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Horm Metab Res 2015; 47(05): 335-339
DOI: 10.1055/s-0035-1545302
Review
© Georg Thieme Verlag KG Stuttgart · New York

Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools

L. A. Siminoff
1   Department of Public Health, Philadelphia, College of Health Professions and Social Work, Temple University, USA
,
D. E. Sandberg
2   Department of Pediatrics, Child Health Evaluation & Research (CHEAR) Unit, University of Michigan, Ann Arbor, USA
› Author Affiliations
Further Information

Publication History

received 29 September 2014

accepted 26 January 2015

Publication Date:
08 April 2015 (online)

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Abstract

Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach.

Key words

disorders of sex development - shared decision making - decision aids - decisional regret - genital surgery - gender assignment - disclosure
 

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