Sociocultural Aspects of Disorders of Sex Development

Abstract

The management practice of patients with a disorder of sex development (DSD) in Western countries differs greatly from those approaches applied in Asian countries (Warne and Bhatia, 2006). Late presentation, delayed identification, lack of diagnostic facilities and treatment options, and lack of expertise have been reported as major challenges in the management of DSD in poor-resource countries (Armstrong et al., 2006; Warne and Bhatia, 2006; Warne and Raza, 2008; € Ozbey and Etker, 2013; Zainuddin et al., 2013). It was argued that poverty and cultural aspects influence the man-agement practices between Western and non-Western coun-tries differently (Warne and Bhatia, 2006). Poverty makes health-care facilities not only less available, but if available also less accessible for poor patients. Cultural background and social context both influence the patients’, as well as health-care professionals’ cognition about illness and their decisions in dealing with it. In poor-resource countries of Asia, it is common that children born with ambiguous geni-tals grow up with their original anatomy, due to unafford-able medical treatment or struggles for cultural acceptance (Armstrong et al., 2006; Warne and Bhatia, 2006).