Wisniewski Amy B
Department of Urology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Scientifica (Cairo). 2012;2012:834967. doi: 10.6064/2012/834967. Epub 2012 Sep 19.
Variables that impact gender development in humans are difficult to evaluate. This difficulty exists because it is not usually possible to tease apart biological influences on gender from social variables. People with disorders of sex development, or DSD, provide important opportunities to study gender within individuals for whom biologic components of sex can be discordant with social components of gender. While most studies of gender development in people with 46,XY DSD have historically emphasized the importance of genes and hormones on gender identity and gender role, more recent evidence for a significant role for socialization exists and is considered here. For example, the influence of parents' perceptions of, and reactions to, DSD are considered. Additionally, the impact of treatments for DSD such as receiving gonadal surgeries or genitoplasty to reduce genital ambiguity on the psychological development of people with 46,XY DSD is presented. Finally, the role of multi-disciplinary care including access to peer support for advancing medical, surgical and psychosexual outcomes of children and adults with 46,XY DSD, regardless of sex of rearing, is discussed.
影响人类性别发展的变量难以评估。存在这种困难是因为通常不可能将性别方面的生物影响与社会变量区分开来。性发育障碍（DSD）患者为研究性别提供了重要机会，这些个体的性生物学成分可能与性别社会成分不一致。虽然历史上大多数关于46,XY DSD患者性别发展的研究都强调基因和激素对性别认同和性别角色的重要性，但最近有证据表明社会化也起着重要作用，本文将对此进行探讨。例如，会考虑父母对DSD的认知及反应的影响。此外，还介绍了DSD治疗（如接受性腺手术或生殖器整形以减少生殖器模糊性）对46,XY DSD患者心理发展的影响。最后，讨论了多学科护理的作用，包括获得同伴支持对改善46,XY DSD儿童和成人的医疗、手术及性心理结果的作用，无论其抚养性别如何。
