Sex change, or sometimes called sex reassignment therapy, is a medical procedure to change sex from male to female or female to male under a genitalia surgery or any other sexual reassignment surgeries. Sex change is usually undergone by transgender people or intersexual people, specifically children. The larger definition of sex change is scoping not only the medical procedures associated with it, but also the whole process of changing roles and responsibilities in life. This affects the life of the person undergone the procedures, since it gives impact to the surrounding and people around him or her. That is why, confirming sex change as just a medical procedure to change sex is an inaccurate approach because it ignores the social and legal impact.
Human sex change
In fact, sex change is more specifically defined as sex change in humans. This refers to sex reassignment surgery that people may undergo in certain conditions. However, many people see “sex change” or “sex reassignment procedure” from an inaccurate definition. Biologically, human sex is determined by four factors: chromosomes, gonads (ovaries or testicles), hormonal status, and primary or secondary sex characteristics. In a sex reassignment procedure to make a male to female or female to male, not all those four factors can be changed. Chromosome is the main thing that cannot be changed because it is inherited. Ovaries or testicles can be removed, but cannot be replaced one to another. Hormonal status is dynamically changed. Only primary or secondary sex characteristics can be changed, but it is only until a certain boundaries.
By this condition, changing a male genitalia into a perfect and excellent female genitalia with a good function is complicated but still possible. However, changing female genital anatomy into a functioning, good male genital anatomy is also complicated, but hardly succesful.
Before undergoing a sex reassignment surgery, the patient must be under a period of feminization or masculinization, regarding to what gender he or she wants to be. This is commonly two years before the sex reassignment surgery, just like what is ruled by the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People. In this period, some synthetic or natural hormones like estrogens, androgens, progesterons, and antiandrogens are used. Counselling is also compulsory to start the body changing hormones. In this counselling, a period of full days living in the target gender for at least six months is also accomplished.
Natural sex change in humans
Not only via sex reassignment surgery, sex change in humans also happened naturally. Some specific medical conditions can result to sex change. This is can be seen after a long period of a lifetime. So, a human who is born and appears of one sex can transforms into the other sex after a long period. Female to male sex change is mostly happened in this natural sex change, because of either 5-alpha-reductase deficiency (5alpha-RD-2) or 17-beta-hydroxysteroid dehydrogenase deficiency (17beta-HSD-3). Meanwhile, male to female sex change is a rare occurence and still can not be understood well by experts.
Genetic females (with two X chromosomes) with congenital adrenal hyperplasia lack an enzyme needed by the adrenal gland to make the hormones cortisol and aldosterone. Without these hormones, the body produces more androgen, a type of male sex hormone. This causes male characteristics to appear early (or inappropriately).
The lack of certain enzymes can also cause in a natural sex change, although not an obvious one (but only by appearance). Females (with two X chromosomes) with congenital adrenal hyperplasia (or lack of enzyme for the adrenal gland to produce hormones cortisol and aldosterone) can show male characteristics and appearance early and inappropriately because the body will produce more androgen, which is a type of male sex hormone. In the other hand, males (with one X and one Y chromosome) with androgen insensitivity syndrome (AIS) is not sensitive to androgen. It results to the person showing an entire or partial characterisitic of a woman. AIS sometimes include other diseases like Reifenstein syndrome which cause men to develop breast on their chest.
0 komentar:
Posting Komentar