Predictors of psychosocial distress in parents of young children with disorders of sex development

Megan N. Perez, Alexandria M. Delozier, Christopher E. Aston, Paul Austin, Laurence Baskin, Yee Ming Chan, Earl Y. Cheng, David A. Diamond, Allyson Fried, Saul Greenfield, Thomas Kolon, Bradley Kropp, Yegappan Lakshmanan, Sabrina Meyer, Theresa Meyer, Natalie Nokoff, Blake Palmer, Alethea Paradis, Dix Poppas, Kristy J.Scott ReyesJonathan M. Swartz, Amy Tishelman, Amy B. Wisniewski, Cortney Wolfe-Christensen, Elizabeth Yerkes, Larry L. Mullins*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Purpose: We evaluated demographic, financial and support predictors of distress for parents of young children with disorders of sex development including atypical genital development, and characterized early parental experiences. This work extends our previous findings to identify those parents at risk for distress. Materials and Methods: Participants included mothers (76) and fathers (63) of a child (78) diagnosed with disorders of sex development characterized by moderate to severe genital atypia. Parents completed a demographic questionnaire, measures of anxious and depressive symptoms, quality of life, illness uncertainty and posttraumatic stress symptoms, and rated their satisfaction with the appearance of their child's genitalia. Results: Depressive and posttraumatic stress symptoms of caregivers were comparable to standardized norms while levels of anxious symptoms were below norms. A subset of parents reported clinically elevated symptoms. Overall 26% of parents reported anxious symptoms, 24% reported depressive symptoms and 17% reported posttraumatic stress symptoms. Levels of illness uncertainty were lower than those of parents of children with other chronic illnesses. Differences by parent sex emerged, with mothers reporting greater distress. Lower income, increased medical care and travel expenses, and having no other children were related to increased psychosocial distress. Conclusions: Early psychosocial screening is recommended for parents of children with disorders of sex development. Clinicians should be aware that financial burden and lack of previous parenting experience are risk factors for distress.

Original languageEnglish (US)
Pages (from-to)1046-1051
Number of pages6
JournalJournal of Urology
Issue number5
StatePublished - 2019


  • Disorders of sex development
  • Parents
  • Stress, psychological

ASJC Scopus subject areas

  • Urology


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