ESPE Abstracts (2016) 86 CON1.3

Psychological Challenges

Franco D’Alberton

Bologna, Italy

The new care paradigm for DSD promoted by the Chicago Consensus of 2005 raised many psychological challenges, the most important being the way decisions regarding the sex of rearing and diagnosis communication are made. The traditional care paradigm, sustained by a binary sex categorization, suggested that for newborns, the decision about the sex of rearing should be made as soon as possible and no later than 18 months of life and that little should be said to the involved person in order to limit the potential effects of psychic trauma. New trends in DSD care are based on a more open conceptualization of gender, like in a bimodal continuum, where the subjective experience of the person and their full acknowledgement of their condition plays a major role. Moreover, experience has shown us that gender changes may happen in any stage of life. The decision about the sex of rearing of a newborn with a DSD challenges our knowledge, our ethical and moral certainties, our beliefs and personal opinions. Effective team work is necessary in order for individuals not to be overwhelmed by such a difficult process, maintaining the capacity to think together, thus avoiding shortcuts such as returning to previous ways of thinking. It is very important that healthcare operators work together, sharing their doubts, uncertainties and discussing the pros and cons of the possible choices in order to be able to help parents to cope with the new and unexpected situation. The aim of this close collaboration between specialists, beginning from birth or time of diagnosis, is to provide people living with DDS with the opportunity to live in an environment which is able to support the development of their personal, social and sexual identity as far as possible.

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