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Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia

BACKGROUND: In congenital adrenal hyperplasia (CAH) with ambiguous genitalia, assigning gender of rearing can be complex, especially If genitalia is highly virilized. Apart from karyotype, prenatal androgen exposure, patient's gender orientation, sociocultural, and parental influences play a ro...

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Autores principales: Gangaher, Arushi, Jyotsna, Viveka P., Chauhan, Vasundhera, John, Jomimol, Mehta, Manju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105576/
https://www.ncbi.nlm.nih.gov/pubmed/27867895
http://dx.doi.org/10.4103/2230-8210.192922
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author Gangaher, Arushi
Jyotsna, Viveka P.
Chauhan, Vasundhera
John, Jomimol
Mehta, Manju
author_facet Gangaher, Arushi
Jyotsna, Viveka P.
Chauhan, Vasundhera
John, Jomimol
Mehta, Manju
author_sort Gangaher, Arushi
collection PubMed
description BACKGROUND: In congenital adrenal hyperplasia (CAH) with ambiguous genitalia, assigning gender of rearing can be complex, especially If genitalia is highly virilized. Apart from karyotype, prenatal androgen exposure, patient's gender orientation, sociocultural, and parental influences play a role. The aim of this study was to assess gender dysphoria and psychosocial issues in patients of CAH raised as males and females. MATERIALS AND METHODS: This is a cross-sectional study that includes patients (old and new) with CAH who were treated by us in the last 6 months. A semi-structured interview proforma was used to elicit history and psychosocial background of the patients. The clinical and biochemical details were noted. For psychological analysis, patients were screened for gender dysphoria using Parent Report Gender Identity Questionnaire for children <12 years and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. RESULTS: We analyzed 22 46 XX CAH patients among which, 3 were reared as males and 19 as females. Among the 19 patients reared as females, 17 patients showed no gender dysphoria. Two patients revealed gender dysphoria as indicated by their marginally low scores on the gender dysphoria assessment. However, in view of current literature and the age groups of the patients, behavior of the 6-year-old patient can be best understood as being tomboyish. Gender dysphoria in the 22-year-old can be explained by the dominance of psychosocial factors and not hormones alone. Among the three patients reared as males, two prepubertal were satisfied with their male gender identity. The third patient, aged 32 years, had gender dysphoria when reared as a male that resolved when gender was reassigned as female and feminizing surgery was done. CONCLUSION: Gender assignment in 46 XX CAH is guided by factors such as degree of virilization of genitalia, gender orientation, patient involvement, sociocultural, and parental influences.
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spelling pubmed-51055762016-11-18 Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia Gangaher, Arushi Jyotsna, Viveka P. Chauhan, Vasundhera John, Jomimol Mehta, Manju Indian J Endocrinol Metab Endocrinology and Gender BACKGROUND: In congenital adrenal hyperplasia (CAH) with ambiguous genitalia, assigning gender of rearing can be complex, especially If genitalia is highly virilized. Apart from karyotype, prenatal androgen exposure, patient's gender orientation, sociocultural, and parental influences play a role. The aim of this study was to assess gender dysphoria and psychosocial issues in patients of CAH raised as males and females. MATERIALS AND METHODS: This is a cross-sectional study that includes patients (old and new) with CAH who were treated by us in the last 6 months. A semi-structured interview proforma was used to elicit history and psychosocial background of the patients. The clinical and biochemical details were noted. For psychological analysis, patients were screened for gender dysphoria using Parent Report Gender Identity Questionnaire for children <12 years and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. RESULTS: We analyzed 22 46 XX CAH patients among which, 3 were reared as males and 19 as females. Among the 19 patients reared as females, 17 patients showed no gender dysphoria. Two patients revealed gender dysphoria as indicated by their marginally low scores on the gender dysphoria assessment. However, in view of current literature and the age groups of the patients, behavior of the 6-year-old patient can be best understood as being tomboyish. Gender dysphoria in the 22-year-old can be explained by the dominance of psychosocial factors and not hormones alone. Among the three patients reared as males, two prepubertal were satisfied with their male gender identity. The third patient, aged 32 years, had gender dysphoria when reared as a male that resolved when gender was reassigned as female and feminizing surgery was done. CONCLUSION: Gender assignment in 46 XX CAH is guided by factors such as degree of virilization of genitalia, gender orientation, patient involvement, sociocultural, and parental influences. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5105576/ /pubmed/27867895 http://dx.doi.org/10.4103/2230-8210.192922 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Endocrinology and Gender
Gangaher, Arushi
Jyotsna, Viveka P.
Chauhan, Vasundhera
John, Jomimol
Mehta, Manju
Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title_full Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title_fullStr Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title_full_unstemmed Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title_short Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia
title_sort gender of rearing and psychosocial aspect in 46 xx congenital adrenal hyperplasia
topic Endocrinology and Gender
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105576/
https://www.ncbi.nlm.nih.gov/pubmed/27867895
http://dx.doi.org/10.4103/2230-8210.192922
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