RESUMO
OBJECTIVE: It was to verify the association between the definition of sex of rearing and, clinical and cytogenetic features among patients with genital ambiguity referred without a sex assignment. METHODS: The sample consisted of 133 patients with genital ambiguity seen at a single reference service. These patients did not have a defined social sex at the first consultation and their etiological diagnosis was obtained during follow-up. RESULTS: A total of 133 cases were included, 74 of which were reared as males and 59 as females. No correlation was found between the year of birth and the year of the first consultation with the definition of sex of rearing. However, the definition of sex of rearing was associated with age at the first consultation, severity of genital ambiguity, presence of palpable gonad(s), presence of uterus on ultrasound, karyotype, and diagnosis. Palpable gonad(s), more virilized genitalia, absence of a uterus on ultrasound, 46, XY karyotype, or a karyotype with sex chromosome abnormalities emerged as strong predictors for defining male sex. All 77 (58 %) patients over 18 years old had a gender identity in accordance with the sex of rearing; though 9 of 77 (12 %) had homo or bisexual orientation, especially girls with Congenital Adrenal Hyperplasia. CONCLUSIONS: Clinical and cytogenetic data were strongly associated with the definition of the sex of rearing of children with genital ambiguity referred to a DSD center without sex assignment. Management in a specialized center allows the establishment of a gender identity in accordance with the sex of rearing.
Assuntos
Transtornos do Desenvolvimento Sexual , Humanos , Masculino , Feminino , Criança , Adolescente , Pré-Escolar , Lactente , Transtornos do Desenvolvimento Sexual/genética , Transtornos do Desenvolvimento Sexual/diagnóstico , Identidade de Gênero , CariotipagemRESUMO
Congenital adrenal hyperplasia (CAH) most commonly due to 21-hydroxylase deficiency is the most common type of disorder of sex development. This review will focus on CAH addressing historical and current surgical techniques with their anatomical foundations, with special attention to long-term results and outcomes on sexual function, patient satisfaction, patient attitude toward surgery, and ongoing controversies in management of these patients.
RESUMO
O estudo investigou as representações de mães e pais sobre a constituição de identidade de gênero em crianças nascidas com diagnóstico de Anomalias da Diferenciação Sexual (ADS). As ADS são distúrbios da diferenciação sexual que resultam em ambiguidade genital na criança. O estudo tem um delineamento qualitativo, com três mães e três pais de crianças nascidas com ADS, de diferentes idades. Utilizou-se a entrevista narrativa e a análise de conteúdo para coleta e análise dos dados. Os resultados mostraram que mães e pais entendem que a identidade de gênero se constitui através da anatomia da genitália, do sexo de criação com o qual a criança é educada e do reconhecimento social que a criança recebe no ambiente em que vive.(AU)
The present study investigated the representations of gender identity construction by mothers and fathers whose children were born with Disorders of Sex Development (DSD). DSD are disorders of sex differentiation which result in ambiguous genitalia in children. A qualitative study with three mothers and three fathers, whose children of different ages were born with DSD, was carried out. Narrative interviews and content analyses were, respectively, the methodological procedures used to collect and analyze the data. Results showed that the criteria mothers and fathers consider as fundamental for the gender identity construction are the genital anatomy, how the child is raised, and the social recognition of the environment where the child lives.(AU)
Assuntos
Humanos , Masculino , Feminino , Transtornos do Desenvolvimento Sexual/psicologia , Percepção Social , Pais/psicologia , Identidade de GêneroRESUMO
O estudo investigou as representações de mães e pais sobre a constituição de identidade de gênero em crianças nascidas com diagnóstico de Anomalias da Diferenciação Sexual (ADS). As ADS são distúrbios da diferenciação sexual que resultam em ambiguidade genital na criança. O estudo tem um delineamento qualitativo, com três mães e três pais de crianças nascidas com ADS, de diferentes idades. Utilizou-se a entrevista narrativa e a análise de conteúdo para coleta e análise dos dados. Os resultados mostraram que mães e pais entendem que a identidade de gênero se constitui através da anatomia da genitália, do sexo de criação com o qual a criança é educada e do reconhecimento social que a criança recebe no ambiente em que vive...
The present study investigated the representations of gender identity construction by mothers and fathers whose children were born with Disorders of Sex Development (DSD). DSD are disorders of sex differentiation which result in ambiguous genitalia in children. A qualitative study with three mothers and three fathers, whose children of different ages were born with DSD, was carried out. Narrative interviews and content analyses were, respectively, the methodological procedures used to collect and analyze the data. Results showed that the criteria mothers and fathers consider as fundamental for the gender identity construction are the genital anatomy, how the child is raised, and the social recognition of the environment where the child lives...