中華心理衛生協會

 Background: People suffering from gender dysphoria are living a painful life in which their psychological gender is inconsistent with their biological sex. Hormonal therapy and sex reassignment surgery can make their appearance consistent with their psychological gender and relieve their pain. A medical team must assess the client's mental state to determine whether they are ready for sex reassignment surgery by observing the client's self-descriptions, behavior, and emotional expressions. To discuss assessment issues, we use a case study of a client seeking assessment in order to have sex reassignment surgery. Methods: The client is a 34 year old whose sex is male and gender is female. The client has been living as a female for many years and suffers from gender dysphoria. Results: This case is too ideal for the surgery. Even if the surgery can reduce the gap between body and mind, it is unclear whether it would reduce subjective distress. Conclusions: A clinical psychologist's responsibility is to help clients clarify what they really want and what their best option is, including sex reassignment surgery or other possibilities. However, in the current system the assessor also decides whether the client can have the surgery or not. This dual role may increase the difficulty of establishing a relationship between the client and the assessor. This issue and the concrete practices surrounding it still need further discussion.