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Kristie Overstreet: What doctors should know about gender identity
克莉絲蒂·奧佛史特利: 對於性別認同，醫生應該要知道什麼？
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Readability: 3.7
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克莉絲蒂·奧佛史特利的任務是要確保變性人族群的健康照護需求能被滿足。在這場充滿資訊、打破謎思的演說中，她帶大家入門，了解性別身分認同，並邀請大家轉變對於變性人健康照護的看法——讓人人去看醫生時都能獲得他們應得的尊敬和尊嚴。
Kristie Overstreet - Clinical sexologist and psychotherapist
Kristie Overstreet works with individuals to help strengthen their relationship with themselves and others. Full bio
Kristie Overstreet works with individuals to help strengthen their relationship with themselves and others. Full bio
Double-click the English transcript below to play the video.
00:12
About six months
into my career as a therapist,
into my career as a therapist,
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在成為一位醫生大約六個月左右，
00:15
I was working at a drug
and alcohol rehab facility.
and alcohol rehab facility.
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我在一間毒品與酒精勒戒機構工作。
00:18
I got a call from one of the nurses
down at the detox unit.
down at the detox unit.
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戒癮單位的一位護士打電話給我。
00:22
She asked me to come down
and assess one of the new patients
and assess one of the new patients
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她請我過去評估
當天早些時候抵達的一位病患。
00:25
that had arrived earlier in the day.
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00:27
So I went down to the unit
and had the pleasure of meeting Anne.
and had the pleasure of meeting Anne.
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所以我去了那個單位，
很榮幸見到了安。
很榮幸見到了安。
00:30
Anne's a transgender female,
and as her and I started talking,
and as her and I started talking,
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安是一位女性變性人，
當她和我開始交談時，
當她和我開始交談時，
00:34
she was sharing with me
about what brought her into treatment,
about what brought her into treatment,
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她和我分享了
她來接受治療的原因。
她來接受治療的原因。
00:37
but I could hear this fear in her voice,
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但我能在她的聲音中聽出恐懼，
00:40
and I could see this worry in her eyes,
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也能在她的眼中看出擔憂。
00:41
and she began to tell me
that she didn't fear coming into rehab
that she didn't fear coming into rehab
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她開始告訴我，
她並不害怕來到勒戒所，
她並不害怕來到勒戒所，
00:44
and having to give up drugs and alcohol.
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和必須要放棄毒品和酒精。
00:47
Her fear was that the doctors
that were going to be treating her
that were going to be treating her
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她的恐懼是將要治療她的醫生，
可能不會把她當女性來對待。
00:50
would not treat her as her female self.
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00:53
She then told me about this ongoing pain
that she has experienced her whole life
that she has experienced her whole life
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她接著告訴我她一生中
所遭遇的這種持續不斷的痛苦。
所遭遇的這種持續不斷的痛苦。
00:57
of being assigned male
but knowing she's female.
but knowing she's female.
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她被認定為男性，
但她知道她是女性。
但她知道她是女性。
00:59
And what she meant by that is,
when she was born,
when she was born,
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她的意思是，當她出生時，
01:03
the doctor held her up to her parents
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醫生把她抱起來交給她的父母，
01:05
and based on her genitalia said,
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根據她的生殖器，說：
01:07
"It's a boy."
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「是個男孩。」
01:08
She always knew she wasn't a boy.
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她一直都知道她不是男孩。
01:11
Many years passed and the feelings
that she was feeling
that she was feeling
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許多年過去了，
她所感受到的感覺，
她所感受到的感覺，
01:14
and holding all this in grew and grew,
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被她壓抑在心中，但越來越強。
01:16
and she knew she had
to come out to her family.
to come out to her family.
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她知道她得要向她的家人坦白。
01:18
And when she did,
it didn't go over so well.
it didn't go over so well.
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當她坦白時，
結果並沒有很順利。
結果並沒有很順利。
01:21
Her parents said,
"Absolutely not. You're not a girl.
"Absolutely not. You're not a girl.
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她的父母說：
「絕對不是。你不是女生。
「絕對不是。你不是女生。
01:24
This is not how we raised you.
We don't know what you're thinking.
We don't know what you're thinking.
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我們不是這樣養育你的。
我們搞不懂你在想什麼。
我們搞不懂你在想什麼。
01:27
Get out."
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滾出去。」
01:29
So Anne then found herself on the streets
and in and out of homeless shelters,
and in and out of homeless shelters,
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接著，安就流落街頭，
進進出出無家可歸者收容所。
進進出出無家可歸者收容所。
01:33
and it's here where
she started using drugs and alcohol
she started using drugs and alcohol
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在那裡，她開始染上毒品和酒精，
01:36
to numb this pain she felt inside.
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以麻痺她內心感受的痛苦。
01:39
She told me about her journey of being
in and out of hospitals and rehabs
in and out of hospitals and rehabs
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她告訴我那段不斷進出
醫院和勒戒所的過程。
醫院和勒戒所的過程。
01:43
trying to get sober,
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她試著讓自己清醒。
01:44
and when she did, the health care
providers and doctors
providers and doctors
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當她清醒時，
健康照護提供者以及醫生
健康照護提供者以及醫生
01:47
wouldn't use the correct
female name or pronouns.
female name or pronouns.
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不願意使用她的正確的
女性名字或女性代名詞。
女性名字或女性代名詞。
01:50
This caused her pain.
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這讓她很痛苦。
01:53
You see, when I was studying
to become a therapist,
to become a therapist,
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當我還在讀書準備要當醫生時，
01:55
I wasn't taught how to work
with transgender patients.
with transgender patients.
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沒有人教我要如何對待變性病人。
01:59
I had no idea these would be
the patients I'd be working with.
the patients I'd be working with.
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我完全不知道
我會接觸到這樣的病人。
我會接觸到這樣的病人。
02:02
But the more I worked with Anne
and other patients like Anne,
and other patients like Anne,
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但我和安以及其他
類似的病人接觸越多，
類似的病人接觸越多，
02:06
I began to see my mission evolve,
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我發現我的任務有所演變了。
02:08
and that was to make sure
that the transgender community
that the transgender community
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那就是要確保變性人族群的
02:11
got their health care needs met.
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健康照護需求能被滿足。
02:14
The more I looked into this,
I saw how this very real fear
I saw how this very real fear
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在這方面，我研究越多，
我越能了解這種對於
我越能了解這種對於
02:18
of violence, discrimination
and this lack of acceptance
and this lack of acceptance
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暴力、歧視，以及
不被接受的真實恐懼感
不被接受的真實恐懼感
02:22
caused so many of these patients
to turn to alcohol and drugs.
to turn to alcohol and drugs.
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使許多這類病人轉向毒品及酒精。
02:26
And I also heard these horror stories
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我也聽到許多駭人的故事，
02:29
of when these patients
were seeking medical care
were seeking medical care
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關於這類病人在尋求醫療照護時，
02:32
and how they were treated,
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他們所受的對待，
02:33
and how a lot of their
medical needs were ignored.
medical needs were ignored.
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以及他們許多醫療的需求
如何被忽視。
如何被忽視。
02:37
Now let me tell you about Leah.
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讓我告訴各位莉亞的故事。
02:39
I had the pleasure
of meeting Leah a few years back.
of meeting Leah a few years back.
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幾年前，我有榮幸認識了莉亞。
02:42
She's a female and she has
a wife and a child.
a wife and a child.
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她是女性，她有妻子和一個孩子。
02:46
See, Leah was also assigned male at birth
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莉亞也是出生時被認定為男性，
02:49
and she knew since she was a young child
that she was not a male,
that she was not a male,
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但她從小時候就知道她不是男性，
02:53
that she was a female.
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她是女性。
02:55
She hid it from herself
and from everyone she knew,
and from everyone she knew,
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她將這件事瞞著
自己以及她認識的每個人，
自己以及她認識的每個人，
02:58
especially from her wife,
until the age of 50.
until the age of 50.
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特別是她的妻子，直到五十歲時。
03:01
She couldn't take it anymore.
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她無法再忍受了。
03:02
She was like, I can't
keep living like this.
keep living like this.
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她心想，我不能繼續這樣過日子。
我得要誠實。
03:05
I gotta get honest.
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她非常害怕將這件事告訴她的妻子。
03:06
She was extremely scared to tell her wife.
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03:09
What if her wife said,
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萬一她的妻子說：
「這是不能接受的，
「這是不能接受的，
03:10
"This is unacceptable,
I want a divorce, get out"?
I want a divorce, get out"?
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我要離婚，滾出去。」怎麼辦？
03:14
To her surprise, her wife was accepting.
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讓她意外的是，她的妻子接受了。
03:17
She said, "I love you
regardless of who you are.
regardless of who you are.
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她說：「我愛你，不論你是誰。
03:20
I want to help you in every way I can."
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我想要盡我所能來協助你。」
03:22
So she talked with her wife,
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所以，她和妻子長談，
03:24
and she made the decision
that she wanted to medically transition,
that she wanted to medically transition,
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她決定要做醫學的變性。
03:28
and she was interested in being
assessed for hormone replacement therapy,
assessed for hormone replacement therapy,
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她有興趣接受
更換荷爾蒙治療法的評估，
更換荷爾蒙治療法的評估，
也就是大家所知的 HRT。
03:32
otherwise known as HRT.
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03:34
So she made an appointment
with her doctor.
with her doctor.
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所以，她和她的醫生
約了會面時間。
約了會面時間。
03:37
She arrived on the day
of her appointment early.
of her appointment early.
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當天，她提早赴約。
03:40
She filled out all the paperwork,
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她填寫了各種表單，
03:41
put the name correctly down there
and waited patiently.
and waited patiently.
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把名字正確地填寫好，
耐心地等待。
耐心地等待。
03:46
A little bit of time passed and a nurse
called her back to the exam room.
called her back to the exam room.
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不久後，一位護士把她叫回檢查間。
03:50
When she got back there,
she took a deep breath,
she took a deep breath,
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當她去到檢查間時，
她深吸了一口氣，
她深吸了一口氣，
03:53
and the doctor and the nurse walked in.
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醫生和護士走進來。
03:56
She extended her hand to the doctor
and said, "Hi, I'm Leah."
and said, "Hi, I'm Leah."
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她把手伸向醫生，說：
「嗨，我是莉亞。」
「嗨，我是莉亞。」
03:59
The doctor looked at her,
didn't shake her hand and said,
didn't shake her hand and said,
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醫生看著她，
並沒有握她的手，說：
並沒有握她的手，說：
04:03
"Why are you here?"
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「你為什麼來這裡？」
04:05
She took another deep breath and said,
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她再次深呼吸，說：
04:09
"Well, I'm a transgender female.
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「我是女性變性人。
04:11
I've known this my whole life,
I've hid it from everyone,
I've hid it from everyone,
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我一直都知道這一點，
但都沒讓別人知道，
但都沒讓別人知道，
但我無法繼續這樣了。
04:13
but I can't do it anymore.
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我妻子支持我，錢我負擔得起。
04:15
My wife's supportive,
I can financially afford it,
I can financially afford it,
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04:17
I've got to make these changes.
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我得要做這些改變。
04:19
Please consider me,
and let's evaluate me for HRT."
and let's evaluate me for HRT."
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請考慮我，請評估我是否
適合更換荷爾蒙治療法。」
適合更換荷爾蒙治療法。」
04:23
The doctor said,
"We can't do anything today.
"We can't do anything today.
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醫生說：
「今天我們什麼都不能做。
「今天我們什麼都不能做。
你得去做愛滋病病毒檢測。」
04:25
You need to go get an HIV test."
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04:29
She couldn't believe it.
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她無法置信。
她很憤怒。
04:31
She was furious.
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04:32
She was angry. She was disappointed.
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她很生氣。她很失望。
04:35
If her doctor treated her this way,
how would the rest of the world treat her?
how would the rest of the world treat her?
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如果連她的醫生都這樣對待她，
世界上的其他人會如何對待她呢？
世界上的其他人會如何對待她呢？
04:38
First, he wouldn't shake her hand,
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首先，他不願意和她握手，
04:41
and second, when he heard
she was transgender,
she was transgender,
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再者，當他聽到她是變性人時，
04:44
all he cared about was getting
an HIV test and ending the appointment.
an HIV test and ending the appointment.
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他在乎的只有愛滋病病毒檢測
以及結束面談。
以及結束面談。
他甚至沒有問她其他問題。
04:47
He didn't even ask her
any other questions.
any other questions.
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04:50
See, I can understand
where Leah's coming from,
where Leah's coming from,
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我能了解莉亞的感受，
04:53
because the years that I've worked
with the community,
with the community,
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因為我在工作上
接觸這個族群的這些年，
接觸這個族群的這些年，
04:55
I hear myths every single day
that aren't true at all.
that aren't true at all.
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我每天都會聽到一些謎思，
它們都完全不是真的。
它們都完全不是真的。
04:59
A couple of those are:
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其中一些包括：
05:01
every transgender person wants
to transition with medication or surgery;
to transition with medication or surgery;
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每個變性人都想要
用藥物或手術來變性；
用藥物或手術來變性；
05:06
transgender people are mentally ill,
this is a disorder;
this is a disorder;
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變性人心理有病，這是一種失調；
05:09
and: these people
aren't real men and women.
aren't real men and women.
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還有，這些人不是
真正的男人或女人。
真正的男人或女人。
05:12
These are all myths and untrue.
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這些都是謎思，且不是真的。
05:15
As this community expands and grows older,
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隨著這個族群擴大和年紀漸長，
05:18
it is imperative that all
health care providers be trained
health care providers be trained
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所有的健康照護提供者
都必須要接受訓練，
都必須要接受訓練，
05:21
on how to take care
of their health care needs.
of their health care needs.
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了解如何處理
他們的健康照護需求。
他們的健康照護需求。
05:24
Back in 2015, a survey was done
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在 2015 年，有一項調查
發現 72% 的健康照護提供者
05:26
and found that 72 percent
of health care providers
of health care providers
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05:30
did not feel well-informed
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不覺得他們對於 LGBT 族群的
05:32
on the health care needs
of the LGBT community.
of the LGBT community.
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健康照護需求有足夠的資訊。
05:37
There's a huge gap
in the education and training.
in the education and training.
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在他們的教育和訓練中，
有很大的缺口。
有很大的缺口。
05:40
Today, in this talk,
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今天，在這場演說中，
05:42
I want to offer a new way of thinking
for three groups of people:
for three groups of people:
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我想要將一種
新的思考方式提供給三種人：
新的思考方式提供給三種人：
05:45
doctors, the transgender community
and, well, the rest of us.
and, well, the rest of us.
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醫生、變性人族群，
以及剩下的其他人。
以及剩下的其他人。
05:49
But before we do, I want to cover
a couple of definitions
a couple of definitions
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但在這之前，
我想要先談幾個定義，
我想要先談幾個定義，
05:52
that's going to help you wrap your head
around gender identity a little bit more.
around gender identity a little bit more.
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它們能協助各位
對性別認同多了解一點。
對性別認同多了解一點。
05:56
So I hope you've got your paper and pen.
Get ready to take some notes.
Get ready to take some notes.
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我希望你們已經準備好
紙筆要來寫筆記了。
紙筆要來寫筆記了。
06:00
So let's start out
with this idea of a binary system.
with this idea of a binary system.
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咱們就從這個
二元系統的想法開始。
二元系統的想法開始。
06:03
And what this means is,
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意思就是，
以前我們認為只有兩種性別，
男和女。
男和女。
06:04
before, we always thought
there was only two, male and female.
there was only two, male and female.
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06:07
Get it? Binary? Right?
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懂嗎？二元？對吧？
06:09
So we've come to find out
that this isn't true.
that this isn't true.
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我們漸漸發現，事實不是如此。
06:12
Gender identity is a spectrum
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性別認同像是光譜，
06:15
with maleness on one side
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一端是男性，
06:17
and femaleness over here
on the other side.
on the other side.
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另一端是女性。
06:19
This spectrum of identities
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這個性別認同的光譜
06:22
include identities such as
gender-nonconforming,
gender-nonconforming,
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包含了非常規性別、
06:25
gender-affirming,
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性別確認、
06:27
gender-nonbinary,
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非二元性別、
06:28
two-spirited, three-spirited,
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雙靈、三靈，
06:30
as well as people that are intersex.
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以及陰陽人。
06:33
The term transgender is this umbrella term
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變性人這個詞是一個總稱，
06:36
that encompasses all these
different types of identities.
different types of identities.
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包括上述各類的性別認同。
06:39
But for today's talk, I want you
to think about transgender
to think about transgender
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但，在今天的演說，
我希望各位能把變性人
我希望各位能把變性人
06:42
as someone who is assigned
a sex at birth that doesn't match
a sex at birth that doesn't match
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視為在出生時被認定的性別
不符合自己本人的認定
和他們的自我感覺。
和他們的自我感覺。
06:46
with who they are as a person
and their sense of self.
and their sense of self.
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06:49
Now, this is very different
than biological sex.
than biological sex.
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這和生物學上的性別是很不同的。
06:51
So gender identity is sense of self.
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性別認同是自我的感覺。
06:53
So think of it as
what's between your ears:
what's between your ears:
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你可把它想成是在你的兩耳之間：
對自己的感覺，你是怎樣的人。
06:57
sense of self, who you are.
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06:59
This is very different
than biological sex, right?
than biological sex, right?
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這和生物學上的性別
很不一樣，對吧？
很不一樣，對吧？
07:01
Hormones, genitalia, chromosomes:
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荷爾蒙、生殖器、染色體：
07:03
that's what's between our legs.
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那是在我們的兩腿之間。
07:07
Now, you may be thinking, "Dr. Kristie,
I have never questioned who I am.
I have never questioned who I am.
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你們可能在想：「克莉絲蒂醫生，
我從來沒有質疑過我是什麼人。
我從來沒有質疑過我是什麼人。
07:10
I know I'm a man, or I know I'm a woman."
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我知道我是男人，
或我知道我是女人。」
或我知道我是女人。」
07:13
I get it. You know who you are.
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我懂。你知道你是什麼人。
07:16
This is how many
transgender individuals feel.
transgender individuals feel.
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許多變性人也有這種感覺。
07:18
They just know who they are
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他們就是知道他們是什麼人，
07:20
with that same conviction.
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有著和你們同等的信心。
07:24
It's important to know that there
are many different types of identities,
are many different types of identities,
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重要的是要知道
有許多不同類型的身分認同，
有許多不同類型的身分認同，
而我認同的是順性別的女性。
07:27
and I identify as a cisgender female.
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07:30
Now, for all y'all out there
that like to know how to spell things,
that like to know how to spell things,
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如果你們想要知道如何寫這個詞，
07:34
cis is spelled "c-i-s."
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「順」性別的順是「c－i－s」。
07:36
It's the Latin term
for "on the same side of."
for "on the same side of."
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這個詞來自拉丁文，
意思是「在同一邊」。
意思是「在同一邊」。
07:39
When I was born,
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我出生時，
07:41
the doctor held me up
to my parents and said,
to my parents and said,
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醫生把我抱起來交給我父母，
說：「是個女孩。」
07:43
"It's a girl."
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這完全是根據我的生殖器判斷的。
07:44
All this, based on my genitalia.
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07:46
Even though I grew up
in a small farm town in Georgia,
in a small farm town in Georgia,
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雖然我是在喬治亞州的
小農場長大，
小農場長大，
07:49
very much a tomboy,
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是個很男性化的女孩。
07:52
I never questioned that I was a female.
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我從來沒有質疑過我是女性。
07:54
I've always known I was a girl,
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我一直都知道我是個女孩，
07:56
regardless of how I was as a kid.
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不論我在孩提時是怎樣的。
07:58
Now, this is very different
than someone who's transgender.
than someone who's transgender.
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這和變性人是非常不同的。
08:01
Now, trans is a Latin term
for "on the other side of" --
for "on the other side of" --
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「變（trans）」也來自拉丁文，
意思是「在另一邊」——
意思是「在另一邊」——
08:05
think about transcontinental airlines,
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想想看橫貫（trans）
大陸的航線，
大陸的航線，
08:07
across, on the other side of --
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橫越，到另一邊——
08:09
someone that's assigned a sex at birth
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有人在出生時被認定了一個性別，
08:12
and they identify
on the other side of the spectrum.
on the other side of the spectrum.
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而他們認同的是另一端的性別。
08:15
A transgender male is someone
who was assigned female at birth,
who was assigned female at birth,
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男性變性人就是在出生時
被認定為女性，
被認定為女性，
08:19
but their sense of self,
who they are, how they live their life,
who they are, how they live their life,
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但他們的自我感覺、他們是誰、
要如何過他們的生活，
要如何過他們的生活，
08:23
is as a male.
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是男性的。
08:24
And the opposite is, as we talked earlier,
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相對的，我們前面談過，
女性變性人是在出生時
被指定為男性，
被指定為男性，
08:26
a transgender female,
someone that's assigned male at birth
someone that's assigned male at birth
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但以女性的身分過生活，
且自我感覺是女性。
且自我感覺是女性。
08:29
but lives their live
and sense of self as a female.
and sense of self as a female.
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08:32
It's also important to point out here
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這裡還有一個重點，
08:34
that not everyone
that has a nonbinary identity
that has a nonbinary identity
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並不是所有非二元性別認同的人，
08:37
identifies with the term "transgender."
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就一定是「變性人」。
08:40
Just so nobody gets confused,
I want to point out sexual identity,
I want to point out sexual identity,
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為了不要讓大家困惑，
我要談一下性認同，
我要談一下性認同，
08:44
or orientation.
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或是性取向，
08:45
That is simply who we're attracted to,
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那只是看我們被什麼人吸引，
08:48
physically, emotionally,
sexually, spiritually.
sexually, spiritually.
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身體上、感情上、性別上、心靈上。
08:52
It's got nothing to do
with gender identity.
with gender identity.
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這和性別認同是沒關係的。
08:54
So just for a quick recap,
before we continue on:
before we continue on:
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在我們繼續下去之前，
先快速回顧一下重點：
先快速回顧一下重點：
08:57
gender identity between the ears,
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性別認同在兩耳之間，
08:58
biological sex, just think
of it between your legs,
of it between your legs,
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生物學的性別則是在兩腿之間的，
09:02
and then sexual identity,
well, sometimes we use our heart,
well, sometimes we use our heart,
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而性認同，
有時我們會用我們的心，
有時我們會用我們的心，
09:04
but it's here.
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但它在這裡。
09:06
Three very different identity spectrums.
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三種不同的身分認同光譜。
09:11
Now, the average medical student
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一般的醫學院學生
09:13
spends about five hours learning
about the LGBT health-related needs
about the LGBT health-related needs
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在上醫學院時會花
大約五小時的時間，
大約五小時的時間，
學習關於 LGBT 的健康相關需求。
09:18
while they're in medical school.
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09:20
Now, this is despite us knowing
that there are unique health risks
that there are unique health risks
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而且這是在我們已經知道
這個族群會面對獨特的健康風險。
09:24
to this community.
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09:27
And there's an estimated
10 million American adults
10 million American adults
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根據估計，有一千萬名美國成人的
09:31
that identify as LGBT.
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性別認同是 LGBT。
09:34
Most doctors that work
with transgender patients,
with transgender patients,
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大部分在工作上需要接觸
變性人病人的醫生，
變性人病人的醫生，
09:36
they learn trial by fire.
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他們學的是火審。
09:39
That means they figure it out
as they go along,
as they go along,
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意思就是說，他們邊做邊學，
09:41
or the patient ends up spending their time
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或是最後反而是病人要花時間
09:43
trying to teach the doctor
how to take care of them.
how to take care of them.
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來教導醫生如何照顧他們。
09:47
Many doctors don't feel comfortable
asking about gender identities.
asking about gender identities.
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許多醫生對於詢問病人的
性別認同感覺不自在。
性別認同感覺不自在。
09:50
Some don't feel like it's relevant at all
to their medical care
to their medical care
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有些醫生覺得性別認同
和醫療照護一點關係都沒有。
和醫療照護一點關係都沒有。
09:54
and others just don't want
to say the wrong thing.
to say the wrong thing.
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還有些醫生不希望說錯話。
09:58
Many doctors who say
something inappropriate
something inappropriate
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當醫生說出了不妥當的話，
10:00
or they say something negative,
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或是負面的話時，
10:02
they may not be coming
from a malicious or mean place,
from a malicious or mean place,
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他們不見得是有惡意或是故意的。
10:05
they may have never been trained
on how to care for these individuals.
on how to care for these individuals.
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他們可能從來沒有受過
如何照顧這些人的訓練。
如何照顧這些人的訓練。
10:09
But this can't be accepted
as a norm anymore either.
as a norm anymore either.
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但我們不能再接受
把這種狀況當成常態了。
把這種狀況當成常態了。
10:14
So what happens to a transgender male --
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所以，當男性變性人——
10:17
for a quick recap, that's someone
who is assigned female at birth
who is assigned female at birth
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快速回顧一下，
就是出生時被認定為女性，
就是出生時被認定為女性，
但以男性身分過日子的人——
10:20
but lives their life as a male --
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10:22
what happens when this transgender male
goes for their yearly gynecological visit?
goes for their yearly gynecological visit?
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當男性變性人去做每年的
婦科檢查時，會發生什麼事？
婦科檢查時，會發生什麼事？
10:28
How that doctor treats that patient
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那位醫生如何對待這個病人，
10:31
will set the whole tone for the office.
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會決定那間診所的氛圍。
10:33
If that doctor treats that male
with the correct pronouns, correct name,
with the correct pronouns, correct name,
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如果醫生用正確的代名詞、
正確的名字來對待那位男性，
正確的名字來對待那位男性，
10:38
gives dignity and respect,
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給予他尊嚴和尊重，
10:40
it's highly likely
that the rest of the staff will too.
that the rest of the staff will too.
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很可能其他工作人員也會這麼做。
10:44
So that's a little bit
about my thoughts on doctors,
about my thoughts on doctors,
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那是我對於醫生的小小想法，
10:46
and now let's move on
to the transgender community.
to the transgender community.
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現在，咱們接著來談變性人族群。
10:49
I'm here talking about fear,
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我要談的是恐懼。
10:51
but y'all know who
is really fearful, right?
is really fearful, right?
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你們都知道真正感到
害怕的人是誰，對吧？
害怕的人是誰，對吧？
10:54
It's the transgender community.
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是變性人族群。
10:57
Earlier I shared the story about Anne
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剛才我分享了安的故事，
10:58
and how she was so worried
about going into treatment
about going into treatment
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提到她有多擔心要去接受治療時，
不會被當成女性來尊重，
11:01
and not being respected
as her female self,
as her female self,
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11:03
and then Leah who was scared
about how her doctor would react,
about how her doctor would react,
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接著是莉亞，
她害怕的是醫生的反應，
她害怕的是醫生的反應，
11:06
and the second
that he didn't shake her hand
that he didn't shake her hand
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當醫生沒有跟她握手，
11:08
and ordered that HIV test,
her fears came true.
her fears came true.
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並要求愛滋病檢測的那一刻，
她的恐懼成真了。
她的恐懼成真了。
11:12
The transgender community
needs to be empowered
needs to be empowered
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變性人族群需要能夠
大聲說出他們的健康照護需求。
11:15
to speak up for their health care needs.
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11:18
The days of remaining silent and taking
whatever treatment you can get are over.
whatever treatment you can get are over.
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保持沉默和接受任何
能得到之治療的日子已經過去了。
能得到之治療的日子已經過去了。
11:23
If you don't speak up
for your health care needs,
for your health care needs,
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如果你不大聲說出
自己的健康照護需求，
自己的健康照護需求，
沒有人會為你發聲。
11:25
no one's going to do it for you.
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11:29
So what about the rest of us?
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那麼，我們剩下的人呢？
11:32
A lot of y'all, maybe in the next week
or a couple of months,
or a couple of months,
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在座很多人，
在下週或是幾個月後，
在下週或是幾個月後，
11:34
are going to have
a doctor's appointment, right?
a doctor's appointment, right?
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可能已預約了要看醫生，對吧？
11:37
So let's say you go
to your doctor's appointment
to your doctor's appointment
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假設說你照約定的時間去看醫生，
11:39
and when it's over,
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結束時，
11:40
you feel worse than you did
when you got there.
when you got there.
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你的感覺比去看醫生之前更糟。
11:44
What if you felt dismissed by the doctor,
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你覺得被醫生打發掉，
11:47
that they ignored your needs,
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醫生不理會你的需求，
11:48
or you even felt judged?
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或你甚至覺得受到評斷。
11:52
That's what happens for many
of the 1.4 million transgender adults
of the 1.4 million transgender adults
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美國 140 萬名成年變性人當中，
有許多人就會有這樣的遭遇，
11:56
here in the US
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11:58
if they're lucky enough
to get an appointment.
to get an appointment.
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前提是他們夠幸運地
預約到醫生。
預約到醫生。
12:01
Now, you may be thinking,
"Why is this important to me?
"Why is this important to me?
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你們現在可能在想：
「這對我來說有什麼重要的？
「這對我來說有什麼重要的？
12:04
I'm not transgender.
I don't know anybody that's transgender.
I don't know anybody that's transgender.
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我又不是變性人。
我也不認識任何變性人。
我也不認識任何變性人。
12:07
Why should I even care?"
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我幹嘛在乎？」
12:10
Think of it this way.
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就這樣想吧。
12:11
A transgender individual is human,
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變性人是人，
12:14
just like you and me.
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就像你和我一樣。
12:16
They deserve competent
and trained health care providers,
and trained health care providers,
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他們也該能取得有能力
且受過訓練的健康照護提供者，
且受過訓練的健康照護提供者，
12:19
just like you and me.
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和你我一樣。
12:22
So let me ask, if you don't
mind raising your hand:
mind raising your hand:
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讓我問個問題，
如果不介意，請舉手：
如果不介意，請舉手：
12:24
Do you know or have you met
anyone who is transgender,
anyone who is transgender,
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你們認識或遇見過任何變性人、
12:28
gender-nonconforming, agender, intersex,
two-spirited, three-spirited?
two-spirited, three-spirited?
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非性別常規、無性別、陰陽人、
雙靈、或三靈的人嗎？
雙靈、或三靈的人嗎？
12:32
Thank y'all so much. Lovely. Thank y'all.
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非常謝謝你們。真好。謝謝。
12:35
Every one of y'all
who did not raise your hand,
who did not raise your hand,
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所有沒舉手的人，
12:38
in the very near future
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在不久的將來，
12:40
you will get the opportunity to meet
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你們會有機會遇見
上述的其中一種，我保證。
12:42
someone that falls into one
of these identities, I guarantee it.
of these identities, I guarantee it.
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12:46
The number of this
community is increasing.
community is increasing.
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這個族群的人數在增加。
12:49
That's not because it's a fad
or the new thing to do.
or the new thing to do.
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並不是因為這是流行或是很新鮮。
12:53
It's safer to come out.
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而是他們對站出來感到更安全了。
12:55
There's more awareness.
There's more visibility.
There's more visibility.
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有更多的意識。有更多的能見度。
12:58
There's more safety, so people
are speaking up about their true self
are speaking up about their true self
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有更多的安全感，
所以大家會展現出真實的自己，
所以大家會展現出真實的自己，
13:01
like never before.
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以前是不可能的。
13:04
That's why it's so important
that our health care system get on board
that our health care system get on board
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這就是為什麼，很重要的是
我們的健康照護體制要能上路，
我們的健康照護體制要能上路，
13:08
and make sure that our doctors
and health care providers are trained
and health care providers are trained
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確保我們的醫生和健康照護
提供者都受到訓練，
提供者都受到訓練，
13:12
to approach these patients
with dignity and respect,
with dignity and respect,
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知道如何在接觸這些病人時
保持他們的尊嚴和尊重，
保持他們的尊嚴和尊重，
13:15
just like we expect.
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就像我們所有人都期望得到的。
13:18
I remember being
in my 11th grade literature class,
in my 11th grade literature class,
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我記得我十一歲在上文學課時，
麥克連老師是我最喜歡的老師之一，
13:21
with one of my favorite
teachers, Mr. McClain,
teachers, Mr. McClain,
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13:23
and he shared this quote by Heraclitus
that sticks with me to this day.
that sticks with me to this day.
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他引述了赫拉克利特的話，
至今我都忘不了。
至今我都忘不了。
13:26
Y'all may have even heard it.
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你們可能也聽過。
13:28
It's, "The only thing that is constant
is that things will change."
is that things will change."
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「唯一不變的即是變。」
13:34
Familiar, right?
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很耳熟，對吧？
13:36
Every single one of us
face changes in our lives,
face changes in our lives,
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我們每個人在人生中
都會面臨改變，
都會面臨改變，
13:39
and often when we're faced
with these changes,
with these changes,
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通常，當我們面臨這些改變時，
13:42
we've got some difficult
decisions to make.
decisions to make.
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我們得要做出一些困難的決定。
13:45
Will we remain in fear, stay stuck
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我們是否會持續
留在恐懼中，被卡住，
留在恐懼中，被卡住，
13:48
and not grow?
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無法成長？
13:50
Or, will we face fear with bravery,
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或者，我們會勇敢面對恐懼，
13:55
evolve, take the opportunity to grow?
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進化，抓住機會來成長？
13:59
Every one of us face new things.
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我們每個人都會面臨新事物。
14:01
What will you do?
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你們會怎麼做？
14:03
Will you remain in fear,
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你們會持續留在恐懼中？
14:06
or will you grow?
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還是你們會成長？
14:09
I invite each of you, doctors,
the transgender community
the transgender community
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我想邀請每個人：
醫生、變性人族群，
醫生、變性人族群，
14:12
and you and I,
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以及你和我，
14:14
to face fear together
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在走進這個勇敢的新世界時，
14:15
as we walk into this brave new world.
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一起面對恐懼。
14:18
Thank you.
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謝謝。
14:19
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Kristie Overstreet - Clinical sexologist and psychotherapistKristie Overstreet works with individuals to help strengthen their relationship with themselves and others.
Why you should listen
Dr. Kristie Overstreet is a clinical sexologist, psychotherapist, author, speaker and consultant. With more than twelve years of clinical experience, she has developed best practices for transgender healthcare. Her mission is to educate every behavioral and healthcare worker to provide dignity care for the LGBTQIA+ community.
Overstreet has written three books on improving relationships and is a sought-after expert. She is the creator of the Transgender Healthcare Dignity Model training and certification program. Her new book Finding Your True Self: A Guide to Gender Acceptance will be published in 2019. She serves as a national contributor to CNN, Psychology Today, Readers Digest, Your Workplace, Women’s Health, Men’s Health, Cosmopolitan, Glamour and various other media.
Overstreet holds a PhD in Clinical Sexology, Master of Arts in Professional Counseling and Bachelor of Science in Biology. She is a licensed counselor in California, Florida, Georgia and Louisiana. She is also a certified sex therapist and addiction professional. She is president of Therapy Department, a private practice in Orange County, California, that provides counseling, training, speaking and consulting services throughout the United States.
Kristie Overstreet | Speaker | TED.com