2009年7月14日火曜日

アメリカのGIDニュース (その1)


<アメリカのMTF・FTM>


2009年6月17日のCNNニュースのネット版に、アメリカのGIDに関する記事がありましたので以下にご紹介します。

**********

男性から女性へ(MTF)

ヘンリー・ジョセフ・マデンは高校時代には成績のよい生徒として、また陸上部のトラック競技の選手として青春を謳歌しているように見えたが、実は彼には秘密があった。ときどきひそかに母親のパンストや下着を自分の服の下に着用していたのである。

「本気で女の子になりたかったのです。母親の下着を身につけるのは、そのような気持ちを満足させるひとつの方法だったのです。ただ、いつも誰かから肩越しに見られているような不思議な気持ちを味わいました。」とマデンは述懐している。

女になりたいという気持ちはその後も消えることはなく、48歳になってから初めて医師に自分の気持ちを打ち明けて相談した。紹介されたジェンダー・セラピストのもとで治療をはじめ、その結果マデンはトランスジェンダーと診断された。

電気脱毛法やレーザーによる体毛除去、発声法のレッスン、そして性別適合手術(SRS)とすすみ、それまでのヘンリー・ジョセフはジェニファー・エリザベスとなり、通称はジェニーとして知られている。ジェニーの職業は内科医師、アメリカの東北部にあるニューハンプシャー州ナシュアの街で自分のクリニックを持つ開業医である。

女性から男性へ(FTM)

有名な女優であるチャーを母に、エンターテイナーからアメリカ下院議員になった故ソニー・ボノを父として生まれたチャスティティ・ボノが、先週マスコミに発表したのは、女性から男性への性転換への第一歩を踏み出した、という驚くような内容であった。

比較的にまれであるこの性転換症という症状は、近年になってもっと広範に知られるようになってきた。一部の研究家の説ではアメリカ人口の0.25%から0.5%の割合で、性転換症(トランスジェンダー)がいると言われている。

LGBT(Lesbian,Gay,Bisexual,Transgender)という略語は普通の話題となり、性転換症の人々も評判となった映画“Boys Don‘t Cry”や2002年出版の“Middlesex”という本で描かれる存在になったのは記憶に新しい。

性転換を成し遂げた人たちの話から言えることは、MTFとFTMを問わず、その多くが子供時代から自分が間違った性に生まれていることに気づいていたということだ。男の子として生まれたジュリー・プラウス医師は、もう3歳の頃からなぜ父親がキャッチボールをして遊びたいのか理解できなかった。男の子として、プラウスは魚釣りやハンティングの仕方も教わったが、本当に楽しかったのは大恐慌時代のガラス工芸の花瓶を集めることだった。アメリカ東部バーモント州で精神科医を開業しているプラウス医師は、48歳になった2008年3月から女性としての人生を始めている。

「毎朝起きると、鏡に映る自分を見つめて“ワァー、凄い”と言う。今まではそんなこと出来なかったのです、鏡の自分を見つめている何者かは自分ではなかった気がしたのですから。」とプラウスは自分の達成感に満足している。

性の自認には生物学的な根拠があると医学者たちは想定しているが、しかし生物学上のどのような仕組みが性別を決めるのかについては誰もまだ結論を出せないでいる。性意識の決定には個人の個性とその文化的背景が相関して影響することもあり得る、と言うのはジョンズ・ホプキンス大学の性行動調査班のクリス・クラフトである。

性転換のプロセス

生物学的に性別を変えたい人は、まず最初のステップとして精神カウンセリングを受けなければならない、と説明するのはカリフォルニア州・ビバリーヒルズの形成外科医のゲーリー・アルター医師。一年間もかかるこの精神治療プロセスを経ずに彼のもとに来る患者はいないと言う。

セラピストの診断書で認定されてから、医師の指導のもとにホルモン治療が行われるようになり、この時点から本人の希望により自らの望む性での生活を始めることができる。

男性として生きたい女性は、外科手術でまず乳房を除去する場合が多い。ホルモン治療のテストステロンの作用で、ほぼ2年後には顔のひげや胸毛が生えるようになる。

女性として生きるのを望む男性の場合では、女性から男性への転換の場合とくらべて、外科的方法で性器官を変えるのを選択するケースが目立って多い、とアルター医師は言う。男性のペニスを作る方法は、女性に備わっているクリトリスを使って小さなペニスに作り上げる方法から、前腕部の皮膚筋肉組織を移植してペニスに作り上げる方法などがあるが、いずれも完全とは言い難く、多くの患者はただ乳房を除去するだけで満足している。
(注)バンコクのPAIでは前腕部ではなく、移植の傷跡が目立たない腹部皮膚筋肉を使ってペニス形成を行っている。

一方、男性の身体に女性の性器官を造るのは、望むような結果が得られることが多い。アルター医師の方法は、ペニスの先端をクリトリスとして整形して使い、そして膣のスペースを新たに造るというスタンダードになっている方法である。

社会への適応

ジェンダー(性意識)の転換の道をすすむ人々で、途中で引き返すケースはまずないとみてよい。とくに外科的方法が取られている場合はなおさらである、と専門家たちは言っている。

「目に見える男になって」という本の著者で、現在60歳のFTMジャミソン・グリーンは、乳房除去から男性器形成まで外科手術を受けて男性となり、性を変えたのは自分の行った行為のなかで人生最高の決断だったと述べている。

「そのことについて人に話すことには抵抗は感じません。最初はやはり心配しましたが、当時はこの性転換症についての理解がなくサポートグループなどもなかったからです。ただ当時から感じていたのは、恐れや恥という気持ちを抱きながら生きていくのは健康によくない」、ということでした。

40歳でトランスへの道を歩み始めたグリーンは、その時点では何の接点もなかった女性と結婚して、今は幸せに暮らしている。プラウスはトランス開始から知り合いだった女性と結婚している。またマデンにはボーイフレンドがいる。

マデンは言う、「自分は精神病だと思いこんでいた時代は本当に長くつらかった。今はそんな気持ちは完全に消え失せてしまっている。」

ただ、この三人とも、自分の周囲の人々が受けたショックや当惑は感じざるを得なかった。グリーンの場合は、母親を納得させるまでに5年もかかった。プラウスの息子の一人は口も聞いてくれなくなった。マデンの女性との結婚はトランスしている間に破綻していまい、子供たちも苦悩の時代を送った。

しかし、三人とも自分が選らんだ性で生きていることに多くの意味でよかったと思っている。

医師のプラウスは言う、「私の患者さんは前よりもいい医者になったと言ってくれる。自分自身を隠すことに余計なエネルギーを使わなくなったのがいいのかも知れないですね。」

精神科医は、性転換をする人は新しい性意識を身につけて行動するようにし、性同一性障害の過去やトランジションの過程を隠さないように勧める。しかし、新しく身に付けた性役割で「パス」できている人も、ばれた場合のリスクを恐れて、身近で信頼できる少数の人にしか打ち明けない人も多い。

クラフトの見解では、女性から男性になる場合にくらべて、男性から女性に転換するトランスセクシュアルの方が直面する問題が多いと言える。男として生き始めた人たちは、とくにそのトランジションの振幅が大きく際立っている場合には、それだけ直面する悩みも大きい。

今は“チャズ”という愛称で呼ばれるチャスティティ・ボノの場合は、ゲイの権利擁護の運動家として有名であった。それだけに有名人の場合は、もっと複雑な性転換の当事者ということになれば問題がより深刻になってくるのは想像できるでしょう、とクラフトも言っている。

注〕FTMのチャスティティ・ボノについては次回の投稿で詳細をお伝えします。

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