我個人經驗也相對較少
04:30
and my experience was more typical
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而我的經歷較典型
04:33
only because I had an adolescent practice.
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因為我接觸的是青少年治療
04:35
And I saw someone age 24,
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我曾見過一個24歲的人
04:37
went through Harvard, genetically female,
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就讀哈佛，基因上是女性
04:39
went through Harvard with three male roommates
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與三位知道它故事的男性室友
04:41
who knew the whole story,
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度過哈佛時光
04:43
a registrar who always listed his name
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總在註冊時
04:46
on course lists as a male name,
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在選課單上填寫男性姓名
04:48
and came to me after graduating saying, "Help me.
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並在畢業後尋求我的協助
04:53
I know you know a lot of endocrinology."
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他說:幫我。我知道你是內分泌專家
04:55
And indeed I've treated a lot of people
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事實上我也的確治癒了很多
04:57
who were born without gonads.
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出生時缺乏性腺的人
04:59
This wasn't rocket science.
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這不是什麼難如登天的科學
05:01
But I made a deal with him:
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但我跟他做了個約定:
05:02
I'll treat you if you teach me.
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如果你教導我，我就治療你
05:05
And so he did.
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他照辦了
05:08
And what an education I got
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而我從照顧
05:10
from taking care of all the members
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他的支持小組所有成員中
05:12
of his support group.
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真的學到了很多
05:15
And then I got really confused,
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我當時十分困惑
05:17
because I thought it was relatively easy at that age
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因我當時認為在那種年紀
05:20
to just give people the hormones
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只要為他們施打
想成為的性別的賀爾蒙
想成為的性別的賀爾蒙
05:22
of the gender in which they were affirming,
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事情就能簡單解決
05:26
but then my patient married,
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但接下來我的病患結婚了
05:29
and he married a woman
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他與一個女人結合
05:32
who had been born as a male,
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而她出生時是生理男性
05:34
had married as a male, had two children,
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曾以男性的身分結婚，育有兩個孩子
05:37
then went through a transition into female,
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之後才轉為女性
05:43
and now this delightful female
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現在這快樂做自己的女性
05:48
was attached to my male patient,
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與我的男性病患結合了
05:52
in fact got legally married because they showed up
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實際上是合法結婚了
05:54
as a man and a woman, and who knew?
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因為他們看起來是一男一女，誰又看得出來呢?
05:56
Right? (Laughter)
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你說是吧?(笑聲)
05:59
And while I was confused about,
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當我正感到困惑:
06:03
does this make so-and-so gay?
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這種情況該說是男同性戀呢?
06:05
Does this make so-and-so straight?
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還是正常呢?
06:07
I was getting sexual orientation
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我正是把性傾向
06:10
confused with gender identity.
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跟性別自我認可搞混了
06:13
And my patient said to me,
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我的病患跟我說:
06:15
"Look, look, look.
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"嘿，聽我說，聽我說。
06:17
If you just think of the following, you'll get it right:
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你只要照我說的去想，就會搞懂了。
06:20
Sexual orientation is who you go to bed with;
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性傾向代表你要同床的對象
06:23
gender identity is who you go to bed as."
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性別自我認同就是你赴床上時的身分
06:29
And I subsequently learned from the many adults --
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而我接著從許多成年人身上學到--
06:32
I took care of about 200 adults —
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我曾照顧了約200個成年人--
06:34
I learned from them
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我學到了
06:36
that if I didn't look, peek as to who
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如果我不看或偷瞄
06:39
their partner was in the waiting room,
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他們在等待室裡的伴侶的話
06:41
I would never be able to guess
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我永遠也沒法猜到--
06:43
better than chance
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單純用機率都比我準--
06:45
whether they were gay, straight, bi,
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他們會是男同、直、女同
06:47
or asexual in their affirmed gender.
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或是無性者
06:51
In other words,
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換句話說
06:52
one thing has absolutely nothing to do
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許多事情之間
06:55
with the other.
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是沒有絕對的關聯的
06:57
And the data show it.
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而資料也如此顯示
06:59
Now, as I took care of the 200 adults,
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現在，當我照顧這200個成年人
07:04
I found it extremely painful.
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我發現這極度令人傷痛
07:06
These people were -- many of them
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這些人們
07:09
had to give up so much of their lives.
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大多必須放棄自己的人生
07:13
Sometimes their parents would reject them,
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他們有時會被父母給否定
07:16
siblings, their own children,
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被手足、自己的子女拒絕
07:18
and then their divorcing spouse
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與他們離婚的配偶
07:20
would forbid them from seeing their children.
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也會禁止他們與孩子見面
07:24
It was so awful, but why did they do it
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結果如此悲慘
07:27
at 40 and 50?
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他們為何要在四、五十歲時這麼做?
07:30
Because they felt they had to affirm themselves
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因為他們覺得有必要在自殺之前
07:34
before they would kill themselves.
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確認自己的性別
07:37
And indeed, the rate of suicide
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而的確，
07:39
among untreated transgendered people
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未受治療的跨性別者的自殺率
07:43
is among the highest in the world.
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在世上是數一數二的高
07:46
So what to do?
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所以該怎麼辦?
07:49
I was intrigued in going to a conference
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我曾被一個研討會給吸引去
07:52
in Holland, where they are experts in this,
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在荷蘭，那兒有許多專家
07:54
and saw the most remarkable thing.
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並見識了許多令人印象深刻的事
07:58
They were treating young adolescents
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他們治療的是年輕的青少年
08:01
after giving them the most intense
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先給予最密集的心理測試
08:04
psychometric testing of gender,
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以鑑定性別
08:07
and they were treating them by blocking
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再用阻擋他們不想要的青春期
08:09
the puberty that they didn't want.
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來治療他們
08:11
Because basically, kids look about the same,
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因為基本上，無論哪個性別
08:14
each sex, until they go through puberty,
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孩子們在經歷青少年時期之前看起來都一樣
08:17
at which point, if you feel you're in the wrong sex,
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在青少年時期若認為自己性別錯了
08:20
you feel like Pinocchio becoming a donkey.
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感覺就像自己是一個正變成驢子的皮諾丘
08:23
The fantasy that you had that your body will change
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認為自己身體會隨著青春期而改變
08:26
to be who you want it to be with puberty
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成為自己想要的樣子的幻想
08:28
actually is nullified by the puberty you get.
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實際上正是被自己
所成為的青少年給毀滅
所成為的青少年給毀滅
08:33
And they fall apart.
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而他們也因此崩潰了
08:36
So that's why putting the puberty on hold—
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所以這就是為什麼要先保留這些青少年--
08:39
Why on hold? You can't just give them
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為什麼是保留? 因為你不能
在他們這麼年輕的時候
在他們這麼年輕的時候
08:41
the opposite hormones that young.
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就給他們相反性別的賀爾蒙
08:43
They'll end up stunted in growth,
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因為那會使他們發育不良
08:45
and you think you can have
a meaningful conversation
a meaningful conversation
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而你覺得你和一個十歲女孩或十二歲男孩
08:48
about the fertility effects of such treatment
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在這種療程會造成的生殖能力影響上
08:50
with a 10-year-old girl, a 12-year-old boy?
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能有什麼有意義的對話嗎
08:54
So this buys time in the diagnostic process
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這種情況下
08:56
for four or five years
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能夠爭取四到五年的診斷時間
08:58
so that they can work it out,
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所以那些青少年可以有機會克服
09:01
they can have more and more testing,
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可以做更多檢測
09:04
they can live without feeling their bodies
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可以好好活著，而不會感到自己的身體
09:06
are running away from them.
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正離自己而去
09:08
And then, in a program they call 12-16-18,
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而接著，在一個叫做12-16-18的計畫中
09:12
around age 12 is when they
give the blocking hormones,
give the blocking hormones,
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十二歲左右給予阻擋青春期的賀爾蒙
09:17
and then at age 16 with retesting,
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在十六歲時再度測試時
09:19
they requalify.
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他們必須能夠符合
09:21
Now remember, the blocking
hormones are reversible,
hormones are reversible,
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現在注意，那些賀爾蒙是可逆的
09:25
but when you give the hormones of the opposite sex,
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但只要給予相反性別的賀爾蒙
09:28
you now start spouting breasts and facial hair
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他們就能開始長出胸部和臉毛
09:30
and voice, depending on what you're using,
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而聲音決定於你要使用什麼
09:32
and those effects are permanent
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且那些效應是永久的
09:35
or require surgery to remove
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或需要手術去移除
09:37
or electrolysis,
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或電離法
09:38
and you can never really affect the voice.
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且你其實沒法真的改變聲音
09:40
So this is serious, and this is 15-, 16-year-old stuff.
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所以這很嚴肅，而且這跟著你有15、16年久了
09:45
And then at 18, they're eligible for surgery,
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接著到18歲，他們能夠接受手術了
09:48
and while there's no good surgery
for females to males genitally,
for females to males genitally,
187
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雖然女轉男的生殖器
改變手術無法盡善盡美
改變手術無法盡善盡美
09:52
the male-to-female surgery
has fooled gynecologists.
has fooled gynecologists.
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男轉女的手術卻能騙過婦產科醫師
09:57
That's how good it can be.
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你看看它有多完善
10:00
So I looked at how the patients were doing,
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所以我觀察病患的改善情況
10:03
and I looked at patients who
just looked like everybody else,
just looked like everybody else,
191
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3010
也觀察病患順利融入人群，與別人並無二致
10:06
except they were pubertally delayed.
192
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除了他們青春期有被延遲之外
10:09
But once they gave them the hormones
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2059
一旦給了與他們所認同的性別
10:11
consistent with the gender they affirm,
194
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相符合的賀爾蒙
10:13
they look beautiful.
195
601999
1978
他們會變得美麗
10:15
They look normal. They had normal heights.
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看起來正常，有著正常的身高
10:19
You would never be able to pick them out
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你永遠無法在人群中
10:21
in a crowd.
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挑出他們來
10:24
So at that point, I decided I'm going to do this.
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在那時刻，我決定自己也要往這方面去做
10:26
This is really where the pediatric
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這就是我踏入
10:29
endocrine realm comes in,
201
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1988
小兒科內分泌領域的時候
10:31
because in fact, if you're going to deal with it
202
619490
1981
因為事實上
10:33
in kids age 10-12, 10-14,
203
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2681
假如你要治療10-12或10-14歲的孩子
10:36
that's pediatric endocrinology.
204
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那就該是小兒科內分泌學啦
10:39
So I brought some kids in,
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3779
所以我引入了一些孩子
10:43
and this now became the standard of care,
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2657
而這現在成了照護的標準
10:45
and Children's Hospital was behind it.
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有兒童醫院在後面支援
10:48
By my showing them the kids before and after,
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4441
展示了這些孩子的前後樣貌後
10:53
people who never got treated
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從未受治療的人們
10:54
and people who wished to be treated,
210
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想接受治療的人們
10:56
and pictures of the Dutch,
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3146
以及荷蘭人
11:00
they came to me and said,
212
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1129
都來找我並說:
11:01
"You've got to do something for these kids."
213
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1991
"你必須為這些孩子做點事"
11:03
Well, where were these kids before?
214
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3307
那麼，之前這些孩子們在哪?
11:06
They were out there suffering, is where they were.
215
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3154
他們在那兒承受痛苦
11:09
So we started a program in 2007.
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6311
所以我們在2007年開始了一個計劃
11:15
It became the first program of its kind --
217
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2152
它成為這類型中的第一個計劃--
11:18
but it's really of the Dutch kind --
218
666135
2598
但它其實是之前說的荷蘭方法--
11:20
in North America.
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2141
不過是在北美洲實行
11:22
And since then, we have 160 patients.
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4197
自那時起，我們有了160個病患
11:27
Did they come from Afghanistan? No.
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3277
他們來自阿富汗嗎?不。
11:30
They came, 75 percent of them came
222
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3273
他們其中有百分之七十五
11:33
from within 150 miles of Boston.
223
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5068
來自距波士頓150哩以內的地方
11:38
And some came from England.
224
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3397
而有些人來自英格蘭
11:42
Jackie had been abused in the Midlands, in England.
225
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3819
傑琪曾在英格蘭的米德蘭茲被虐
11:45
She's 12 years old there,
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2015
那時她十二歲
11:47
she was living as a girl
227
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1353
以女孩的身分過活
11:49
but she was being beaten up.
228
697273
2152
但一直受到毒打
11:51
It was a horror show.
229
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1053
那情形慘不忍睹
11:52
They had to homeschool her.
230
700478
1996
他們得讓她在家自學
11:54
And the reason the British were coming was
231
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2749
這些英國人會來求助的原因是
11:57
because they would not treat anybody
232
705223
3365
在英國任何未滿16歲的人
12:00
with anything under age 16,
233
708588
1940
都不能接受治療
12:02
which means they were consigning them
234
710528
1788
等同於無論多可怕的事會發生
12:04
to an adult body, no matter what happened,
235
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3468
他們都會被交付一個成年的身軀
12:07
even if they tested them well.
236
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2024
就算已經做過良好的檢驗了
12:09
Jackie, on top of it, was,
237
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2368
在這情況下
12:12
by virtue of skeletal markings,
238
720176
2575
傑琪雖在骨骼測量中
12:14
destined to be six feet five.
239
722751
4087
被預測能長到約195公分
12:18
And yet, she had just begun
240
726838
1971
但她才剛開始進入
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
我做了件有點創新的事
12:26
because I do know hormones,
243
734409
1950
因為我的確了解賀爾蒙
12:28
and that estrogen is much more potent
244
736359
2070
知道雌激素在關閉骨端生長板
12:30
in closing epiphyses, the growth plates,
245
738429
3706
是很有能力的
12:34
and stopping growth, than testosterone is.
246
742135
3317
比睪固酮更能停止成長發育
12:37
So we blocked her testosterone
247
745452
2386
所以我們使用了賀爾蒙
12:39
with a blocking hormone,
248
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2558
去阻斷她的睪固酮
12:42
but we added estrogen, not at 16, but at 13.
249
750396
4339
並在13而非16歲時為她施打雌激素
12:46
And so here she is at 16, on the left.
250
754735
3518
左邊這個就是她16歲時的樣子
12:50
And on her 16th birthday, she went to Thailand,
251
758253
2001
在她16歲生日，她去了泰國
12:52
where they would do a genital plastic surgery.
252
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2143
去做生殖器整形手術
12:54
They will do it at 18 now.
253
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1900
現在他們是在18歲時做
12:56
And she ended up 5'11"
254
764297
2864
結果她只長了約180公分
12:59
but more than that, she has normal breast size,
255
767161
3307
更棒的是，她擁有正常的胸部大小
13:02
because by blocking testosterone,
256
770468
2263
因為藉由阻斷睪固酮
13:04
every one of our patients
257
772731
1630
我們的每個病患
13:06
has normal breast size
258
774361
1875
都能有正常胸部大小
13:08
if they get to us at the appropriate age, not too late.
259
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4175
只要他們及早在適當年齡來找我們
13:12
And on the far right, there she is.
260
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2280
而在最右邊，也是她
13:14
She went public,
261
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1715
她公開參加英國小姐選美
13:16
semifinalist in the Miss England competition.
262
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3082
進入準決賽
13:20
The judges debated as to, can they do this?
263
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3232
評審們互相辯論，他們該怎麼做
13:24
Can they make her —
264
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1868
他們能不能讓她進入決賽
13:25
And one of them quipped, I'm told,
265
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2291
據我所知，其中有一人諷刺道:
13:28
"But she has more natural self
266
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2055
"但她比起其他參賽者的一半
13:30
than half the other contestants."
267
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1925
擁有更多的自然的自我"
13:32
(Laughter)
268
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1967
(笑聲)
13:34
And some of them have been rearranged a little bit,
269
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4216
雖然其中有些部分被重新排列更動
13:38
but it's all her DNA.
270
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3312
但畢竟全是她的DNA啊
13:41
And she's become a remarkable spokeswoman.
271
809634
3313
接著她成為一個令人印象深刻的發言人
13:44
And she was offered contracts as a model,
272
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4010
並得到模特兒的合約
13:48
at which point she teased me, where she said,
273
816957
1843
當時她開玩笑說:
13:50
"You know, I might have had a better chance
274
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2080
"你知道的，要是你當時讓我長到185，
13:52
as a model if you'd made me six feet one."
275
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2727
現在我就有更好的條件可以當模特兒"
13:55
Go figure. (Laughter)
276
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4453
天知道(笑聲)
14:00
So this picture, I think, says it all.
277
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3653
所以這張照片，我想，解釋了一切
14:03
It really says it all.
278
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1747
真的解釋了一切
14:05
These are Nicole and brother Jonas,
279
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3851
他們是尼蔻和她兄弟，瓊納斯
14:09
identical twin boys,
280
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2816
同卵雙生男孩
14:12
and proven to be identical,
281
840127
2569
經過證實的
14:14
in which Nicole had affirmed herself
282
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2490
但尼蔻早在三歲時
14:17
as a girl as early as age three.
283
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2230
就確定自己是女的
14:19
At age seven, they changed her name,
284
847416
2501
七歲時，他們改了她的名
14:21
and came to me at the very beginnings
285
849917
3213
並在剛進入青春期時
14:25
of a male puberty.
286
853130
1646
來找我求診
14:26
Now you can imagine looking at Jonas
287
854776
1568
現在你們看著14歲的瓊納斯
14:28
at only 14 that male puberty
288
856344
1758
可以想像在他家族裡
14:30
is early in this family,
289
858102
2517
青春期很早開始
14:32
because he looks more like a 16-year-old,
290
860619
2251
因為他看起來比較像16歲了
14:34
but it makes the point all the more
291
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1840
但這只是再次強調了
14:36
why you have to be conscious
292
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1657
為什麼你應該更加留意
14:38
of where the patient is.
293
866367
1952
病人的年齡狀況
14:40
Nicole has done pubertal blockade in here,
294
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3960
尼蔻當時就做了中斷青春期的措施
14:44
and Jonas is just going -- biologic control.
295
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3793
而瓊納斯只有做生理控制
14:48
This is what Nicole would look like
296
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1538
假如我們不做任何事
14:49
if we weren't doing what we were doing.
297
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2180
他是尼蔻會變成的樣子
14:51
He's got a prominent Adam's apple.
298
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2392
他有一個明顯的喉結
14:54
He's got angular bones to the face, a mustache,
299
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3707
臉骨有稜有角，有鬍鬚
14:57
and you can see there's a height difference
300
885889
1520
且你也看得出有身高差距
14:59
because he's gone through
301
887409
1300
因為他經歷了青春期成長
15:00
a growth spurt that she won't get.
302
888709
2040
而她沒有
15:02
Now Nicole is on estrogen.
303
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1881
現在尼蔻正使用雌激素
15:04
She has a bit of a form to her.
304
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3289
很有成效
15:07
This family went to the White House last spring
305
895919
3307
這個家族去年春天去了白宮
15:11
because of their work
306
899226
2621
因為他們的成就
15:13
in overturning an anti-discrimination,
307
901847
3398
也就是翻轉了歧視
15:17
there was a bill that would block
308
905245
2841
在緬因州曾有一個法條
15:20
the right of transgender people in Maine
309
908086
2257
禁止跨性別的人
15:22
to use public bathrooms,
310
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1679
使用公廁
15:24
and it looked like the bill was going to pass,
311
912022
3123
這法條一度很有機會通過
15:27
and that would have been a problem,
312
915145
1377
將造成一大麻煩
15:28
but Nicole went personally
to every legislator in Maine
to every legislator in Maine
313
916522
3611
但尼蔻個人拜訪了緬因州每個議員
15:32
and said, "I can do this.
314
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2074
並說:"我能做到。
15:34
If they see me, they'll understand
315
922207
1951
如果他們看到了我
15:36
why I'm no threat in the lady's room,
316
924158
2063
他們就會了解為什麼我在女廁不會構成任何威脅
15:38
but I can be threatened in the men's room."
317
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2337
而會在男廁受到威脅。"
15:40
And then they finally got it.
318
928558
3438
而他們最終真的懂了
15:43
So where do we go from here?
319
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3020
所以我們究竟能到達怎樣的目標呢?
15:47
Well, we still have a ways to go
320
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2390
我敢說在反歧視方面
15:49
in terms of anti-discrimination.
321
937406
1623
還有一段很長的路要走
15:51
There are only 17 states that have
322
939029
1415
只有17個州
15:52
an anti-discrimination law
323
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2062
擁有反歧視法律
15:54
against discrimination in housing,
324
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2950
避免在居住、
15:57
employment, public accommodation,
325
945456
2813
工作、公共場所可能出現的各種歧視
16:00
only 17 states, and five of them are in New England.
326
948269
3294
只有17州，其中五個在新英格蘭
16:03
We need less expensive drugs.
327
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1791
我們還需要不那麼昂貴的藥
16:05
They cost a fortune.
328
953354
1433
藥物是一筆很大的花費
16:06
And we need to get this condition
329
954787
2176
且我們需要把這情況
16:08
out of the DSM.
330
956963
2037
帶出《精神疾病診斷與統計手冊》
16:11
It is as much a psychiatric disease
331
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2609
這是精神疾病
16:13
as being gay and lesbian,
332
961609
1805
不單單是男同志或女同志的問題
16:15
and that went out the window in 1973,
333
963414
2961
它在1973年就走了樣
16:18
and the whole world changed.
334
966375
1842
使得全世界都改變
16:20
And this isn't going to break anybody's budget.
335
968217
2734
而這不會超出任何人的預算
16:22
This is not that common.
336
970951
2116
因為這問題沒有那麼普遍
16:25
But the risks of not doing anything for them
337
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4638
但不為他們做任何事的風險
16:29
not only puts all of them at risk
338
977705
4211
不只是讓他們
16:33
of losing their lives to suicide,
339
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2457
處於自殺的危險中
16:36
but it also says something about
340
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2697
也是考驗著我們這社會
16:39
whether we are a truly inclusive society.
341
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3791
究竟是不是真正有包容性
16:42
Thank you.
342
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2569
謝謝
16:45
(Applause)
343
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2566
(掌聲)
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