title: Sexual quality of life of individuals with 46,XY disorders of sex development.
abstract: BACKGROUND
  There has recently been a growing acceptance that it is not only heterosexual functioning of surgically adjusted genitalia which should be considered when measuring the treatment outcome of persons with disorders of sex development (DSD) but also their overall sexual quality of life (SexQoL).
  
  
  OBJECTIVE
  A comprehensive cross-sectional investigation of SexQoL of persons with 46,XY DSD.
  
  
  METHODS
  Forty-seven persons with 46,XY DSD (age 17-60 years) were examined by means of a questionnaire on various aspects of SexQoL. Scores were compared to a nonclinical convenience sample consisting of 145 women. Data were analyzed separately for diagnostic subgroups. Furthermore, persons whose external genitalia had been surgically corrected were compared with persons whose genitalia had been left unaltered.
  
  
  METHODS
  The Multidimensional Scale of Sexuality, the German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS), items on sexual dysfunctions according to DSM-IV-TR and self-constructed measures on sexual-activity history (e.g., previous sexual experience), sexual anxieties, and satisfaction with overall sex life and sexual function comprised the standardized assessment instruments.
  
  
  RESULTS
  Compared with the nonclinical group, persons with 46,XY DSD had more often no partner (P = 0.056), felt more insecure in social (Mdn(DSD) = 17.0, Mdn(comparison) = 12.0, P = 0.001) and sexual situations (Mdn(DSD) = 17.0, Mdn(comparison) = 11.0, P = 0.006), had more sexual problems (Mdn(DSD) = 4.0, Mdn(comparison) = 3.0, P = 0.001), and were less satisfied with overall sex life (Mdn(DSD) = 3.0, Mdn(comparison) = 4.0, P = 0.000) and sexual function (Mdn(DSD) = 4.0, Mdn(comparison) = 4.0, P = 0.000). Results were inconsistent with regard to sexual-activity history (e.g., previous sexual experience). Participants who underwent genital surgery showed less dyspareunia (P = 0.027) but more fear of injuries during intercourse (P = 0.019) than those whose genitals were left unaltered.
  
  
  CONCLUSIONS
  SexQoL of persons with 46,XY DSD may be impaired. Differences in SexQoL between diagnostic subgroups, effect of corrective genital surgery, and the influence of gender assignment will have to be further investigated in future studies.
authors.affiliation: University Hospital Hamburg-Eppendorf, Institute for Sex Research and Forensic Psychiatry, Hamburg, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Schönbucher
authors.forename: Katinka
authors.initials: K
authors.lastname: Schweizer
authors.forename: Lisa
authors.initials: L
authors.lastname: Rustige
authors.forename: Karsten
authors.initials: K
authors.lastname: Schützmann
authors.forename: Franziska
authors.initials: F
authors.lastname: Brunner
authors.forename: Hertha
authors.initials: H
authors.lastname: Richter-Appelt
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D058490:Disorder of Sex Development, 46,XY / Q000523:psychology* / Q000601:surgery; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult