《经济学人》双语：变性医疗的风险？

原文标题：
Trans treatments
The dangers of gender medicine
Too many doctors have suspended their professional judgment
跨性别治疗
性别医学的风险
很多医生不使用他们的专业知识和经验来做决定

[Paragraph 1]
In a free society it is not the government’s place to tell adults how to live and dress, which pronouns to use, or what to do with their bodies.

在一个自由的社会中，政府无权干预成年人的生活和穿着方式，代词使用或者性别选择。

[Paragraph 2]

On different sides of the Atlantic, medical experts have weighed the evidence for the treatment of gender-dysphoric children and teenagers, those who feel intense discomfort with their biological sex. This treatment is life-changing and can lead to infertility.

在大西洋两岸，医学专家已经权衡了治疗儿童和青少年的性别焦虑（指对他们的生理性别感到极度不适）的证据。这种治疗会改变一个人的一生，且可能导致不孕。

Broadly speaking, the consensus in America is that medical intervention and gender affirmation are beneficial and should be more acessible.

总体而言，美国人的共识是，医疗干预和性别认同有益，且支持医学干预便利化。

Across Europe several countries now believe that the evidence is lacking and such interventions should be used sparingly and need further study. The Europeans are right.
欧洲有几个国家认为证据不足，应该少用医学干预，且需要进一步研究。欧洲人是正确的。

[Paragraph 3]

The number of children and teenagers diagnosed with gender dysphoria in America has soared.

在美国，被诊断为性别焦虑症的儿童和青少年数量激增。

One estimate found that there were over 42,000 new diagnoses in 2021, three times the count in 2017.

一项估计发现，2021年有4.2万多个新确诊案例，是2017年的三倍。

Gender-affirming care, as America understands it, stipulates counselling, which can lead to puberty-blocking drugs and subsequently cross-sex hormones (testosterone for girls and oestrogen for boys—used, by one estimate, in 10% of cases).

美国人所理解的性别认同护理规定的咨询，可能导致使用青春期阻滞药物，继而会使用异性荷尔蒙（女孩用睾酮，男孩用雌激素——据估计，有10%的确诊病例会使用）。

The goal is to align the patient’s body with the way that they think about themselves.
目标是使患者的生理性别与他们的期待性别一致。

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Proponents say that the care is vital to the wellbeing of dysphoric children.

支持者说，这种护理对性别焦虑儿童的健康至关重要。

Failure to provide it, they say, is transphobic, and risks patients killing themselves.

他们说，如果未能提供相关护理就会演变成跨性别恐惧症，且可能导致患者自杀。

The affirmative approach is supported by the American Academy of Paediatrics, and by most of the country’s main medical bodies.
美国儿科学会和大多数主要医学机构都支持性别认同的护理。

[Paragraph 5]

Arrayed against those supporters are the medical systems of Britain, Finland, France, Norway and Sweden, all of which have raised the alarm, describing treatments as “experimental” and urging doctors to proceed with “great medical caution”.

反对者是英国、芬兰、法国、挪威和瑞典等国家的医疗系统，它们都发出了警告，称这些治疗方法处于“试验阶段”，并敦促医生在治疗上要“极度谨慎”。

There is growing concern that, if teenagers are offered this care too widely, the harms will outweigh the benefits.
越来越多人担心如果青少年过度接受这种护理，那么会导致弊大于利。

[Paragraph 6]

Twenty years ago, the typical patient was male, with a long history of dysphoria. Children and teenagers with psychological problems besides dysphoria were disqualified from treatment.

20年前，患者普遍是男性，他们有长期的性别焦虑症状。除了性别焦虑之外，有心理问题的儿童和青少年都被取消了治疗资格。

These days most patients are adolescent girls. Their dysphoria may be relatively recent.Some are depressed, anxious or autistic, but mental illness is no longer a hard barrier to treatment.

如今，大多数患者是青少年女孩。她们的性别焦虑相对较新。有些人抑郁、焦虑或自闭，但精神疾病不再是治疗的硬性指标。

Do these patients respond to drugs and surgery in the same way?
这些患者对药物和手术的反应是否相同呢？

[Paragraph 7]

It is unclear. And that is because the clinical evidence for intervention in broader categories of adolescents is vague.

目前尚不清楚。因为针对更广泛范围青少年的临床证据模糊不清。

A formal British review of the clinical evidence, prepared in 2020, found that almost all the studies in this area were of poor quality; one in Sweden came to similar conclusions.

2020年开始的英国正式审查临床证据发现，这一领域几乎所有的研究质量都很差；瑞典的一项研究得出了类似的结论。

When researchers find benefits, the effects tend to be small. It is often impossible to conclude whether they are lasting, or how much the credit is down to drugs or counselling or both.

研究人员发现的效益往往很小。无论是在效果时长上，还是在药物或咨询单独作用或共同作用方面，都无法得出结论。

Some older studies suggest that, left alone, most children will naturally grow out of their dysphoric feelings.

一些较早的研究表明，如果不干预，大多数儿童会自然地摆脱性别焦虑的困扰。

The longterm effects of pubertyblockers remain unknown, though there are worries about brain development and decreasing bone density.

尽管存在有关大脑发育和骨密度降低的担忧，青春期阻滞剂的长期影响仍未可知。

[Paragraph 8]

Medical bodies build safeguards into their treatment protocols, but they vary. And in any case practitioners may ignore them.

医疗机构将保障措施纳入其治疗方案，但都各不相同。无论何种方式，从业者都可能会忽略它们。

Whistleblowers say that some children and teenagers are being put on pubertyblockers after only a cursory assessment.

有人举报说一些儿童和青少年仅在粗略评估后就开始服用青春期阻滞剂。

A growing number of “detransitioners”, who regret their treatment, say that they have been left scarred, infertile, with irreversibly altered appearances and were unhappy with how their dysphoria was treated.
越来越多的“变性者”对他们的治疗感到后悔，他们留下了疤痕、不孕、外表发生不可逆转的改变，并对治疗他们性别焦虑的方式感到不满。

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America’s professional bodies acknowledge the science is low quality, but say they have a duty to alleviate patients’ mental anguish.

美国专业机构承认科学质量较低，但也表示他们有责任缓解患者的精神痛苦。

Some patients suffer regret in all medical procedures, from knee surgery to liposuction.

有些患者对所有的医疗程序（从膝盖手术到抽脂手术）都感到后悔。

And they observe that the most shocking allegations about poor treatment are only anecdotes.
他们观察到关于治疗不佳的最骇人听闻的指控也只是个别案例。

[Paragraph 10]

Except that there is. And when medical staff raise concerns—that teenage girls may be caught up in a social contagion, say, or that some parents see transition as a way to have a straight daughter rather than a gay son—they have been vilified as transphobic and, in some cases, suffered personal and professional opprobrium.
除了这些，还有其他情况。当医务人员提出担忧时——比如说青少年女孩被社交传染，或者一些父母认为变性手术是让同性恋儿子变成异性恋女儿的一种方式——医生人员会被诽谤患有跨性别恐惧症，并且在某些情况下，会受到人身攻击和职业谴责。

[Paragraph 11]

Medical science is not supposed to work this way.

医学科学不应该以这种方式运作。

Treatments are supposed to be backed by a growing body of well-researched evidence that weighs the risks and benefits of intervention.

治疗方法应该得到更多的经过充分研究的证据支持，这些证据会权衡性别干预利弊。

The responsibility is all the heavier when treatments are irreversible and the decisions about whether to go ahead are being taken by vulnerable adolescents and their anxious parents.

当治疗不可逆转并且是否继续治疗的决定由脆弱的青少年和他们焦虑的父母做出时，医学的责任就更重了。

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What to do? To some, the uncertainties that surround medical interventions are grounds for an outright ban.

怎么办？对于一些人来说，不确定性是彻底禁止医疗性别干预的理由。

In fact, the lack of evidence cuts both ways.

事实上，缺乏证据是双向的。

Perhaps, when proper trials are complete, their proponents will be proved correct.
也许，当适当的试验完成后，性别干预的支持者或将被证明是正确的。

[Paragraph 13]

Ideally, American regulators would insist on trials, too. Above all, they should not add to the tragedy.
理想情况下，美国监管机构也会坚持进行试验。最重要的是，他们不应增加悲剧的发生。

（恭喜读完，本篇英语词汇量861左右，有删减）
原文出自：2023年4月8日《The Economist》Leaders版块

精读笔记来源于：自由英语之路

本文翻译整理: Irene

本文编辑校对: Irene
仅供个人英语学习交流使用。

【补充资料】（来自于网络）
社交传染是指信息（如态度、情感或行为）在一个群体中从一个成员迅速传播到其他成员，而不需要理性思考和推理 。社交传染的过程可以放大社交网络中信息的传播。社交传染的两个主要分支是行为传染和情感传染 。

【重点句子】（3 个）
There is growing concern that, if teenagers are offered this care too widely, the harms will outweigh the benefits.
越来越多人担心如果青少年过度接受这种护理，那么会导致弊大于利。

When researchers find benefits, the effects tend to be small. It is often impossible to conclude whether they are lasting, or how much the credit is down to drugs or counselling or both.
研究人员发现的效益往往很小。无论是在效果时长上，还是在药物或咨询单独作用或共同作用方面，都无法得出结论。

Treatments are supposed to be backed by a growing body of well-researched evidence that weighs the risks and benefits of intervention.
治疗方法应该得到更多的经过充分研究的证据支持，这些证据会权衡性别干预利弊。