Psychological Adjustment of Parents of Children Born with Atypical Genitalia 1 Year after Genitoplasty

J Urol. 2017 Oct;198(4):914-920. doi: 10.1016/j.juro.2017.05.035. Epub 2017 May 11.

Abstract

Purpose: We examined the psychological adjustment of parents of children born with moderate to severe genital atypia 12 months after their child underwent genitoplasty.

Materials and methods: Parents were recruited longitudinally from a multicenter collaboration of 10 pediatric hospitals with specialty care for children with disorders/differences of sex development and/or congenital adrenal hyperplasia. Parents completed measures of depressive and anxious symptoms, illness uncertainty, quality of life, posttraumatic stress and decisional regret.

Results: Compared to levels of distress at baseline (before genitoplasty) and 6 months after genitoplasty, data from 25 mothers and 20 fathers indicated significant improvements in all psychological distress variables. However, a subset of parents continued endorsing clinically relevant distress. Some level of decisional regret was endorsed by 28% of parents, although the specific decision that caused regret was not specified.

Conclusions: Overall the majority of parents were coping well 1 year after their child underwent genitoplasty. Level of decisional regret was related to having a bachelor's level of education, increased levels of illness uncertainty preoperatively and persistent illness uncertainty at 12 months after genitoplasty but was unrelated to postoperative complications.

Keywords: adjustment disorders; disorders of sex development; gender identity; genitalia; parents.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Child, Preschool
  • Decision Making
  • Disorders of Sex Development / psychology
  • Disorders of Sex Development / surgery*
  • Emotional Adjustment*
  • Female
  • Genitalia / abnormalities*
  • Genitalia / surgery
  • Gynecologic Surgical Procedures / adverse effects
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parents / psychology*
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / psychology*
  • Postoperative Period
  • Quality of Life
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology
  • Treatment Outcome
  • Urologic Surgical Procedures, Male / adverse effects
  • Urologic Surgical Procedures, Male / methods