Parenting a Child With Disorder of Sexual Development in Traditional Society: Psychological Impact

Background: Disorders of Sexual Development can cause significant psychological distress for parents, particularly in traditional societies where such conditions are stigmatized. Aim: This study aims to investigate the psychoaffective impact of sexual development disorders caused by congenital adrenal hyperplasia in children with 46, XX karyotype, in order to determine the predictive factors for the onset of anxiety and depression among parents and the coping strategies employed by parents to adapt to their child's condition. Materials and methods: This is a retrospective, cross-sectional, descriptive, and analytical study involving parents of children treated for sexual development disorders related to congenital adrenal hyperplasia, with a 46, XX karyotype, who underwent feminizing genitoplasty during the period from January 1, 2005 and December 31, 2021. The Beck Depression Inventory, the Hamilton Anxiety Scale, and the Brief COPE, in their Arabic versions, were used to assess depression, anxiety and coping respectively. Results: This study included 54 parents. Among them 57,4% exhibited depressive symptomatology, while 37 % reported anxiety symptoms. The most frequently adopted coping strategies among parents were acceptance (88,9 %), reliance on religion (66,7 %), planning (63 %), and active coping (63 %). Predictive factors of depression included the child's current age (OR = 1280), the age of the child at the time of feminizing genitoplasty (OR = 1273), and the non-disclosure of the genitoplasty to the child (OR = 331,522). Predictive factors of anxiety included the parent's female gender (OR = 7756), the child's current age (OR = 1499), the age of the child at the time of feminizing genitoplasty (OR = 1150), and the nondisclosure of the genitoplasty to the child (OR = 115,278). Conclusion: Despite the various coping strategies adopted by parents of children with disorder of sexual development related to congenital adrenal hyperplasia, the occurrence of anxiety and depression remains inevitable for many of these parents, depending on several well-defined predictive factors. It is therefore imperative to implement appropriate psychological support to help these parents effectively adapt to this complex situation. Type of Study: Case-Control Study. Level of Evidence: III. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.