The Australian & New Zealand journal of obstetrics & gynaecology · 2026
A Cognitive Behavioural Therapy for Mayer-Rokitansky-Küster-Hauser Syndrome Adapted for Other Disorders of Sex Development: A Qualitative Study.
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Heller-Boersma J G, Edmonds D K, Rose G L, Deans R
Аннотация
BACKGROUND: Variations in Sex Characteristics (VSC) also called Differences in/Disorders of Sex Development (DSD) include a range of conditions of congenital abnormalities of the reproductive system. Either the internal and/or external genital tract are affected, presenting as androgenisation of the external genitalia, or incomplete formation of the vagina and uterus, and/or gonads. We previously developed a model of the core psychological impact of diagnosis/medical treatment of one of these conditions, namely utero-vaginal-agenesis or Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), and a Cognitive-Behavioural Therapy of MRKH (CBT-MRKH) based on this, a randomized-controlled-trial of which showed improved psychological outcomes in participants.
AIMS: The current study reviews both the consolidation of CBT-MRKH and its subsequent adaptation to CBT-MRKH/DSD+ to reach a wider VSC/DSD audience, who similarly experience a threat to their sense of self/identity following diagnosis.
MATERIALS AND METHODS: A qualitative audit of therapy notes was completed, of both 2 further CBT-MRKH group programs run, and a 3rd and 4th series, of its broadened/deepened CBT-MRKH/DSD+ version. This audit focused on participants' experiences of therapy and impact on view of self/self-beliefs.
RESULTS: Participants collectively valued the group support, and the techniques used such as the therapeutic writing tasks and cognitive restructuring of negative beliefs, plus VSC/DSD-specific tools/skills training. The collective quotes illustrate the marked positive changes participants experienced in terms of their view of themselves and their condition, emotions processed, and adaptive self-schemata and coping developed throughout therapy.
CONCLUSIONS: Taking the results from CBT-MRKH we were able to apply it to a broader VSC/DSD audience with success.
AIMS: The current study reviews both the consolidation of CBT-MRKH and its subsequent adaptation to CBT-MRKH/DSD+ to reach a wider VSC/DSD audience, who similarly experience a threat to their sense of self/identity following diagnosis.
MATERIALS AND METHODS: A qualitative audit of therapy notes was completed, of both 2 further CBT-MRKH group programs run, and a 3rd and 4th series, of its broadened/deepened CBT-MRKH/DSD+ version. This audit focused on participants' experiences of therapy and impact on view of self/self-beliefs.
RESULTS: Participants collectively valued the group support, and the techniques used such as the therapeutic writing tasks and cognitive restructuring of negative beliefs, plus VSC/DSD-specific tools/skills training. The collective quotes illustrate the marked positive changes participants experienced in terms of their view of themselves and their condition, emotions processed, and adaptive self-schemata and coping developed throughout therapy.
CONCLUSIONS: Taking the results from CBT-MRKH we were able to apply it to a broader VSC/DSD audience with success.