Intersex

Intersex rukuni ne na yanayi inda akwai rashin daidaituwa tsakanin al'aura ta waje da al'aura ta ciki (gwaji da ƙwai).

Babban lokacin da wannan yanayin shine hermaphroditism. Kodayake har yanzu ana haɗa tsofaffin kalmomin a cikin wannan labarin don tunani, yawancin masana, marasa lafiya da iyalai sun maye gurbinsu. Ari, ana kiran wannan rukuni na yanayin rikicewar haɓakar jima'i (DSDs).

Intersex za a iya kasu kashi 4:

• 46, XX intersex
• 46, XY intersex
• Gaskiya gonadal intersex
• Ungiya ko ma'anar intersex

Kowane ɗayan yana tattaunawa dalla-dalla a ƙasa.

Lura: A cikin yara da yawa, dalilin intersex na iya kasancewa ba a tantance shi ba, koda da dabarun binciken zamani.

46, XXARIYA INTERSEX

Mutum yana da chromosomes na mace, ƙwarjin mace, amma al'aurar waje (waje) da ke bayyana ta namiji. Wannan mafi yawancin lokuta sakamakon ɗan tayi ne wanda aka fallasa shi da ƙarancin homon maza kafin haihuwa. Labia ("lebba" ko kuma fatar fatar al'aurar mace ta waje) ta hadu, kuma maziyyi ya kara bayyana kamar azzakari. A mafi yawan lokuta, wannan mutumin yana da mahaifa ta al'ada da tublop fallopian. Wannan yanayin ana kiransa 46, XX tare da yin ƙaura. A da ana kiranta mace da maƙaryata. Akwai dalilai da dama da zasu iya haifar:

• Hawan jini na hyperplasia (mafi yawan lokuta shine).
• Hormone na namiji (kamar su testosterone) wanda uwa ta sha ko ta ci karo dashi yayin daukar ciki.
• Ciwan mahaifa mai haifar da mahaifa a cikin mahaifiya: Waɗannan galibi sune cututtukan ƙwai. Iyaye mata da ke da yara 46, XX intersex ya kamata a bincika sai dai idan akwai wata hanyar da ta dace.
• Rashin Aromatase: Wannan bazai iya zama sananne ba har sai balaga. Aromatase enzyme ne wanda yakan canza sinadarin mace zuwa na mace. Yawan aiki aromatase na iya haifar da isrogen da yawa (hormone mace); yayi kadan zuwa 46, XX intersex. A lokacin balaga, waɗannan yaran na XX, waɗanda aka tashe su a matsayin 'yan mata, na iya fara ɗaukar halayen maza.

46, XY INTERSEX

Mutum yana da chromosomes na mutum, amma al'aura ta waje ba cikakkiyar halitta ce, shubuha, ko mace bayyananniya. A ciki, gwaji na iya zama na al'ada, ba daidai ba, ko ba su nan. Wannan yanayin ana kiransa 46, XY tare da rashin ƙarfi. A da ana kiransa namiji da maƙarƙashiya. Halittar al'aura na waje na al'ada ya dogara da daidaitattun daidaituwa tsakanin homonin mata da na mace. Sabili da haka, yana buƙatar wadataccen samarwa da aikin homon namiji. 46, XY intersex yana da dalilai masu yawa:

• Matsaloli game da gwajin: Gwaji yakan samar da kwayar halittar namiji. Idan gwajin bai yi kyau ba, zai haifar da mara lafiyar jiki. Akwai dalilai da dama da zasu iya haifar da wannan, gami da XY tsarkakakken ƙwayar cuta.
• Matsaloli tare da samuwar testosterone: An samar da Testosterone ta hanyar jerin matakai. Kowane ɗayan waɗannan matakan yana buƙatar enzyme daban. Ficaranci a cikin ɗayan waɗannan enzymes na iya haifar da ƙarancin testosterone kuma suna haifar da wata cuta daban ta 46, XY intersex. Daban-daban nau'ikan cututtukan mahaifa na iya haifar da wannan nau'in.
• Matsaloli tare da amfani da testosterone: Wasu mutane suna da gwaji na al'ada kuma suna yin isasshen testosterone, amma har yanzu suna da 46, XY intersex saboda yanayi irin su 5-alpha-reductase rashi ko inrogen insensitivity syndrome (AIS).
• Mutanen da ke da rashi 5-alpha-reductase ba su da enzyme da ake buƙata don canza testosterone zuwa dihydrotestosterone (DHT). Akwai aƙalla nau'ikan nau'ikan 5 na rashi 5-alpha-reductase. Wasu daga cikin jariran suna da al'aura irin ta maza, wasu kuma suna da al'aurar mace ta al'ada, kuma da yawa suna da wani abu a tsakanin su. Mafi yawan canzawa zuwa al'aurar maza na waje a lokacin balaga.
• AIS shine sanannen sanadin 46, XY intersex. An kuma kira shi feminization na mata. Anan, hormones duka al'ada ne, amma masu karɓar homon na maza basa aiki yadda yakamata. Akwai sama da lahani daban-daban guda 150 waɗanda aka gano har yanzu, kuma kowannensu yana haifar da nau'in AIS daban.

GASKIYA GONADAL INTERSEX

Dole ne mutum ya kasance yana da ƙwayoyin halittar kwan mace da na ƙwaya. Wannan na iya kasancewa a cikin gonad guda (na ovotestis), ko kuma mutum na iya samun ovary 1 da kuma testis 1. Mutumin na iya samun chromosomes XX, chromosomes XY, ko duka biyun. Al'aura na waje na iya zama na shubuha ko kuma ya bayyana mace ko namiji. Wannan yanayin ana kiransa da gaske hermaphroditism. A mafi yawan mutane da ke da gonadal intersex na gaskiya, ba a san dalilin da ke haifar da hakan ba, kodayake a wasu nazarin dabbobin ana alakanta shi da kamuwa da magungunan kwari na gona.

Hadaddun Hadaddun Hadaddun Hadaddun Sadarwa Na Zamani

Yawancin jigilar chromosome banda 46, XX ko 46, XY na iya haifar da rikicewar ci gaban jima'i. Waɗannan sun haɗa da 45, XO (ɗayan X ne kawai), da 47, XXY, 47, XXX - duka batutuwan suna da ƙarin chromosome na jima'i, ko dai X ko Y. Waɗannan rikice-rikicen ba sa haifar da yanayin da akwai bambanci tsakanin na ciki da farjin mace na waje. Koyaya, za'a iya samun matsaloli game da matakan hormone na jima'i, ci gaban jima'i gabaɗaya, da canza lambobi na chromosomes na jima'i.

Kwayar cututtukan da ke haɗuwa da intersex za su dogara ne akan tushen. Suna iya haɗawa da:

• Al'aura mara kyau a lokacin haihuwa
• Micropenis
• Clitoromegaly (kara girman kirinji)
• Sashin layi na layi
• A bayyane gwajin da ba a ba shi ba (wanda zai iya zama ovaries) a cikin yara maza
• Labial ko inguinal (groin) taro (wanda zai iya zama gwaji) a cikin girlsan mata
• Hypospadias (buɗewar azzakari wani wuri ne banda na ƙarshen; a cikin mata, maziyon fitsari [hanyar fitsari] yana buɗewa cikin farji)
• In ba haka ba-bayyanar al'aura a lokacin haihuwa
• Rashin daidaiton lantarki
• Balaga ta jinkirta ko rashi
• Canje-canje marasa tsammani a lokacin balaga

Za a iya yin gwaje-gwaje da gwaje-gwaje masu zuwa:

• Binciken Chromosome
• Hormone matakan (alal misali, matakin testosterone)
• Gwajin gwajin motsa jiki
• Gwajin lantarki
• Takamaiman gwajin kwayoyin
• Gwajin Endoscopic (don tabbatar da rashi ko gaban farji ko mahaifa)
• Duban dan tayi ko MRI don tantance ko gabobin ciki na ciki (misali, mahaifa)

Yakamata, ƙungiyar kwararrun masu kula da lafiya tare da ƙwarewa a cikin intersex yakamata suyi aiki tare don fahimta da kula da yaron tare da hulɗar juna da tallafawa iyali.

Iyaye ya kamata su fahimci rikice-rikice da canje-canje a cikin magance intersex a cikin 'yan shekarun nan. A baya, ra'ayi mafi rinjaye shine cewa yafi dacewa a sanya jinsi da wuri-wuri. Wannan galibi yana dogara ne akan al'aurar waje maimakon jinsin chromosomal. An gaya wa iyaye kada su yi shubuha a cikin tunaninsu game da jinsin yaron. Sau da yawa ana ba da shawarar saurin tiyata. Za a cire kayan ƙwanji na mace ko na mace daga wata jinsi. Gabaɗaya, an ɗauka da sauƙin sake ginin al'aura mace fiye da aikin al'aura namiji, don haka idan zaɓin "daidai" bai bayyana ba, ana sanya yaro sau da yawa ya zama yarinya.

Kwanan nan, ra'ayin masana da yawa ya sauya. Respectaukaka girmamawa ga rikitarwa na aikin jima'i na mata ya sa suka yanke shawarar cewa al'aurar mata ba zata iya zama mafi kyawu bisa ga al'aurar namiji ba, koda kuwa maimaitawar ta "fi sauƙi." Bugu da kari, wasu dalilai na iya zama masu mahimmanci a cikin gamsuwa da jinsi fiye da yadda al'amuran waje suke aiki. Chromosomal, na jijiyoyin jiki, na hormonal, na tunani, da na ɗabi'a duk suna iya yin tasiri ga asalin jinsi.

Yawancin masana yanzu suna buƙatar jinkirta jinkirin aikin tiyata muddin yana cikin ƙoshin lafiya, kuma ya dace da yaron cikin shawarar jinsi.

A bayyane yake, jima'i tsakanin maza da mata lamari ne mai sarkakiya, kuma maganinsa yana da sakamako na gajere da na dogon lokaci. Amsar mafi kyau zata dogara ne akan dalilai da yawa, gami da takamaiman dalilin intersex. Zai fi kyau a ɗauki lokaci don fahimtar batutuwan kafin a hanzarta yanke hukunci. Supportungiyar tallafi tsakanin intersex na iya taimakawa sanar da iyalai da sabon bincike, kuma ƙila ta samar da wata al'umma ta wasu iyalai, yara, da kuma manyan mutane waɗanda suka fuskanci matsaloli iri ɗaya.

Kungiyoyin tallafi suna da matukar mahimmanci ga iyalai masu ma'amala da intersex.

Groupsungiyoyin tallafi daban-daban na iya bambanta a cikin tunaninsu game da wannan batun mai matukar damuwa.Nemi wanda zai goyi bayan tunaninku da abubuwan da kuke ji akan batun.

Organizationsungiyoyi masu zuwa suna ba da ƙarin bayani:

• Forungiyar don bambancin X da Y chromosome - genetic.org
• Gidauniyar CARES - www.caresfoundation.org/
• Ersungiyar Intersex ta Arewacin Amurka - isna.org
• Turnungiyar Turner Syndrome ta Amurka - www.turnersyndrome.org/
• 48, XXYY - XXYY Project - genetic.org/variations/about-xxyy/

Da fatan za a duba bayani kan yanayin mutum. Hannun hangen nesa ya dogara da takamaiman dalilin intersex. Tare da fahimta, tallafi, da kulawa mai dacewa, hangen nesa gaba ɗaya yana da kyau.

Idan ka lura cewa yaronka yana da al'ada ta al'ada ko ci gaban jima'i, tattauna wannan tare da mai kula da lafiyar ka.

Rikicin ci gaban jima'i; DSDs; Pseudohermaphroditism; Hermaphroditism; Hermaphrodite

Diamond DA, Yu RN. Rikicin ci gaban jima'i: ilimin ilimin halittu, kimantawa, da kula da lafiya. A cikin: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: babi na 150.

Donohoue PA. Rikicin ci gaban jima'i. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi 606.

Wherrett DK Gabatarwa zuwa ga jariri tare da rikicewar rikicewar ci gaban jima'i. Pediatr Clin Arewacin Am. 2015; 62 (4): 983-999. PMID: 26210628 www.ncbi.nlm.nih.gov/pubmed/26210628.