十項跨性別應注意的健康議題

10 Things Transgerder Persons Should Discuss With Their Healthcare Provider

1. 醫療可近性 Access to Healthcare

找到理解跨性別人士的醫療院所是困難的，甚至很難找到願意診治跨性別的醫療人員。有些醫護人員可能會因為你的跨性別身份而認定你有問題。即使你找到願意提供醫療服務的院所，你的保險也可能不給付醫藥支出。問問你的醫療人員，你的保險是否會給付你的醫藥費用，如果沒有，問問看是否願意減免些費用，讓你得以負擔。

It is not easy to find a healthcare provider who knows how to treat transgender people. Sometimes it is difficult to find someone who will agree to treat you. Some providers may feel that there is something wrong with you because you are a transgender person. They are not correct, of course. They may not understand that you have always been this way. Even if you do find someone who will treat you, your insurance may not pay for the treatment. Ask your provider if your costs will be covered by your insurance. If they will not, ask if they will reduce your bill so you can pay.

2. 健康史 Health History

信任你的醫療人員是很重要的事，告訴他們你曾服用的藥物與施行的手術。如果他們能知道你做過哪些醫療行為，他們可以給你比較適當的醫療服務。

Its important for you to be able to trust your healthcare provider. Tell them about the medicines you have taken and the surgeries you may have had. If your provider knows what has happened with you in the past, he or she will be better able to give you the best treatment today.

3. 荷爾蒙 Hormones

告知你的醫療人員你的荷爾蒙療法。如果你是第一次使用荷爾蒙，問問他們有哪些應該注意的事項。如果你是跨性別女性，應該詢問有關雌激素與血栓、腫脹、高或低血壓與高血糖；如果你是跨性別男性，你需要血液監測，確保你的睪固酮劑量是安全的。請確保只使用醫療院所處方的荷爾蒙。

Talk with your provider about hormone treatment. If you are starting hormones for the first time, ask about the things you need to watch out for while taking these medicines. If you are a transgender woman, ask about estrogen and blood clots, swelling, high or low blood pressure and high blood sugar. If you are a transgender man, ask about the blood tests you will need to be sure your testosterone dose is safe. Be sure and take only the hormones prescribed by your provider.

4. 心血管健康 Cardiovascular Health

跨性別者可能有較高的心臟病發與中風風險，不僅是因使用荷爾蒙，也包括吸菸、過重、高血壓和糖尿病。跨性別女性會擔心如果她們有心臟問題，醫療人員會拒絕給予雌激素處方，所以她們傾向不告知胸痛與呼吸困難的問題，但這些問題應該要讓他們知道才對。

Transgender persons may be at increased risk for heart attack or stroke, not only from hormone use but from cigarette smoking, overweight, high blood pressure and diabetes. Transgender women may fear that their provider may make them stop estrogen if they develop heart trouble, and so they may not report feelings such as chest pain or trouble breathing. Be sure to tell your provider if you do have these feelings.

5. 癌症 Cancer

因荷爾蒙療法而罹患癌症是非常少見的，但若你正在進行荷爾蒙療法，你的醫生就須評估你的罹癌風險。如果你沒有移除原生性器官，你的醫生也應檢查相關癌症。雖然因荷爾蒙而導致癌症的案例不多，但仍須與其它健康檢查一樣定期篩檢。

It is very rare to develop cancer due to hormone treatment, but your provider will evaluate you for this possibility when he or she sees you for check-ups. Your provider will also check for possible cancer of your sex organs, if they have not been removed. Again this is very rare but it should be checked along with the rest of your physical examination.

6. 性傳染病與安全性行為 Sexually Transmitted Diseases and Safe Sex

跨性別者，尤其是年輕跨性別者，可能是有性行為的。就像其他人一樣，跨性別者也有可能得到性傳染病。安全性行為是非常重要的，以免感染愛滋病毒或其它性傳染病。詢問你的醫生有關安全的性行為。

Transgender people, particularly young transgender people, may be engaging in sexual activity. Just like anyone else, transgender people may get a sexually transmitted disease. It is very important to practice safe sex, so you will not become infected with HIV or other sexually transmitted diseases. Ask your provider about safe sex practices.

7. 酒精與菸草 Alcohol and Tobacco

跨性別者常因飲酒過量造成肝臟或其它器官的危害。飲酒過量者容易自暴自棄或脾氣糟，也可能為危險駕駛。酒精與荷爾蒙的相乘作用也會造成更大的危害。許多跨性別者吸菸，這增加他們心臟與肺臟疾病風險，特別是對荷爾蒙使用者。關心自己健康的跨性別者應該拒絕抽菸，飲酒請少量。

Transgender persons who drink alcohol may drink too much and risk damage to the liver or other organs. Too much alcohol may also cause a person to treat themselves or other people badly, or to drive unsafely. Alcohol and hormones may be more dangerous when taken together. Many transgender people smoke cigarettes. This increases their risk of heart and lung disease, especially in persons taking hormones. Transgender persons who care about their health should not smoke, and they should drink only small amounts, if at all.

8. 抑鬱 Depression

跨性別者很容易悲傷與憂鬱。當我們的家人或朋友不想再見到我們時，那是一段非常沮喪的時光。即使接受了變性手術，憂鬱仍是個大問題。當某人憂鬱時，無論做什麼事都開心不起來。憂鬱的人可能會做出錯誤的決定或傷害自己。請告訴你的醫護人員或治療師你的感覺，悲傷或是憂鬱。現在有很多解決憂鬱的治療方式。

It is very easy for transgender persons to become sad and depressed. If our families or friends don’t want to see us anymore, it is a very depressing time. Even after transition, depression can still be a problem. When someone is depressed, they cannot be happy no matter what they are doing. Depressed persons may make bad choices and may harm themselves. Please talk with your provider or your therapist about your feelings and tell him or her if you feel sad or depressed. Many good treatments are available for depression.

9. 矽膠注射 Injectable Silicone

一些跨性別女性為了女人味的外貌，等不及雌激素的作用，選擇以矽膠注射帶來「即時曲線」。這些由非醫事人員組成的地下組織「pumping parties」所販售的矽膠，可能會在身體組織間移動，並造成難看的疤痕。這些矽膠通常不是醫用級的，可能被污染且常有共用針頭的現象並造成感染。共用針頭可能得到肝炎或愛滋病毒，而矽膠是危險的，不應該被使用。

Some transgender women want to look feminine and beautiful without having to wait for the effects of estrogen. They expect injections of silicone to give them “instant curves.” The silicone, sold at “pumping parties” by non-medical persons, may move around in the tissues and cause ugly scars years later. It is usually not medical grade, may be contaminated and is often injected using a shared needle. You can get hepatitis or HIV through shared needles. Silicone is dangerous and should not be used.

10. 身體意象（飲食與運動）Fitness (Diet & Exercise)

許多跨性別者過重且不運動。對於需要長時間工作的人來說，抽空運動是很困難的。健康的飲食與規律的運動對跨性別者來說相當重要。如果你計劃接受手術，你的醫生會希望你的身體狀況是健康而穩定的。試著吃得健康並每週運動三次，每次運動至少20分鐘。

Many transgender people are overweight and do not exercise. It is hard to make time for exercise if you have to work long hours. A healthy diet and a frequent exercise routine are just as important for transgender persons as for anyone else. If you are planning to have surgery, your surgeon will want to be sure you are in good physical condition to do well during and after surgery. Try to eat a healthy diet and try to exercise for at least 20 minutes three times a week.