I-Intersex

I-Intersex liqela leemeko apho kukho ukungangqinelani phakathi kwezitho zangasese zangaphandle kunye nezitho zangasese zangaphakathi (iimvavanyo kunye namaqanda).

Ixesha elidala lale meko yi-hermaphroditism. Nangona amagama amadala asabandakanyiwe kweli nqaku ukuze kubhekiswe kulo, athathelwe indawo ziingcali ezininzi, abaguli kunye neentsapho. Ngokwandayo, eli qela leemeko libizwa ngokuba kukuphazamiseka kwesini (DSDs).

I-Intersex inokwahlulwa ngokwamacandelo ama-4:

• 46, XX yokuhlangana
• 46, XY intersex
• Inyaniso ye-gonadal intersex
• I-intersex okanye i-intersex engagqitywanga

Nganye ixoxwa nzulu ngezantsi.

Qaphela: Kubantwana abaninzi, unobangela we-intersex unokuhlala ungagqitywanga, nokuba uneendlela zangoku zokuqonda isifo.

46, XX I-INTERSEX

Umntu une-chromosomes yomfazi, amaqanda esini sowasetyhini, kodwa amalungu angaphandle (ngaphandle) avela kumadoda. Oku kuxhaphakileyo sisiphumo sokuba umntwana obhinqileyo abe sesichengeni sokudlula kwiihomoni zesilisa ezingaphezulu kokuzalwa. Ilebia ("imilebe" okanye ulusu olusisi malungu obufazi bangaphandle) iyahlangana, kwaye iklitoris iyanda ukuze ivele njengepipi. Kwiimeko ezininzi, lo mntu unesibeleko esiqhelekileyo kunye nemibhobho yesibeleko. Le meko ikwabizwa ngokuba yi-46, XX nge-virilization. Yayifudula ibizwa ngokuba lilungu lomfazi ekuthiwa li-pseudohermaphroditism. Zininzi izinto ezinokubangela:

• I-hyperplasia ye-adrenal ye-congenital (oyena nobangela uqhelekileyo).
• Amahomoni angamadoda (anje nge testosterone) athathwe okanye adibana nawo ngexesha lokukhulelwa.
• Amathumba avelisa ihomoni emadodeni kunina: Ezi ziimvumba ze-ovari. Oomama abanabantwana abane-46, XX intersex kufuneka bahlolwe ngaphandle kokuba kukho esinye isizathu esicacileyo.
• Ukusilela kwe-Aromatase: Lo unokungabonakali de kube kukufikisa. I-Aromatase yi-enzyme edla ngokuguqula iihomoni zesilisa zibe zihomoni zabasetyhini. Umsebenzi omninzi we-aromatase ungakhokelela kwi-estrogen engaphezulu (ihomoni yabasetyhini); mncinci kakhulu ukuya kuma-46, XX intersex. Ngexesha lokufikisa, aba bantwana be-XX, ababekhuliswe bengamantombazana, banokuqalisa ukuthatha iimpawu zamadoda.

46, XY I-INTERSEX

Umntu unama-chromosomes endoda, kodwa amalungu angasese angaphandle awenziwe ngokupheleleyo, ayintsingiselo, okanye ngokucacileyo abhinqileyo. Ngaphakathi, iimvavanyo zinokuthi ziqheleke, zingalunganga, okanye zingabikho. Le meko ikwabizwa ngokuba yi-46, XY ngokungasebenzi. Yayifudula ibizwa ngokuba yimbumbulu yamadoda. Ukwenziwa kwamalungu esini angaphandle angamadoda kuxhomekeke kwibhalansi efanelekileyo phakathi kwehomoni yamadoda neyasetyhini. Ke ngoko, ifuna ukuveliswa okwaneleyo kunye nokusebenza kwamahomoni angamadoda. 46, XY intersex inezizathu ezininzi ezinokubangela:

• Iingxaki ngovavanyo: Iimvavanyo zihlala zivelisa iihomoni zesilisa. Ukuba iimvavanyo azenzi kakuhle, ziya kukhokelela ekungafunekiyo. Zininzi izizathu ezinokubangela oku, kubandakanya i-XY emsulwa ye-gonadal dysgenesis.
• Iingxaki ngokwenziwa kwe testosterone: I-Testosterone yenziwa ngothotho lwamanyathelo. Nganye kula manyathelo ifuna i-enzyme eyahlukileyo. Ukusilela kuyo nayiphi na kwezi enzymes kunokubangela ukungonelanga kwe testosterone kunye nokuvelisa isifo esahlukileyo se-46, XY intersex. Iindidi ezahlukeneyo zokuzalwa kwe-adrenal hyperplasia zinokuwela kweli nqanaba.
• Iingxaki ngokusebenzisa i-testosterone: Abanye abantu baneemvavanyo eziqhelekileyo kwaye benza inani elaneleyo le-testosterone, kodwa bane-46, i-XY intersex ngenxa yeemeko ezinje nge-5-alpha-reductase defence okanye i-androgen insensitivity syndrome (AIS).
• Abantu abane-5-alpha-reductase defence abanayo i-enzyme efunekayo ukuguqula i-testosterone kwi-dihydrotestosterone (DHT). Kukho iintlobo ezi-5 ubuncinci ezahlukeneyo ze-5-alpha-reductase defence. Abanye beentsana banamalungu esini obuqhelekileyo obudoda, abanye banesini sangaphantsi esiqhelekileyo sabasetyhini, kwaye uninzi lunento phakathi. Uninzi lotshintsho kumalungu angaphandle angamadoda ngexesha lokufikisa.
• I-AIS sesona sizathu siqhelekileyo se-46, XY intersex. Ikwabizwa ngokuba kukuqina kwamatyhalarha. Apha, iihormoni ziqhelekile, kodwa ii-receptors kwiihomoni zesilisa azisebenzi kakuhle. Kukho ngaphezulu kwe-150 yeziphene ezichongiweyo ukuza kuthi ga ngoku, kwaye nganye nganye ibangela uhlobo olwahlukileyo lwe-AIS.

I-INTERSEX YOKWENZA YOKWENZA

Umntu kufuneka abenee-ovari kunye namatyhalarha. Oku kunokuba kwi-gonad efanayo (i-ovotestis), okanye umntu abe ne-ovary e-1 kunye ne-testis e-1. Umntu unokuba nee-chromosomes ezingama-XX, ii-chromosomes ze-XY, okanye zombini. Izitho zangasese zangaphandle zinokungangqinelani okanye zibonakale zingowasetyhini okanye indoda. Le meko ibizwa ngokuba yi-hermaphroditism yokwenyani. Uninzi lwabantu abane-gonadal intersex yokwenyani, oyena nobangela awaziwa, nangona kwezinye izifundo zezilwanyana kunxulunyaniswa nokuvezwa kwichiza lokubulala izitshabalalisi.

INKCUKACHA OKANYE AKUQINISEKISIWE KWI-INTERSEX DISORDERS ZOPHUHLISO LWEZESINI

Unxibelelwano oluninzi lwe-chromosome ngaphandle kwe-46 elula, i-XX okanye i-46, i-XY inokubangela ukuphazamiseka kophuhliso lwesondo. Oku kubandakanya i-45, i-XO (inye kuphela i-X chromosome), kunye ne-47, XXY, 47, XXX-omabini la matyala ane-chromosome yesini eyongezelelweyo, nokuba ngu-X okanye u-Y. Ezi ngxaki azikhokeleli kwimeko apho kukho ukungangqinelani phakathi kwangaphakathi kunye namalungu angaphandle angaphandle. Nangona kunjalo, kunokubakho iingxaki ngamanqanaba ehomoni yesini, ukukhula okupheleleyo ngokwesondo, kunye nenombolo eguqulweyo yee-chromosomes zesini.

Iimpawu ezinxulunyaniswa ne-intersex ziya kuxhomekeka kwisizathu esisisiseko. Banokubandakanya:

• Isini esingaqondakaliyo ekuzalweni
• IMicropenis
• I-Clitoromegaly (iklitorisi eyandisiweyo)
• Umxube we-labial fusion
• Kuyabonakala ukuba ii-testes ezingafunekiyo (ezinokuthi zivele zibe ngamaqanda) kubafana
• Ubuninzi beLabial okanye inguinal (groin) (ezinokuthi zivavanywe) kumantombazana
• IHypospadias (ukuvulwa kwelungu lobudoda kwenye indawo ngaphandle kwencam; kubantu ababhinqileyo, umchamo [umjelo womchamo] uvula kwilungu lobufazi)
• Ngaphandle koko i-genitalia engaqhelekanga ebonakalayo ekuzalweni
• Ukungaqheleki kwe-Electrolyte
• Ukulibaziseka okanye ukungabikho komntwana ofikisayo
• Utshintsho olungalindelekanga xa ufikisa

Ezi mvavanyo neemviwo zilandelayo zinokwenziwa:

• Uhlalutyo lweChromosome
• Amanqanaba eHormone (umzekelo, inqanaba le testosterone)
• Uvavanyo lweHormone lokukhuthaza
• Uvavanyo lwe-Electrolyte
• Uvavanyo oluthile lweemolekyuli
• Uvavanyo lwe-Endoscopic (ukuqinisekisa ukungabikho okanye ubukho besini okanye umlomo wesibeleko)
• I-Ultrasound okanye i-MRI yokuvavanya ukuba ingaba amalungu ezesondo angaphakathi akho (umzekelo, isibeleko)

Ngokufanelekileyo, iqela labaqeqeshi bezempilo elinobuchule kwi-intersex kufuneka basebenze kunye ukuqonda nokunyanga umntwana nge-intersex kunye nokuxhasa usapho.

Abazali kufuneka baqonde impikiswano kunye notshintsho ekuphatheni i-intersex kule minyaka idlulileyo.Kwixesha elidlulileyo, uluvo olwalukho kukuba kwakulunge kakhulu ukwabela isini ngokukhawuleza. Oku bekuhlala kusekwe kwilungu lesini elingaphandle kunesini se-chromosomal. Abazali baxelelwe ukuba bangabinangqondo ezingqondweni zabo malunga nesini somntwana. Ukuhlinzwa ngokukhawuleza kwakucetyiswa. I-Ovarian okanye izicubu zamatyhalarha ezivela kwelinye isini ziya kususwa. Ngokubanzi, bekujongwa njengokulula ukwakha amalungu esini sowasetyhini kunokusebenza kwamalungu esini sangamadoda, ke ukuba ukhetho "oluchanekileyo" alucacanga, umntwana wayehlala enikwa ukuba abe yintombazana.

Kutshanje, uluvo lweengcali ezininzi lutshintshile. Intlonipho enkulu yokuntsonkotha kokusebenza kwabasetyhini ngokwesondo ibakhokelele ekubeni bagqibe kwelokuba isini esigqibeleleyo samalungu esini sangasese asinakuba ngcono ngokwendalo kunakwimizimba yamadoda engaphantsi, nokuba ukwakhiwa kwakhona "kulula." Ukongeza, ezinye izinto zibaluleke ngakumbi kulwaneliseko ngokwesini kunokusebenza kwamalungu angaphandle angaphandle. I-Chromosomal, neural, hormonal, psychological, kunye nokuziphatha kunokuchaphazela isazisi.

Iingcali ezininzi ngoku zikhuthaza ukulibaziseka kotyando oluchanekileyo okoko nje kusempilweni, kwaye kufanelekile ukubandakanya umntwana kwisigqibo sesini.

Ngokucacileyo, i-intersex ngumba ontsonkothileyo, kwaye unyango lwayo luneziphumo zexesha elifutshane kunye nexesha elide. Eyona mpendulo ilungileyo iya kuxhomekeka kwizinto ezininzi, kubandakanya nesizathu esithile se-intersex. Kungcono ukuthatha ixesha lokuyiqonda imiba ngaphambi kokungxamela kwisigqibo. Iqela lenkxaso ye-intersex linokunceda ekuqhelaneni neentsapho ngophando lwamva nje, kwaye linokubonelela uluntu lwezinye iintsapho, abantwana nabantu abadala abajamelene nemicimbi efanayo.

Amaqela enkxaso abaluleke kakhulu kwiintsapho ezijongana ne-intersex.

Amaqela ahlukeneyo enkxaso ahluka kwiingcinga zawo malunga nesi sihloko sinobuzaza. Khangela enye exhasa iingcinga zakho kunye neemvakalelo zakho ngesihloko.

Le mibutho ilandelayo inikezela ngolwazi oluthe kratya:

• Umbutho we-X kunye no-Y chromosome ukwahluka-gene-genex.org
• Isiseko seCARES- www.caresfoundation.org/
• Umbutho we-Intersex waseMntla Melika-isna.org
• I-Turner Syndrome Society yase-United States- www.turnersyndrome.org/
• I-48, XXYY-XXYY Projekthi-igenetic.org/variations/about-xxyy/

Nceda ubone ulwazi malunga neemeko ezizezinye. Ukuxela kwangaphambili kuxhomekeke kwisizathu esithile se-intersex. Ngokuqonda, inkxaso kunye nonyango olufanelekileyo, umbono opheleleyo ubalasele.

Ukuba uqaphela ukuba umntwana wakho une-genitalia engaqhelekanga okanye ukukhula ngokwesondo, xoxa oku nomboneleli wakho wezempilo.

Ukuphazamiseka kokukhula ngokwesondo; IiDSD; Pseudohermaphroditism; Hermaphroditism; IHermaphrodite

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IDonohoue PA. Ukuphazamiseka ekukhuleni kwesondo. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 606.

Wherrett DK. Indlela yosana olunokukrokreleka ekuphazamisweni kokukhula ngokwesondo. Iiklinikhi zePediatriki eMantla Am. 2015; 62 (4): 983-999. IINKCUKACHA: 26210628 www.ncbi.nlm.nih.gov/pubmed/26210628.