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2018-10-29

Living with permanent infertility: A German study on attitudes toward motherhood in individuals with Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS).

Health Care Women Int. 2018 Oct 26:1-21. doi: 10.1080/07399332.2018.1490739. [Epub ahead of print]

Living with permanent infertility: A German study on attitudes toward motherhood in individuals with Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS).

Fliegner M, Richter-Appelt H1, Krupp K1, Brucker SY2, Rall K2, Brunner F1.

Author information
1a University Medical Center Hamburg-Eppendorf, Institute for Sex Research and Forensic Psychiatry , Hamburg , Germany.2b Tübingen University Hospital, Center for Women's Health , Tübingen , Germany.

Abstract

In this study the authors examined the issue of permanent infertility in two diagnoses of the diverse sex developments (DSD) spectrum: Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-KÏster-Hauser Syndrome (MRKHS). The participants with CAIS (n = 12) was older, showed a lower wish for a child and was less distressed about their infertility compared to participants with MRKHS (n = 49). Our data indicated an "indifferent" attitude toward motherhood in CAIS and an "ambivalent" attitude in MRKHS. Depression was frequent in both. Infertility is a source of distress. However, the two groups seem to cope in different ways. Comprehensive medical information and psychological support should be provided.

2018-08-25

Experiences of People Living with Disorders of Sex Development and Sex Re-assignment: Meta-ethnography of Qualitative Studies.

J Adv Nurs. 2018 Aug 21. doi: 10.1111/jan.13833. [Epub ahead of print]

Experiences of People Living with Disorders of Sex Development and Sex Re-assignment: Meta-ethnography of Qualitative Studies.

Sani AM1, Soh KL2, Ismail IA3, Arshad MM3, Mungadi IA4, Yau SL5, Soh KG6.

Author information

1Department of Nursing Sciences, Usmanu Danfodiyo University Sokoto, Nigeria, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
2Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
3Department of Professional Development and Continuing Education, Faculty of Education, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
4Department of Surgery, Usmanu Danfodiyo University, Sokoto, Nigeria.
5Department of Nursing, College of Health Science, Federal University Birnin Kebbi, Nigeria.
6Department of Sport Studies, Faculty of Education/Sport Academy, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

Abstract

AIM:

The aim of this study was to synthesize the experiences of people with disorders of sex development.

BACKGROUND:

The quality of life of people with disorders of sex development depends largely on the availability of good psychosocial and psychosexual management. There is a lack of qualitative systematic reviews of the literature on the experiences of people with disorders of sex development.

DESIGN:

The seven steps of qualitative meta-ethnography were employed in this review.

DATA SOURCES:

The following electronic databases were systematically searched until January 2017: Science Direct, Scopus, Sage online, CINAHL, PsycINFO, Medline, Wiley Online Library and Google Scholar. Search terms for this review were "disorders of sex development", "intersex", "ambiguous genitalia", "experiences", "qualitative study and "method".

REVIEW METHOD:

A 13 item scale was applied to evaluate the quality of the selected studies and synthesized using the principles of meta-ethnography.

FINDINGS:

Twelve studies met the eligibility criteria. Six major themes described the experiences of people with disorders of sex development. These included a range of physical, psychological, social and sexual experiences which affect their quality of life. Different coping strategies were employed by individuals who live with the lifelong condition.

CONCLUSION:

Disorders of sex development affect the quality of life of people living with these disorders. Nurses are tasked with providing holistic care for people with disorders of sex development in order to improve their quality of lives. As such, there is a need to explore the experiences of nurses in the management of disorders of sex development. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.


KEYWORDS:
disorders of sex development; experiences; meta-ethnography; nurses; nursing experience; qualitative studies; quality nursing care; sex re-assignment

2018-08-23

Sex differences in psychiatric disorders: what we can learn from sex chromosome aneuploidies.

Neuropsychopharmacology. 2018 Jul 16. doi: 10.1038/s41386-018-0153-2. [Epub ahead of print]

Sex differences in psychiatric disorders: what we can learn from sex chromosome aneuploidies.

Green T1,2, Flash S3, Reiss AL3,4,5.



Author information

1Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, CA, 94305, USA. tgreen2@stanford.edu.
2Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA. tgreen2@stanford.edu.
3Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, CA, 94305, USA.
4Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
5Department of Radiology, Stanford University, Stanford, CA, 94305, USA.

Abstract

The study of sexual dimorphism in psychiatric and neurodevelopmental disorders is challenging due to the complex interplay of diverse biological, psychological, and social factors. Males are more susceptible to neurodevelopmental disorders including intellectual disability, autism spectrum disorder, and attention-deficit activity disorder. Conversely, after puberty, females are more prone to major depressive disorder and anxiety disorders compared to males. One major biological factor contributing to sex differences is the sex chromosomes. First, the X and Y chromosomes have unique and specific genetic effects as well as downstream gonadal effects. Second, males have one X chromosome and one Y chromosome, while females have two X chromosomes. Thus, sex chromosome constitution also differs between the sexes. Due to this complexity, determining genetic and downstream biological influences on sexual dimorphism in humans is challenging. Sex chromosome aneuploidies, such as Turner syndrome (X0) and Klinefelter syndrome (XXY), are common genetic conditions in humans. The study of individuals with sex chromosome aneuploidies provides a promising framework for studying sexual dimorphism in neurodevelopmental and psychiatric disorders. Here we will review and contrast four syndromes caused by variation in the number of sex chromosomes: Turner syndrome, Klinefelter syndrome, XYY syndrome, and XXX syndrome. Overall we describe an increased rate of attention-deficit hyperactivity disorder and autism spectrum disorder, along with the increased rates of major depressive disorder and anxiety disorders in one or more of these conditions. In addition to contributing unique insights about sexual dimorphism in neuropsychiatric disorders, awareness of the increased risk of neurodevelopmental and psychiatric disorders in sex chromosome aneuploidies can inform appropriate management of these common genetic disorders

2018-05-20

Gender Dysphoria in Adults.

Annu Rev Clin Psychol. 2016;12:217-47. doi: 10.1146/annurev-clinpsy-021815-093034. Epub 2016 Jan 18.

Gender Dysphoria in Adults.

Zucker KJ1, Lawrence AA2, Kreukels BP3.
Author information
1 Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada; email: ken.zucker@utoronto.ca.
2 Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada.
3 Department of Medical Psychology, VU University Medical Center and EMGO Institute for Health and Care Research, Amsterdam 1081 HV, The Netherlands.

Abstract

Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.

KEYWORDS:

causal mechanisms; gender dysphoria; gender identity disorder; transsexualism; treatment

DSDsの言及あり

2018-04-04

Body image and self-esteem in disorders of sex development: A European multicenter study.

Body image and self-esteem in disorders of sex development: A European multicenter study.

Health Psychol. 2018 Apr;37(4):334-343

Authors: van de Grift TC, Cohen-Kettenis PT, de Vries ALC, Kreukels BPC

Abstract

OBJECTIVE: Disorders/differences of sex development (DSD) refer to congenital conditions with atypical sex development and are associated with psychosexual issues. The aim of this study was to assess body image and self-esteem across the DSD spectrum and to study the impact of diagnosis and mediating characteristics.

METHOD: Data collection was part of dsd-LIFE, a cross-sectional study conducted by 14 European expert clinics on wellbeing and health care evaluation of adults diagnosed with DSD. Main outcome measures in the present analyses were the Body Image Scale and Rosenberg Self-Esteem Scale. Additional data were obtained on treatments, openness, body embarrassment, sexual satisfaction, anxiety, and depression.

RESULTS: The participating sample (n = 1,040) included 226 classified as Congenital Adrenal Hyperplasia, 225 as Klinefelter Syndrome, 322 as Turner Syndrome, and 267 as conditions with 46,XY karyotype. Many participants had received hormonal and surgical treatments. Participants scored lower on body image and self-esteem compared to control values, whereas each diagnosis showed different areas of concern. Limited openness, body embarrassment, and sexual issues were frequently reported. Overall body satisfaction was associated with BMI, hormone use, openness, body embarrassment, anxiety, and depression; genital satisfaction with age at diagnosis, openness, sexual satisfaction, and body embarrassment. Body embarrassment, anxiety, and depression predicted lower self-esteem.

CONCLUSIONS: While each DSD showed specific issues related to body image and self-esteem, our findings indicate that the related factors were similar across the conditions. Clinical care on this subject could be improved by giving specific attention to factors like openness, body embarrassment, sexuality, anxiety, and depression. (PsycINFO Database Record)

DSD-LIFEによる1,040人規模の調査研究。身体的健康・精神的健康・ジェンダーバリアンスの3編。