Psychological Adjustment of Parents of Children Born with Atypical Genitalia 1 Year after Genitoplasty

Ellens, Rebecca E.H.; Bakula, Dana M.; Mullins, Amy; Reyes, Kristy J. Scott; Austin, Paul F.; Baskin, Laurence S.; Bernabé, Kerlly J.; Cheng, Earl Y.; Fried, Allyson; Frimberger, Dominic; Galan, Denise; Gonzalez, Lynette; Greenfield, Saul P.; Kolon, Thomas F.; Kropp, Bradley P.; Lakshmanan, Yegappan; Meyer, Sabrina; Meyer, Theresa; Mullins, Larry L.; Nokoff, Natalie; Palmer, Blake; Poppas, Dix P.; Paradis, Alethea; Yerkes, Elizabeth B.; Wisniewski, Amy B.; Wolfe‐Christensen, Cortney

doi:10.1016/j.juro.2017.05.035

Cited by 44 publications

(28 citation statements)

References 28 publications

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“…Peck and Feder (2017) have also urged consideration of how health care professionals in DSD teams may commit institutional evils-not out of conscious intentbut rather out of the failure to consider and challenge institutional norms which may reasonably be foreseen to bring about intolerable harms. Parents often chose interventions for their children in medical practice, when those interventions are made available to them (Ellens et al, 2017;Timmermans et al, 2018). Vulnerability to human rights abuse emerges at the intersection of familial and organizational socialities.…”

mentioning

confidence: 99%

Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

Hegarty

Prandelli

Lundberg

et al. 2020

Review of General Psychology

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Human rights statements on intersex characteristics distinguish legitimate “medically necessary” interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist “disorder of sex development” (DSD) multidisciplinary teams located medical interventions on a continuum ranging from “medically essential” to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients “coping” abilities, and patients’ own choices. Concepts of “medical necessity” were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of “medically necessary” intervention that is discursively flexible. Psychologists’ long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.

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mentioning

confidence: 99%

Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

Hegarty

Prandelli

Lundberg

et al. 2020

Review of General Psychology

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“…We reached to all corresponding authors and we received required data from Patanwala et al (2017) and Roley et al (2015). The remaining three publications (Ellens et al, 2017;Korenromp, Page-Christiaens, van den Bout, Mulder, & Visser, 2009;Rouhani et al, 2016) could not be included due to missing replies. As such, a total of 36 eligible publications were included in the narrative review and 24 samples from 21 publications in the meta-analysis (see Figure 2).…”

Section: Study Selectionmentioning

confidence: 99%

If only… a systematic review and meta-analysis of social, temporal and counterfactual comparative thinking in PTSD

Hoppen

Heinz-Fischer

Morina

2020

European Journal of Psychotraumatology

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Comparative thinking is ubiquitous in human cognition. Empirical evidence is accumulating that PTSD symptomatology is linked to various changes in social, temporal and counterfactual comparative thinking. However, no systematic review and meta-analysis in this line of research have been conducted to this date. We searched titles, abstracts and subject terms of electronic records in PsycInfo and Medline from inception to January 2019 with various search terms for social, temporal and counterfactual comparative thinking as well as PTSD. Journal articles were included if they reported a quantitative association between PTSD and social, temporal and/or counterfactual comparative thinking in trauma-exposed clinical or sub-clinical samples. A total of 36 publications were included in the qualitative synthesis. The number of publications on the association between PTSD and social and temporal comparative thinking was too scarce to warrant a meta-analytic review. A narrative review of available literature suggests that PTSD is associated with distortions in social and temporal comparative thinking. A meta-analysis of 24 independent samples (n = 4423) assessing the association between PTSD and the frequency of counterfactual comparative thinking yielded a medium to large positive association of r =.464 (p <.001, 95% CI =.404; .520). Higher study quality was associated with higher magnitude of association in a metaregression. Most studies collected data cross-sectionally, precluding conclusions regarding causality. Overall, study quality was found to be moderate. More longitudinal and experimental research with validated comparative thinking measures in clinical samples is needed to acquire a more sophisticated understanding of the role of comparative cognitions in the aetiology and maintenance of PTSD. Comparative thinking might be a fruitful avenue for a better understanding of posttraumatic reactions and improving treatment.

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“…Most patients (70.8%) considered the timing of their surgery correct (mean age at first surgery 2.1 years), while 3 patients said they were operated too late (9, 14, and 17 years) (30). Ellens et al reported that mental health problems and depressive symptoms in parents of children with DSD improved progressively 6 to 12 months after surgery (31).…”

Section: Surgical Aspectsmentioning

confidence: 99%

Controversies on Timing of Sex Assignment and Surgery in Individuals With Disorders of Sex Development: A Perspective

et al. 2019

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Appropriate management of disorders of sex development (DSD) has been a matter of discussion since the first guidelines were published in the 1950s. In the last decade, with the advent of the 2006 consensus, the classical methods, especially regarding timing of surgery and sex of rearing, are being questioned. In our culture, parents of DSD newborns usually want their children to undergo genital surgery as soon as possible after sexual assignment, as surgery helps them to confirm the assigned sex. Developmental psychology theories back this hypothesis. They state that anatomic differences between sexes initiate the very important process of identification with the parent of the same sex. Sex-related endocrinological issues also demand early care. For example, using dihydrotestosterone cream to increase penile length or growth hormone treatment to improve final height require intervention at young ages to obtain better results. Although the timing of surgery remains controversial, recent evidence suggests that male reconstruction should be performed between 6 and 18 months of age. Feminizing surgery is still somewhat controversial. Most guidelines agree that severe virilization requires surgical intervention, while no consensus exists regarding mild cases. Our perspective is that precocious binary sex assignment and early surgery is a better management method. There is no strong evidence for delays and the consequences can be catastrophic in adulthood.

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Psychological Adjustment of Parents of Children Born with Atypical Genitalia 1 Year after Genitoplasty

Cited by 44 publications

References 28 publications

Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

If only… a systematic review and meta-analysis of social, temporal and counterfactual comparative thinking in PTSD

Controversies on Timing of Sex Assignment and Surgery in Individuals With Disorders of Sex Development: A Perspective

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