Together ︱终结对LGBT的转化治疗，精神医学应有何所为？
2022/12/12 8:19:31 性健康研究与教育
哈医大性健康研究与教育 Together?一个可思、有悟，且有为的交流与分享平台美好与同行一直在这里
文本翻译:
白柳，王钰璇 / 硕士研究生(2021级), RECSG
译文校译:
张永瑶, 许丛 / 硕士研究生(2020级), RECSG
Whatpsychiatry can do to end LGBT conversion therapy
终结对LGBT的转化治疗，精神医学应有何所为？
We agree that the psychiatry communityshould do more to help end harmful practices of so-called conversion therapyfor LGBTQ+ people. Preliminary research suggests conversion practices are aproblem with global reach. Further research is needed to clarify its scope.Updating professional consensus on appropriate treatment for LGBTQ+ people isespecially important now when medical care for these populations is miscast asscientific pseudocontroversy for political reasons.
我们认为，精神医学界在终结对LGBTQ+(女同性恋，男同性恋，双性恋，跨性别者和酷儿等其他性少数人士)进行有害的“转化疗法”方面，可以有更多的作为。早期的研究已经表明，“转化疗法”是全球范围内存在的问题。对此，为确定存在的具体问题以及波及的范围，依然需要进行深入的研究。此外，不断更新针对LGBTQ+人士提供医疗保健服务的共识是很重要的，尤其是在现实中，对这些人士提供的医疗保健服务常被从政治的角度标定为以科学之名而进行改头换面的“转化治疗”。
Internationalhuman rights law and bioethics provide several strategies for ending harmfulconversion therapy within a health justice framework. Examples includecriminalisation of such practices by legislatures; strengthening ofprofessional guidelines for licensing, ethics, and other regulatory bodies; andapplication of anti-discrimination, anti-torture, or consumer-protection law toconversion practice. Of these strategies, we believe that strengtheningprofessional guidelines has many advantages and is an important tool.
国际人权法和生命伦理学提供了几种在健康道义框架内寻求终结有害“转换疗法”的策略，具体包括：立法机关将此类做法定为犯罪行为; 加强有关执业许可、伦理道德及其他监管机构的专业指导; 以及针对“转化治疗”，使用反歧视，反身心摧残或消费者保护法。在这些策略中，我们认为加强专业指导及相关条例的建设有很多优势，也是一个重要的工具。
Manyleading mental health organisations around the world have position statementsabout the harms of conversion therapy dating back 10 years or more (eg, theMemorandum of Understanding on Conversion Therapy among UK bodies, and the PanAmerican Health Organization’s and the World Psychiatric Association’sstatements). These position statements help to define the appropriate scope ofmental health practice for LGBTQ+ people. Doing so helps to guide professionalethics regulators, licensing bodies, and other professionally qualifiedoverseers to appropriately limit conversion therapies and prevent the abusesassociated with them. Periodically updating professional guidelineson appropriate care is a useful alternative to increasingly widespreadlegislative bans.
在世界上，许多卓越的心理健康机构都有关于“转化治疗”危害的立场声明，这可以追溯到10年前或更早时期(例如，在英国，医疗、咨询和心理治疗相关的机构共同签署了有关“转化治疗”的协议备忘录，也含有泛美卫生组织和世界精神医学学会的声明)。这些专业机构的声明有助于界定对LGBTQ+人士提供心理健康服务的适当范围，而且有助于指导职业伦理监管机构、执业许可机构和其他有专业资格的监督者对“转化疗法”作出恰当的限制，并防止与之相关治疗的滥用行为。此外，定期更新适切照护的专业指南是替代日益广泛颁布立法禁令的有用选择。
Suchbans risk normalising excessive legislative and judicial regulation of medicalpractice. In the USA, this overreach has paved the way for recent outlawing ofmedical practice to treat gender dysphoria based upon long-establishedevidence-based treatment guidelines, and has mischaracterised it as childabuse. Strengthening guidelines would also avoid excessive criminalisation orconcern about potential encroachments on other human rights.
因为这些禁令有可能使得在医疗实践中过度的立法和司法监管成为常态现象。在美国，这种越权行为把长期确立的并基于循证治疗指南而制定的性别不安的医学关照视为非法的，并错误地将其定性为虐待儿童。重视并加强专业的指导还应当避免过度刑法化或是对于潜在的侵犯其他人权的可能性。
Forthese reasons, it would be helpful for professional psychiatric organizationsto update their position statements on conversion therapy to reflect recentresearch findings on what constitutes appropriate and inappropriate care forhistorically under-represented groups across sex, gender identities, andexpression, and racial, ethnic, and cultural groups (eg, the ILGA World andAmerican Psychological Association’s resolutions). A great deal of research hasalso been done in the past decade on the relationship of stigma to mental andphysical health disparities among LGBTQ+ people, which underscores thepotential harm of conversion practices and would be important to include in updatedguidelines.
上述的这些理由将有助于专业的精神医学机构更新他们关于“转化治疗”的立场声明，以反映在如下议题方面一些新近的研究结果：即什么构成了对性别、性别认同和表达以及种族、民族和文化群体等历史上弱势群体的适当和不适当的照护(例如，国际男女同性恋联合会和美国心理协会的决议)。在过去的十年中，有诸多针对LGBTQ+人士因遭遇污名化而出现心理健康、躯体健康不平等的相关研究，这些研究强调了“转化疗法”的潜在危害，将这些研究结果纳入到最新指南中将是重要的举措。
Source: www.thelancet.com/psychiatryVol 9 September 2022
WPA Position Statement on Gender Identity and Same-Sex Orientation,Attraction and Behaviours
国际精神医学学会(WPA)关于性别认同和同性恋倾向、吸引力和行为的立场声明Recent controversies in many countries suggest aneed for clarity on same sex orientation,attraction and behaviour(formerlyreferred to as homosexuality). Along with other international organizations,the WPA considers sexual orientation to be innate and determined bybiological,psychological,developmental and social factors.
最近在许多国家发生的争议表明，有必要澄清同性恋倾向、吸引力和行为(以前归类为同性恋)。WPA与其他国际组织一样，认为性倾向是与生俱来的，由生物、心理、发育和社会因素决定。
Psychiatrists have a social responsibility toadvocate for a reduction in social inequalities for all individuals, includinginequalities related to gender identity and sexual orientation.
精神科医生具有社会责任，应倡导减少所有个体受到的社会不平等，包括与性别认同和性取向相关的不平等。
Despite an unfortunate history of perpetuatingstigma and discrimination.it has been decades since modern medicine abandonedpathologizing same-sex orientation and behaviour. The World Health Organization(WHO) accepts same-sex orientation as a normal variant of human sexuality. TheUnited Nations Human Rights Council5 values lesbian, gay, bisexualand transgender(LGBT)rights. In two major diagnostic and classification systems(ICD-10 and DSM-5) same-sex sexual orientation attraction and behaviour are notseen as pathologies.
尽管耻辱和歧视曾长期存在，但现代医学放弃将同性恋倾向和行为病理化已经几十年了。世界卫生组织(WHO)接受同性恋倾向是人类性行为的一种正常存在。联合国人权理事会(UNHRC)重视女同性恋、男同性恋、双性恋和跨性别者(LGBT)的权利。在两种主要的疾病诊断和分类系统(ICD-10和DSM-5)中，同性恋倾向者之间的吸引和行为并不被视为病理现象。
There is considerable research evidence to suggestthat sexual behaviours and sexual fluidity depend upon a number of factors. Furthermore,it has been shown conclusively that LGBT individuals have higher than expectedrates of psychiatric disorders, and once their rights and equality arerecognized these rates start to drop.
有大量的研究证据表明，性行为和性流动性取决于许多因素。此外，已有确凿的证据表明，LGBT个体的精神障碍发病率高于预期，而一旦他们的权利和平等得到承认，发病率就开始下降。
People with diverse sexual orientations and genderidentities may have grounds for exploring therapeutic options to help them livemore comfortably, reduce distress, cope with structural discrimination, anddevelop a greater degree of acceptance of their sexual orientation or genderidentity. Such principles apply to any individual who experiences distressrelating to an aspect of their identity, including heterosexual individuals.
具有不同性倾向和性别认同的人有理由去获得相关治疗，从而可协助他们更舒适地生活、减少痛苦、应对结构性歧视以及更大程度上提高他们对自己的性倾向或性别认同的接受度。这些原则适用于任何因其身份的某个方面而经历痛苦的个人，包括异性恋者。
The WPA believes strongly in evidence basedtreatment. There is no sound scientific evidence that innate sexual orientationcan be changed. Furthermore, so-called treatments of homosexuality can create asetting in which prejudice and discrimination flourish and they can bepotentially harmful. The provision of any intervention purporting to “treat”something that is not a disorder is wholly unethical.
WPA坚信基于循证的治疗方法，没有可靠且科学的证据表明先天的性倾向是可以改变的。此外，所谓的同性恋治疗会创造一个偏见和歧视盛行的环境，它们具有潜在的危害。任何声称可提供“治疗”非疾病的干预措施，都是完全不道德的。
The WPA holds the view that lesbian, gay, bisexualand transgender individuals are and should be regarded as valued members ofsociety, who have exactly the same rights and responsibilities as all othercitizens. This includes equal access to health care and the rights andresponsibilities that go along with living in a civilized society.
WPA认为，女同性恋、男同性恋、双性恋和跨性别者不仅是而且应该被视为社会的重要成员，他们拥有与所有其他公民完全相同的权利和责任。这包括平等获得医疗保健服务，以及生活在文明社会中所享有的权利和责任。
TheWPA recognizes the universality of same-sex expression, across cultures. Itholds the position that a same-sex sexual orientation per se does no implyobjective psychological dysfunction or impairment in judgement, stability orvocational capabilities.
WPA认识到同性之爱的表达在不同文化中存在的普遍性，并认为同性恋倾向本身并不意味着客观的心理障碍或者判断力、稳定性或职业能力的损害。
The WPA considers same-sex attraction, orientationand behaviour as normal variants of human sexuality. It recognizes themulti-factorial causation of human sexuality, orientation, behaviour andlifestyle. It acknowledges the lack of scientific efficacy of treatments thatattempt to change sexual orientation and highlights the harm and adverseeffects of such “therapies”.
WPA认为同性之间的吸引力、同性之恋的倾向和行为是人类性存在的不同状况，并认识到人类性状况、性倾向、行为和生活方式间存在着多方面的因果关系，而试图改变性倾向的治疗方法是缺乏科学效用的，同时，强调了这种“疗法”的危害和不利影响。
The WPA acknowledges the social stigma andconsequent discrimination of people with same-sex sexual orientation andtransgender gender identity. It recognizes that the difficulties they face area significant cause of their distress and calls for the provision of adequatemental health support.
WPA认为，对同性恋和跨性别者的社会污名化和随之而来的歧视，是这些人士所面临的困难，也是造成他们痛苦的一个重要原因，因此，需要为他们提供足够的心理健康支持。
The WPA supports the need to decriminalize same-sexsexual orientation and behaviour and transgender gender identity, and torecognize LGBT rights to include human, civil and political rights. It alsosupports anti-bullying legislation; anti-discrimination student ,employment andhousing laws; immigration equality; equal age of consent laws; and hate crimelaws providing enhanced criminal penalties for prejudice-motivated violenceagainst LGBT people.
WPA支持将同性恋性倾向、行为和跨性别者的性别认同非罪化，并认识到LGBT人士拥有的权利，包括人权、公民权利和政治权利。WPA还支持反欺凌的立法；反歧视学生、就业和住房法；移民平等；同意平等的年龄立法；以及“恨罪法”，即对那些基于偏见而对LGBT人士实施暴力行为者予以更严厉的刑事处罚。
The WPA emphasizes the need for research on and thedevelopment of evidence-based medical and social interventions that support themental health of lesbian, gay, bisexual and transgender individuals.
WPA强调需要研究和探讨以证据为基础的医疗和社会干预措施，来支持女同性恋、男同性恋、双性恋和跨性别者的心理健康。
Source: https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20340
电邮：
reallove_999@aliyun.com
源网页 http://weixin.100md.com
信息仅供参考，不构成任何之建议、推荐或指引。文章版权属于原著作权人，若您认为此文不宜被收录供大家免费阅读，请邮件或电话通知我们，我们收到通知后，会立即将您的作品从本网站删除。
返回 性健康研究与教育 返回首页 返回百拇医药