整/變性別？ 性徵打造者的身體認同與醫療處遇

Modifying Sexuality and Gender? The Body Identity and Medical Encounter of Sexual Modifiers

吳姿芊(Chih-Chien Wu)

指導教授 ： 成令方

高雄醫學大學/護理學院/性別研究所/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00023

摘要

本研究從我的經驗與疑問出發。我想以醫療（手術）打造性徵（胸部），而不想「變性」，但我卻在求醫的過程中面臨到不少阻礙。我開始思考性別身體與性別認同的關係，以及性別身體除了男卅女二分之外，能否有其它的選擇。本研究以「性徵打造者未必都想要全套變性手術」的觀點出發，期能挑戰社會對「性徵打造者就是想變性」的刻板印象。本研究除了呈現出性徵打造者在使用醫療打造性徵的困境，還要指出性徵打造者（她－它－他們）的困境不只來自醫療，更源自社會對性別二分的單一想像。在理解性徵打造時，本研究是將變性手術、整形手術與性徵打造三者都視為一種協調自我的身體打造，除了抵抗主流醫學對性徵打造的病理化看待外，也進一步透過主體的醫療過程，釐清這三種「殊途同歸」的手術在性別社會中的異同。

本研究藉由訪問十位性徵打造者以及二位作手術的外科醫師，探究二個主題：（一）藉由性徵打造者的主體經驗，以釐清伴隨原生性別而生的性別規範與性別身體，例如性別服裝、性別特質和第二性徵對主體的壓迫與限制，如何促成她－它－他們打造性徵的動機，以及主體在打造一個理想身體時，所做的考量。（二）由於主體對性徵打造的不同考量，連帶地影響她－它－他們打造性徵的方式；不同的打造方式，讓主體付出不等程度的代價。無論是性別規範的壓迫、限制或是性徵打造的考量與代價，其實都與社會制度和醫療體系對性別的二分思維密切相關。最後指出，我們從主體的生命歷程體認到，若把身體性別視為連續光譜的樣貌展現，不僅可以看見更多不同的性別身體，同時也能將性別多元呈現當作人類多樣化的展現，進而反轉社會與醫療對打造性徵的疾病化和失序化。

關鍵字

平胸手術 ； 性別規範 ； 性徵打造者 ； 身體認同 ； 變性手術

並列摘要

This study starts from my personal experience and questions about traditional category of gender. I want to remove my breast which is a sign of female sexuality; however, I don't want to change my sex. I have encountered many difficulties when I approached doctors. Some doctors turned me down because they think breast removal and sex change surgery are inseparable. I began to wonder how sexed body is related to gender identity, and is there any possibility to go beyond male and female dichotomy?

From the point of view that “Not every Sexual Modifier wants to have a sex change surgery,” the study attempt not only to challenge the view that Sexual Modifiers equal to transsexuals, but also to reveal the difficulties that Sexual Modifiers have encountered when they try to modify their sexual characteristics under current medical environment. In addition, the difficulties they encountered are not just from the medical treatment, but also derive from the view of gender dichotomy. I take sex change surgery, cosmetic surgery, and sexual modify as a kind of body rebuilding in which the makers rebuild their body in order to match with their self identity. Through the comparison, I try to reveal the unjust stigma on Sexual Modifiers who are treated by current medical system as pathological.

The data is collected from 10 Sexual Modifiers and two surgeons. There are two issues discussed in the study. First, through the discussion of personal experience of Sexual Modifiers, to clarify how gender norm and sexed body motivate them to modify their sexual characteristics. What is their consideration when it comes to rebuild an ideal body? Second, through focusing on the medical encounters we can understand how their different considerations affect the ways they modify the undesired sexual characteristic, and different ways of sexual characteristic modification make them pay high prices at different level. In conclusion, the study attempts to show that if we take sexed body as a continuum, we can see not merely more different sexed body, but also understand gender diversities represent the varieties of human being and society. Moreover, it might challenge the social and medical pathological bias toward Sexual Modifiers.

並列關鍵字

body identity ； FtM top surgery ； gender norm ； sex change surgery ； Sexual Modifier

參考文獻

中文：

孔繁鐘編譯（1998）《DSM-IV精神疾病診斷準則手冊》，台北：合記。

方榮煌（1990）＜變性手術之概論＞，《榮總護理》，7：143-144。

王仕圖、吳慧敏（2003）＜深度訪談與案例操作＞，齊力、林本炫編《質性研究方法與資料分析》，95-113。嘉義：南華

王茂山（2005）＜變性手術之發展＞，《臨床醫學》，56：81-87。