Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center (location VUmc), Amsterdam, the Netherlands; Department of Medical Psychology, Amsterdam University Medical Center (location VUmc), Amsterdam, the Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center (location VUmc), Amsterdam, the Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.
J Adolesc Health. 2022 Dec;71(6):688-695. doi: 10.1016/j.jadohealth.2022.07.012. Epub 2022 Sep 8.
Adolescence is an important period for sexual development, including sexual debut. The purpose of this study was to assess first romantic and sexual experiences and debut age in individuals with differences of sex development (DSD/intersex) and compare these with age-matched and gender-matched population control values.
Questionnaire data on sociodemographic characteristics, romantic and sexual milestones (e.g., masturbation, dating), satisfaction with sexual life and sexual activity at follow-up, self-esteem, and feelings of femininity or masculinity were collected from 976 participants in Europe with a DSD condition. Participants were divided into six diagnostic subgroups based on their diagnostic classification: women with Turner syndrome, congenital adrenal hyperplasia, 46XY-DSD nonvirilized, and 46XY-DSD female partially virilized conditions and men with 46XY-DSD male or Klinefelter syndrome. Age-specific and gender-specific reference values were retrieved from a Dutch population sample.
Individuals with DSD were less likely to reach each of the romantic and sexual milestones compared to their peers without these conditions and they were significantly older when reaching these milestones. Between clinical subgroups, individuals with Klinefelter were significantly older when reaching milestones and in the female groups and individuals with Turner were the least likely to reach milestones. Furthermore, a higher age when reaching several romantic and sexual milestones was correlated with lower self-esteem, lower satisfaction with sexual life, and lower sexual frequency at follow-up.
Due to a difference in biopsychosocial context, individuals with DSD often experience a different and/or delayed sexual development during adolescence. Healthcare providers should be aware of these differences in adolescents with DSD and their sexual development to optimize affirmative counseling.
青春期是性发育的重要时期，包括性初体验。本研究旨在评估性发育障碍（DSD/间性）个体的首次浪漫和性体验以及初潮年龄，并将其与年龄匹配和性别匹配的人群对照值进行比较。
从欧洲的 976 名 DSD 患者中收集了社会人口统计学特征、浪漫和性里程碑（例如，自慰、约会）、对性生活的满意度和随访时的性活动、自尊以及女性气质或男性气质的问卷数据。参与者根据诊断分类分为六个诊断亚组：特纳综合征、先天性肾上腺皮质增生、46XY-DSD 非男性化和 46XY-DSD 女性部分男性化以及 46XY-DSD 男性或克莱恩费尔特综合征。从荷兰人群样本中检索了年龄和性别特定的参考值。
与没有这些情况的同龄人相比，DSD 个体不太可能达到每个浪漫和性里程碑，而且他们达到这些里程碑的年龄明显更大。在临床亚组之间，克莱恩费尔特综合征患者达到里程碑的年龄明显更大，而在女性组中，特纳患者最不可能达到里程碑。此外，达到几个浪漫和性里程碑的年龄较高与较低的自尊、较低的性生活满意度和随访时较低的性频率相关。
由于生物心理社会背景的差异，DSD 个体在青春期通常经历不同和/或延迟的性发育。医疗保健提供者应该意识到 DSD 青少年及其性发育的这些差异，以优化肯定性咨询。
