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TransgenderMemahami Hak Mereka

Mohamed Hatta ShaharomPsychiatrist & Founding Dean, Medical Faculty, CUCMS

Ahli, Majlis Profesor NegaraAhli, DPN, IKRAM

Wacana Anjuran

Belia IKRAM Ampang Jaya21 Muharram 1436 / 20 Nov 2014

The Healer

يشفين فهو مرضت وإذا

“And when I fall ill, He is the One who heals me.”

Al-Shu‘arā’ (The Poets) 26:80

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The Healing

Fوشفاء هدى آمنوا ذين لل هو قل

“…Say (O Muhammad): It is to the Believers a Guidance and a Healing…”

Fussilat (Explained in Detail) 41:44

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Tranquility

الله بذكر أال الله بذكر قلوبهم وتطمئن آمنوا ذين الالقلوب تطمئن

“Those who believe, and whose hearts find their rest in the remembrance of Allah, verily, in the

remembrance of Allah hearts do find their rest.”

Al-Ra‘d (The Thunder) 13:28

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Reasoning

So have they not traveled through the earth and have hearts by which to reason and ears by which to hear? For indeed, it is not eyes that are blinded, but blinded

are the hearts which are within the breasts.

Al-Haj (The Pilgrimage) 22:46

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Hadis

وسلم : عليه الله صلى النبي لعن قال عنهما الله رضي عباس ابن عنالنساء من والمترجالت ، الرجال من المخنثين

Ibn Abbas r.a. berkata: “Rasulullah s.a.w. melaknati mereka yang menyerupai wanita daripada kalangan lelaki dan mereka yang menyerupai lelaki daripada kalangan wanita.”

H.R. al-Bukhari

http://www.e-fatwa.gov.my/fatwa-negeri/hukum-wanita-menyerupai-lelaki-pengkid-dan-hukum-lelaki-menyerupai-perempuan-pondan-dan 20 Nov 2014

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Isu Transgender1. Mukadimah2. Kontroversi3. Pengurusan4. Etika5. Penutup.

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1 Mukadimah• Definisi• Pendekatan holistik• Keseimbangan hayat dan kesihatan

Bio-physical

Psychological

Social

Spiritual

Holistic Approach to LifeFour Domains

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Klasifikasi DiagnosisDSM-5 (APA, 2013)ICD-10 (WHO, Version 2015)

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LGBT1. Lesbian, Gay, Bisexual, Transsexual2. Homosexual, heterosexual, bisexual.

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Khunsa1. Hermafrodit (hermaphrodite);2. Kewujudan kedua-dua organ seksual;3. Genitalia samar (ambiguous genitalia).

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Sexual OrientationAn enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender.http://en.wikipedia.org/wiki/Sexual_orientation Retrieved 19 Nov 2014

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Transexualism: Definitionis when an individual identifies with a gender inconsistent or not culturally associated with their assigned sex i.e. in which a person's assigned sex at birth conflicts with their psychological gender.

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Transexualism: DiagnosisA medical diagnosis can be made if a person experiences discomfort as a result of a desire to be a member of the opposite gender, or if a person experiences impaired functioning or distress as a result of that gender identification.

http://en.wikipedia.org/wiki/Transsexualism. Retrieved 19 Nov 2014

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Disforia

Rasa tidak puas hati, bimbang dan resah.

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Disforia Jantina (Definisi)1. People who have gender dysphoria feel

strongly that they are not the gender they physically appear to be;

2. The mismatch between body and internal sense of gender is not a mental illness;

3. What need to be addressed are the stress, anxiety, and depression that go along with it.

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Disforia Jantina (Contoh)A person who hasi. a penis and all other physical traits of

a male might feel instead that he is actually a female, and would have an intense desire to have a female body and to be accepted by others as a female; or

ii. the physical characteristics of a female would feel her true identity is male.

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Transexualism & GID

1. Transsexualism and Gender Identity Disorder (GID) are outdated terms;

2. Transgender is now often used to describe someone who feels his or her body and gender do not match.

http://www.webmd.com/mental-health/gender-dysphoria Retrieved18 Nov 2014

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2a Kontroversi Paradigma• Klasifikasi berpaksikan paradigma

liberalisme dan sekularisme Barat;• Pendekatan nomenklatur ini tidak holistik

dan kurang mengambil kira pengaruh serta pandangan hidup (worldview) agama dan budaya individu;

• Nature, nuruture or both?

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2b Kontroversi dan Kritikan• Usaha yang amat bersungguh-sungguh

untuk menonjolkan bukti biosaintifik tentang punca transgender;

• Kritikan berterusan oleh para profesional, khususnya yang beragama Kristian dan Islam.

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2c Kontroversi dan Cabaran• Para profesional dari masyarakat

beragama perlu menyiapkan nomenklatur alternatif tentang kesihatan dan kecelaruan mental dan tingkah laku;

• Pendekatan holistik dan empirikal mesti dijadikan asas untuk menyahut cabaran ini.

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2d Kontroversi dan Pembedahan• Tidak semua transgender yang menjalani

Sex Reassignment Surgery (SRS) mengalami kepuasan dan kebahagiaan hidup;

• Antara mereka, ada yang menyesali tindakan untuk menukar jantina.

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3a Pengurusan: Prinsip• Pendekatan psiko-sosio-spiritual untuk

pengendalian serta terapi yang berkesan (contohnya terapi berprinsipkan Islam bagi individu Muslim);

• Sumbangan faktor neuro-biologikal dalam usaha ini;

• Pengendalian stigma yang keterlaluan sehingga memudaratkan kesihatan dan keselamatan pesakit.

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3b Pengurusan: Rawatan Holistik

• Terapi psikospiritual;• Farmakoterapi jika diperlukan;• Pengukuhan sokongan sosial.

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4a Etika dan Sikap• Peranan etika dan akhlak di kedua-dua

pihak yang memberi bantuan dan pihak yang menerimanya;

• Golongan transgender adalah golongan insan yang memerlukan perhatian dan bantuan, bukan cemuhan dan kutukan.

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4b Etika dan Syariah

Maqasid Syariah untuk menjaga

i. Agama (al-din) الدينii. Kehidupan (al-nafs) النفسiii. Keturunan (al-nasl) لFسFنFالiv. Akal (al-‘aql) العقلv. Harta (al-mal) المال

Hadis Tentang Kejujuran dan Amanah

Maksud sebagian daripada sebuah Hadis Rasulullahs.a.w. yang disampaikan oleh ‘Abdullah bin ‘Amr r.a.tentang empat sifat mulia yang disebut oleh Rasulullah:1. Penjagaan amanah (ḥifẓu amānah); 2. Kebenaran pertuturan (ṣidqu ḥadīth); 3. Kebaikan akhlak (ḥusnu khalīqah);4. Kesucian makanan (‘iffatun fi ṭa‘matin).

Imam Ahmad (Misykat, Hadis 5222 & Sahih al-Jami‘, Hadis 873).

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5 Penutup• Sebab psiko-sosial serta spiritual yang

memerlukan pengendalian yang bersepadu;

• Kontroversi punca bio-fizikal yang memerlukan perhatian dan kajian yang lebih mendalam.

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Fools learn…I prefer to learn…“Fools learn from experience. I prefer to

learn from the experience of others.”

Otto von Bismarck, Chancellor of the German Empire (1815-1898 CE)

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The Person, the Disease“It is more important to know what sort of person

has a disease than to know whatsort of disease a person has.”

Hippocrates, Greek physician (460–370 BCE)

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The Ummah, the Disorder“It is important to know what kind of peoples the

ummah has become while identifying the disorder the ummah is suffering from.”

Bung Hatta (2013 CE / 1434 AH)

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Tough Love

Unlike pampered love that fatigues the giver and spoils the receiver, tough love flourishes in

the meadow of disciplined learning and relentless striving.

It is watered by divine knowledge and blessed love…

Thus manifesting in good deeds, enriching the soul and benefiting mankind.

Love’s Good But Tough: LGBTBung Hatta (2013 CE / 1434 AH)