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Psychosexual Development in Individuals with Disorders of Sex Development

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Gender Dysphoria and Disorders of Sex Development

Part of the book series: Focus on Sexuality Research ((FOSR))

Abstract

Disorders of sex development include a large, very heterogeneous group of genetic conditions resulting in atypical anatomical development of the sex organs due to errors in genes determining fetal gonadal development, hormone production, or response to hormones. Broad categories encompass individuals with 46,XY karyotype and varying degrees of undervirilization who may live as boys or girls, may live as men or women, or may choose a third or no gender as adults. Individuals with 46,XX karyotype are mostly women affected by prenatal excess androgen exposure with varying degrees of virilization. In Europe, the great majority of 46,XX DSD persons live in the female gender, which may be different in other cultures and healthcare systems where hormone treatment may be late or not available. Among many outcomes, psychosexual development can be affected by the condition itself, medical interventions such as surgery or hormone replacement therapy, impact of delayed or precocious development, experience of stigmatization or psychological trauma, societal expectations of gender role behavior, dysphoria with assigned sex of rearing, and comorbid mental health conditions. In this chapter, we review the literature and present the major findings of the German clinical evaluation study which included about 400 individuals with DSD of all ages. The conclusions follow the findings and the considerations of the National German Ethical Board issued in 2012.

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Notes

  1. 1.

    Euro DSD website: http://www.eurodsd.eu, last access 2013-01-12; information on DSD Life: http://cordis.europa.eu/search/index.cfm?fuseaction=proj.document&PJ_RCN=13271097

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Acknowledgements

The work of the senior author (Ute Thyen) was in part supported by a senior fellowship grant of the Alfried Krupp Wissenschaftskolleg in Greifswald, Germany. The clinical evaluation study was part of the German Network on IS/DSD and funded by the German Ministry of Education and Science (FKZ 01GM0311) within the research program on rare diseases.

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Authors and Affiliations

  1. Department of Pediatric Endocrinology, University Children’s Hospital, Charité, Humboldt University, Augustenburger Platz 1 CVK, Berlin, 143353, Germany

    Birgit Köhler M.D.

  2. Institute for Social Medicine, University Lübeck, Luebeck, Germany

    Martina Jürgensen Ph.D.

  3. Department for Paediatric and Adolescent Medicine, University Clinic Schleswig-Holstein, Campus Lübeck, Ratzeburger Alle 160, 23538, Luebeck, Germany

    Martina Jürgensen Ph.D., Eva Kleinemeier M.D. & Ute Thyen M.D., Ph.D.

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  1. Birgit Köhler M.D.
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  2. Martina Jürgensen Ph.D.
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  3. Eva Kleinemeier M.D.
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  4. Ute Thyen M.D., Ph.D.
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Corresponding author

Correspondence to Birgit Köhler M.D. .

Editor information

Editors and Affiliations

  1. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, ...., Amsterdam, 1007 MB, Netherlands

    Baudewijntje P.C. Kreukels

  2. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, Amsterdam, 1007 MB, Netherlands

    Thomas D. Steensma

  3. Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psych, VU University Medical Center, P.O. Box 7057, Amsterdam, 1007 MB, Netherlands

    Annelou L.C. de Vries

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Köhler, B., Jürgensen, M., Kleinemeier, E., Thyen, U. (2014). Psychosexual Development in Individuals with Disorders of Sex Development. In: Kreukels, B., Steensma, T., de Vries, A. (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7441-8_6

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