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发表时间:2015-02-05 10:41:56 562 0 0

双性人,医学上称为两性畸形或性别畸形,俗称“阴阳人”,是指生殖器官发生变异,出现与正常的男女生殖器官不同的器官的人。 雌雄同体的人在不同文化中有不同待遇。在某些文化中这种人被归类为“第三性”或性别混合的社会角色。在大部分社会中,雌雄同体的人期待选择一个生物性别,并顺从此性别的社会性别角色。 现代医学在西方社会兴起后,性别不明的雌雄同体个体会以手术改变其生殖器,使生殖器看来像雄性或雌性。

真性与假性

假性

假两性畸形又可分为“男性假两性畸形”和“女性假两性畸形”两种。

女性

“女性假两性畸形”是在同一个人的体内,其生殖腺是女性卵巢,但外生殖器却像是有着男性的性征。此类的患者在外阴部有着发育不良,尤其以阴蒂与正常女性相较是呈特别肥大,严重者会易使人误认为是阴茎,并且大阴唇会左右连合,若有的患者是卵巢发育位置生长于接近外阴部,导致外观鼓胀而状似阴囊,易使人将与连合的大阴唇看成是阴囊一部分,其中有的患者是没有睾丸。此类的患者,出生则具有状似男性生殖器,若无专业的医疗人员进一步发现诊断,易被父母视为男孩来抚养,其发育随时间增长,生理表征逐渐出现喉结、胡须,严重者则呈外观与其它正常男性无异,因此被周围人们误为男性。

男性

“男性假两性畸形”,是在同一个人的体内,其生殖腺是睾丸,但外生殖器却象女性的外阴。此类的患者因阴茎发育不良,较与正常男性相较呈现明显的萎缩,犹如女性的阴蒂,又因尿道下裂,造成外观似女性的阴道口,有的患者在阴囊的发育上是外观不明显,若隐匿于体内则为隐睾症,但有的患者则是阴囊形若女性的大阴唇,因两颗阴囊并未连合且发育萎缩所致。此类的患者出生后,由于外生殖器呈女性的性征,若无专业的医疗人员进一步发现诊断,易被父母视为女孩来抚养,其发育随时间增长,在青春期之后,因患者的发育状况不同而各自有不同生理现象。有的患者是阴茎能够勃起,并具有射精能力,而有的患者则是声音如似女性,也没有喉结、胡须。[1]通常此类的患者自小视己为女性而生活,在青春期或结婚后,为了追查自己为何没有月经而求诊于妇产科,因此从染色体检验之下,患者才被发现其性征属于男性。[1][2]

真性

真两性畸形是在同一个人的体内,既有男性睾丸,又有女性卵巢的现象。体内所具卵巢和睾丸皆可有内分泌功能,即体内同时有雌激素和雄激素,但常以其中一种激素占优势。[2]

外生殖器多为性别不明,也可能表现为女性,也可能表现为男性,而第二性征的发育往往随占优势的激素而定。如体内雌激素占优势,第二性征就倾向于女性。如雄激素占优势,第二性征就倾向于男性。这种人外阴的尿道上方有一较小的阴茎,下方又有两片分开的大阴唇,在两片大阴唇之间有一小的开口似乎是阴道口,而实际上是排尿的地方。这种真两性人会同时出现男女两种特征,乳房丰满,阴茎可以勃起,有时会遗精,不长胡须。如果作为女性,阴道浅而小,子宫很小,因此没有生育能力。但也曾报道发现有生育功能者。

“假两性畸形”与“真两性畸形”不同之处在于:假性双性人体内实际只有一种性腺,或者是男性性腺,或者是女性性腺。具有男性性腺者,其外生殖器的外观是女性特征;具有女性性腺者,其外生殖器的外观却是男性特征。因而出现貌似女性,实为男性,或貌似男性,实为女性的假两性畸形人。

假性双性人一般不能生育,但真性双性人不但能够生育,甚至两套器官均能够成功运作,成功生育或令配偶受孕[3]。

嵌合体现象

嵌合体现象可能是真性双性人的一个解释。根据《新英伦医学杂志》(vol 338, p 166)报道,英国有发现拥有阴茎,一个睾丸,一个卵巢与输卵管的新生儿。此个体一部分细胞是XY染色体,一部分是XX。推测可能是两个不同胚胎在发育中嵌合成一个。

第二性征倒错
阴阳人与体育运动

运动员[编辑]

有些国际运动赛事要求运动员作性别鉴定。最早期,是要求运动员在专家前赤身裸体。不久,这种方法改为抽取口腔细胞,以巴尔体(惰性X染色体)的存在与否来判定。1992年冬季奥运会起,国际奥委会改为用聚合酶链锁反应,测试一种与Y染色体有关的基因SRY。在500至600位运动员中,约有1位会呈阳性反应。国际田径联合会和国际奥委会分别在1991年和1999年决定不再进行性别鉴定。性别鉴定有种种争议:

·         基因性别并不等于生物性别——有男性基因者,体能未必是男性方向发展。

·         准确度成疑:有人体内可能先天拥有多种染色体,例如部分细胞为XY,部分细胞为XX。

·         歧视:只有女性运动员要接受测试。若该运动员不能通过测试,该测试结果会因此公开。

个案

·         1948年生的奥地利人Erik Schinegger(原名Erika)1966年是世界公认的女子滑雪冠军,直到1967年验出他的染色体是雄性。

·         1932年奥运会女子100米金牌得主波兰人斯坦尼斯洛娃·瓦拉谢维奇(Stanisława Walasiewicz),死后发现他有男性生殖系统。

·         1960年代,乌克兰人Tamara和Irina Press姐妹创了26个世界纪录,最后都因1966年不能通过性别鉴定而被取消。

·         2006年亚洲运动会女子800米银牌得主印度人松达拉贾恩(Santhi Soundarajan),因不能通过性别鉴定而被取消奖牌。[1]

参考文献

1.     ^ 1.0 1.1 国际中心. “男性假两性畸形症”隐藏生殖器 家人误把男当女养. NOWnews 今日新闻网. 2009-12-09 [2012-11-08](中文(台湾)‎).

2.     ^ 2.0 2.1 黎清. 湖北25岁美女教师十余年无例假 经检查实为男性. 凤凰网. 2012-11-07 [2012-11-08] (中文(中国大陆)‎).

3.     ^ 曾为人母今为父 一位双性人的坎坷人生(图). [2013-10-03] (中文(简体)‎).

 

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本文作者

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长程个案

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