Analysis of 39 Forensic Clinical Sex Identification Cases after Sex Reassignment Surgery

doi:10.12116/j.issn.1004-5619.2023.230602

Abstract

Abstract:

Objective To analyze the characteristics of forensic clinical sex identification cases after sex reassignment surgery for transsexualism, discuss the main point of forensic clinical sex identification in China based on domestic and foreign sex change policies and related cases, so as to standardize relevant identification. Methods A total of 39 cases of forensic clinical sex identification were collected from Center for Forensic Science, Shanghai Medical College of Fudan University in recent years, and the ratio of sex, identification time, the location of surgery, secondary sex characteristic and other information were statistically analyzed. Results Transgender woman accounted for 97.4% of the cases, and 94.9% of the cases were operated in Thailand. All cases were identified after the sex reassignment surgery, and at least one of the secondary sex characteristics was consistent with the postoperative primary sexual characters. There were only 2 cases in which auxiliary examination was applied. Conclusion Forensic clinical sex identification should be based on the principle that the primary and secondary sex characteristics are consistent with the changed sex.

Key words: forensic medicine, sex identification, transsexualism, sex reassignment surgery, cases analysis

CLC Number:

Yu-jiao WU, Yue-qin ZHOU, Yi-wen SHEN, Jie-qing JIANG. Analysis of 39 Forensic Clinical Sex Identification Cases after Sex Reassignment Surgery[J]. Journal of Forensic Medicine, 2024, 40(4): 365-371.

Figures/Tables 2

References 29

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第二性征	与认同性别相符	与认同性别不相符
喉结	36	3
乳房	19	20
音调	26	13
体毛	38	1

第二性征	与认同性别相符	与认同性别不相符
喉结	36	3
乳房	19	20
音调	26	13
体毛	38	1

项目	泰国《医务委员会关于医务职业道德的条例——变性手术治疗规则》《关于对性别身份感到困惑或希望接受变性手术治疗的人士的指引》	中国
项目		《性别重置技术管理规范（2017年版）》	《性别重置技术临床应用管理规范（2022年版）》
年龄	满20岁；或满18岁未满20岁，并得到至少1位监护人同意	满20岁，具备完全民事行为能力	满18岁，具备完全民事行为能力
诊断	参考ICD-11诊断为性别不一致	精神科或心理科医师开具的易性症诊断证明	三级医院精神科或心理科医师开具的易性症（性别焦虑/性别不一致）诊断证明
持续时间	激素治疗至少6个月，真实生活体验至少1年	对性别重置的要求至少持续5年，且无反复过程	对性别重置的要求至少持续5年，且无反复过程
其他	2位精神科医师的批准文件，外国人应取得外国医师的批准	接受心理、精神治疗1年以上且无效；未在婚姻状态；无在案犯罪记录证明；本人要求手术的书面报告并进行公证；已告知直系亲属拟行性别重置术的相关证明	未在婚姻状态；无在案犯罪记录证明；本人要求手术并经本人签字的书面报告；已告知直系亲属拟行性别重置术的相关证明

项目	泰国《医务委员会关于医务职业道德的条例——变性手术治疗规则》《关于对性别身份感到困惑或希望接受变性手术治疗的人士的指引》	中国
项目		《性别重置技术管理规范（2017年版）》	《性别重置技术临床应用管理规范（2022年版）》
年龄	满20岁；或满18岁未满20岁，并得到至少1位监护人同意	满20岁，具备完全民事行为能力	满18岁，具备完全民事行为能力
诊断	参考ICD-11诊断为性别不一致	精神科或心理科医师开具的易性症诊断证明	三级医院精神科或心理科医师开具的易性症（性别焦虑/性别不一致）诊断证明
持续时间	激素治疗至少6个月，真实生活体验至少1年	对性别重置的要求至少持续5年，且无反复过程	对性别重置的要求至少持续5年，且无反复过程
其他	2位精神科医师的批准文件，外国人应取得外国医师的批准	接受心理、精神治疗1年以上且无效；未在婚姻状态；无在案犯罪记录证明；本人要求手术的书面报告并进行公证；已告知直系亲属拟行性别重置术的相关证明	未在婚姻状态；无在案犯罪记录证明；本人要求手术并经本人签字的书面报告；已告知直系亲属拟行性别重置术的相关证明

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