Is cosmetic surgery needed on CAH girls?
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Unless there is a medical necessity, no.
There are several factors that make cosmetic genital surgery on
children a very bad idea. First of all the many adult women who had such surgery done as a child or
infant, strongly wish it hadn't. Second, medical technology is constantly improving, so surgery now most
likely will rule out the chance for a more improved surgery later. In the end it is better to wait until
the girl is old enough to be a part of the decision, that way she will have less regrets and will have
more control over her own body.
As the parents of a virulized girl, my wife and I made the
decision, wholly agreed upon by both her Pediatric Endocrinoligist and well as her Urologist, that since
there is no present medical necessity for any cosmetic surgery, we would wait. The brunt of any problems
regarding the look of her genitals (awkward questions from relative or child care workers) we gladly take
upon ourselves in order to preserve her right to be in control of what is done to her body. We also
reinforce her value and worth and gender identity. She is and always will be 100% girl, and we will make
sure she always understands that the uninformed opinions of those who do not know better than to speak out
in ignorance cannot change that.
-- Danny Carlton |
For medical necessities and self-esteem
issues, it can be.
There are several factors that make
cosmetic genital surgery a good option. More adult women
are beginning to speak out saying that they have had the recent surgery techniques done by competent
doctors. They have stated that not only are they satisfied with
their decision but also wished it had been done earlier if these techniques had been available. Medical
technology has improved and may continue to do so but in those who have been pleased by their results now it
shows there is no reason to wait. It is better to have the
surgery when a child is young enough to not remember it and make for an easier and quicker recovery period. In their teen years, being part of a decision like this might be optimal
but questionable in regards to motive and ability to think far enough into the future to what adult life
will be like. Mentally and socially, having the
surgery early on, can alleviate unnecessary awkwardness and additional feelings of being "not
normal" when medications
and other precautions they deal with already can lead to low self-esteem.
As parents of a virilized girl, my
husband and I made the decision (also wholly agreed upon by her Urologist and Endocrinologist who presented
both sides) to have the two surgeries done now. There are
treatments to prevent the total virilization from occurring in-vitro but they are not as thoroughly tested
as some would like and future ramifications are still yet unknown. This
treatment would be optimal if CAH is known to be an outcome but since not everyone knows this first nor is
it satisfactorily proven to be completely harmless to future brain and/or physical function it is not always
an option for those concerned.
Because a body part of
your child has been altered for cosmetic or medical reasons, a child will have questions and issues
regarding the decision made for them. Our child will have no
doubt that they are valued and valuable. Loved and lovable. No matter a parents decision, all issues can be dealt with and
overcome when they arise as long as the decision was made for the right reasons and a lot of introspection
as well as research on possibilities and capable doctors is done. It is not a decision for everyone but it
can be a good one.
-- RebeccaM |
Will CAH make my child a homosexual?
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Whether a person engages in heterosexual or homosexual behavior is a choice made by
the individual. While there may be factors that influence that decision, just as there are factors that
influence whether a person will be more susceptible to alcoholism, it still remains a choice by the
individual. There are some factors in relation to CAH that influence gender identity, whether physical,
emotional or societal, but each of these can be dealt with.
Having an enlarged clitoris makes a woman no less a woman than having small breasts
would, but unfortunately there are those that try to imply that such superficial characteristic defines a
person.
The effects of elevated testosterone in women has not been conclusively examined.
Some effects, such as aggressiveness, heightened libido, and slight changes in mental focus have been
observed enough to be conclusive, but there has never been any conclusive proof that such influences forces
a woman to become a lesbian.
The crux of the problem is the societal ignorance that suggests any person outside
of what's considered normal must be "wrong" or "broken". Young people in the confusion
of puberty can be misled into thinking that any differences in their body, thinking or feelings are a sign
that they are "messed up" and not normal, when they are as normal as any other teenager. The key
is to reinforce your child's self image, specifically in relation to their gender. Assure them that they are
fully male or female, and all that kids go through confusing times.
-- Danny Carlton |
-- to be added when submitted --
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