原文標(biāo)題：
Trans treatments
The dangers of gender medicine
Too many doctors have suspended their professional judgment
跨性別治療
性別醫(yī)學(xué)的風(fēng)險(xiǎn)
很多醫(yī)生不使用他們的專業(yè)知識(shí)和經(jīng)驗(yàn)來(lái)做決定

[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.

在一個(gè)自由的社會(huì)中，政府無(wú)權(quán)干預(yù)成年人的生活和穿著方式，代詞使用或者性別選擇。

[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.

在大西洋兩岸，醫(yī)學(xué)專家已經(jīng)權(quán)衡了治療兒童和青少年的性別焦慮（指對(duì)他們的生理性別感到極度不適）的證據(jù)。這種治療會(huì)改變一個(gè)人的一生，且可能導(dǎo)致不孕。

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

總體而言，美國(guó)人的共識(shí)是，醫(yī)療干預(yù)和性別認(rèn)同有益，且支持醫(yī)學(xué)干預(yù)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.
歐洲有幾個(gè)國(guó)家認(rèn)為證據(jù)不足，應(yīng)該少用醫(yī)學(xué)干預(yù)，且需要進(jìn)一步研究。歐洲人是正確的。

[Paragraph 3]

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

在美國(guó)，被診斷為性別焦慮癥的兒童和青少年數(shù)量激增。

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

一項(xiàng)估計(jì)發(fā)現(xiàn)，2021年有4.2萬(wàn)多個(gè)新確診案例，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).

美國(guó)人所理解的性別認(rèn)同護(hù)理規(guī)定的咨詢，可能導(dǎo)致使用青春期阻滯藥物，繼而會(huì)使用異性荷爾蒙（女孩用睪酮，男孩用雌激素——據(jù)估計(jì)，有10%的確診病例會(huì)使用）。

The goal is to align the patient’s body with the way that they think about themselves.
目標(biāo)是使患者的生理性別與他們的期待性別一致。

[Paragraph 4]

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

支持者說(shuō)，這種護(hù)理對(duì)性別焦慮兒童的健康至關(guān)重要。

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

他們說(shuō)，如果未能提供相關(guān)護(hù)理就會(huì)演變成跨性別恐懼癥，且可能導(dǎo)致患者自殺。

The affirmative approach is supported by the American Academy of Paediatrics, and by most of the country’s main medical bodies.
美國(guó)兒科學(xué)會(huì)和大多數(shù)主要醫(yī)學(xué)機(jī)構(gòu)都支持性別認(rèn)同的護(hù)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”.

反對(duì)者是英國(guó)、芬蘭、法國(guó)、挪威和瑞典等國(guó)家的醫(yī)療系統(tǒng)，它們都發(fā)出了警告，稱這些治療方法處于“試驗(yàn)階段”，并敦促醫(yī)生在治療上要“極度謹(jǐn)慎”。

There is growing concern that, if teenagers are offered this care too widely, the harms will outweigh the benefits.
越來(lái)越多人擔(dān)心如果青少年過(guò)度接受這種護(hù)理，那么會(huì)導(dǎo)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，他們有長(zhǎng)期的性別焦慮癥狀。除了性別焦慮之外，有心理問(wèn)題的兒童和青少年都被取消了治療資格。

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，大多數(shù)患者是青少年女孩。她們的性別焦慮相對(duì)較新。有些人抑郁、焦慮或自閉，但精神疾病不再是治療的硬性指標(biāo)。

Do these patients respond to drugs and surgery in the same way?
這些患者對(duì)藥物和手術(shù)的反應(yīng)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?yàn)獒槍?duì)更廣泛范圍青少年的臨床證據(jù)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年開(kāi)始的英國(guó)正式審查臨床證據(jù)發(fā)現(xiàn)，這一領(lǐng)域幾乎所有的研究質(zhì)量都很差；瑞典的一項(xiàng)研究得出了類似的結(jié)論。

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.

研究人員發(fā)現(xiàn)的效益往往很小。無(wú)論是在效果時(shí)長(zhǎng)上，還是在藥物或咨詢單獨(dú)作用或共同作用方面，都無(wú)法得出結(jié)論。

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

一些較早的研究表明，如果不干預(yù)，大多數(shù)兒童會(huì)自然地擺脫性別焦慮的困擾。

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

盡管存在有關(guān)大腦發(fā)育和骨密度降低的擔(dān)憂，青春期阻滯劑的長(zhǎng)期影響仍未可知。

[Paragraph 8]

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

醫(yī)療機(jī)構(gòu)將保障措施納入其治療方案，但都各不相同。無(wú)論何種方式，從業(yè)者都可能會(huì)忽略它們。

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

有人舉報(bào)說(shuō)一些兒童和青少年僅在粗略評(píng)估后就開(kāi)始服用青春期阻滯劑。

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.
越來(lái)越多的“變性者”對(duì)他們的治療感到后悔，他們留下了疤痕、不孕、外表發(fā)生不可逆轉(zhuǎn)的改變，并對(duì)治療他們性別焦慮的方式感到不滿。

[Paragraph 9]

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

美國(guó)專業(yè)機(jī)構(gòu)承認(rèn)科學(xué)質(zhì)量較低，但也表示他們有責(zé)任緩解患者的精神痛苦。

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

有些患者對(duì)所有的醫(yī)療程序（從膝蓋手術(shù)到抽脂手術(shù)）都感到后悔。

And they observe that the most shocking allegations about poor treatment are only anecdotes.
他們觀察到關(guān)于治療不佳的最駭人聽(tīng)聞的指控也只是個(gè)別案例。

[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.
除了這些，還有其他情況。當(dāng)醫(yī)務(wù)人員提出擔(dān)憂時(shí)——比如說(shuō)青少年女孩被社交傳染，或者一些父母認(rèn)為變性手術(shù)是讓同性戀兒子變成異性戀女兒的一種方式——醫(yī)生人員會(huì)被誹謗患有跨性別恐懼癥，并且在某些情況下，會(huì)受到人身攻擊和職業(yè)譴責(zé)。

[Paragraph 11]

Medical science is not supposed to work this way.

醫(yī)學(xué)科學(xué)不應(yīng)該以這種方式運(yùn)作。

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

治療方法應(yīng)該得到更多的經(jīng)過(guò)充分研究的證據(jù)支持，這些證據(jù)會(huì)權(quán)衡性別干預(yù)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.

當(dāng)治療不可逆轉(zhuǎn)并且是否繼續(xù)治療的決定由脆弱的青少年和他們焦慮的父母做出時(shí)，醫(yī)學(xué)的責(zé)任就更重了。

[Paragraph 12]

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

怎么辦？對(duì)于一些人來(lái)說(shuō)，不確定性是徹底禁止醫(yī)療性別干預(yù)的理由。

In fact, the lack of evidence cuts both ways.

事實(shí)上，缺乏證據(jù)是雙向的。

Perhaps, when proper trials are complete, their proponents will be proved correct.
也許，當(dāng)適當(dāng)?shù)脑囼?yàn)完成后，性別干預(yù)的支持者或?qū)⒈蛔C明是正確的。

[Paragraph 13]

Ideally, American regulators would insist on trials, too. Above all, they should not add to the tragedy.
理想情況下，美國(guó)監(jiān)管機(jī)構(gòu)也會(huì)堅(jiān)持進(jìn)行試驗(yàn)。最重要的是，他們不應(yīng)增加悲劇的發(fā)生。

（恭喜讀完，本篇英語(yǔ)詞匯量861左右，有刪減）
原文出自：2023年4月8日《The Economist》Leaders版塊

精讀筆記來(lái)源于：自由英語(yǔ)之路

本文翻譯整理: Irene

本文編輯校對(duì): Irene
僅供個(gè)人英語(yǔ)學(xué)習(xí)交流使用。

【補(bǔ)充資料】（來(lái)自于網(wǎng)絡(luò)）
社交傳染是指信息（如態(tài)度、情感或行為）在一個(gè)群體中從一個(gè)成員迅速傳播到其他成員，而不需要理性思考和推理 。社交傳染的過(guò)程可以放大社交網(wǎng)絡(luò)中信息的傳播。社交傳染的兩個(gè)主要分支是行為傳染和情感傳染 。

【重點(diǎn)句子】（3?個(gè)）
There is growing concern that, if teenagers are offered this care too widely, the harms will outweigh the benefits.
越來(lái)越多人擔(dān)心如果青少年過(guò)度接受這種護(hù)理，那么會(huì)導(dǎo)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.
研究人員發(fā)現(xiàn)的效益往往很小。無(wú)論是在效果時(shí)長(zhǎng)上，還是在藥物或咨詢單獨(dú)作用或共同作用方面，都無(wú)法得出結(jié)論。

Treatments are supposed to be backed by a growing body of well-researched evidence that weighs the risks and benefits of intervention.
治療方法應(yīng)該得到更多的經(jīng)過(guò)充分研究的證據(jù)支持，這些證據(jù)會(huì)權(quán)衡性別干預(yù)利弊。