Psychological support

According to the international scientific literature about intersex people's well-being and health, it is important that professionals are adequately trained and provide help based on the person’s individual characteristics and needs. Psychological support is aimed at understanding and defining what could be the best path to achieve psychological well-being in all areas of life, listening to what the person directly concerned and/or their family may need. Psychological support may be needed when the person directly concerned and/or their family learns of the diagnosis of Variation of Sex Characteristics (VSC)/Difference of Sex Development (DSD). In these cases, the psychologist's role within a multidisciplinary team is to facilitate communication between family and professionals by increasing understanding of the diagnosis, using an inclusive and respectful language in a positive and accepting atmosphere. At the time of the diagnosis of VSC/DSD involving a minor, parents may feel pain from a sense of loss towards the child they had expected, fear that their child is ill and worry that their child may grow up feeling different. This moment, in fact, can be very delicate considering that the family may face aspects for which it is unprepared and experience intense feelings such as sadness, shock, confusion, disbelief, fear, anger, apprehension and/or shame. Sometimes such experiences can lead to the development of depression, anxiety, or post-traumatic stress that can make it difficult for parents to take care of their child. In light of this, psychological support can be crucial for the family to have a space to process these emotions and manage those experiences, in order to be able to properly care for their child. Psychological interviews can be a space where the family can reflect on the information to be shared with the child and/or on the path to be taken, deepening the benefits and risks of every possibility and choice also of medical type and evaluating the expectations and requests so that any decision taken is aware and the result of the real needs.
In all these cases, it is of fundamental importance to establish a relationship of trust with the family and monitor its emotional and psychological framework in order to provide adequate support and accompany the person concerned and their family in the different stages of life.

The psychological interviews must foresee a progressive involvement of the child or adolescent with a VSC/DSD in order to involve them in the foreground in the process of knowledge and awareness of their VSC/DSD, supporting them in making decisions regarding their own medical path on the basis of an informed consent model. Psychological support may also be requested by adults with a VSC/DSD who, following a history of early surgical interventions and frequent invasive examinations, report experiences associated with mood alterations, anxiety and dissatisfaction with their own body image. In addition, in some cases, people with a VSC/DSD may have difficulties in understanding, accepting and/or declaring their VSC/DSD, being stigmatized and discriminated against for their condition in various living environments. Finally, since people with a VSC/DSD may in some cases present an incongruence between gender identity (the intimate and deep sense of belonging to a gender, male, female or otherwise) and the sex assigned at birth (sex assigned on the basis of the appearance of external genitalia), psychological support interviews can allow you to have a safe space in which to explore and define your own gender identity.

Bibliography
Coleman, E et al. Standards of care for the health of transgender and gender diverse people, version 8. International journal of transgender health. 2022 Sep 6;23(Suppl 1):S1-S259
Yang JH, Baskin LS, DiSandro M. Gender identity in disorders of sex development: review article [Abstract]. Urology. 2010 Jan;75(1):153-9