terça-feira, 18 de outubro de 2016

Fwd: [Bioética e Fé Cristã] Disforia de Gênero - posicionamento Christian Medical Fellowship (Reino Unido)

Changing views of transsexuality are making waves in popular culture, politics and medicine. This File examines these developments from a Christian and scientific perspective and will be of interest to health professionals, pastors, churches, organisations and families relating to people with gender dysphoria (previously gender identity disorder). It updates a previous CMF File. (1) 

Bruce Jenner, American Olympic gold medal-winning decathlete, made headline news in 2015 when he publicly announced his transition to a female, Caitlyn Jenner. In 2016, nominations for BAFTA awards included The Danish Girl, a film loosely based on the life of Einar Wegener, a Dutch painter in the 1920s who transitioned to Lili Elbe and became one of the first to undergo reassignment surgery, from the complications of which she tragically died.

Transgender people - those who identify with a different gender to the one assigned to them at birth - were first given legal recognition in their new gender under the terms of the UK Gender Recognition Act 2004. (2) To acquire Gender Recognition Certificates they had to have been medically diagnosed with significant dysphoria (discomfort or distress as a result of a mismatch between their biological sex and gender identity (3)) and to have lived successfully for at least two years whilst presenting themselves in their acquired gender.

The Equality Act 2010 (4) made it unlawful to discriminate against transgender people and the Marriage (Same Sex Couples) Act 2013 (5) made it possible for an opposite-sex marriage to continue following one partner's gender transition, given the agreement of the other. 

A recent parliamentary committee report called for a move away from viewing transgender identity as a disease or disorder of the mind, and replacement of the present medicalised process with a simplified administrative procedure based on selfdeclaration by the individual applicant, free of intrusion by medical and legal personnel. The same report proposed that 16- and 17- year-olds should be eligible to apply for gender recognition, that children should be able to use puberty-blockers and cross-sex hormones earlier, and that Government should move towards 'non-gendering' official records. (6)

Changes in the law reflect changes in public attitudes and culture and have their counterparts in professional guidelines. The US Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4, 1994) referred to cross-gender identification as 'Gender Identity Disorder'. (7) In the Fifth Edition (DSM-5, 2013) (8) the same phenomenon is described as 'Gender Dysphoria', shifting the emphasis from gender incongruence as a disorder to the distress (dysphoria) associated with the experience of that incongruence: 'It is important to note that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition'. (9)

This change appears to have been ideologically driven, the aim being to de-pathologise gender incongruence. A minority of psychologists and psychiatrists dispute the reclassification, preferring to see gender identity disorder as a body image disorder whereby a person may have an unshakeable conviction that they are one gender when in fact they are the other.
The General Medical Council (GMC) has produced guidance for doctors treating transgender patients (10) and the Royal College of Psychiatrists published its 'UK Good Practice Guidelines' in 2013. (11)

Postado no Bioética e Fé Cristã em 10/18/2016

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