性别肯定过程评估中的染色体分析:一项回顾性研究

A. Bağcaz, O. Boduroglu, K. Başar
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引用次数: 4

摘要

目的性别焦虑症是指因性别认同与出生时生理性别不一致而产生的不适。目前这种临床病症的治疗方法是性别确认程序。关于性别确认的国际指南不推荐常规的基因评估。在土耳其,为这些手术产生的医疗费用提供健康保险需要进行遗传咨询,这往往涉及染色体分析(核型分析)。然而,常规染色体分析对性别焦虑症的评估和管理的贡献尚未确定。本研究旨在评估染色体分析的结果及其对性别焦虑管理的影响。方法回顾性分析精神科综合门诊281例性别确认患者中已完成的染色体分析结果和217例观察记录。结果217例个体中有213例(98.2%)的染色体分析结果与出生性别一致。在4个出生时性别为女性的个体的核型中发现了变异,其中只有1人被诊断患有性发育障碍。然而,在其他病例中,染色体分析并不影响诊断或临床干预。结论性别肯定评定过程中常规染色体分析对临床诊断和治疗影响较小,与既往研究报道一致,支持仅在病史、体格检查和必要影像学检查提示性别发育障碍的情况下才进行染色体分析的建议。
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[Chromosome Analysis in the Assessment for Gender Affirmation Process: A Retrospective Study].
OBJECTIVE Gender dysphoria refers to the experienced discomfort related to the incongruence between gender identity and the sex assigned at birth. Current treatment approach for this clinical condition is gender affirmation procedures. International guidelines about gender affirmation do not recommend routine genetic evaluation. In Turkey, provision of health insurance for medical expenses incurred by these procedures requires genetic consultation which frequently involves chromosome analysis (karyotyping). However, the contribution of routine chromosome analysis to the assessment and management of gender dysphoria is not established. This study aims to assess the results of chromosome analysis and its effect on the management of gender dysphoria. METHOD The completed chromosome analysis results and observational records of 217 individuals among a total of 281 evaluated for gender affirmation in the psychiatry polyclinic were investigated retrospectively. RESULTS The chromosome analysis results of 213 (98.2 %) of the 217 individuals investigated were congruent with the sex assigned at birth. Variations were found in the karyotypes of 4 individuals with female sex assigned at birth, only 1 of whom had been diagnosed with a disorder of sex development. In the other cases, however, chromosome analysis did not affect the diagnosis or the clinical intervention. CONCLUSION Finding that routine chromosome analysis during the assessment for gender affirmation process rarely affected the clinical diagnosis and the treatment was consistent with the reports of previous studies and supported the recommendation that chromosome analysis should be carried out only in cases where history, physical examination and the required imaging investigations suggested a disorder sex development.
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