Ergenlerde Cinsiyet Hoşnutsuzluğu

Doğumda genetik ve biyolojik olarak belirlenmiş cinsiyet ile cinsiyet kimliğinin uyuşmaması cinsiyet disforisi (cinsiyet hoşnutsuzluğu) olarak tanımlanmaktadır. Çocukluk yaşlarından itibaren görülmekle beraber sekonder seks karakterlerinin geliştiği ergenlik döneminde bu tablo ağırlaşmaktadır. Bu nedenle DSM-V tanı kriterleri ile birey değerlendirilmeli gerekli tıbbi onamlar alındıktan sonra geri dönüşümlü bir tedavi olan GnRH agonistleri ile önce puberte baskılanmalı ve tıbbi endikasyon konulan hastalarda bir sonraki aşama olan istenen cinsiyet yönünde puberte indüksiyonu uygulanmalıdır. Daha sonraki aşamada ise uygun vakalarda cinsiyet değiştirici ameliyatlar yapılmaktadır. Bu ameliyatlar tam olarak geri dönüşümsüz olup uygun endikasyonlar açısından çok titiz davranılmalı ve operasyon kararı için acele edilmemelidir. Bu konuda tam bir konsensus sağlanmalıdır. Ameliyat kararı alınan hastalar için operasyon öncesinde doğurganlık ile ilgili tüm seçenekler ayrıntıları ile sunulmalıdır. Tüm bunların yanında sağlıklı nesillerin devamı açısından cinsel disforisi olan ergenleri yaftalamaktan kaçınılmalı ve bu bireylere tedavinin her aşamasında eşlik eden psikopatolojik durumlar nedeniyle psikolojik destek sağlanmalıdır.

Anahtar Kelimeler:

Ergen, cinsiyet, hoşnutsuzluk

Gender Dysphoria in Adolescents

The incompatibility of genetically and biologically determined gender at birth and gender identity is defined as gender dysphoria (gender discontentment). Although it is seen from childhood, this picture is aggravated in adolescence when secondary sex characteristics develop. Therefore, the individual should be evaluated with the DSM-V diagnostic criteria, and after obtaining the necessary medical consents, puberty should be suppressed with GnRH agonists, which is a reversible treatment, and the next step, puberty induction, should be applied in patients with medical indications. For sex-changing surgeries, rushing should be avoided as it is completely irreversible, and the subject should be considered in detail. In case of an indication, all fertility options should be presented in detail before the operation. In addition to all these, stigmatizing adolescents with sexual dysphoria should be avoided for the continuation of healthy generations, and psychological support should be provided to these individuals due to the psychopathological conditions accompanying them at every stage of treatment.

Keywords:

Gender, dysphoria, adolescent,

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