Intersex

ʻO ka Intersex kahi hui o nā kūlana kahi e loaʻa ai ka discrepancy ma waena o nā genital kūwaho a me nā genital o loko (nā testes a me nā ovaries).

ʻO ka huaʻōlelo kahiko no kēia ʻano hermaphroditism. ʻOiai hoʻokomo ʻia nā huaʻōlelo kahiko i kēia ʻatikala no ke kuhikuhi ʻana, ua hoʻololi ʻia lākou e ka hapa nui o ka poʻe loea, nā mea maʻi a me nā ʻohana. Ke hoʻonui nei, ua kapa ʻia kēia hui o nā kūlana nā maʻi o ka hoʻomohala kāne (DSDs).

Hiki ke hoʻokaʻawale ʻia ʻo Intersex i nā mahele 4:

• 46, XX intersex
• 46, XY intersex
• Intersec gonadal ʻoiaʻiʻo
• Pākuʻi paʻakikī a i ʻole koho ʻia

Kūkākūkā kēlā me kēia me nā kikoʻī ma lalo.

Kaha: i nā keiki he nui, mau ke kumu o ka intersex i hoʻoholo ʻole ʻia, ʻoiai me nā ʻano hana diagnostic o kēia ao.

46, XX INTERSEX

Loaʻa i ke kanaka nā chromosome o ka wahine, nā ovaries o ka wahine, akā ʻo waho o waho (waho) o nā genital e hōʻike ʻia he kāne. ʻO kēia ka hopena pinepine o ka hānai wahine i hōʻike ʻia i nā homone kāne keu ma mua o ka hānau ʻana. ʻO ka labia ("lehelehe" a i ʻole nā ​​pelu o ka ʻili o nā genital wahine waho) fuse, a hoʻonui ka clitoris e like me kahi penis. I ka hapanui o nā hihia, he uterus maʻamau kēia kanaka a me nā paipu fallopian. Kāhea ʻia kēia ʻano he 46, XX me ka virilization. Ua kapa ʻia ia he wahine pseudohermaphroditism. Aia kekahi mau kumu kūpono:

• ʻO ka hyperplasia adrenal adrenal (ke kumu maʻamau).
• ʻO nā homone kāne (e like me testosterone) i lawe a hui ʻia paha e ka makuahine i ka wā hāpai.
• Nā kūpuna hana-kāne kāne i ka makuahine: ʻO kēia nā tumo ovarian pinepine. Pono e nānā ʻia nā makuahine i loaʻa nā keiki me 46, XX intersex ke ʻole he kumu ʻē aʻe.
• Ka hemahema o ka Aromatase: ʻAʻole ʻike ʻia kēia mea a hiki i ka wā ʻōpio. ʻO ka Aromatase kahi enzyme e hoʻololi maʻamau i nā homone kāne i nā wahine wahine. Hiki i ka hana aromatase keu ke alakaʻi i ka estrogen (wahine wahine); liʻiliʻi loa i 46, XX intersex. I ka wā ʻōpio, ʻo kēia mau keiki XX, i hānai ʻia i kaikamahine, hoʻomaka paha e lawe i nā ʻano kāne.

46, XY INTERSEX

Loaʻa i ke kanaka nā chromosome o kahi kāne, akā ʻo nā genital o waho kahi i hana ʻole ʻia, ʻano ʻole, a wahine maoli paha. I loko, he maʻamau paha nā hōʻike, malformed, a i ʻole ma kahi o. Kāhea ʻia kēia ʻano he 46, XY me ka undervirilization. Ua kapa ʻia ia he kāne pseudohermaphroditism. ʻO ka hoʻokumu ʻia ʻana o nā genital kūwaho kāne kūlike i ke kaulike kūpono ma waena o nā kāne a me nā wahine. No laila, koi ʻia ka hana kūpono a me ka hana o nā kāne kāne. 46, XY intersex he nui nā kumu kūpono:

• Nā pilikia me nā hōʻike: Hoʻokumu nā testes i nā homone kāne. Inā ʻaʻole kū pololei nā hōʻike, e alakaʻi ia i ka undervirilization. Aia kekahi mau kumu kūpono no kēia, me XY maʻemaʻe gonadal dysgenesis.
• Nā pilikia me ka hoʻokumu testosterone: Hoʻokumu ʻia ka testosterone ma o ke kaʻina o nā ʻanuʻu. Koi ʻia kēlā me kēia ʻanuʻu i kekahi enzyme ʻokoʻa. Hiki i nā hemahema i kekahi o kēia mau enzyme ke kūpono i ka lawa ʻole o ka testosterone a hana i kahi maʻi ʻokoʻa o 46, XY intersex. Hiki ke hāʻule i nā ʻano ʻokoʻa o ka hyperplasia adrenal congenital i kēia mahele.
• Nā pilikia me ka hoʻohana ʻana i ka testosterone: He mau hōʻoia maʻamau ko kekahi poʻe a loaʻa ka nui o ka testosterone, akā he 46, XY intersex ma muli o nā kūlana e like me ka hemahema o 5-alpha-reductase a i ʻole androgen insensitivity syndrome (AIS).
• ʻO ka poʻe me ka hemahema 5-alpha-reductase nele i ka enzyme e pono ai e hoʻohuli i ka testosterone i dihydrotestosteron (DHT). Aia ma kahi o 5 mau ʻano like ʻole o ka hemahema o 5-alpha-reductase. Loaʻa i kekahi o nā pēpē ke kāne kāne maʻamau, loaʻa kekahi i nā genitalia wahine maʻamau, a he nui nā mea ma waena. Hoʻololi ka hapa nui i nā genitalia kāne kūwaho a puni ka wā ʻōpio.
• ʻO AIS ke kumu maʻamau o 46, XY intersex. Ua kapa ʻia ʻo ia ʻo ka wahine. Maʻaneʻi, he maʻamau nā homoni a pau, akā ʻaʻole holo pono nā mea loaʻa i nā kāne kāne. Aia ma kahi o 150 mau kīnā ʻē aʻe i ʻike ʻia a hiki i kēia manawa, a ke kumu nei kēlā me kēia ʻano i kekahi ʻano ʻAIS.

TRSE GONADAL INTERSEX

Pono i ke kanaka ʻelua ovarian a me nā kiko kiko. Aia paha kēia i loko o ka gonad like (kahi ovotestis), a i ʻole he 1 ovary a me 1 hōʻike ko ke kanaka. Loaʻa paha i ke kanaka nā chromosome XX, nā chromosome XY, a i ʻole ʻelua paha. Huikau paha nā ʻōiwi o waho a wahine paha a kāne paha. Ua kapa ʻia kēia ʻano he hermaphroditism maoli. I ka hapanui o ka poʻe me ka intersect gonadal maoli, ʻaʻole ʻike ʻia ke kumu kumu, ʻoiai i loko o kekahi mau holoholona e pili ana i ka pili ʻana i nā pesticides ahupuaʻa maʻamau.

KA PALAPALA A I ʻole UNDETERMINED INTERSEX DISORDERS O KA HUI MAKAHIKI

ʻO nā hoʻonohonoho chromosome he nui ʻē aʻe ma mua o 46, XX a 46 paha, XY hiki ke hopena i nā maʻi o ka ulu wahine. Pākuʻi ʻia kēia me 45, XO (hoʻokahi X chromosome), a me 47, XXY, 47, XXX - he chromosome moekolohe keu, he X a he Y paha kēia mau maʻi. a me ka genitalia kūwaho. Eia nō naʻe, aia paha he mau pilikia me nā pae hormone kolohe, ka hoʻomohala moekolohe holoʻokoʻa, a me nā helu i hoʻololi ʻia o nā chromosome wahine.

Pili nā ʻōuli e pili ana i ka intersex i ke kumu kumu. Pākuʻi ʻia lākou:

• ʻO ke genigu ambiguous i ka wā hānau
• ʻO Micropenis
• ʻO Clitoromegaly (kahi clitoris hoʻonui ʻia)
• Hoʻohui pālua hapa
• Kohu mea hōʻikeʻike ʻole ʻia (a he ovary ia) i nā keikikāne
• Labial a inguinal (groin) lehulehu (a i ʻole huli ʻia he mau testes) i nā kaikamahine
• Hypospadias (ʻo ka hāmama o ka peni kahi ma kahi ʻē aʻe ma ka piko; i nā wahine, wehe ka urethra [ke aʻa mimi] i loko o ka ʻōpū)
• Inā ʻole-ʻike kūʻē genitalia i ka wā hānau
• Nā mea pono ʻole electrolyte
• Hoopanee a hele ole i ka wa opiopio
• Nā hoʻololi i manaʻo ʻole ʻia i ka wā ʻōpio

E hana ʻia kēia mau hoʻāʻo a me nā hoʻokolohua:

• Ka Ikepili Chromosome
• Nā pae Hormone (ʻo kahi laʻana, pae testosterone)
• Nā hoʻāʻo hoʻāʻo Hormone
• Nā hoʻāʻo uila
• ʻImi mole kikoʻī
• Hōʻike Endoscopic (e hōʻoia i ka loaʻa ʻole a i ʻole ke kūloko o kahi ʻōpū a cervix paha)
• Ultrasound a i ʻole MRI e loiloi inā aia nā mea pili wahine i loko (e laʻa me, he kōpū)

ʻO ke kūpono, he hui o nā ʻoihana mālama ola me ka loea i ka intersex e pono e hana pū e hoʻomaopopo a mālama i ke keiki me ka intersex a kākoʻo i ka ʻohana.

Pono e hoʻomaopopo nā mākua i nā hoʻopaʻapaʻa a me nā hoʻololi i ka mālama ʻana i ka intersex i nā makahiki i hala iho nei.I ka wā ma mua, ʻo ka manaʻo nui ʻoi aku ka maikaʻi o ka hāʻawi ʻana i ke kāne i ka hiki wawe. Hoʻokumu pinepine ʻia kēia i nā ʻōpū o waho ma mua o ka wahine chromosomal. Ua haʻi ʻia nā mākua e ʻaʻohe kānalua i ko lākou manaʻo no ke kāne a ke keiki. Paipai ʻia ke ʻoki wikiwiki. Lawe ʻia ka ovarian a i ʻole ke kiko testicular mai ka wahine ʻē aʻe. Ma ke ʻano laulā, manaʻo ʻia ka maʻalahi o ke kūkulu hou ʻana i nā genitalia wahine ma mua o ka hana ʻana i nā genitalia kāne, no laila inā ʻaʻole maopopo ke koho "pololei", hāʻawi pinepine ʻia ke keiki i kaikamahine.

I kēia mau lā, ua loli ka manaʻo o nā loea he nui. ʻO ka mahalo nui i nā paʻakikī o ka hana moekolohe wahine ka mea i alakaʻi iā lākou e hoʻoholo i ka maikaʻi ʻole o ka wahine ʻoihana wahine ma mua o ka male suboptimal kāne, ʻoiai inā "maʻalahi ka hana hou." Hoʻohui ʻia, ʻoi aku ka nui o nā kumu ʻē aʻe i ka hōʻoluʻolu kāne ma mua o ka hana ʻana i nā genital o waho. Hiki i nā Chromosomal, neural, hormonal, psychological, a me nā ʻano hana ke hoʻohuli i ka ʻike kāne.

Koi aku nā loea he nui i ka hoʻopanee ʻana i ke kaha pono no ka lōʻihi o ke olakino, a pili pono i ke keiki i ka hoʻoholo kāne.

ʻIke loa, he pilikia paʻakikī ka intersex, a he hopena pōkole a lōʻihi hoʻi nā hopena. ʻO ka pane maikaʻi e hilinaʻi ʻia i nā kumu he nui, me ke kumu kikoʻī o ka intersex. ʻOi aku ka maikaʻi e lawe i ka manawa e hoʻomaopopo ai i nā pilikia ma mua o ka wikiwiki ʻana i kahi hoʻoholo. Hiki i kahi hui kōkua intersex ke kōkua i ka hoʻomaʻamaʻa ʻana i nā ʻohana me ka noiʻi hou loa, a hāʻawi paha i kahi kaiāulu o nā ʻohana ʻē aʻe, nā keiki, a me nā kānaka makua i kū i nā pilikia like.

He mea nui nā hui kākoʻo no nā ʻohana e pili ana i ka intersex.

ʻOkoʻa paha nā hui kākoʻo ʻokoʻa i ko lākou mau manaʻo e pili ana i kēia kumuhana koʻikoʻi loa. E nānā i kahi e kākoʻo i kou mau manaʻo a me kou mau manaʻo ma ke kumuhana.

Hāʻawi nā ʻoihana aʻe i ka ʻike hou aku:

• ʻO ka hui no nā ʻokoʻa chromosome X a me Y - genetic.org
• Kumu Foundation - www.caresfoundation.org/
• Intersex Society of North America - isna.org
• ʻO Turner Syndrome Society o ʻAmelika Hui Pū ʻIa - www.turnersyndrome.org/
• 48, XXYY - XXYY Papahana - genetic.org/variations/about-xxyy/

E ʻoluʻolu e ʻike i ka ʻike ma nā kūlana pākahi. Pili ka wānana i ke kumu kikoʻī o ka intersex. Me ka hoʻomaopopo, kākoʻo, a me ka lapaʻau kūpono, maikaʻi loa ka nānā holoʻokoʻa.

Inā ʻoe e ʻike i ka loaʻa ʻole o ka genitalia o kāu keiki a i ʻole ka hoʻomohala kolohe ʻana, e kūkākūkā me kēia me kāu kahu mālama ola.

Nā maʻi o ka hoʻomohala kolohe; DSDs; Pseudohermaphroditism; Hermaphroditism; Hermaphrodite

ʻO Diamond DA, Yu RN. Nā maʻi o ka hoʻomohala moekolohe: etiology, loiloi, a me ka hoʻokele olakino. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA: Elsevier; 2016: chap 150.

Donohoue PA. Nā maʻi o ka hoʻomohala moekolohe. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 606.

ʻO Wherrett DK. E hoʻokokoke aku i ka pēpē me kahi maʻi i manaʻo ʻia no ka hoʻomohala ʻana i ka wahine. ʻO Pediatr Clin North Am. 2015; 62 (4): 983-999. PMID: 26210628 www.ncbi.nlm.nih.gov/pubmed/26210628.