title: Psychosocial well-being in Dutch adults with disorders of sex development.
abstract: OBJECTIVE
  Atypical sex development is associated with psychosocial vulnerability. We investigated psychosocial well-being in individuals with disorders of sex development (DSD) and hypothesized that psychosocial well-being was related to degree of genital atypicality at birth.
  
  
  METHODS
  120 male (n=16) and female (n=104) persons with DSD, aged 14-60 years, participated in a follow-up audit on psychosocial well-being. They were stratified in: women with 1) 46,XY and female genitalia, 2) 46,XY or 46,XX and atypical genitalia, and 3) men with 46,XY and atypical genitalia. We used the Illness Cognition Questionnaire (ICQ), Checklist Individual Strength (CIS8R), TNO-AZL Quality of Life questionnaire (TAAQOL), Adult Self-Report (ASR), and the Rosenberg Self-Esteem Scale (RSES).
  
  
  RESULTS
  Data were compared to reference groups. Participants generally were coping well with DSD (ICQ). Women with DSD reported elevated levels of fatigue (CIS8R) and slightly more attention and memory problems (TAAQOL, ASR). Women with atypical genitalia reported more emotional and behavioral problems. On the ASR Rule-breaking Behavior and Antisocial Personality scales, these women had similar scores as reference men. Women with DSD reported a higher self-esteem (RSES). No differences in psychosocial well-being were found between men with DSD and reference men.
  
  
  CONCLUSIONS
  Individuals with DSD across all diagnostic groups generally reported a good psychosocial well-being. The results further suggest involvement of prenatal androgens in the development of personality traits related to assertiveness and egocentricity. We recommend that individuals with a DSD and their families are involved in decision-making processes and have access to multidisciplinary care.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Nita G M
authors.initials: NG
authors.lastname: de Neve-Enthoven
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital Ghent and Ghent University, Ghent, Belgium.
authors.forename: Nina
authors.initials: N
authors.lastname: Callens
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center-Amalia Children's Hospital Nijmegen, Nijmegen, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: van Kuyk
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center-Amalia Children's Hospital Nijmegen, Nijmegen, The Netherlands.
authors.forename: Jet H
authors.initials: JH
authors.lastname: van Kuppenveld
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Stenvert L S
authors.initials: SL
authors.lastname: Drop
authors.affiliation: Department of Medical Psychology and Medical Social Work and Center of Expertise on Gender Dysphoria, VU University Medical Center Amsterdam, The Netherlands.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: a.b.dessens@erasmusmc.nl.
authors.forename: Arianne B
authors.initials: AB
authors.lastname: Dessens
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001242:Assertiveness; D001288:Attention; D012734:Disorders of Sex Development / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009426:Netherlands; D010551:Personality; D011788:Quality of Life; D057566:Self Report
keywords: Disorders of sex development (DSD); Emotional problems; Fatigue; Health related quality of life; Psychosocial well-being; Self-esteem