Adverse Birth Experiences and Parent Adjustment Associated With Atypical Genital Appearance Due to Differences of Sex Development

Katherine A. Traino, Rachel S. Fisher, Nathan L. Basile, Taylor M. Dattilo, Laurence S. Baskin, Cindy L. Buchanan, Yee Ming Chan, Earl Y. Cheng, Douglas E. Coplen, Thomas F. Kolon, Yegappan Lakshmanan, Blake W. Palmer, Larry L. Mullins, Lucia M. Ciciolla, Amy B. Wisniewski

Research output: Contribution to journalArticlepeer-review


Objective: Differences/disorders of sex development (DSDs) are rare, congenital conditions involving discordance between chromosomes, gonads, and phenotypic sex and are often diagnosed in infancy. A key subset of parents of children newly diagnosed with a DSD experience clinically elevated distress. The present study examines the relationship between perinatal factors (i.e., gestational age, delivery method) and trajectories of parental adjustment. Methods: Parent participants (mothers = 37; fathers = 27) completed measures at baseline, 6- and 12-month follow-up. Multilevel linear regression controlled for clustering of the data at three levels (i.e., time point, parent, and family) and examined the relationship between perinatal factors and trajectories of depressive and anxious symptoms. Two-way interactions between perinatal factors and parent type were evaluated. Results: Overall depressive and anxious symptoms decreased over time. There were significant interactions between gestational age and parent type for depressive and anxious symptoms, with younger gestational age having a stronger negative effect on mothers vs. fathers. There was a significant interaction between time and gestational age for depressive symptoms, with 36 weeks' gestational age demonstrating a higher overall trajectory of depressive symptoms across time compared to 38 and 40 weeks. Findings for the delivery method were not significant. Conclusions: Findings uniquely demonstrated younger gestational age was associated with increased depressive symptoms, particularly for mothers compared to fathers. Thus, a more premature birth may predispose parents of infants with DSD to distress. Psychosocial providers should contextualize early diagnosis-related discussions within stressful birth experiences when providing support.

Original languageEnglish
Pages (from-to)759-767
Number of pages9
JournalJournal of pediatric psychology
Issue number9
StatePublished - Sep 1 2023


  • disorders of sex development
  • infancy and early childhood
  • longitudinal research
  • parent psychosocial functioning
  • prematurity


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