Dessens Arianne, de Neve-Enthoven Nita, Callens Nina, van der Zwan Yvonne, van Kuijk Maaike, Verhaak Chris, Wolffenbuttel Katja, Cohen-Kettenis Peggy, Drop Stenvert, Beerendonk Ina, Cools Martine

(210) ADAPTING THE SEXUAL SELF-CONCEPT: A USEFUL APPROACH TO IMPROVE SEXUAL FUNCTIONING FOR WOMEN WITH A DIFFERENCE OF SEX DEVELOPMENT?

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives Differences of Sex Development (DSDs) are a large group of congenital conditions characterized by an altered development of the internal and external genitalia. Examination of sexual function in relationship to cognitions and emotions that hinder or promote sexuality (i.e. sexual self-concept) may contribute to the development of specific interventions to improve sexual functioning. Methods 91 women participated in a follow-up study consisting of a standardized gynecological examination and psychosocial assessment of sexual functioning. Outcome measures included genital atypicality at birth,1-3 applied surgical and non-surgical interventions,1-3 Dutch versions of the Female Sexual Functioning Index (FSFI),1-4 Female Sexual Distress Scale-Revised (FDFS-R),1-4 Body Image Scale,1-4 (dis)satisfation with the functionality of the genitalia1-4 and the Women Sexual Self-Concept Scale (WSSCS-D).1-4 Statistics: different types of parametric and non-parametric tests for categorical and continuous variables and principal component analysis.1-4 Results Many women born with DSD reported sexual problems, in particular women who have undergone extensive genital reconstruction.1,3 Large percentages of women were not in a romantic relationship, had not been sexually active recently or had never been sexually active. Of women who completed the FSFI questionnaire, 66% scored in the rangeof a sexual dysfunction and 41% of women experienced sexually related distress (FDFS-R).1,3 Women with DSD harbored more negative emotions and cognitions regarding their sexuality and were less satisfied with their genitalia. Sexual self-concept was associated with compromised outomes on sexual functioning and distress.1,3,4 Conclusions Problems in sexual functioning are common among women with DSD. Negative cognitions and emotions related to sexual self-concept probably play a role in their sexual functioning. A cognitive behavioral approach with focus on acceptance and coping with genital variety, explorations of the own sexual needs and adaptation of negative emotions and cognitions into more positive ones, could prove useful in this group. Conflicts of Interest The authors declare no conflict of interest.

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