Subjective need for psychological support (PsySupp) in parents of children and adolescents with disorders of sex development (dsd)

Eur J Pediatr. 2015 Oct;174(10):1287-97. doi: 10.1007/s00431-015-2530-8. Epub 2015 Apr 14.


Disorders/diversity of sex development (dsd) is an umbrella term for congenital conditions often diagnosed within childhood. As most parents are unprepared for this situation, psychological support (PsySupp) is recommended. The aim of this study was to analyse the extent to which parents express a need for PsySupp. Three hundred twenty-nine parents of children with dsd were included; 40.4 % of the parents indicated to have a need for PsySupp, only 50 % of this group received it adequately. The diagnoses partial gonadal dysgenesis, partial androgen insensitivity syndrome (pAIS) and disorders of androgen synthesis are associated with a high need for PsySupp in parents (54, 65, and 50 %). Sex assignment surgery neither reduced nor increased the need for PsySupp. Taking a picture, radiography, laparoscopy, gonadal biopsy, gonadectomy and hormonal puberty induction are associated with a high need for PsySupp. There was no association between the need for PsySupp and the parents' perception of the appearance of the genitalia.

Conclusion: Having a child with dsd is associated with a high need for PsySupp in parents. In particular, parents of children with XY-dsd with androgen effects other than hypospadias expressed a high need of PsySupp. PsySupp for parents should be an obligatory part of interdisciplinary care to reduce fears and concerns. What is known • In parents, having a child with dsd provokes insecurities and fears. Hence, psychological support is recommended as part of the interdisciplinary care. What is new • This is the first study investigating the subjective need for psychological support in a large sample of parents of children with dsd in Germany. We present data on the subjective need for psychological support of the parents, related diagnoses and factors, which should be considered in psychological counselling.

Keywords: Congenital adrenal hyperplasia; Disorders of sex development; Parents; Psychological support; dsd.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Disorders of Sex Development / psychology*
  • Disorders of Sex Development / rehabilitation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parent-Child Relations*
  • Parents / psychology*
  • Psychometrics / methods*
  • Retrospective Studies
  • Sexual Maturation
  • Surveys and Questionnaires
  • Young Adult