Migeon Claude J, Wisniewski Amy B, Brown Terry R, Rock John A, Meyer-Bahlburg Heino F L, Money John, Berkovitz Gary D
Department of Pediatrics, Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Pediatrics. 2002 Sep;110(3):e32. doi: 10.1542/peds.110.3.e32.
The objective of this study was to identify and study adults who have a 46,XY karyotype and presented as infants or children with variable degrees of undermasculinization of their genitalia (female genitalia, ambiguous genitalia, or micropenis). Participants' knowledge of their condition, satisfaction with their knowledge, and desire for additional education about their intersex condition were assessed.
Participants were classified according to the cause underlying their intersex condition based on review of medical and surgical records. Knowledge of medical condition, satisfaction with that knowledge, and desire for additional education were assessed with a written questionnaire and a semistructured interview.
Patients were ineligible for recruitment because of death (9%), because of developmental delay (12%), or because they were not located (27%). Among the 96 eligible patients, 78% participated. Approximately half of the men (53%) and women (54%) exhibited a good understanding of their history. Fewer women who have a 46,XY chromosome complement and were born with female genitalia were informed about their intersex condition (36% with complete androgen insensitivity syndrome) than were women who were born with masculinized genitalia such as micropenis (80%) or ambiguous genitalia (72%). More women (66%) than men (38%) were satisfied with their knowledge of their medical and surgical history.
Almost half of the patients, reared male or female, were neither well informed about their medical and surgical history nor satisfied with their knowledge.
本研究的目的是识别和研究具有46,XY核型且在婴儿期或儿童期表现为不同程度生殖器男性化不足(女性生殖器、生殖器模糊或小阴茎)的成年人。评估了参与者对自身病情的了解、对所了解情况的满意度以及对关于其双性畸形状况的额外教育的需求。
根据对医疗和手术记录的审查,参与者按照其双性畸形状况的潜在病因进行分类。通过书面问卷和半结构化访谈评估对病情的了解、对该了解情况的满意度以及对额外教育的需求。
患者因死亡(9%)、发育迟缓(12%)或未找到(27%)而不符合招募条件。在96名符合条件的患者中,78%参与了研究。大约一半的男性(53%)和女性(54%)对自己的病史有较好的了解。与出生时具有男性化生殖器如小阴茎(80%)或生殖器模糊(72%)的女性相比,出生时具有46,XY染色体组成且生殖器为女性的女性中,了解其双性畸形状况的比例更低(完全雄激素不敏感综合征患者为36%)。对自己的医疗和手术史了解情况感到满意的女性(66%)多于男性(38%)。
几乎一半的患者,无论抚养为男性还是女性,对自己的医疗和手术史既了解不足,对自己的了解情况也不满意。