Department of Women's Health, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK.
University College London Hospitals, Department of Women's Health, 250 Euston Road, London NW1 2PG, UK.
Nat Rev Endocrinol. 2014 Jul;10(7):436-42. doi: 10.1038/nrendo.2014.62. Epub 2014 May 20.
Disorders of sex development (DSDs) continue to present many challenges. A clear consensus among clinicians has emerged in paediatric care; however, the same cannot be said of adult care services. Moreover, transition to adult care is a process that takes many years. Although evidence-based models of transitional care do exist in other medical specialities, few studies have been conducted in adolescents with DSDs, and a clear and pressing need exists for further research to guide the care of these patients. A general move towards independence and self-responsibility is common to all transition programmes, but specific issues for those with a DSD include disclosure, genital examinations and potential vaginal treatments. Psychological support underpins the whole transition process for patients with a DSD and encourages an individual approach to develop. In this Perspectives article, we describe the barriers to successful transition in this setting and outline suggestions to overcome them.
性发育障碍（DSD）仍然存在许多挑战。在儿科护理方面，临床医生之间已经达成明确共识；然而，成人护理服务却并非如此。此外，向成人护理的过渡是一个需要多年的过程。尽管在其他医学专业中已经存在基于证据的过渡护理模式，但在 DSD 青少年中进行的研究很少，因此迫切需要进一步的研究来指导这些患者的护理。向独立和自我负责的普遍转变是所有过渡计划的共同目标，但对于 DSD 患者而言，具体问题包括披露、生殖器检查和潜在的阴道治疗。心理支持是 DSD 患者整个过渡过程的基础，并鼓励采用个体化方法进行发展。在这篇观点文章中，我们描述了在这种情况下成功过渡的障碍，并提出了克服这些障碍的建议。
