ESPE Abstracts (2019) 92 P3-237

Gender Self-Identification and Intra-Family Relations in Children with Disorders of Sex Development

Nataliya Zelinska1, Iryna Schevchenko1, Olena Anoprienko2, Nataliya Pogadayeva2, Olha Hamidova2, Eugenia Globa1


1Ukrainian Scientific and Practical Centre of Endocrine Surgery of the MOH of Ukraine, Kyiv, Ukraine. 2National Pediatric hospital OHMATDYT, Kyiv, Ukraine


Introduction: The birth of a child with disorders of sex development (DSD) requires a long-term strategy of monitoring and treatment which is carried out by a multidisciplinary group of professional physicians, with a mandatory understanding of the psychosocial problems in a child and parents.

Materials and Methods: Gender self-identification was investigated in 20 children and adolescents with DSD aged 1.5-17 years. To determine gender identity, we used the methodology of "Homunculus", to assess gender socialization - the Wartegg method of spontaneous drawing, to assess internal family relations - the method "My family" and the method of structured interviews. An assessment of intra-family relations was done also in a control group, which included 28 families with healthy children. All DSD patients carried out a cytogenetic test, and, if necessary, fluorescence in situ hybridization (FISH).

Results: In DSD group, chromosomal DSD was diagnosed in 6 (30%), 46,XY DSD - in 13 (65%) and 46,XX DSD - in 1 (5%) patients. Diagnosis of DSD was established in different age: from birth to 16 years old, on average at 7,26 [1,50; 13,00] years. Disorders of gender identity in children with DSD did not depend on the child's age, the karyotype, or gender of the child's civil registration (p>0.05). 54.25% of families with DSD child did not seek to have children in the future because of the fear of having a child with genetic disorders again. The frequency of divorces in the families with DSD children did not depend on the presence of a DSD child and his age (p>0.05). In 25.0% of families, children had often been criticized, and negatively assessed by parents, which worsened the formation of a child's gender identity. The issue of gender self-identification and intra-family relationships in children with DSD is an important issue that requires further study and analysis of data obtained from a larger cohort of patients.

Conclusions: The psychological support of children with DSD and their families is an important component of comprehensive medical and social rehabilitation.

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