Endocrine Abstracts

Background: Individuals with Differences in sex disorders (DSD) may experience mental and psychosocial challenges related to stigma, gender identity, sexual health and multiple therapeutic interventions which are influenced by cultural and societal contexts. Long-term psychosocial and psychosexual outcome data in individuals with DSD remains limited, particularly from developing countries.

Methods: This cross-sectional study included 30 individuals with DSD aged ≥14 years, along with 15 age-matched healthy controls and 15 disease controls (Type 1 Diabetes). Participants completed validated instruments including the Rosenberg Self-Esteem Scale (RSES), Hospital Anxiety and Depression Scale (HADS), Coping with DSD and Core Gender Identity, Gender Role Behaviour and Gender Orientation Scale. Self-constructed questionnaires for pshychosexual health and sociodemographic factors were administered.

Results: The mean age of DSD participants was 21.3 ± 4.6 years (9 reared male, 21 reared female), compared with 23 ± 3.8 years and 23.7 ± 4.2 years in healthy and disease controls respectively. Clinically significant anxiety and depression (HADS scale >10) were observed in 4(13%) and 1(3.3%) DSD participants respectively. Reports of suicidal ideation were more frequent in individuals with DSD compared with disease controls (30% vs 0%), while lack of psychological support was also commonly reported. Self-esteem remained comparable among DSD and both control groups.Gender identity was largely concordant with sex of rearing across all DSD subgroups (P >0.05). Statistically significant differences in self-esteem and clinical depression scores across DSD categories (P = 0.012 and P = 0.026 respectively) were noted. Individuals with DSD reared as males exhibited lower self-esteem and higher psychological distress. 46,XY DSD – female rearing – partial androgen effect subgroup showed comparatively higher anxiety scores though not statistically significant. High levels of perceived shame and stigmatization were observed (mean ± SD: 14.2 ± 4.5/20) along with decreased openness related to disease.

Conclusions: These findings underscore the need for long-term multidisciplinary care incorporating psychological support, gender counselling, and sexual health services.