This thesis introduces and describes the concept of patient autonomy, or the right of patients to make informed medical decisions without outside influence. The concept of patient autonomy, its importance in medicine, and the role parents play in autonomous decisions is explained. The pathology of five disorders of sexual development are described and the most common treatments of each disorder are outlined. The literature related to the physical and psychological outcomes of these treatments are examined. The disorders of sexual development reviewed include complete androgen insensitivity syndrome, 5-alpha reductase deficiency, congenital adrenal hyperplasia, klinefelter syndrome, and turner syndrome. The concept of patient autonomy is taken into consideration in the review of treatments of these disorders. Suggestions to maintain patient autonomy are provided, if necessary. It was determined that in the treatment of most of these disorders of sexual development, genital reconstruction surgery is done at an early age. Evidence suggesting that the literature commonly used to support early genitoplasty is inaccurate and unreliable is presented and reviewed. Datum are presented which details the psychological outcome of patients who underwent genitoplasty at an early age. In cases where early intervention or surgical treatment is required, suggestions are made to provide these individuals with the best medical care. These solutions include frequent clinical visits, increased accessibility to psychological support throughout childhood, adolescence, and early adulthood, and dialogue between patients and physicians that is age-appropriate and concise.
Semester/Year of Award
Robert W. Mitchell
Mentor Department Affiliation
Restricted Access Thesis
Orr, Bethany A., "Maintaining Patient Autonomy: Treatment of Disorders of Sexual Development" (2021). Honors Theses. 867.