Bangalore Krishna Kanthi, Kogan Barry A, Ernst Michelle M, Romao Rodrigo Lp, Mohsin Fauzia, Serrano-Gonzalez Monica, Quintos Jose Bernardo, Phornphutkul Chanika, Aguiar Liza, Lee Peter A
Penn State College of Medicine, Hershey, PA, 17033, USA.
Albany Medical Center, Albany, NY, 12208, USA.
J Pediatr Urol. 2020 Oct;16(5):598-605. doi: 10.1016/j.jpurol.2020.06.004. Epub 2020 Jun 11.
The focus of this article is to review the complex determinants of gender assignment in a child with a disorder of sex development using four different clinical cases. While the care of patients with DSD may be shared across several specialties and opinions regarding their management may vary, this may be further complicated by psychosocial, cultural and economic factors. In this regard, access to behavioral health specialists with experience and specialization in the treatment of patients with DSD should be a foundational component of the standard of care and can greatly assist in the complex decision-making regarding gender assignment. We recommend an individualized approach by a multidisciplinary team utilizing a range of evolving strategies, including outcome data (or lack thereof) to support families during the decision-making process.
本文的重点是通过四个不同的临床案例，回顾性发育障碍儿童性别指定的复杂决定因素。虽然性发育障碍患者的护理可能由多个专科共同承担，且关于其管理的意见可能各不相同，但心理社会、文化和经济因素可能会使情况更加复杂。在这方面，获得有治疗性发育障碍患者经验和专业知识的行为健康专家的帮助，应成为护理标准的基本组成部分，并且在有关性别指定的复杂决策过程中能提供极大的帮助。我们建议多学科团队采用个性化方法，运用一系列不断发展的策略，包括结果数据（或缺乏结果数据的情况），在决策过程中为家庭提供支持。
