Sexual Development
As a pediatrician and urologist specializing in disorders of sexual development (DSD), my top priority is to ensure the best possible treatments and advice are given to my patients. Disorders of sexual development are conditions that affect the sexual development of humans. Patients afflicted with DSD are people who cannot neatly fit into our perceived sex notions of male and female. In some cases, these patients will request treatments that will lessen these afflictions. However, there are some cases in which the best course of action is not always clear. One such case involved a pregnant woman insisting that I treat her unborn child with high doses of the steroid drug Dexamethasone. This patient previously had a female child born with Congenital
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This disorder can be inherited from the parent as opposed to other disorders of sexual development which appear sporadically. Since she had already had a female child with CAH, she knew that she carried the gene responsible for this disorder of sexual development. After learning she was once again pregnant, she searched the internet for ways to prevent her next child from being born with CAH as well. She read that Dexamethasone could prevent the development of ambiguous genitalia and, in the eyes of the mother, resolve the issues with this disorder of sexual development. My responsibility, as her doctor, is to inform her of what it means to be born with CAH and what consequences the use of Dexamethasone could have on the child. Secondly, I must do what I think is best for her as well as her child. I refused to treat this woman with dexamethasone and did my best to dissuade this woman from seeking this treatment because it was not ideal for the …show more content…
If there were no side effects to the administering of this drug to a fetus, then I would have obliged and given her the treatment. However, there have been some documented negative side effects to being exposed to dexamethasone unnecessarily (Vilain, Lecture 12). For example, children with exposure to high amounts of dexamethasone have been reported to exhibit some negative side effects from exposure to the drug such as impaired verbal working memory, increased social anxiety, and more gender-neutral behaviors in boys (Vilain, Lecture
This disorder can be inherited from the parent as opposed to other disorders of sexual development which appear sporadically. Since she had already had a female child with CAH, she knew that she carried the gene responsible for this disorder of sexual development. After learning she was once again pregnant, she searched the internet for ways to prevent her next child from being born with CAH as well. She read that Dexamethasone could prevent the development of ambiguous genitalia and, in the eyes of the mother, resolve the issues with this disorder of sexual development. My responsibility, as her doctor, is to inform her of what it means to be born with CAH and what consequences the use of Dexamethasone could have on the child. Secondly, I must do what I think is best for her as well as her child. I refused to treat this woman with dexamethasone and did my best to dissuade this woman from seeking this treatment because it was not ideal for the …show more content…
If there were no side effects to the administering of this drug to a fetus, then I would have obliged and given her the treatment. However, there have been some documented negative side effects to being exposed to dexamethasone unnecessarily (Vilain, Lecture 12). For example, children with exposure to high amounts of dexamethasone have been reported to exhibit some negative side effects from exposure to the drug such as impaired verbal working memory, increased social anxiety, and more gender-neutral behaviors in boys (Vilain, Lecture