Indian Journal of Endocrinology and Metabolism

ENDOCRINOLOGY AND GENDER
Year
: 2016  |  Volume : 20  |  Issue : 6  |  Page : 870--877

Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia


Arushi Gangaher1, Viveka P Jyotsna1, Vasundhera Chauhan1, Jomimol John1, Manju Mehta2 
1 Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Viveka P Jyotsna
Room 305, Biotechnology Block, All India Institute of Medical Sciences, New Delhi - 110 029
India

Background: In congenital adrenal hyperplasia (CAH) with ambiguous genitalia, assigning gender of rearing can be complex, especially If genitalia is highly virilized. Apart from karyotype, prenatal androgen exposure, patient's gender orientation, sociocultural, and parental influences play a role. The aim of this study was to assess gender dysphoria and psychosocial issues in patients of CAH raised as males and females. Materials and Methods: This is a cross-sectional study that includes patients (old and new) with CAH who were treated by us in the last 6 months. A semi-structured interview proforma was used to elicit history and psychosocial background of the patients. The clinical and biochemical details were noted. For psychological analysis, patients were screened for gender dysphoria using Parent Report Gender Identity Questionnaire for children <12 years and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. Results: We analyzed 22 46 XX CAH patients among which, 3 were reared as males and 19 as females. Among the 19 patients reared as females, 17 patients showed no gender dysphoria. Two patients revealed gender dysphoria as indicated by their marginally low scores on the gender dysphoria assessment. However, in view of current literature and the age groups of the patients, behavior of the 6-year-old patient can be best understood as being tomboyish. Gender dysphoria in the 22-year-old can be explained by the dominance of psychosocial factors and not hormones alone. Among the three patients reared as males, two prepubertal were satisfied with their male gender identity. The third patient, aged 32 years, had gender dysphoria when reared as a male that resolved when gender was reassigned as female and feminizing surgery was done. Conclusion: Gender assignment in 46 XX CAH is guided by factors such as degree of virilization of genitalia, gender orientation, patient involvement, sociocultural, and parental influences.


How to cite this article:
Gangaher A, Jyotsna VP, Chauhan V, John J, Mehta M. Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia.Indian J Endocr Metab 2016;20:870-877


How to cite this URL:
Gangaher A, Jyotsna VP, Chauhan V, John J, Mehta M. Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia. Indian J Endocr Metab [serial online] 2016 [cited 2019 Dec 15 ];20:870-877
Available from: http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=6;spage=870;epage=877;aulast=Gangaher;type=0