Sexual Function and Attitudes Toward Surgery After Feminizing Genitoplasty

Fagerholm, Riitta; Santtila, Pekka; Miettinen, Päivi J.; Mattila, Aino K.; Rintala, Risto; Taskinen, Seppo

doi:10.1016/j.juro.2010.12.099

Cited by 81 publications

(62 citation statements)

References 24 publications

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“…58,60,61 Women, who had undergone surgery, when asked about the optimal timing of surgery, preferred scheduling the feminizing procedure in early childhood. [62][63][64] On the other hand, altered physical sex development does not usually represent a surgical emergency for newborns. …”

Section: Current and Emerging Therapies -Ethical Challengesmentioning

confidence: 99%

Disorders of sex development: advances in genetic diagnosis and challenges in management

Kyriakou¹,

Lucas‐Herald²,

McGowan³

et al. 2015

AGG

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Disorders of sex development (DSD) are a group of rare conditions that usually present with atypical genitalia in the newborn period or as delayed puberty in an adolescent. Although a concern about the development of external genitalia may exist in one in 300 newborn infants, discrete genetic conditions that underlie DSD are generally rarely identified. It is likely that this diagnostic gap exists for a number of reasons and these include an inadequate knowledge of the pathogenesis and underlying mechanisms that lead to DSD, variation in assessment and in-depth phenotyping of these rare conditions, inadequate availability of quality accredited laboratories and, lastly, limited awareness of the value of a molecular genetic diagnosis for improving short-term and long-term care of the affected person.

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Section: Current and Emerging Therapies -Ethical Challengesmentioning

confidence: 99%

Disorders of sex development: advances in genetic diagnosis and challenges in management

Kyriakou¹,

Lucas‐Herald²,

McGowan³

et al. 2015

AGG

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“…Extensive research on hormonal influences started appearing as important determinants of gender behavior and identity in patients with DSD (21)(22)(23)(24)(25)(26)(27)(28)(29), as well as reviews of long-term consequences for patients treated under the previously presented regimen, showing that many of them were not satisfied with their treatment or their assigned sex (30)(31)(32)(33)(34)(35)(36)(37)(38). Until then, the policy used to justify the designation of a child as being a female was based on the technical limitations of the surgery, that is, on the belief that it was "easier" to construct a vagina than a penis.…”

Section: Clinical Effects Of This Modelmentioning

confidence: 99%

Management framework paradigms for disorders of sex development

Telles-Silveira

Knobloch

Kater

2015

Arch. Endocrinol. Metab.

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Until 2005, questions regarding medical treatment and diagnostic information on Disorders of Sex Development (DSD) were not systematically discussed with both the patients and their families; however, the way these patients are currently treated have been changing with time. Interventional changes in the clinical-psychotherapeutic-surgical areas of DSD determine not only different medical recommendations but also help to place the patient and the family into the decisional process of therapy. We must consider two paradigmatic periods that have influenced and transformed the clinical management framework of patients with DSD: a) The "Money era" (1955), which emphasized the role of the gonads as the diagnostic criterion, having the environment as determinant of the sex identity; and b) The Chicago Consensus (2005) phase, in which the role of genetics and molecular biology was critical for an early identification, as well as in building a proper sex identity, emphasizing ethical questions and the "stigma culture" . In addition, recent data have focused on the importance of interdisciplinarity and statements on questions concerning Human Rights as key factors in treatment decision making. Despite each of these management models being able to determine specific directions and recommendations regarding the clinical handling of these patients, we verify that a composite of these several models is the clinical routine nowadays. In the present paper, we discuss these several paradigms, and pinpoint clinical differences and their unfolding regarding management of DSD patients and their families. Arch Endocrinol Metab. 2015;59(5):383-90

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“…While retrospective evidence for suboptimal cosmetic and functional outcomes of early genitoplasty exists for people born with ambiguous genitalia, some people report satisfaction with the timing of their early surgery [61]. It is not known at this time if these people are representative of DSD individuals overall, nor is it known if preferences for timing of surgery (early, late, never) vary by diagnosis and sex of rearing.…”

Section: Timing Of Surgerymentioning

confidence: 99%

Advances in diagnosis and care of persons with DSD over the last decade

Lee

Wisniewski

Baskin

et al. 2014

Int J Pediatr Endocrinol

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It is clear that the major issues raised by the Chicago Disorders of Sex Development (DSD) Consensus meeting primarily the need of more data, especially outcome information, are still not available. Hence, there are insufficient data to merit another consensus statement. However, there has been a major shift in the thinking and approach to the care of patients with DSD. This was a consequence of the emphasis of the need to reconsider the criteria for sex assignment, to incorporate new genetic and hormonal knowledge in the care, and to investigate impact of surgical timing and techniques. Much of the reconsideration is in response to patient, family, social and legal demands, including the need for full disclosure and family or individual participation in decisions. Further, there remains a lack of sufficient information to provide predictors for future gender development. Hence, it still is impossible to develop specific clinical guidelines to apply to patients generally or individually. Thus, it is pertinent to periodically evaluate and assess some of these multifaceted changes. This report discusses cultural and social forces, legal factors, surgical perspectives, treatment shifts including psychological approaches, progress regarding genetic diagnosis, gender issue comparisons with transgender patients, and on-going research studies occurring since the consensus conference.

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Sexual Function and Attitudes Toward Surgery After Feminizing Genitoplasty

Abstract: Sexual intercoital relationships started later in females who underwent genital reconstruction in childhood. Early surgery is preferred by the patients and satisfactory sex life is possible in adulthood.

Cited by 81 publications

References 24 publications

Disorders of sex development: advances in genetic diagnosis and challenges in management

Disorders of sex development: advances in genetic diagnosis and challenges in management

Management framework paradigms for disorders of sex development

Advances in diagnosis and care of persons with DSD over the last decade

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