Genital Surgery for Disorders of Sex Development: Implementing a Shared Decision-Making Approach
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Katrina Karkazis
ABSTRACT
Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear “best-choice” treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: 1) Set the stage and develop an appropriate team; 2) Establish preferences for information and roles in decision-making; 3) Perceive and address emotions; 4) Define concerns and values; 5) Identify options and present evidence; and 6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.
© Freund Publishing House Ltd. 2010
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- Selection of Elite Athletes, Hormones and Genes
- Association of Serum Adiponectin Levels with Artherosclerosis and the Metabolic Syndrome in Obese Children
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- Antihyperlipidemic Agents Cause a Decrease in von Willebrand Factor Levels in Pediatric Patients with Familial Hyperlipidemia
- GHR and VDR Genes do not Contribute to the Growth Hormone (GH) Response in GH Deficient and Turner Syndrome Patients
- Is BaF3 Bioassay Useful to Identify Patients with Bioinactive Growth Hormone?
- Genital Surgery for Disorders of Sex Development: Implementing a Shared Decision-Making Approach
- Mean Platelet Volume in Obese Adolescents with Nonalcoholic Fatty Liver Disease
- Congenital Hypothyroidism: Etiology
- Familial Hyperinsulinism-Hyperammonemia Syndrome in a Family with Seizures: Case Report
- Genital Sanguineous Discharge in Prepuberty: A Case of Mullerian Papilloma of Vagina in a 9 Year-Old Girl
- Glycogen Storage Disease Type III with Hypoketosis
- McCune-Albright Syndrome (MAS): Early and Extensive Bone Fibrous Dysplasia Involvement and “Mistaken Identity” Oophorectomy
- Two New Unrelated Cases of Hereditary 1,25-Dihydroxyvitamin D-resistant Rickets with Alopecia resulting from the same Novel Nonsense Mutation in the Vitamin D Receptor Gene
