Psychological Counseling for DSD Family

Disorders of Sexual Development (DSD) are identified at various points of time, such as at birth, early childhood, or puberty, when there is a departure from the usual course of sexual development. They are doubly challenging compared to other childhood disorders, as, in addition to medical complications they are also perceived as highly stigmatizing and alienating, with evaluations and medical assessments themselves being distressing for not only the child but the parents as well. The diagnosis itself is traumatic for parents and they have the added responsibility of assigning the gender at birth, decision-making regarding sometimes irreversible hormonal and surgical treatments for their child, and having to come to terms with child’s behavior/play which may not conform to assigned or traditional gender roles. Raising a child with DSD can turn out to be a very isolating ordeal for the parents, one that can adversely impact parental mental health and their quality of life. This chapter provides an overarching view on the assessment of psychological challenges in parents of children with DSD, accompanying psychosocial and cultural factors as well as approaches for parental counseling and psychological support with a particular focus on the Indian perspective.