第3課:性別不安拆解
第3課:性別不安拆解
💡Part 1:定義進化論(由病理化到去病化)
▫️ 時代巨變:
2013年前:「性別認同障礙」→ 似罵人「黐線」😠
2013年後:「性別不安」→ 強調社會適應困境😣
2022年ICD-11:「性別不一致」→ 完全脫離精神疾病分類🎉
⚠️ 關鍵區分:
「性別不安」未必等於「想做另一個性別」,而係「因性別錯配導致痛苦」
「性別不一致」=單純不認同原生性別,冇痛苦都成立
🧬Part 2:成因迷宮(科學界仲拗緊)
▫️ 混合燃料論:
• 生物油:子宮內荷爾蒙失調/腦結構差異🧠
• 基因氣:雙胞胎研究顯示33%相關性👯
• 環境火:童年創傷?社會排斥?媒體影響?🔥
📌 重要結論:冇單一成因,戒絕「都係阿媽教壞」嘅思維!
👶👴Part 3:症狀圖鑑(兒童vs成人大不同)
▫️ 細路GD特徵:
• 堅持「我係女/男孩」好似呼吸自然(早發型)
• 見到自己個body反應大過見蟑螂🪑
• 玩芭比定變形金剛?根本係生存抉擇!
▫️ 大人GD特徵:
• 長期覺得自己「困錯軀殼」嘅窒息感
• 對性徵嘅厭惡感堪比見到曱甴蛋
• 社會角色錯位引發嘅「日常演技大賞」🎭
📜Part 4:DSM-5診斷密碼
▫️ 症狀checklist:
1️⃣ 身體vs心理性別嚴重「撞板」
2️⃣ 想切除原生性徵嘅衝動
3️⃣ 渴望擁有異性生理特徵
4️⃣ 強烈希望成為另一性別
5️⃣ 需要被當作另一性別對待
6️⃣ 深信自己擁有異性心理特質
⚠️ 必須持續半年以上+影響正常生活!
🚨Part 5:輔導員踩雷區(GD≠...)
▫️ 五大誤診陷阱:
✖️ 把「跨性別」= 有病要醫
✖️ 將「性別不安」混為同性戀
✖️ 誤會「易服癖」等於GD
✖️ 以為所有TGNC都需要治療
✖️ 忽略社經壓力放大痛苦
✅ 黃金法則:當事人嘅主觀痛苦先係核心指標
靈魂同身體打交:「照鏡好似睇緊恐怖片」
社交窒息體驗:「每次被叫『先生』都似中箭」
生理性別焦慮:「諗起要沖涼就手震」
💡 關鍵:唔係「心理有病」,係身體同身份唔同步!
🧩Part 6:常見誤判陷阱
▫️ 三大偽陽性情境:
1️⃣ 自閉光譜(ASD)嘅「分類強迫症」:
• 特徵:將性別當樂高砌,邏輯先行於感受🧠
• 警號句:「既然做唔好『男人』角色,轉會可能更有效率」
• 關鍵區分:問「轉性別會唔會幫你更容易跟社交規則?」
2️⃣ 強迫症(OCD)嘅「思想恐怖谷」:
• 特徵:對性別轉換念頭產生侵入性恐懼😱
• 典型模式:越抗拒「我係咪跨性別?」越焦慮→形成惡性循環
• 區分「恐懼引發焦慮」vs「壓抑引發痛苦」
3️⃣ 特殊性癖(Paraphilia)嘅慾望迷宮:
• 特徵:性興奮與易裝行為掛鈎,事後有罪惡感👗
• 經典矛盾:享受女裝勃起 vs 日常抗拒女性身份
• 鑑別重點:慾望高峰後會否出現「性別焦慮戒斷反應」?
⚠️ 黃金守則:唔好急住貼標籤!如果有疑惑,要交給醫生判斷🍲
🌈記住:心靈迷宮需要耐心導航,我哋嘅任務係幫人搵到最貼近真相嘅出口,唔係製造更多混亂!🧭
💡 關鍵:唔係「心理有病」,係身體同身份唔同步!
Reference:
American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed., text revision. Washington, DC: American Psychiatric Association. [online] Available at: https://www.psychiatry.org/psychiatrists/practice/dsm [Accessed 6 March 2025].
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World Health Organization, 2022. International Classification of Diseases (ICD-11): Gender incongruence. [online] Available at: https://www.who.int/standards/classifications/classification-of-diseases [Accessed 6 March 2025].
Zucker, K.J. and Bradley, S.J., 1995. Gender identity disorder and psychosexual problems in children and adolescents. New York, NY: Guilford Press. [Note: Placeholder link unavailable; cited based on standard edition.]