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- Title
Gender Issues and Related Social Stigma Affecting Patients with a Disorder of Sex Development in India.
- Authors
Joseph, Angela; Kulshreshtha, Bindu; Shabir, Iram; Marumudi, Eunice; George, Tony; Sagar, Rajesh; Mehta, Manju; Ammini, Ariachery; Joseph, Angela Ann; George, Tony Sam; Ammini, Ariachery C
- Abstract
Children with disorders of sex development (DSD) manifest at birth with malformed genitalia or later with atypical pubertal development. Those born with malformed genitalia are often diagnosed at birth. However, in resource-poor countries like India, where not all births are supervised by healthcare workers, some of these children remain undiagnosed until puberty or even later. The aim of this study was to assess the gender issues and psychosocial problems of children with DSD. Participants included 205 children with DSD (103 with 46,XX DSD and 102 with 46,XY DSD). Both the children with DSD and their parents underwent semistructured interviews by a clinical psychologist. The birth of a child with DSD was perceived as a major medical and social problem by parents from all socioeconomic strata. Mothers were distressed as many believed the DSD condition was transmitted through the mother. Children who were not diagnosed and treated during infancy or early childhood experienced considerable social discrimination not only from relatives and friends but also from medical and paramedical staff in hospitals. Several patients had been operated during infancy without an etiological diagnosis and without provision of adequate information to the parents. Some children had problems related to complications of surgery. Most teenage patients with 5α-reductase-2 deficiency reared as females presented with gender dysphoria, while children with androgen insensitivity (except for one) or with gonadal dysgenesis developed a gender identity concordant with their gender of rearing. Parents of children with DSD preferred a male gender assignment for their children (if that was possible) because of the social advantages of growing up male in a patriarchal society.
- Subjects
INDIA; SEX differentiation disorders; INTERSEXUALITY; INTERSEX children; SOCIAL conditions in India; GENDER identity &; society; PATRIARCHY; TWENTY-first century; PSYCHOLOGICAL adjustment testing; DISEASES; GENDER identity; PARENTS; PSYCHOLOGICAL tests; SOCIAL participation; PSYCHOLOGY
- Publication
Archives of Sexual Behavior, 2017, Vol 46, Issue 2, p361
- ISSN
0004-0002
- Publication type
journal article
- DOI
10.1007/s10508-016-0841-0