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陳安潛:初探跨性別的社會倫理 PDF Print E-mail
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Sunday, 27 March 2016 15:29

初探跨性別的社會倫理

推介人:郭鴻標博士

作者:陳安潛

一、引言

「香港跨性別者:從羞恥到驕傲」[1] 一語道出跨性別人士所爭取的方向。「驕傲遊行」統稱作LGBT女同性戀(Lesbian)、男同性戀(Gay)、雙性戀(Bisexual)、跨性別者(Transgender爭取權益的行動,自1970年於美國紐約每年舉行,全球不少地方追隨仿效。亞洲對相關的課題雖然開始較遲,但其概念與此區域所重視的榮辱文化[2]有些根本的相同,其發展不容忽視。自從1997Jagose出版跨性別的酷兒理論[3],相關的神學也出現[4]。酷兒迅速在網絡流行,更發展出亞洲的風格。對於華人,有學者研究中國的歷史文化中跨性別的人物角色,例如男女易服的戲劇、才子佳人故事的投射、太監正面的位置等等。[5]

幾位香港大學學者出版支持LGBT權益的書籍,其中有批評傳統教會對跨性別所作出道德恐慌的反應。[6] 2013年終審廷裁決政府不讓變性人W小姐結婚,是違反基本法與人權法,屬於違憲。[7] 20159月本港醫管局新東聯網爭取撥款助變性[8],預期將有更多變性的情況。香港教會有需要了解跨性別的發展趨勢,作出適切的思考及回應。

二、跨性別的定義與改變趨勢

跨性別一般泛指在心理、思想、或行為上,未能認同自己身體性別的性向或身份,故此需要「跨越」其性別的限制與障礙。1910年有德國學者對男女易服群體作社會行為學的研究,開始覺察性向定位及性別角色的多樣關係1931年在柏林完成第一個標誌性完整的變性手術,1980年醫學上斷定性別認同障礙症為精神科的疾病。[9] 2010年歐盟斯特拉斯歐洲委員會反對把性別認同障礙列為精神病,對比同性戀亦曾列為精神病而在1974年移除。維權人士認為性別認同障礙不是疾病,而是不同,選擇性別是基本人權之一。[10]

歐盟各國對跨性別雖有不同的政策與法例,但2010年歐盟國會制定一致的守則:「每個人自我定義(self-defined)的性向定位及性別角色是與其人格整合的,並且是最基本的自我認定、尊嚴、及自由」。[11] 澳洲於2003年首次在出生證明書以X作為性別[12]2013年聯邦政府容許所有成年人選擇X第三性別組別[13]2014年美國醫學會接納跨性別者並不需接受任何變性手術,亦可更改法律上的性別證明,包括出生證明書。而社會保障局亦有權處理跨性別者的婚姻個案,不再需要征詢地區法律顧問的意見。[14]

香港對相關的法例,被報章評為不但落後於世界多個地區,甚至更遠遜於專政的中國內地及專權的新加坡。[15] 香港大學法律系醫學倫理及法律中心亦正草擬跨性別人士的法律地位[16],亦有香港學者提倡性別身份光譜的概念[17]。現今除了LBGT,還有IQQAAP包括雙性(Intersex)、酷兒(Queer)、懷疑者(Questioning)、盟友(Allies)、無性(Asexual)、泛性(Pansexual)等等。支持跨性別人士強調跨性別是與生俱來的,有研究認為心理治療是沒有果效的[18],科學初步發現變性的傾向能夠從腦部掃描分辨[19]維權人士更引用歷史的支持,包括北美的土著、印度[20]及中國[21]傳統文明中,跨性別的人早已存在。

三、自由選擇自己的性別——值得驕傲還是自我傷害?

「驕傲」代表人性尊嚴得到肯定,價值得到認同,比權益的爭取更為基本。神學學者認為跨性別是彰顯神的形象,表達人類整體更多元豐富的生命,讓人在性別多樣選擇上,發揮上帝賦予的自主性及創造力。[22] 以往跨性別人士被壓抑,視為羞恥;今天重新被肯定,值得驕傲。但人自由選擇以及自我定義自己的性向定位與性別角色,夠竟是值得驕傲還是自我傷害?

3.1.變性的後遺症

荷爾蒙調整及變性手術改變跨性別者部分器官及形體外貌,幫助投入另一性別角色的生活。有學者在醫學及倫理的角度,推動性別重置手術。例如Hume強調人的自主性,並且認為手術對患者身體的害處少於心裡的益處。[23] 但接受變性手術後,不單是身體承受不可逆轉的改變,亦出現不少心理傷害的情況。例如Heyer曾由男變女,但發覺他心底的痛楚沒有消失,反成酗酒,甚至瀕臨自殺的邊緣。最後他藉著信仰的力量重新站起來,並以無比的勇氣和毅力重新變回男人[24] 澳洲的May-Melby在變性手術後依然感到性別身份模糊,2014年得到最高法院判為未能鑒別的性別,確認變性手術未能使之明確性別。[25] 近日,報章亦報道英國在12年內三次變性的事件。[26]

201010月的一個調查訪問了七千個變性人,其中高達41%有自殺的意圖。[27] 瑞典一項有關跨性別者的長期研究報告亦顯示,變性人有較高的死亡率、自殺行為、及心理疾病,結論是手術未能滿足性別認同障礙的需要。[28] 一項長期研究發現,變性手術後15年仍會發生後悔的情況,心理狀態難以調節。[29] 另外,變性後的性行為及荷爾蒙注射的過程,增加罹患AIDS的風險。荷爾蒙的調整可能會降低免疫力,影響心臟、肝、糖代謝等功能。[30]

關啟文認為此類負面的報道一般相當低調,乃基於接受變性是今天政治正確的意識形態,反面報道遭受攻擊。[31] 例如,歐洲及美國對跨性別人士的醫療、就業、及公民權益等各方面,均有一定的法律保障。[32] 美國普林斯頓大學在學術報刊報道LGBT中心的成立,傳統學生被形容為邊緣化的一群。[33] 本港一主要報章,在今年四月刊登一連5日相關變性的報道,以他/她的重生為題。[34] 對跨性別的批判被視為歧視,這使人對變性作偏頗的評估,其實對變性者不利。而且,變性手術雖能夠改變形體外貌,但染色體依然不變,未能真正改變一個人的性別。

3.2.個人的自由與自我的失落

若不必須通過荷爾蒙調整及變性手術等外在醫學技術,單憑自我意願定義性別,人則享有更大的自由,身體亦不受到醫療後遺症的負面影響。但人能夠自我定義性別身份這前設正確嗎?已接受變性手術的人士,沒有直接因醫學手術而造成死亡的報告,但卻有高企的自殺傾向比率。這表示跨性別者的心理問題,比身體創傷可能更大。上文3.1提及的HeyerMay-Melby及英國12年三度變性的例子,都表示過程中性別身份未能真正的清晰。我們的選擇是基於天生的腦部信息[35],環境的影響,還是個人的自由意志?支持跨性別人士雖認為變性的傾向是天生的,但也接受不同階段可以有不同的性別傾向。儘管腦掃描或者可以找出性別認同控制的區域及其表達的形式,但在一生裡會否改變依然存疑。雖然判定性別認同障礙,其徵狀最少持續六個月[36],診斷一般歷時一至兩年,在醫學療程及資源運用上為期不短,但相對整個人生的歷程卻只屬於一小部份的階段。若窮一生為尋找自己的性別身份,是個悲劇。

其實,自由選擇性別本身是否人內心真正的需要?這種自由能否帶來滿足?有提出人類富有創造力,認為作出性別的改變、第三性別和性別光譜等概念可令人生更精彩豐富。維權人士則往往把焦點,投放於外在爭取社會認同及相關權益,集中自由被限制。可是,上述變性人自殺的傾向、反覆的變性,不少變性人甚至牽涉在性商業活動、毒品問題[37],仿佛表示在這選擇中,人的內心並未得到滿足。人更大的渴求,相信是在某性別身份中享受愛與幸福。但愛不單建基於自由,也基於約。[38] 神對人的愛表達在約裡,人與人之間的愛也表現在約中,婚姻是最突出的例子。人需要自由之外,也需要穩定、可靠的遠像。主張自由地在不同階段選擇不同的性別,包括X性別,會帶來更大的自我失落。神自由地與人立約,人也自由地回應,但約卻限制立約者的自由。跨性別——「跨越」性別限制本身,必須接受一定的限制才能達至滿足。

特別需要考慮性別身份,高峰是青春期。雖然已有不少關注針對青少年[39],包括考慮在兒童及少年階段是否進行手術[40],使用延遲性成熟的藥物[41],對原生家庭的影響[42],以及倫理與法律在決定跨性別治療的年齡限制、父母及監護人的角色等等[43]。但在青春期中,因身體的發育和心理成長的變化,性向與角色會發生矛盾和拉扯。[44] 加上青少年人容易受朋輩影響,這衝突可以受相互影響而加強。引進自我定義性別的概念,可能使這一代難以擬定自己的性向定位及性別角色。同意歐盟守則中,認為性向定位及性別角色是與其人格整合的,所以性向及角色的迷失,能夠深遠地摧毀人格。

「值得驕傲」本來是指人的尊嚴被肯定、價值被確立,但在今天後現代的社會,自尊往往被過份地重視。劉翔平形容這現象為自尊上癮症,人努力追求自尊,過渡維護自尊,甚至因自尊受傷害而積極報復,那是在玩致命的自尊遊戲。其實真正有自尊的人,並不依賴外界的肯定。[45] 這情況並不針對跨性別人士,而是時代的趨勢,且以青少年尤甚,把人推向危險的境地而不自覺。

3.3.沒有自由選擇的下一代

近日報章報道英國一名跨性別的模特兒,籌劃在接受變性手術前,保存精子,尋找代母為自己孕育下一代,同時當爸爸及媽媽。[46] 變性人Heyer描述兒子的說話:這個「媽媽」既像爸爸,也不像爸爸,因為她同時有豐滿的乳房和男性的器官。

1990年《兒童權利公約》寫道:「深信家庭作為社會的基本單元應讓兒童在家庭環境成長幸福的自然環,應獲得必要的保護和協助,以充分負起它在社會上的責任。[47] 公約至今是25週年,有世界190多個國家參與並展開相關的工作,表示其理念仍得到全球的認受性。孩子沒有機會選擇自己的父母和家庭,社會有責任保護其成長,以達致整體人類的進步。

跨性別的婚姻與家庭,會把失落與傷害延及下一代,個人自由人權有違整體利益。[48] 對生於跨性別婚姻的孩子成長的研究,取樣及數字分析有受到意識形態的影響。但其中孩子撫養權及其身份的危機,卻是不爭的事實。[49] 現今婚姻與家庭的法律制度是鼓勵性的,不結婚、不組織家庭,並不會被懲罰。[50] 人應該鼓勵追求更「值得驕傲」的價值標準。

四、相關的聖經經文及神學討論

聖經幾乎沒有相關的經文,最接近的是申命記22:5「婦女不可穿戴男子所穿戴的,男子也不可穿婦女的衣服,因為這樣行都是耶和華─你神所憎惡的。」對這禁止穿戴異性服飾的律法,有不同的解說。一、在申21-25章異文化中分別為聖的框架內,針對迦南宗教的生殖崇拜中,男祭司穿著女性服裝的儀式;亦可能是避免有人扮作異性混進異性群體,威脅社會安全。二、申22:1-12作為一小段在愛的格式中,包括歸還及救護弟兄的牲口(22:1-4)、放生野鳥(22:6-7)、建房顧及別人安全(22:8),對應撇除混合的耕作造衣模式(22:9-11)的規律。22:1-12這一小段落中,只有22:5寫上「耶和華」一字,呼應外衣繸子(22:12)公開顯示宗教的作用。

另外,哥林多前書11:3-15有關蒙頭的教導中,「你們的本性不也指示你們」(11:14),指出男女不同的身份角色。「本性」是自然規律,自明的法規(羅2:14-15)。雖然今天教會已很少按字面遵守這類經文,但仍反映按照本性,男女是有區分的,不應罔顧逾越。[51] 從這角度理解,自我定義性別超越人的本性,因而無法得到滿足。Aquinas認為萬物皆有自然規律,倫理的善是本質上的終極,包括人類延續生命、尋找真理的渴求。[52] 聖經的基本對像雖是分別為聖的屬神群體,但其指導性覆蓋所有的人。Barth提出人不是為自己而存在,而是在神創造所賦予的愛與自由中有其秩序與界限。這是好的、是揭開救恩歷史的前提,但這並不獨立存在,而是在耶穌基督的恩典裡運作。[53]

多元文化的後現代相對主義進一步否定人類擁有「本性」,如Sartre說道人首先存在,面對自己及世界,然後作出自我定義。[54] 道德(ethics)一字在希臘文中,本含與品格有關的意思[55],但今天幾乎只選擇解釋作約定俗成[56]Boyd反駁相對主義並未有效解釋真實,世界是有客觀自然規律存在的,不能把一切降解為自我描述。[57] Hittinger提出自然規律這概念,乃從非屬神群體孕育。在世俗的架構裡,倫理亦不是完全由人類自己建構。人權是在自然規律的框架中,過少限制的人權與自由本質是極權。[58]

Kierkegaard認為希望帶來幸福快樂[59],跨性別人士抱著朝往更美好生活的希望而變性,無論是身體或角色上的改變。希望可分為屬世自然的,及屬天永恆的。跨性別人士所持的是屬世自然的希望,變性本身並不是所追求的目的,而是背後的幸福快樂。但自我定義性向定位及性別角色,超越了人類的本性及能力,而使人陷入自我的失落。Kierkegaard提出屬天永恆的盼望,即使在絕望的疾病中,仍可跨越屬世自然的希望。以變性來尋找幸福是虛幻,唯有在「本性」的限制中,深層的人格及親密的關係才能完整滿足。[60]

慾望是扭曲的秩序,自我定義性向定位及性別角色,是企圖自我制定秩序,扭曲創造自然規律Niehber提出道德的人不道德的社會指出結構性的罪。[61] 企圖自我制定秩序的慾望並不針對跨性別者,而是整個社會共同的慾望。它所帶來的後果,也超過個人或少數群體的層面。

五、牧養的挑戰

2012年,一位從男性變為女性的青年,擬控告正生書院強迫扭轉其性向。[62] 這包括強迫他編配到男生宿舍,與男生一同生活、洗澡、游泳,集體施壓要他做男人,安排傳道人向他講道作為治療,更使他錯過變性的黃金時期。有學者指出跨性別政治的活躍以及社會意識的改變,對相關的輔導帶來重要的影響。其重點已由通過手術及使用荷爾蒙讓跨性別者投入傳統兩性角色,轉至輔助跨性別者尋找其獨有的性別角色。[63] 曾有專業輔導員以LGBT違反其宗教道德標準,拒絕提供輔導服務,被其僱主作出律法訴訟。律師以宗教歧視理由辯護,但基於接受輔導者的目標與價值是輔導的中心,而非輔導員,所以不被接納。以宗教理由拒絕作出輔導被判違反專業操守,並指責輔導員頑固執著。[64] 香港教會及其弟兄姊妹可能也會遇到相關的問題,轉變相當急速,牧者需準備面對。

六、小結

跨性別者的尊嚴與價值,作為上帝所創造的人,是被肯定的,是「值得驕傲」的。但自由選擇並自我定義性向定位與性別角色,卻不是人類內心真正所尋求的幸福和滿足。基於人本性與能力的限制,這反會帶來自我的迷失和傷害,甚至摧毀人格,且延及後代。這秩序的扭曲,絕不應委過於跨性別者,整個社會須共同負責及承擔。而若身受性向與角色障礙之苦的人士,能夠「跨越」當今個人選擇自由及外在肯定自尊的迷思,尋求更真實的幸福和滿足,引領社會走向愛與約的秩序,則更「值得驕傲」。

七、參考書目及資料

西蒙諾維茲、皮爾斯著,唐蘊玉譯:《人格的發展》。上海:上海社會科學院出版社2006

杜藹姍。《變性人論爭與牧養反思》,2011

莫特拉娒著,黃東英譯。《危而不亂與病人及親屬面對倫理困境》。香港基道2008

關啟文。《同性與變性-評價同性戀運動和變性人婚姻》。香港:宣道出版社,2015

劉翔平。《自尊上癮我們時代的頭號心理疾病》。臺北市橡實文化2014

Boyd, Craig A. A shared morality: a narrative defense of natural law ethics. Grand Rapids, Michigan: Brazos Press, 2007.

Cheng, Patrick S. Radical Love: Introduction to Queer Theology. NY: Seabury Books, 2011.

Chiang, Howard. Transgender China. NY: Palgrave MacMillan, 2012.

Dallas, Joe. The Transsexual Dilemma: A dialogue about ethics of sex change. Christian Research Journal, 2008.

Flanders, Christopher L. About face: rethinking face for 21st-century mission. Eugene, Or.: Pickwick Publications, 2011.

Fremstedal, Roe. Kierkegaard on the metaphysics of hope. The Heythrop Journal LIII, 2012, p. 51–60.

Grabill, Stephen J. Rediscovering the natural law in reformed theological ethics. Grand Rapids, Mich.: William B. Eerdmans Pub. Co., 2006.

Hittinger, Russell. The first grace: rediscovering the natural law in a post-Christian world. Wilmington, DE: ISI Books, 2007.

Horton, David. Changing channels?: a Christian response to the transvestite and transsexual. Bramcote, Nottingham: Grove Books, 1994.

Huebner, Harry J. An Introduction to Christian Ethics. History, Movements, People. Waco, Texas: Baylor University Press, 2012, 345-360.

Interpretation, a Bible Commentary for Teaching and Preaching. Louisville: J. Knox Press, 1990.

Jagose, Annamarie. Queer Theory: An Introduction. NY: New York University Press, 1997.

Piderit, John J. Sexual morality: a natural law approach to intimate relationships. New York: Oxford University Press, 2012.

Stuart, Elizabeth, Morrison, Tim, and McMahon, John. Religion is a Queer Thing: A Guide to the Christian Faith for Lesbian, Gay, Bisexual and Transgendered People. Cleveland: Pilgrim Press, 1998.

The New International Commentary on the Old Testament. Grand Rapids, Mich.: W.B. Eerdmans, 1976.

The NIV Application Commentary. Grand Rapids, MI: Zondervan, 2012.

White, James E. Contemporary moral problems. Belmont, Calif.: Wadsworth; Andover: Cengage Learning distributor, 2012.

Word Biblical Commentary. Nashville, TN: Thomas Nelson Publisher, 2002.

網上資料:

英男12年三變性》。《東方日報》,2015105日。http://www.orientaldaily.on.cc/cnt/china_world/20151005/00180_029.html

《英變性人籌劃同時做爸媽》。《東方日報》,2015103日。http://www.orientaldaily.on.cc/cnt/china_world/20151003/00180_040.html

《兒童權利公約》。http://www.soco.org.hk/children/q2_content_3.htm

《校內被逼「治療」 錯過變性黃金期 準變性人擬控正生書院》,《蘋果日報》,201248日。

http://hk.apple.nextmedia.com/news/art/20120408/16229059

《新東聯網爭撥款助變性》。《文匯報》,2015924日。http://paper.wenweipo.com/2015/09/24/HK1509240034.htm

【變性()】她的重生》。《蘋果日報》,201544日。http://hk.apple.nextmedia.com/news/art/20150404/19101356

Abel, Brendan S. Hormone Treatment of Children and Adolescents with Gender Dysphoria: An Ethical Analysis. Hastings Center Report, Vol. 44, Sep. 2014 Supplement, p. S23-S27.

http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=7039

Carroll, Lynne, Gilroy, Paula J., Ryan, Jo. Counseling Transgendered, Transsexual, and Gender-Variant Clients. Journal of Counseling & Development, Vol. 80(2), 2002, p.131-139.

http://www.tgmeds.org.uk/downloads/Lynne-Carroll-Paula-J.-Gilroy-Jo-Ryan-Counseling-Transgendered-Transsexual-and-Gender-Variant-Clients.pdf

Coolhart, Deborah, Baker, Amanda, Farmer, Sara, Malaney, Meaghan and Shipman, Dara. Therapy with transsexual youth and their families: a clinical tool for assessing youth's readiness for gender transition. The Journal of Marital and Family Therapy, Vol. 39(2), April 2013, p. 223(21).

http://onlinelibrary.wiley.com/doi/10.1111/j.1752-0606.2011.00283.x/abstract

Council of Europe. Discrimination on grounds of sexual orientation and gender identity in Europe, 2nd ed. Council of Europe Publishing, September, 2011.

http://www.coe.int/t/Commissioner/Source/LGBT/LGBTStudy2011_en.pdf

Dhejne, Cecilia, Lichtenstein, Paul, Boman, Marcus, Johansson, Anna L. V., Langstrom, Niklas, Landen, Mikael. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. Plos One, Vol. 6, Iss. 2, e16885, 1 February 2011.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

European Parliament, Directorate General for Internal Policies: Citizens’ Right and Constitutional Affairs. Transgender Persons Rights in the EU Member States. 2010.

http://www.lgbt-ep.eu/wp-content/uploads/2010/07/NOTE-20100601-PE425.621-Transgender-Persons-Rights-in-the-EU-Member-States.pdf

Geddes, Linda. Puberty blockers recommended for transsexual teens. New Scientist [0262-4079], Vol. 200, Iss. 2686, 2008, p. 8-9.

http://www.researchgate.net/publication/250762052_Puberty_blockers_recommended_for_transsexual_teens

Green, Richard. Transsexual Legal Rights in the United States and United Kingdom: Employment, Medical Treatment, and Civil Status. Archives of Sexual Behavior, Vol.39(1), 2010, p.153-160.

http://onesearch.lancs.ac.uk/primo_library/libweb/

Hamzelou, Jessica. Transsexual differences caught on brain scan. New Scientist, Vol. 209 (2796), 22 Jan 2011, 11.

https://www.newscientist.com/article/dn20032-transsexual-differences-caught-on-brain-scan/

Herlihy, Barbara J., Hermann, Mary A., Greden, Leigh R. Legal and Ethical Implications of Using Religious Beliefs as the Basis for Refusing to Counsel Certain Clients. Journal of Counseling & Development, Vol.92(2), 2014, p.148-153.

http://onlinelibrary.wiley.com/doi/10.1002/j.1556-6676.2014.00142.x/abstract

Hume, Maggi C. Sex, Lies, and Surgery: The Ethics of Gender Reassignment Surgery. Res Cogitans, 2:37-48, 2011.

http://commons.pacificu.edu/cgi/viewcontent.cgi?article=1027&context=rescogitans

Institute for Marital Healing, Catholic Covenant Society, U.S. Child Healing: Strengthening Families - Gender Dysphoria, Gender Identity Disorder and Informed Consent.

http://www.childhealing.com/articles/genderidentitydisorder.php

Kolakowski, Victoria S. Toward a Christian Ethical Response to Transsexual Persons. Theology and Sexuality, Vol 1997(6), 10-31.

http://tse.sagepub.com/content/3/6/10.extract

Lambda Legal. Social Security Administration Updates Procedures for Transgender Spouses Following Lambda Legal Advocacy.

http://www.lambdalegal.org/blog/20140402_ssa-updates-procedures-for-transgender-spouses

Mustanski, Brian. Ethical and Regulatory Issues with Conducting Sexuality Research with LGBT Adolescents: A Call to Action for a Scientifically Informed Approach. Archives of Sexual Behavior, Vol. 40(4), 2011, p.673-686.

http://onesearch.lancs.ac.uk/primo_library/libweb/

Molloy, Parke. American Medical Association Calls for Updated Gender Change Requirements. Advocate.com, 2014-06-10.

http://www.advocate.com/politics/transgender/2014/06/10/american-medical-association-calls-updated-gender-change

Neal, Deonna D. Be Who You Are: Karl Barth’s Ethics of Creation. University of Dotre Dame, PhD Thesis, 2010.

https://curate.nd.edu/concern/etds/2r36tx33k50

Nieli, Russell K. Sexual Ethics: Princeton's Peculiar Double Standard. Academic Questions, vol. 24(1), 2011, p.74-84.

http://www.questia.com/

Olsson, Stig-Eric, Möller, Anders. Regret after Sex Reassignment Surgery in a Male-to-Female Transsexual: A Long-Term Follow-Up. Archives of Sexual Behavior, Vol.35(4), 2006, p.501-506.

http://link.springer.com/article/10.1007/s10508-006-9040-8

Royal College of Psychiatrists. Royal College of Psychiatrists' statement on sexual orientation. Position Statement PS02/2014, April 2014. http://www.rcpsych.ac.uk/pdf/PS02_2014.pdf

Scherpe, Jens M. The Legal Status of Transsexual and Transgender Persons. Working Paper No. 1, Centre for Medical Ethics and Law, Faculty of Law, University of Hong Kong, March 2014.

http://www.cmel.hku.hk/sites/default/files/usersUpload/Working%20paper%20on%20'The%20Legal%20Status%20of%20Transsexual%20and%20Transgender%20Persons'.pdf

Trans Media Watch – Accuracy, Dignity, Respect. A Trans Timeline.

http://www.transmediawatch.org/timeline.html

Wiki Dictionary. θος.

https://en.wiktionary.org/wiki/%E1%BC%A6%CE%B8%CE%BF%CF%82

Wiki Encyclopedia. Gender Dysphoria.

https://en.wikipedia.org/wiki/Gender_dysphoria.

Wiki Encyclopedia. Ethics. https://en.wikipedia.org/wiki/Ethics

X marks the spot for intersex Alex. West Australian, bodieslikeours.org., 11 January 2003.

http://www.bodieslikeours.org/pdf/xmarks.pdf



[1]Cheung, P. K. Eleanor, Transgenders in Hong Kong: From Shame to Pride, In: Transgender China, Chiang, Howard (ed.), (NY: Palgrave MacMillan, 2012), 263-286.

[2]Flanders, Christopher L., About face: rethinking face for 21st-century mission, Eugene, (Or.: Pickwick Publications, 2011).

[3]Jagose, Annamarie, Queer Theory: An Introduction, (NY: New York University Press, 1997).

[4]Cheng, Patrick S., Radical Love: Introduction to Queer Theology, (NY: Seabury Books, 2011). Stuart, Elizabeth, Morrison, Tim, and McMahon, John, Religion is a Queer Thing: A Guide to the Christian Faith for Lesbian, Gay, Bisexual and Transgendered People, (Cleveland: Pilgrim Press, 1998).

[5]Chiang, Howard (ed.), Transgender China, (NY: Palgrave MacMillan, 2012).

[6]Yau, Ching, As normal as possible: negotiating sexuality and gender in mainland China and Hong Kong, (Hong Kong: Hong Kong University Press, 2010), 1.

[7]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁233-235252-256

[8]《新東聯網爭撥款助變性》,《文匯報》(2015924日)。http://paper.wenweipo.com/2015/09/24/HK1509240034.htm

[9]Wiki Encyclopedia, Gender Dysphoria. https://en.wikipedia.org/wiki/Gender_dysphoria.

Trans Media Watch – Accuracy, Dignity, Respect, A Trans Timeline. http://www.transmediawatch.org/timeline.html

[10]Royal College of Psychiatrists, Royal College of Psychiatrists' statement on sexual orientation, (Position Statement PS02/2014, April 2014). http://www.rcpsych.ac.uk/pdf/PS02_2014.pdf.

Council of Europe, Discrimination on grounds of sexual orientation and gender identity in Europe, 2nd ed., (Council of Europe Publishing, September, 2011).

Trans Media Watch. Trans Media Watch, Timeline: Accuracy, Dignity, Respect. http://www.transmediawatch.org/timeline.html

[11]European Parliament, Directorate General for Internal Policies: Citizens’ Right and Constitutional Affairs, Transgender Persons Rights in the EU Member States, (2010).

http://www.lgbt-ep.eu/wp-content/uploads/2010/07/NOTE-20100601-PE425.621-Transgender-Persons-Rights-in-the-EU-Member-States.pdf.

[12]X marks the spot for intersex Alex, (West Australian, bodieslikeours.org., 11 January 2003). http://www.bodieslikeours.org/pdf/xmarks.pdf.

[13]Wiki Encyclopedia, Third Gender. https://en.wikipedia.org/wiki/Third_gender.

[14]Lambda Legal, Social Security Administration Updates Procedures for Transgender Spouses Following Lambda Legal Advocacy.

http://www.lambdalegal.org/blog/20140402_ssa-updates-procedures-for-transgender-spouses

Molloy, Parke, American Medical Association Calls for Updated Gender Change Requirements, (Advocate.com, 2014-06-10).

http://www.advocate.com/politics/transgender/2014/06/10/american-medical-association-calls-updated-gender-change

Wiki Encyclopedia. Identity and Status of Transgender People in the United States. https://en.wikipedia.org/wiki/History_of_transgender_people_in_the_United_States#Identity_and_status_issues.

[15]《變性人婚姻權 港落後內地》,《蘋果日報》(2013514日)。http://hk.apple.nextmedia.com/news/art/20130514/18259594

[16]Scherpe, Jens M., The Legal Status of Transsexual and Transgender Persons, (Working Paper No. 1, Centre for Medical Ethics and Law, Faculty of Law, University of Hong Kong, March 2014).

http://www.cmel.hku.hk/sites/default/files/usersUpload/Working%20paper%20on%20'The%20Legal%20Status%20of%20Transsexual%20and%20Transgender%20Persons'.pdf

[17]Yau, Ching, As normal as possible: negotiating sexuality and gender in mainland China and Hong Kong, (Hong Kong: Hong Kong University Press, 2010).

[18]Royal College of Psychiatrists, Royal College of Psychiatrists' statement on sexual orientation,(Position Statement PS02/2014, April 2014). http://www.rcpsych.ac.uk/pdf/PS02_2014.pdf.

[19]Hamzelou, Jessica, Transsexual differences caught on brain scan. (New Scientist, Vol. 209 (2796), 22 Jan 2011), 11. https://www.newscientist.com/article/dn20032-transsexual-differences-caught-on-brain-scan/

[20]Wiki Encyclopedia, Third Gender. https://en.wikipedia.org/wiki/Third_gender.

[21]Chiang, Howard (ed.), Transgender China, (NY: Palgrave MacMillan, 2012).

[22]Cheng, Patrick S., Radical Love: Introduction to Queer Theology, (NY: Seabury Books, 2011). De La Torre, Miguel A., Ethics: a liberative approach, (Minneapolis, MN: Fortress Press, 2013). Stuart, Elizabeth, Morrison, Tim, and McMahon, John, Religion is a Queer Thing: A Guide to the Christian Faith for Lesbian, Gay, Bisexual and Transgendered People, (Cleveland: Pilgrim Press, 1998).

[23]Hume, Maggi C., Sex, Lies, and Surgery: The Ethics of Gender Reassignment Surgery, (Res Cogitans, 2:37-48, 2011).

[24]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁237-244

[25]Wiki Encyclopedia, Third Gender. https://en.wikipedia.org/wiki/Third_gender.

[26]英男12年三變性》,《東方日報》(2015105日)。http://www.orientaldaily.on.cc/cnt/china_world/20151005/00180_029.html

[27]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁245-248

[28]Dhejne, Cecilia, Lichtenstein, Paul, Boman, Marcus, Johansson, Anna L. V., Langstrom, Niklas, Landen, Mikael, Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden, (Plos One, Vol. 6, Iss. 2, e16885, 1 February 2011). http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

[29]Olsson, Stig-Eric, Möller, Anders, Regret after Sex Reassignment Surgery in a Male-to-Female Transsexual: A Long-Term Follow-Up, (Archives of Sexual Behavior, Vol. 35(4), 2006), p.501-506. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

[30]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁237-244

[31]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁248

[32]European Parliament, Directorate General for Internal Policies: Citizens’ Right and Constitutional Affairs, Transgender Persons Rights in the EU Member States, (2010).

http://www.lgbt-ep.eu/wp-content/uploads/2010/07/NOTE-20100601-PE425.621-Transgender-Persons-Rights-in-the-EU-Member-States.pdf. Green, Richard, Transsexual Legal Rights in the United States and United Kingdom: Employment, Medical Treatment, and Civil Status, (Archives of Sexual Behavior, Vol. 39(1), 2010), p.153-160. http://onesearch.lancs.ac.uk/primo_library/libweb/

[33]Nieli, Russell K., Sexual Ethics: Princeton's Peculiar Double Standard, (Academic Questions, Vol. 24(1), 2011), p.74-84. http://www.questia.com/

[34]《蘋果日報》,《【變性()】她的重生》201544http://hk.apple.nextmedia.com/news/art/20150404/19101356

[35]Hamzelou, Jessica, Transsexual differences caught on brain scan, (New Scientist, Vol. 209 (2796), 22 Jan 2011), 11. https://www.newscientist.com/article/dn20032-transsexual-differences-caught-on-brain-scan/

[36]Wiki Encyclopedia, Gender Dysphoria. https://en.wikipedia.org/wiki/Gender_dysphoria.

[37]Yau, Ching, As normal as possible: negotiating sexuality and gender in mainland China and Hong Kong, (Hong Kong: Hong Kong University Press, 2010), 1.

[38]Piderit, John J., Sexual morality: a natural law approach to intimate relationships, (New York: Oxford University Press, 2012), 3-10, 25-29.

[39]Goodrich, Kristopher M., Lived Experiences of College-Age Transsexual Individuals, (Journal of College Counseling, Vol. 15, Iss. 3, Oct. 2012), p. 215-232. http://onlinelibrary.wiley.com/doi/10.1002/j.2161-1882.2012.00017.x/abstract.

[40]Institute for Marital Healing, Catholic Covenant Society, U.S., Child Healing: Strengthening Families - Gender Dysphoria, Gender Identity Disorder and Informed Consent. http://www.childhealing.com/articles/genderidentitydisorder.php

[41]Geddes, Linda, Puberty blockers recommended for transsexual teens, (New Scientist [0262-4079], Vol. 200, Iss. 2686, 2008), p. 8-9. http://www.researchgate.net/publication/250762052_Puberty_blockers_recommended_for_transsexual_teens

[42]Coolhart, Deborah, Baker, Amanda, Farmer, Sara, Malaney, Meaghan and Shipman, Dara, Therapy with transsexual youth and their families: a clinical tool for assessing youth's readiness for gender transition, (The Journal of Marital and Family Therapy, Vol. 39(2), April 2013), p.223(21). http://onlinelibrary.wiley.com/doi/10.1111/j.1752-0606.2011.00283.x/abstract

[43]Abel, Brendan S., Hormone Treatment of Children and Adolescents with Gender Dysphoria: An Ethical Analysis, (Hastings Center Report, Vol. 44, Sep. 2014 Supplement), p.S23-S27. http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=7039. Mustanski, Brian, Ethical and Regulatory Issues with Conducting Sexuality Research with LGBT Adolescents: A Call to Action for a Scientifically Informed Approach, (Archives of Sexual Behavior, Vol. 40(4), 2011), p.673-686. http://onesearch.lancs.ac.uk/primo_library/libweb/

[44]西蒙諾維茲、皮爾斯著,唐蘊玉譯:《人格的發展》(上海:上海社會科學院出版社2006,1-37

[45]劉翔平:自尊上癮我們時代的頭號心理疾病》(臺北市橡實文化2014,9-14306-315

[46]《英變性人籌劃同時做爸媽》,《東方日報》(2015103日)。http://www.orientaldaily.on.cc/cnt/china_world/20151003/00180_040.html

[47]《兒童權利公約》。http://www.soco.org.hk/children/q2_content_3.htm

[48]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁256-261

[49]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁185-218

[50]關啟文:《同性與變性-評價同性戀運動和變性人婚姻》(香港:宣道出版社,2015),頁256-261

[51]Interpretation, a Bible Commentary for Teaching and Preaching, (Louisville: J. Knox Press, 1990). The New International Commentary on the Old Testament, (Grand Rapids, Mich.: W.B. Eerdmans, 1976). The NIV Application Commentary, (Grand Rapids, MI: Zondervan, 2012). Word Biblical Commentary, (Nashville, TN: Thomas Nelson Publisher, 2002).

[52]White, James E., Contemporary moral problems, (Belmont, Calif.: Wadsworth; Andover: Cengage Learning distributor, 2012), 28-30.

[53]Grabill, Stephen J., Rediscovering the natural law in reformed theological ethics, (Grand Rapids, Mich.: William B. Eerdmans Pub. Co., 2006), 21-40.

Neal, Deonna D., Be Who You Are: Karl Barth’s Ethics of Creation, (University of Dotre Dame, PhD Thesis, 2010), Abstract.

https://curate.nd.edu/concern/etds/2r36tx33k50.

[54]Boyd, Craig A., A shared morality: a narrative defense of natural law ethics, (Grand Rapids, Michigan: Brazos Press, 2007), 161-172.

[55]莫特拉娒著,黃東英譯:危而不亂-與病人及親屬面對倫理困境》(香港基道2008),頁18

Wiki Dictionary, θος. https://en.wiktionary.org/wiki/%E1%BC%A6%CE%B8%CE%BF%CF%82

[56]Wiki Encyclopedia, Ethics. https://en.wikipedia.org/wiki/Ethics

[57]Boyd, Craig A., A shared morality: a narrative defense of natural law ethics, (Grand Rapids, Michigan: Brazos Press, 2007), 176-193.

[58]Hittinger, Russell, The first grace: rediscovering the natural law in a post-Christian world(Wilmington, DE: ISI Books, 2007), xi-xivi, 115-133.

[59]Fremstedal, Roe, Kierkegaard on the metaphysics of hope, (The Heythrop Journal LIII, 2012), p. 51–60.

[60]Piderit, John J., Sexual morality: a natural law approach to intimate relationships, (New York: Oxford University Press, 2012), 25-29.

[61]Huebner, Harry J., An Introduction to Christian Ethics. History, Movements, People, (Waco, Texas: Baylor University Press, 2012, 345-360.

[62]《校內被逼「治療」 錯過變性黃金期 準變性人擬控正生書院》,《蘋果日報》(201248日)。http://hk.apple.nextmedia.com/news/art/20120408/16229059

[63]Carroll, Lynne, Gilroy, Paula J., Ryan, Jo, Counseling Transgendered, Transsexual, and Gender-Variant Clients, (Journal of Counseling & Development, Vol. 80(2), 2002), p.131-139. http://www.tgmeds.org.uk/downloads/Lynne-Carroll-Paula-J.-Gilroy-Jo-Ryan-Counseling-Transgendered-Transsexual-and-Gender-Variant-Clients.pdf

[64]Herlihy, Barbara J., Hermann, Mary A., Greden, Leigh R., Legal and Ethical Implications of Using Religious Beliefs as the Basis for Refusing to Counsel Certain Clients, (Journal of Counseling & Development, Vol. 92(2), 2014), p.148-153. http://onlinelibrary.wiley.com/doi/10.1002/j.1556-6676.2014.00142.x/abstract

 
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