I ētahi wā, ina titiro koe ki tētahi pēpi hou, ki te tipu ake rānei o tētahi tamaiti, ka kite pea koe i ētahi huringa o tōna tinana ka pā mai he āwangawanga, he manukanuka rānei. Ina koa mēnā he mea kāore i te mārama mō ngā ira tangata, he mea noa te whakaaro, 'He aha te mea e tupu ana?' I ēnei wā, ko tētahi mea hei mōhio ko ēnei raruraru whanaketanga ā-ira tangata, e kiia nei e tātou ko ngā Mate Whanaketanga Ā-ira Tangata (DSD) .
He aha ēnei mate whanaketanga ā-ira tangata (DSD)?
He kupu whānui ngā DSD mō ngā āhuatanga maha e pā ana ki ngā huringa o ngā āhuatanga ira tangata o te tangata, arā, ō rātou chromosomes , gonads (arā, ngā ovaries, ngā testicles rānei) , ngā ira tāne rānei. Ka kitea ēnei huringa i te whānautanga, i ētahi wā ka puta i te wā o te pakeketanga, i muri mai rānei, me ētahi tohu ka puta i te pakeketanga.
Whakaarohia ētahi tauira:
- Ahakoa ka whānau mai he pēpi me ngā ira tangata o te tāne (XY) , ka rite tonu te āhua o tōna ira tangata o waho (vulva) ki te wahine.
- Ahakoa whānau mai he tamaiti wahine me ngā ira-ira (XX) , tera pea te āhua o te ira tangata o waho he rite ki te ure tāne, ki te kiore rānei kua nui haere.
- Ko ētahi atu he kiko whatukuhu me he kiko tetere kei roto i ō rātou tinana, ā, ka āhua tāne, wahine rānei ō rātou ira tangata, he ranunga rānei o ngā mea e rua.
- I ētahi wā, ahakoa he noa ngā ira tangata, ka taea e te rerekētanga o te hanganga o te ira tangata te whakararuraru i te tipu me te whanaketanga e puta ana i te wā o te pakeketanga.
I ngā wā o mua, i huaina hoki ēnei āhuatanga ko te 'intersex' . Arā, ko ngā tāngata he chromosomes, he ira tangata, he pūnaha whakaputa uri rānei kāore i te tino uru ki te wehenga ira tangata tuku iho o te wahine/tāne.
Ko te mea nui, ko te whai mate (DSD) ehara i te mea he 'hē' kei roto i a koe. Ko tōna tikanga he rerekē te whanaketanga o tō mate i ērā atu. Ina tika te tātaritanga me te rongoā, ka ora noa te nuinga o te hunga whai mate (DSD).
Ko te kupu "differentiation" te mea e pai ake ana ki ētahi tāngata, kaua ki te kupu "disorder" ina kōrerohia ana mō te DSD. E tohu ana tēnei he āhuatanga whanaketanga rerekē tēnei, ehara i te mate.
He aha ngā momo matua o ngā DSD?
E tata ana ki te 60 ngā āhuatanga rerekē i raro i tēnei kupu whānui (Ngā Mate Pūmanawa o te Whanaketanga Ira Tangata). Ko ētahi o ngā mea tino noa ko:
- Te Mate Pāwera o te Androgen (AIS)
- Te hyperplasia adrenal whānau(Te Whakarahinga Adrenal Whanau - CAH)
- Te Mate Kallman
- Te Mate Klinefelter
- Te Mate McCune-Albright
- Te Mate Prader-Willi (PWS)
- Te Mate Swyer
- Te Mate Turner
He rerekē ngā tohu e puta mai ana i ia o ēnei, nō reira he mea nui kia kōrero ki te tākuta kia mōhio ai koe he aha te āhua o te mate.
He aha ngā tohu o ngā DSD?
Tērā pea ka pāngia te tangata whai DSD e ngā momo tohu maha. Ko ētahi o ēnei ko:
- Te korenga o ngā ira tāne i te whānautanga. Hei tauira, ko te (Aphallia) - ko te tikanga he whānau mai kāore he ure, me te (Vaginal agenesis) - ko te tikanga kāore anō kia tino whanake te tenetene.
- Ngā whekau ira tangata e āhua rerekē ana i ērā o te tāne, o te wahine rānei. Hei tauira, he ure kāore i tino whanake, he kiore rānei kua nui haere.
- Ngā āhuatanga motuhake o ngā repe adrenal.
- Ngā taurite kore o ngā homoni.
- Ngā taurite kore o te irahiko i roto i te tinana.
- Te tīmatanga o te paheketanga i tētahi tau rerekē, kāore rānei e tīmata ana.
- Ngā ure kāore i heke iho.
- Ngā Hypospadia - Koinei te wā e rerekē ai te wāhi o te urethra, te pūaha e puta ai te mimi i te ure, i tērā o te pito.
Ki te kite koe i tētahi, i ētahi rānei o ēnei tohu i roto i tāu tamaiti, he mea pai kia rapu tohutohu hauora tonu atu.
He aha ngā take o ngā mate whanaketanga ā-ira tangata?
He maha ngā take e whānau mai ai te tangata me te DSD. I ētahi wā, neke atu i te kotahi ngā take e pā mai ai. Anei ētahi o ngā take matua:
- Ngā whakarerekētanga ira: Ko ēnei ngā huringa o ngā ira. Ko ētahi he whakarerekētanga tuku iho . Ko ētahi he whakarerekētanga tūpono, e puta ana me te kore he take e kitea ana.
- Ngā raruraru whanaketanga i te wā e tipu ana te pēpi i roto i te kōpū: Ka puta ēnei āhuatanga mēnā kāore ētahi okana e tipu tika ana i te wā e tipu ana te pēpi i roto i te kōpū.
- Te korenga o te homoni: Ka puta tēnei ina kore te tinana o te pēpi e whakaputa i te nui o ngā homoni, ina kore rānei te tinana e aro tika ki ngā homoni e whakaputaina ana e ia. Ka taea hoki te puta ina whakararuraruhia te hanga homoni mō ētahi atu take, pērā i te hekenga o te rere o te toto ki ngā testicle, ki ngā ovaries rānei.
- Te pānga ki ētahi homoni, rongoā rānei i te wā e hapu ana:Hei tauira, ka taea e ngā rongoā pēnei i ngā aukati testosterone te take o tēnei.
He tino uaua ēnei take, koia te take e rangahau hōhonu ana ngā tākuta i tēnei.
He aha ngā raruraru ka pā mai i ngā DSD?
Ehara i te mea ka pāngia te katoa e te DSD e ngā raruraru hauora. Heoi anō, tera pea ētahi tāngata ka nui ake te mōrearea ki te pāngia e ētahi mate. Anei ētahi tauira:
- Ngā mate pūnaha ārai mate - Koinei ngā mate e whakaekea ai e te pūnaha ārai mate ngā pūtau o te tinana.
- Mate manawa whānau - he mate manawa e kitea ana i te whānautanga mai.
- Te toto toto tiketike (hypertension) te toto toto iti rānei (hypotension).
- Te kore tamariki.
- Ngā mate whatukuhu.
- Te mate pāwera.
- Osteoporosis - Ko te tikanga ka ngoikore ngā wheua, ka whati ngāwari hoki.
- Mate huka momo 2.
Engari kia maumahara, he 'mōrearea' noa iho ēnei ka puta. Kāore e pāngia te katoa e ēnei mōrearea. Ka taea te whakahaere i ēnei mōrearea mā te tirotiro tika a te rata.
Me pēhea te tautuhi i ngā DSD? (Tautuhinga)
I ētahi wā, ka kitea e ngā tākuta ngā DSD i te whānautanga. Heoi, kei reira ētahi momo DSD ka kitea ake ō rātou tohu ina tae te tamaiti ki te pakeketanga, ina pakeke haere rānei.
Ka tirohia tuatahitia e te tākuta te tinana. Whai muri i tēnā, ka taea e rātou te mahi i ētahi atu whakamātautau hei whakamārama ake i te āhuatanga, pēnei i:
- Whakamātautau oro-ā-tinana , whakamātautau MRI rānei (Magnetic Resonance Imaging) .
- Ko te whakamātautau karyotype he whakamātautau e tirotiro ana i ngā hapa o te chromosome.
- Ngā whakamātautau ira e tautuhi ana i ngā whakarerekētanga ira .
- Ka inehia e ngā whakamātautau homoni ngā taumata o ngā homoni i roto i te tinana.
Mā ngā mōhiohio i kohia mai i ēnei whakamātautau ka taea e te tākuta te whakatutuki i tētahi tātaritanga motuhake.
Me pēhea te rongoā mō ngā DSD?
I runga i te kaha o ngā tohu, ka hiahia pea te tangata whai DSD ki te maimoatanga pēnei i:
- Te rongoā whakakapinga homoni: Ka mahia tēnei hei whakaoho i te pakeketanga me te whakaiti i te mōrearea o te whakawhanake i ngā raruraru hauora e pā ana ki te DSD, pērā i te osteoporosis .
- Pokanga hanga hou: Ka mahia tēnei pokanga hei whakarerekē i te āhua o ngā ira tangata. Heoi anō,Ki te kore e hiahiatia he take hauora, ka whakaroahia e ngā tākuta ngā tikanga pēnei kia tae rā anō ki te pakeketanga o ngā tamariki ki te whakatau i ā rātou ake whakatau. He mea tino nui tēnei.
Mō ētahi tāngata, he tino ngawari ngā tohu o te DSD, ā, kāore pea e hiahiatia he maimoatanga.
Ko wai e rongoā ana i ngā mate whanaketanga ā-ira tangata?
Mena he mate tō tāu tamaiti e kiia nei ko te DSD, me rongoatia ia e tētahi tīma tākuta maha-mātauranga. Kei roto pea i tēnei tīma:
- Ngā tākuta tamariki.
- Ngā rata rongoā taiohi.
- Ngā tākuta endocrinologist tamariki - arā, ngā tohunga homoni.
- Ngā tākuta mimi tamariki.
- Ngā tākuta wahine tamariki.
- Ngā tohunga ira.
- Ngā tohunga hinengaro tamariki.
Mā te tautoko a ēnei tāngata katoa ka whakawhiwhia te tamaiti ki te maimoatanga pai rawa atu.
He aha te heke mai mō te hunga whai DSD?
He nui ake te tūponotanga o te hunga whai (DSD) ki te whakawhanake i ētahi āhuatanga hauora. Heoi, mā te tātaritanga tika me te maimoatanga, ka taea e rātou te ora roa, te ora noa, pērā i te hunga kāore he (DSD). Nō reira kaua e ngaro te tumanako.
He mate DSD tō taku tamaiti. Me pēhea taku tiaki i a ia?
Ehara te pakeketanga i te wā ngāwari mō te tangata. Mō ngā tamariki whai DSD, koinei pea te wā tuatahi ka mōhio rātou he rerekē ō rātou tinana i ō ō rātou hoa. He wheako tino uaua pea tēnei mō rātou.
Ko te mea pai rawa atu ka taea e koe te mahi mā tāu tamaiti ko te aroha me te tautoko i a ia me te kore mutunga. Anei ētahi mea ka taea e koe te mahi hei whakatenatena i a ia:
- Kōrerotia tōna āhua (DSD), pērā i tāu kōrero mō tētahi atu mate. Kaua e huna nuitia.
- Me whakamōhio atu ki a ia i mua i te wā he aha ngā mea ka tūpono, me ngā mea ka tumanakohia i ia wā tirotiro a te tākuta.
- Whakatenatenahia ia kia whai wāhi atu ki ngā mahi whakangahau me ngā mahi e pai ana ki a ia.
- Kimihia he kaiwhakatakoto whakaaro whai tohu hei āwhina i tāu tamaiti ki te whakatau i ngā kare ā-roto uaua e pā ana ki a ia.
Kia maumahara, ko tō aroha, tō māramatanga, me tō tautoko te kaha nui rawa atu mō tāu tamaiti ki te haere i tēnei haerenga.
Ka taea te ārai i ngā DSD?
Kāo, kāore e taea te ārai i ngā DSD. Kāore he huarahi hei mōhio i mua mēnā he raruraru kei te pūtake o te DSD. Waihoki, kāore e taea e koe te whakahaere ko ēhea ngā momo ira ka riro mai i tāu tamaiti. He mea noa iho tēnei e tupu ana i ētahi wā.Kaua e whakama mō taua mea.
Āhea ahau me toro atu ki te tākuta o taku tamaiti?
I te nuinga o te wā, ka kitea e ngā tākuta ngā DSD i te whānautanga. Engari i ētahi wā, ka kitea ngā tohu i te wā o te pakeketanga, i te wā pakeketanga rānei. Ki te whakaaro koe he rerekē tetahi mea mō tāu tamaiti, whakaritea he wā ki te kite i tētahi tākuta. Ka taea e te tākuta te tirotiro tinana, ā, ki te tika, te tono i ētahi atu whakamātautau hei rapu i te take o ngā tohu o tāu tamaiti.
He aha ngā pātai me pātai atu e au ki te tākuta o taku tamaiti?
Mena i whānau mai tāu tamaiti me tētahi mate (DSD), me pātai atu pea koe ki te tākuta i ēnei pātai:
- "He aha rawa te āhua o taku tamaiti?"
- "Kei hea ahau e kite ai i ētahi atu kōrero mō tēnei āhuatanga?"
- "He aha te momo maimoatanga e hiahiatia ana e ia?"
- "He rōpū tautoko kei reira hei āwhina i ngā tamariki me ngā mātua ki te pēnei?"
He mea noa te whakaranu i ngā kare ā-roto ina whiwhi koe i te tātaritanga o te mate (DSD). I tētahi taha, tera pea ka marino koe i te mea kua whakaingoatia ō tohumate (o tō tamaiti rānei). Engari he mea noa anō hoki te pōhēhē me te koretake, me te whakaaro, "Me aha ahau ināianei?" Ko tō tākuta te tangata pai hei kōrero atu mō ō kare ā-roto. Ka taea e rātou te kōrero ki a koe mō ngā rauemi me te mea me rongoā koe.
Hei whakamutunga, he karere hei kawe ki te kāinga
He kaupapa uaua ngā mate whanaketanga ā-ira tangata (DSD), engari he mea nui kia maumahara ki ēnei mea:
- Ehara te (DSD) i te 'he', engari he 'rerekētanga'. Me aroha, me mārama, me tautoko hoki ngā tamariki me ngā pakeke e noho tahi ana me tēnei mate.
- He mea tino nui te kitenga wawe me te tohutohu hauora tika. Mā tēnei ka ārai i ngā raruraru maha, ā, ka taea hoki te whakahaere angitu i aua raruraru.
- Ina whakatau ana i ngā whakataunga kāore e taea te whakakore pēnei i te pokanga, he mea nui kia manawanui kia tae rā anō te tamaiti ki te pakeke ka taea e ia te mārama (ki te kore e hiahiatia he take hauora).
- Kāore koe i te mokemoke. He tākuta, he kaiwhakatakoto whakaaro, me ngā rōpū tautoko hei āwhina i te hunga e pāngia ana e ēnei āhuatanga.
- Mā te whakahaere tika me te tautoko, he tokomaha te hunga whai (DSD) e ora harikoa, e angitu, e ora noa ana.
Ko tāku tumanako he whai hua ēnei mōhiohio ki a koe. Mena kei te hiahia koe, kei te hiahia rānei tētahi atu e mōhio ana koe ki te ako atu mō tēnei mate, kaua e mangere ki te kōrero ki tētahi tākuta.
Ngā mate o te whanaketanga ā-ira tangata, ngā mate DSD, ngā ira tangata, ngā ira chromosomes, ngā homoni, ngā whakarerekētanga ira, te hauora o te tamaiti
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