Gangaher Arushi, Chauhan Vasundhera, Jyotsna Viveka P, Mehta Manju
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):536-41. doi: 10.4103/2230-8210.183471.
Disorders of sexual development (DSD) may pose a challenge to live as a fully-functioning male or female. In this study, we prospectively assessed eleven 46 XY DSD patients who were being treated at our center over the last 8 months for gender dysphoria.
To determine gender dysphoria, age-appropriate gender identity (GI) questionnaires were used. For patients, 12 years and below, parent report GI questionnaire for children was used and for those above 12 years of age, GI/gender dysphoria questionnaire for adolescents and adults was administered.
Of 11 patients with 46 XY DSD, three were diagnosed with 5 alpha reductase deficiency (5aRD), two with partial gonadal dysgenesis, three with partial androgen insensitivity syndrome, one each with ovotesticular, complete gonadal dysgenesis, and complete androgen insensitivity. Gender assigned at birth was female in eight and male in three patients. Among the eight reared as female, gender had been reassigned as male in three patients well before the present study was conducted. None of the eleven patients had gender dysphoria at the time of this study.
Early gender of rearing was seen to be a critical indicator of present GI in our patients except in cases of 5aRD.
性发育障碍（DSD）可能对个体以完全正常功能的男性或女性身份生活构成挑战。在本研究中，我们前瞻性地评估了过去8个月在我们中心接受性别焦虑症治疗的11例46 XY DSD患者。
为确定性别焦虑症，使用了适合年龄的性别认同（GI）问卷。对于12岁及以下的患者，使用儿童家长报告GI问卷；对于12岁以上的患者，使用青少年及成人GI/性别焦虑症问卷。
在11例46 XY DSD患者中，3例被诊断为5α还原酶缺乏症（5aRD），2例为部分性腺发育不全，3例为部分雄激素不敏感综合征，1例为卵睾型、1例为完全性腺发育不全、1例为完全雄激素不敏感。出生时指定的性别为女性的有8例，男性的有3例。在8例被抚养为女性的患者中，在本研究进行之前，有3例患者的性别已重新指定为男性。在本研究时，11例患者均无性别焦虑症。
除5aRD病例外，早期抚养性别被视为我们患者当前性别认同的关键指标。
