A holistic health care policy for Differences of Sex Development

  • Auteur(s):
    Nina Callens, Tim van de Grift, Martine Cools
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Accessible medical and psychological care, provided by multidisciplinary health care teams in centers of excellence, are considered the cornerstone of appropriate management for Differences of Sex Development
(DSD). Person-centered medical care provision focuses on thoughtful diagnostic assessments while helping affected people and families understand complex medical information and tailoring communication to the emotional wellbeing of all involved. Providers can encourage a balanced decision making in relation to elective, medically non-necessary gonadal and genital treatment options, by discussing strengths and weaknesses
of the available evidence, and safeguarding as much as possible participation of the person with DSD in those choices. It is crucial, however, to further invest in ‘credible’ non-surgical pathways, in which a plethora of psychological support formats can provide people with the skills and confidence to deal with challenges in childhood, puberty and later adulthood, such as the development of a positive (genital) self-image
and pleasurable sexual experiences, as well as an open communication about the condition with (significant) others. Opportunities for peer support contacts, access to eHealth applications and decision-making
tools in standard care, in addition to the creation of regional referral networks in collaboration with peer support and advocacy organizations, are likely to enhance the psychological care of DSD support. A far-reaching
centralization of coordinated expertise and health care provision in excellence centers will further optimize a holistic care approach in this field.

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