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Kinder und Jugendliche mit Störungen der Geschlechtsentwicklung

Psychosexuelle und -soziale Entwicklung und Herausforderungen bei der Versorgung

Children and adolescents with disorders of sexual development

Psychosexual and social development and challenges for health care services

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Monatsschrift Kinderheilkunde Zeitschrift für Kinder- und Jugendmedizin Aims and scope Submit manuscript

Zusammenfassung

Die Diagnose von Störungen der Geschlechtsentwicklung (DSD) ist zu jedem Zeitpunkt im Leben eines Menschen möglich. Sie wirft eine Vielzahl von Fragen hinsichtlich der weiteren körperlichen, psychosexuellen und -sozialen Entwicklungen auf. Bisherige Erkenntnisse geben Hinweis darauf, dass ein weitestgehend störungsfreies Heranwachsen der betroffenen Kinder und Jugendlichen weniger von der Art und der Ausprägung der Störung selbst als vielmehr von der Art des Versorgungsmanagements abhängt. Für eine adäquate Versorgung von Personen mit DSD wird heute die Betreuung durch ein multiprofessionelles Team innerhalb eines spezialisierten Referenzzentrums als notwendig angesehen.

Abstract

Disorders of sexual development (DSD) may be diagnosed at any age. At the time of diagnosis, many questions concerning the individual’s physical, psychosexual, and psychosocial development emerge. There is evidence that developmental outcomes of DSD in children and adolescents depend less on the nature and severity of the disorder itself and more on the quality of the management. Only multiprofessional teams working in specialized centers may be able to guarantee adequate treatment for individuals with DSD.

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Literatur

  1. Berenbaum SA (1999) Effects of early androgens on sex-typed activities and interests in adolescents with congenital adrenal hyperplasia. Horm Behav 35: 102–110

    Article  PubMed  CAS  Google Scholar 

  2. Berenbaum SA, Bailey JM (2003) Effects on gender identity of prenatal androgens and genital appearance: evidence from girls with congenital adrenal hyperplasia. J Clin Endocrinol Metab 88: 1102–1106

    Article  PubMed  CAS  Google Scholar 

  3. Berenbaum SA, Korman Bryk K, Duck SC et al. (2004) Psychological adjustment in children and adults with congenital adrenal hyperplasia. J Pediatr 144: 741–746

    PubMed  Google Scholar 

  4. Carmichael P, Alderson J (2004) Psychological care in disorders of sexual differentiation and determination. In: Balen AH, Creighton SM, Davies MC et al. (eds) Paediatric and adolescent gynaecology. Cambridge University Press, Cambridge, pp 158–178

  5. Egan SK, Perry DG (2001) Gender identity: a multidimensional analysis with implications for psychosocial adjustment. Dev Psychol 37: 451–463

    Article  PubMed  CAS  Google Scholar 

  6. Gooren L (2006) The biology of human psychosexual differentiation. Horm Behav 50: 589–601

    Article  PubMed  CAS  Google Scholar 

  7. Hines M, Brook C, Conway GS (2004) Androgen and psychosexual development: core gender identity, sexual orientation and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH). J Sex Res 41: 75–81

    PubMed  Google Scholar 

  8. Hiort O, Reinecke S, Thyen U et al. (2003) Puberty in disorders of somatosexual differentiation. J Pediatr Endocrinol Metab [Suppl 2] 16: 297–306

  9. Hughes IA (2007) Disorders of sexual differentiation. Horm Res [Suppl 1] 67: 91–95

  10. Jurgensen M, Hiort O, Holterhus PM et al. (2007) Gender role behavior in children with XY karyotype and disorders os sex development. Horm Behav 51: 443–453

    Article  PubMed  CAS  Google Scholar 

  11. Kuhnle U, Bullinger M(1997) Outcome of congenital adrenal hyperplasia. Pediatr Surg Int 12: 511–515

    Article  PubMed  CAS  Google Scholar 

  12. Maccoby EE (1988) Gender as a social category. Am Psychol Assoc 24: 755–765

    Google Scholar 

  13. Maccoby EE (1998) The two sexes: growing up apart, coming together. Harvard University Press, Cambridge, MA

  14. Martin CL, Ruble D,N Szkrybalo J (2002) Cognitive theories of early gender development. Psychol Bull 128: 903–933

    Article  PubMed  Google Scholar 

  15. Meyer-Bahlburg HF, Dolezal C, Baker SW et al. (2004) Prenatal androgenization affects gender-related behavior but not gender identity in 5–12-year-old girls with congenital adrenal hyperplasia. Arch Sex Behav 33: 97–104

    Article  PubMed  Google Scholar 

  16. Money J, Hampson, JG, Hampson JL (1955) Hermaphroditism: recommendations concerning assignment of sex, change of sex and psychologic management. Bull Johns Hopkins Hosp 97: 284–300

    PubMed  CAS  Google Scholar 

  17. Pasterski VL, Geffner ME, Brain C et al. (2005) Prenatal hormones and postnatal socialization by parents as determinants of male-typical toy play in girls with congenital adrenal hyperplasia. Child Dev 76: 264–278

    Article  PubMed  Google Scholar 

  18. Reinecke S (2004) Erfahrungen mit Intersexualiät – Ergebnisse einer Interviewstudie mit Eltern und Betroffenen. Psychother Soz 6: 263–295

    Google Scholar 

  19. Ruble DN, Martin CL, Berenbaum SA (2006) Gender development. In: Damon D, Lerner RM, Eisenberg N (eds) Handbook of child psychology, vol 3: Social, emotional, and personality development. Wiley, New York, pp 858–932

  20. Sax L (2002) How common is intersex? A response to Anne Fausto-Sterling. J Sex Res 39: 174–178

    Article  PubMed  Google Scholar 

  21. Schutzmann K, Brinkmann L, Schacht M et al. (2007) Psychological distress, self-harming behavior, and suicidal tendencies in adults with disorders of sex development. Arch Sex Behav Oct 18 [Epub ahead of print]

  22. Serbin LA, Powlishta KK, Gulko J (1993) The development of sex-typing in middle childhood. Society for Research in Child Development, Chicago, IL

  23. Thyen U, Jurgensen M, Kleinemeier E (2005) Die Geburt eines Kindes mit uneindeutigen Genitalien. Richtiges Management in einer kritischen Situation. Kinderarztl Prax 76: 292–297

    Google Scholar 

  24. Thyen U, Richter-Appelt H, Wiesemann C et al. (2005) Deciding on gender in children with intersex conditions: considerations and controversies. Treat Endocrinol 4: 1–8

    Article  PubMed  Google Scholar 

  25. Thyen U, Lanz K, Holterhus PM et al. (2006) Epidemiology and initial management of ambiguous genitalia at birth in Germany. Horm Res 66: 195–203

    Article  PubMed  CAS  Google Scholar 

  26. Ude-Koeller S, Wiesemann C (2005) Ethik und Informed Consent. Empfehlungen für die Behandlung intersexueller Kinder und Jugendlicher. Kinderarztl Prax 76: 305–310

    Google Scholar 

  27. Warne G, Grover S, Hutson J et al. (2005) A long-term outcome study of intersex conditions. J Pediatr Endocrinol Metab 18: 555–567

    PubMed  Google Scholar 

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Jürgensen, M., Hiort, O. & Thyen, U. Kinder und Jugendliche mit Störungen der Geschlechtsentwicklung. Monatsschr Kinderheilkd 156, 226–233 (2008). https://doi.org/10.1007/s00112-008-1674-2

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