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Hypospadias: incidence and effects on psychosexual development as evaluated with the Minnesota Multiphasic Personality Inventory test in a sample of 11,649 young Italian men.

PURPOSE: We evaluated the incidence of hypospadias and its effects on psychosexual development in a sample of 11,649 young Italian males. Over the last 30 years only about 30 major publications have addressed these issues and the results of many studies have been contrasting. Some defects in methodology, such as low response rates, heterogeneity of age ranges and the choice of controls, have been the main limitations. Our study was designed to take these problems into account. MATERIALS AND METHODS: Forty-two hypospadic subjects and a random sample of 500 nonaffected males selected from the large sample of 11,649 young men (>90% of the 18-year-old males living in the Italian region of Tuscany) were screened by the Minnesota Multiphasic Personality Inventory (MMPI) test, psychological interview and clinical evaluation. RESULTS: The incidence of hypospadias in this representative group of Italian men is 3.6/1,000. No difference was noted in the percentage with altered MMPI compared with the control group. The age at surgical corrections and the number of operations are not related to an abnormal global psychological adjustment. Severity of disease influences a more negative genital appraisal and the number of operations is correlated only with more difficulty in initiating contact with the opposite sex. CONCLUSIONS: Surgery for hypospadias has to be strongly pursued in as many cases as possible. In addition, we strongly recommend following up all hypospadics, independently of the severity of their genital malformations, through adolescence to early adulthood, to ensure early detection of subjects with impaired psychological profiles.

Adolescent↗

A pilot intervention to enhance psychosexual development in adolescents and young adults with cancer.

BACKGROUND: Evidence suggests that cancer diagnosed during adolescence and young adulthood may present considerable challenges to what would otherwise be a relatively smooth developmental trajectory, particularly in areas related to reproductive health. We created and pilot tested a two-session, individually-delivered, counseling intervention to enhance psychosexual development in this unique population. PROCEDURES: A total of 21 patients, aged 15 to 25 years and treated for cancer within the past 5 years, completed the counseling intervention. Patients were adaptively randomized to begin the intervention immediately, or to be placed on a 3-month waitlist, after which time, they were reassessed and began the intervention. The content of the intervention included education, dialog, and support regarding cancer and such issues as sexual development and function, body image, fertility, prevention of sexually transmitted disease and unwanted pregnancy, and romantic relationships (e.g., dating, sexual communication). A 1-month follow-up booster call followed the intervention. Questionnaires were completed at baseline, post-waitlist (for half the sample), post-treatment, and at 3-month follow-up. RESULTS: Participation in the intervention increased cancer-specific knowledge regarding sexual issues; improved body image; lessened anxiety about sexual and romantic relationships; and decreased overall level of psychological distress. Gains were maintained through the 3-month follow-up. CONCLUSIONS: Addressing issues of reproductive health in the adolescent/young adult with cancer can and should be offered as a part of comprehensive pediatric cancer care.

Adolescent↗

Learning to drink: the influence of impaired psychosexual development.

Recognized factors in the causation of alcoholism are reviewed, including those contributing to increased prevalence in women. Comparisons are drawn between the locking-on of the alcoholic habit in some people and of certain eating disorders in others, to their respective neurotic needs: particularly in adolescence, serious pairing and involution. Current social mores provide little support for the sexually insecure. The hypothesis is examined that a core reason for a common type of problem drinking is the pervasive anxiety gendered by faulty psychosexual development. Demographic data were recorded for 56 men and 15 women with primary alcohol dependence syndrome, 30 patients with eating disorders and 20 control subjects. Each completed the Parental Bonding Instrument, Eysenck Personality Inventory and visual analogue scales concerning mood and socio-sexual confidence in relation to eating or drinking. Between-group differences are discussed and implications considered.

Adult↗

Psychosexual development among HIV-positive adolescents in Abidjan, Côte d'Ivoire.

Some 84,000 children with HIV/AIDS live in Côte d'Ivoire, where very little therapeutic or psychological help is available to them. The Yopougon Child Programme of the "Agence Nationale de Recherche sur le Sida" was launched in Abidjan in October 2000. It provides services for HIV-infected children and psychological consultations for children and their parents. This paper is about the psychosexual development of the HIV-positive adolescents in the Programme, 11 girls and 8 boys aged 13-17, their problems with HIV-related physiological and psychosexual changes, and relationships with their parents. The information was gathered in individual therapy sessions, group discussions and family support sessions. Bodily development was of major importance to these adolescents, particularly among those who had not yet developed secondary sexual characteristics and were shorter and weighed less than their peers. Those who had not achieved puberty were unable to participate in traditional rituals and worried whether they could ever marry or have children. In most cases, adolescents with HIV have been infected by a sexually transmitted virus without having had sexual relations themselves. They need support dealing with their sexual development and sexual feelings, along with medical care, in a context in which HIV infection is a secret, impossible to talk about with their peers.

Adolescent↗

Psychosexual development in individuals who have female pseudohermaphroditism.

This article describes psychosexual outcomes and issues in syndromes of female pseudohermaphroditism, broadly defined. Congenital adrenal hyperplasia, the most common cause of intersex genitalia at birth, is covered as are Turner Syndrome and syndromes in which XY infants who are born with undervirilized genitalia are assigned and reared as girls (androgen insensitivity syndrome; cloacal exstrophy). The same hormonal abnormalities that cause most physical intersex conditions also influence brain development and behavior; individuals who have intersex conditions can show behavior that is in between that of the typical boy/man and the typical girl/woman. Changes in sex-typical play behavior in childhood are larger than in sexual orientation or core gender identity in adulthood. Most female pseudohermaphrodites, whether XX or XY, who are assigned and reared as girls evolve a feminine core gender identity and primarily are heterosexual. Implications for current debate about the treatment of infants who have ambiguous genitalia are discussed, as is the need for additional research and for consideration of psychologic counseling as part of the treatment program.

Cognition↗