瑪麗醫院性診所本月關閉 -- 姊妹同志評聞區

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Subject: 瑪麗醫院性診所本月關閉

Author:
姊妹同志 - 轉載自hk10news

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Date Posted: 14:49:05 03/10/05 Thu

瑪麗醫院性診所本月關閉新聞—本港新聞
東方日報 09/03/2005

瑪麗醫院本月關閉成立了三十年的性診所，負責該診所工作的香港大學精神醫學系授吳敏倫昨表示，性診所一直缺乏資源，每年只可接收五十宗新症，輪候時間長達一年，累積約一百宗個案，當中十多名病人正接受變性手術前後輔導，但診所只有三名醫生工作，其中一名醫生二月底離職，沒有資源聘請新人，惟有關閉性診所。

他指出，診所關閉後，港島西聯網病人需轉介到瑪麗醫院精神科專科求診，非港島西聯網病人則返回其居所區域的聯網醫院精神科專科跟進。

吳敏倫指出，變性人輔導及性問題是精神科專科中的專科，應該由受專門培訓的醫生負責。

瑪院性診所缺資源停辦
太陽報 09/03/2005

瑪麗醫院性診所向以變性人輔導聞名，但本月因缺資源需「結業」，日後港島西聯網病人需轉介瑪麗醫院精神科專科求診，非港島西聯網病人則需返回其居所區域的聯網醫院精神科跟進。負責該診所工作的香港大學精神醫學系教授吳敏倫昨日批評，變性人輔導及性問題是精神科專科中的專科，由受專門培訓的醫生負責較佳。

Transsexuals lose their only specialist clinic
PATSY MOY
南華早報 SCMP 09/03/2005

Transsexual patients have been told to accept lower quality psychiatric support services because Hong Kong's only specialist clinic for them has been effectively shut, according to its head.

Emil Ng Man-lun said the decision came after months of talks with the Hospital Authority failed.

Dr Ng and two psychiatrists from the clinic at Queen Mary Hospital were told by the authority to see other, more severe, psychiatric cases.

"Over the past six months we have tried very hard to fight for the resources to keep the clinic running," said Dr Ng, who is also a psychiatry professor at the University of Hong Kong.

In the past, transsexual patients from across the city were referred to the psychiatric support service at the 30-year-old clinic.

But from this month, the team has consulted only patients from the West Hong Kong cluster of hospitals from Sheung Wan to Aberdeen. Dr Ng admits the new arrangement effectively closed his clinic.

Both new and existing patients from other districts must be transferred to other public hospitals that may not have the clinical experience in transsexuals' psychiatric issues.

Last night, the authority said the reorganisation of the service was done "in view of the current manpower situation and service prioritisation".

But Dr Ng said psychiatrists needed special skills to handle transsexuals before and after surgery - including two years of pre-surgical psychiatric assessment and post-surgical counselling, which usually lasts for life.

"It is inevitable that the patients have to accept a lower quality of services under these circumstances," Dr Ng warned.

He estimated that about 40 patients had been affected, including 10 transsexuals who were preparing for surgery.

Since 1985, the clinic has catered for transsexuals and it remains the city's only specialist psychiatric support service, according to Dr Ng.

Roddy Shaw Kwok-wah, of the Civil Rights for Sexual Diversities group, said the authority should have provided an alternative.

"This is a very specialised area. Many general practitioners have admitted that they are not able to or don't want to give advice which in many ways is not expert advice," Mr Shaw said.

He was shocked by the decision, which has not been discussed with the transsexual community.

"There were rumours that the clinic was to be shut down but I did not know that they had already done it," he said.

"We are not saying there is outright blatant iscrimination but it does have a negative, desperate effect on the transsexual community that amounts to indirect discrimination."

Mr Shaw said that the transsexual community planned to write to authority officials pressing for a meeting to explain the decision.

瑪麗突撤獨家變性輔導診所
明報 08/03/2005

全港唯一負責為變性人在手術前後輔導的瑪麗醫院，近日突然發出通告，不會再接收港島西聯網以外的病人。

瑪麗醫院指基於人手和資源不足，不會再接收港島西聯網以外的病人，估計有數十人受影響。有醫生批評，輔導變性人是「精神專科中的專科」，非一般精神科醫生能夠處理。醫學界立法會議員郭家麒亦反對縮減服務，但坦言在資源不足下，唯有選擇優先治療一些較重要的病症。

近日有準備接受變性手術的人士，到瑪麗醫院的性診所(SexClinic)覆診，卻發現診所門外貼出一張告示，指部門將進行服務重組，不會再接收其他聯網準備接受變性手術的人士，以及為他們進行精神和心理輔導。

希望變性的市民，若經心理醫生確認其心智成熟及心理沒有問題，便會轉交瑪麗醫院「性診所」，由「性別重建診療小組」的精神科醫生及專家跟進，這亦是手術前的「必要」步驟。據悉，每人平均要等2至5年才能被轉介到律敦治醫院動手術。而現時全港的私家醫院，都沒有提供變性手術服務。

本身是診所負責人的港大心理學系教授吳敏倫昨接受本報查詢時承認有關變動，並指這與診所部分醫生離職而無法補充有關，前來求診的人士將需要另找居住區內的精神科醫生繼續輔導。他指出，診所每年平均收到2至3個新個案，至今累積約數十人。

早於今年1月26日，港大精神醫學系系主任鄧兆華已率先透過醫管局發出「通告」予其他醫院聯網，要求把正接受診治的「非港島西」病人交回其他聯網跟進。

本身是威爾斯醫院精神科醫生的李誠指出，其他聯網的精神科醫生大都缺乏有關變性輔導及跟進的「超專門」知識，故今次改動變相令欲變性的人士「無處可去」。他猜測今次性診所突然停止大部分變性服務，可能與醫療資源緊絀有關，因整個變性輔導及手術過程為時數年，在公立醫院求診的成本相信要逾20萬元。

立法會議員郭家麒反對縮減有關服務，但在本港公營醫療架構出現嚴重財赤的情况下，「癌症病人亦要自行買藥」，社會亦要討論有限的醫療資源如何分配。他說﹕「相較癌症及其他大症，（輔導變性人）只是小眾服務，花費時間又長，當治療一般精神病及癌症的資源都不足，一定要選擇一些較重要的病症去醫。」

明報記者李思穎陳志偉

在港變性關卡重重
明報 08/03/2005

中大精神科學系教授李誠指出，欲變性者屬「性取向異常」，現時仍未能確定原因，但可能與遺傳因素有關。李誠反對把性取向異常視為一種疾病，這些人只是天生覺得上天給了他們錯誤的性別，以致痛苦非常，加上經常飽受外界歧視，所以自殺率特別高。他贊成在可行情況下，協助他們改變性別。

部分寧赴星泰做手術

現時在港如欲變性，是極艱難的事，要通過重重關卡，故不少希望變性的港人，寧花錢到泰國或新加坡做變性手術，因手續比較簡單。

過程至少8年成本十萬元計

根據資料，若想在港變性，先要經過專科心理醫生為期約半年至一年的評估，以確認求助者心智成熟及精神心理狀態良好﹔通過評估的求助者會交由瑪麗醫院性診所的「性別重建診療小組」跟進，接受為期2年的「現實生活測試」觀察期，包括安排男求助者24小時改穿女裝，以監察其是否適應女性身分，以及是否能繼續與親人及同事正常相處。

合適的求助者最後會接受荷爾蒙轉換治療及變性手術，但即使手術成央A變性者仍要接受社工約5年的監察，整個過程牽涉醫療成本數以十萬元計。

求診者﹕普通精神科醫生「不夠專」
明報 08/03/2005

「未接受手術前，我不能接受自己的女性身分。有工作要我穿裙子，我索性不做。那時我真的抑鬱極了……」今年30歲、生來「女兒身」的阿Joe，2001年時下定決心做變性手術，於03年成為「男子漢」。曾接觸過一般精神科醫生的他說，他們對輔導變性人的專業知識不足，部分更投以奇異的眼光。

曾患抑鬱感變性是「必需」阿Joe說，自己從小到大都自覺是男性，性別身分令他無法面對自己，「我那時完全不願到外地，因要向人展示寫明我是女人的證件，我實在不想……」他更因而患上抑鬱症，出現病徵，所以他認為變性手術對部分渴望變性的人來說是
「必需的」。

下月覆診至今未收通知
01年，他決心接受變性手術，於是到一般精神科門診求助，但得到的答案卻令他無法接受。「那個精神科醫生說，他沒聽聞過有關服務，也不知香港有得做。」他認為，當局如今要他們向一般精神科門診求助，等於把他們交託給一班對變性沒認識的人手上。

他輾轉到了瑪麗醫院的「性診所」求助，經過漫長的評估和輔導，03年開始分別接受了3次手術，之後亦要接受診所為期半年的跟進輔導。居於新界的他雖已排期於下月到診所覆診，但至今仍未收到院方正式通知。

他擔心，其他欲變性的人因無法得到適當和充足的輔導，或要因此而等候更長的時間。他又說，之前曾有人因無法接受變性手術而自殺，「實在不想看到悲劇重演，但我們又可怎樣呢﹖」

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