SciELO - Scientific Electronic Library Online

vol.53 issue9Congenital adrenal hyperplasia: a qualitative study on disease and treatment, doubts, anguishes and relationships (part I)The inclusion of new techniques of chromosome analysis has improved the cytogenetic profile of Turner syndrome author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Arquivos Brasileiros de Endocrinologia & Metabologia

On-line version ISSN 1677-9487


TELLES-SILVEIRA, Mariana; TONETTO-FERNANDES, Vânia F.; SCHILLER, Paulo  and  KATER, Claudio E.. Congenital adrenal hyperplasia: a qualitative study on sex definition and redesignation dilation surgery and psychological support (part II). Arq Bras Endocrinol Metab [online]. 2009, vol.53, n.9, pp.1125-1136. ISSN 1677-9487.

OBJECTIVE: To identify relevant questions related to sex definition and re-designation and reconstructive surgery in patients with congenital adrenal hyperplasia (CAH), and to understand the role of the psychologist in providing care for these patients. METHODS: We selected 21 subjects: 7 pediatric endocrinologists from 5 Brazilian Public Health System institutions, 9 parents and 6 patients with CAH, according to a qualitative research model. In this paper, 3 of the studied categories are analyzed: "sex definition and re-designation", "reconstructive surgery/vaginal dilation", and "psychology". RESULTS: Parents' main anguish relates to the situation of an unnamed sex at birth, whereas sex re-designation was distressful to physicians. A sense of loneliness when dealing with the disease and treatment was a common anguish among patients; dilation procedures were the major complaint. In general, physicians recommend that genital reconstructive surgery be performed early on to avoid future trauma. CONCLUSIONS: In such a complex scenario, it is remarkable that not all the reference service staff have a psychologist on duty. Difficulties to deal with questions involving sexuality were evident and dilation procedures are an additional source of trauma for these patients.

Keywords : Congenital adrenal hyperplasia; anomalies of sex differentiation; sex definition; sex re-designation; reconstructive surgery; psychology; psychoanalysis.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License