트랜스젠더 트랜지션 의료의 건강보험 보장에 대한 소고

박한희 ( Park Hanhee ) 서울대학교 BK21 법학연구단 공익인권법연구센터 2018 공익과 인권 Vol.18 No.-

출생 시 지정된 성별과 다른 성별로 자신을 인식하는 트랜스젠더에게 있어 호르몬요법, 생식능력제거수술, 성기형성수술과 같은 트랜지션 의료를 통해 신체적 특징을 변화시키는 것은 자신의 신체에 대한 위화감을 해소하는 데 있어 중요한 수단 중 하나이다. 또한 한국과 같이 법적 성별정정을 위해 일정한 의료적 조치를 요구하는 나라에서 트랜지션 의료는 트랜스젠더가 자신이 원하는 성별로 사회를 살아가기 위해서도 필수적인 부분이다. 그러나 한국의 국민건강보험 체계에서 이러한 트랜지션 의료는 모두 비급여 항목으로 분류되어 건강보험 보장이 전혀 이루어지지 않고 있다. 이에 따라 적게는 수십만, 많게는 수천만 원에 이르는 트랜지션 의료비용을 모두 본인이 부담해야만 한다. 트랜지션 의료의 비급여는 나아가 성별정정을 위해 성전환수술을 요구하는 대법원의 엄격한 요건 및 트랜스젠더를 배제시키는 성별이분법적인 사회구조와 맞물려 트랜스젠더의 낮은 사회경제적 지위를 고착시킨다. 트랜지션 의료는 트랜스젠더가 자신답게 삶을 영위하기 위한 필수적인 의료적 조치로서 그 의료적 필요성이 인정된다. 이에 따라 이미 공적 건강보험으로 트랜지션 의료비용을 보장하고 있는 나라들이 존재하고 그 수가 점차 증가하고 있다. 무엇보다 트랜지션 의료의 건강보험 보장은 트랜스젠더의 건강권, 의료접근권 보장을 위해 필수적인 제도라는 점에서, 보건의료정책을 넘어 인권적 관점에서 이 문제를 논의해갈 필요가 있다. 그럼에도 현재 한국정부는 트랜지션 의료의 건강보험 보장에 소극적이며 어떠한 연구나 검토도 하고 있지 않다. 더 이상 고비용의 의료부담으로 트랜스젠더가 건강권, 의료접근권을 침해받는 일이 없도록 트랜지션 의료에 대해서도 건강보험 보장을 확대해나가는 부분에 대해 논의가 이루어져야 한다. For transgender people, transition-related care such as hormone therapy and gender affirmation surgery has an important meaning. Transition-related care is sometimes the only and effective way to alleviate the gender dysphoria of transgender people. Also, in countries like Korea, which require medical procedures as a precondition for legal gender recognition, transition-related care is an essential for transgender people to live as their affirmed genders. However, in Korea's national health insurance service, all of these transition-related cares are classified as non-benefit items. Therefore, transgender people in Korea have to cover all the costs for transition-related care, which amount to tens of millions of won. In addition, because of the abusive requirements for legal gender recognition and low socioeconomic status of transgender people, classifying transition-related care as non-benefit items is especially problematic and discriminatory for transgender people. Transition-related care is already recognized as a medically necessary and essential treatment for transgender people. Also, covering transition-related care by health insurance is an essential part for the full enjoyment of the right to health and the right to social security for transgender people. As a result, in more and more countries, transition-related care is being covered by public national health insurance systems. Nevertheless, the Korean government is denying the medical benefits for transition-related care and has not conducted any studies or reviews until now. To ensure the fundamental human rights of transgender people, there has to be a discussion about covering transition-related care by the national health insurance service.

포괄적 차별금지법의 의의와 필요성

박한희 ( Park Hanhee ) 영미문학연구회 2021 안과 밖 Vol.- No.50

On June 29, 2020, an anti-discrimination bill is proposed on the 21st National Assembly. First proposed in 2007, the anti-discrimination bill has not been passed in the National Assembly despite three attempts to legislate it. Even in 2013, the draft bills are retracted after organized opposition from anti-LGBTI and conservative Protestant organizations. Therefore, as the bill has been proposed after seven years since 2013, discussions on the enactment of the anti-discrimination law have been active. In the history of a decade-long attempt to enact a law, the anti-discrimination law has been meaningful as the least device the state should do against the hate and discrimination. In particular, anti-discrimination laws are significant in that they fill gaps in individual anti-discrimination laws, expand the concept of discrimination, provide effective remedies, and clarify national responsibilities. Facing a series of recent cases based on hate and discrimination, many people ask "would it have been different if there had been a anti-discrimination law?". Now, we hope to go beyond these questions and ask what more we can talk about through the anti-discrimination law.

남녀 고등학생의 부모통제 및 학교생활만족도와 교복만족도의 관계 연구

박한희(Han Hee Park),이명희(Myoung Hee Lee),강승희(Seung Hee Kang) 한국복식학회 2014 服飾 Vol.64 No.2

The purpose of this study was to examine the differences of the satisfaction with school uniforms according to demographic variables and to investigate the causal relations of parental control, school life satisfaction, and demographic variables to the satisfaction with school uniform. The research method was a survey method using a questionnaire. The subjects were 407 high school students (191 male, and 216 female) residing in Seoul and the suburbs of Seoul. Students were very satisfied with the convenience of not having to choose what to wear every morning, but the satisfactions with uniform cost and design were lower. The aesthetic, psychological, and status symbol satisfaction of school uniforms were higher as parents and adolescents had more communication, and the psychological and status symbol satisfaction of school uniforms were higher as the level of parental supervision for adolescents was higher. The female students had higher psychological satisfaction with school uniforms than the male students were. The aesthetic satisfaction of school uniforms was lower as mother`s education level was higher. The adolescents from upper class families had lower aesthetic, psychological, and status symbol satisfaction with school uniforms than the adolescents from middle and lower class families. The satisfaction with school uniform was influenced by school life satisfaction the most, and the next in the order by grade (-), the social class (-), and the communication with parents. The factors that influenced school life satisfaction for students were parental supervision, school records, the discipline consistency of parents, and their communication with their parents. Therefore, the 4 variables had indirect effect on the satisfaction with school uniform through school life satisfaction.

[판례평석] 미성년 자녀가 있는 트랜스젠더의 성별정정 허가기준 및 입법적 제안 (대상결정: 대법원 2022. 11. 24.자 2020스616 전원합의체 결정)

박한희 ( Park¸ Hanee ) 서울대학교 공익인권법센터 2023 공익과 인권 Vol.23 No.0

On November 24, 2022, the Supreme Court decided that legal gender recognition for transgender people with a minor child is allowed under specific circumstances. It took 11 years to overturn the 2011 Supreme Court case, which ruled that legal gender recognition is absolutely impossible if there is a minor child. In 2006, the Supreme Court made a decision on legal gender recognition for the first time, and in the same year enacted the Supreme Court Regulation to stipulate gender correction requirements and procedures. However, in the regulation, the Supreme Court stipulated that legal gender recognition is impossible for transgender people with a child. In 2011, this regulation was relaxed to having no ‘minor’ child. As a result, transgender people who gave birth to children had to suffer from their gender identity not being recognized. This court regulation was derived from discussions in Japan. However, it is currently difficult to find any other jurisdiction, other than Japan, where the presence of children is the criterion for legal gender recognition. The 2011 Supreme Court decision stated that changing the parents’ gender marker would harm their children's welfare, but this stems from ignorance of the specific transition process of a transgender person and is inconsistent with related social studies research. The 2020Su616 decision is significant because it made clear that legal gender recognition is guaranteed as a basic right and that restrictions on this right should be minimized. However, the fact that the requirement to have no minor child is not abolished and that there is room for denial according to the judgment of individual courts remain as limitations or this decision. Therefore, legislative measures such as enacting the Legal Gender Recognition Act, revising the Act on Registration of Family Relations, and legislating same-sex marriage are presented as follow-up tasks.

미국, 유럽, 일본의 실사용데이터 연구사업 추진현황과 시사점

박한희(Han-Heui Park),정규원(Gyu-Won Jung),성희진(Higin Sung),신주영(Ju-Young Shin) 대한약학회 2020 약학회지 Vol.64 No.1

With the growing interest in big data, regulatory agencies in United States, Europe, and Japan are showing active movements to use real world data (RWD) and real world evidence (RWE). Following the global movements, it is necessary to establish the foundation for utilizing RWD in drug safety management in Korea. The purpose of this study is to examine and analyze the current status of research projects related to RWD in US, Europe, and Japan. We investigated the current state of global research projects on the use of RWD and RWE by utilizing many of the informative resources as follow. We collected information posted on websites operated by each country’s regulatory authority. Also we referred to publications and guidance around the enhanced use of RWE for health-care decision-makers. In addition, web seminars introducing ongoing research projects allowed us to gain substantial amount of resources. We classified research projects into 4 areas; data integrity (accuracy and consistency of data), post-market drug safety monitoring, indication expansion, and consulting and education fields. In this way, we could consider each country’s different market environment and institutional bases. Therefore, this study suggests future directions to prepare research projects for the introduction of Korea’s RWD.

한국, 일본, 대만에서의 의약품 부작용 피해구제 제도 현황 조사

안상완(Sang-Wan An),노윤하(Yunha Noh),백연희(Yeon-Hee Baek),박한희(Han-Heui Park),박소희(So-Hee Park),박성민(Sungmin Park),신주영(Ju-Young Shin) 대한약학회 2019 약학회지 Vol.63 No.4

Abstract The adverse drug reaction relief system is no-fault compensation system which provides compensation for severe injuries that were caused by adverse reaction even after proper use of medicines. The purpose of this study is to evaluate current status of the adverse drug reaction relief system in Japan, Taiwan, and Korea. We investigated the relief system in above three countries through websites, literatures, reports, spot investigation and e-mail questionnaires. Although great similarities for the relief system were recognized among the three countries, the difference among the countries and the unique characteristics of each country’s relief system was also identified; for example, the relief for injuries by offlabel uses, details of relief benefits, the relief payment for the adverse drug reactions, and the compensation for medical expenses which is classified as non-reimbursement treatment. Therefore, it is possible to establish more valuable no-fault compensation system in Korea through application of advantage and experience for the relief system in Japan and Taiwan.

실사용데이터/실사용근거를 활용한 FDA와 EMA의 규제적 의사결정 사례 분석

성희진(Hi Gin Sung),박한희(Han-Heui Park),정규원(Gyu-Won Jung),신주영(Ju-Young Shin) 대한약학회 2020 약학회지 Vol.64 No.2

Lately, the use of Real-World Data (RWD)/Real-World Evidence (RWE) have been actively expanded in regulatory decisions. We aimed to investigate how RWD/RWE were used in pursuit of supporting regulatory actions of FDA and EMA. We selected 9 examples of regulatory decision making with the support of RWD/RWE. To identify information included in RWE submission, we referred to the official website of US FDA or EMA. In addition, we used ClinicalTrials.gov and Medline database to collect information on study design using RWE and RWD source used to generate RWE. Our study drugs were classified into 3 parts according to regulatory context; primary approval, label expansion, and regulatory response to safety signal after marketing. Among these examples, 5 biologic products including 1 vaccine had gone through accelerated review supported by RWE. To summarize, we investigated several examples where RWD/RWE has already been used in the process of making regulatory decisions for assessing the safety of drugs as well as their effectiveness. We recommend further discussions on advancing the use of RWD/RWE in regulatory context to improve patient access to novel rare disease treatments and provide more efficient safety assessment.

형사사법기관의 인권보장역량 종합평가 연구 (Ⅰ) : 수사기관의 인권보장역량 평가

강태경(Gahng, Taegyung),김한균(Kim, Han-kyun),김경찬(Kim, Kyoung Chan),서선영(Seo, Seonyoung),김동현(Kim, Donghyun),김두나(Kim, Doona),김재왕(Kim, Jae Wang),류민희(Ryu, Minhee),박한희(Park, Hanhee),조혜인(Cho, Hyein),최현정(Choi, Hyu 한국형사법무정책연구원 2018 형사정책연구원 연구총서 Vol.- No.-