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.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology