Transition of care for adolescents with disorders of sex development.
Disorders of sex development (DSDs) continue to present many challenges. A clear consensus among clinicians has emerged in paediatric care; however, the same cannot be said of adult care services. Moreover, transition to adult care is a process that takes many years. Although evidence-based models of transitional care do exist in other medical specialities, few studies have been conducted in adolescents with DSDs, and a clear and pressing need exists for further research to guide the care of these patients. A general move towards independence and self-responsibility is common to all transition programmes, but specific issues for those with a DSD include disclosure, genital examinations and potential vaginal treatments. Psychological support underpins the whole transition process for patients with a DSD and encourages an individual approach to develop. In this Perspectives article, we describe the barriers to successful transition in this setting and outline suggestions to overcome them.
Department of Women's Health, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK.
Naomi S
NS
Crouch
University College London Hospitals, Department of Women's Health, 250 Euston Road, London NW1 2PG, UK.
Sarah M
SM
Creighton
D000293:Adolescent; D000328:Adult; D002648:Child; D012734:Disorders of Sex Development / Q000523:psychology / Q000628:therapy*; D005260:Female; D005836:Genitalia, Female / Q000002:abnormalities / Q000033:anatomy & histology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D010290:Parents; D017060:Patient Satisfaction; D010808:Physical Examination; D011788:Quality of Life; D046468:Sexual Development; D060305:Transition to Adult Care / Q000458:organization & administration