THE IMPORTANCE OF SEXUAL WELL-BEING

Although it often makes adults uncomfortable to think about the future sexual lives of children, it is very important that attention be paid to ensuring that patients with DSDs grow up to feel sexually healthy, mentally and physically. In the past, too much attention has been paid to genital appearance and gender identity at the expense of the patient’s sexual health.[ Schober2004b Bailez1992 Krstic1995 ] Sexual health is central to an adult’s over-all well-being; it is critical to the establishment of short- and long-term intimate relationships and pair bonding, but also more generally to the establishment of a positive sense of self.[Kuhnle1997]

Patients have reported that genital surgeries (with resultant scars), gonadectomies, exogenous hormones, being lied to or misled by health care professionals, and repeated genital examinations have contributed to sexual dysfunction and the cascade effects that come from sexual dysfunction (especially difficulties establishing and maintaining partnerships). Clinicians should use the techniques mentioned above (including actions designed to reduce stigma and maximize patient decision-making) to reduce threats to patients’ sexual well-being.