LAUSR

Paediatric clinical psychology literature provides applicable evidence for use in specialist health care settings and services. The general approach of psychological care of children and families with paediatric conditions is recognisable as preventative and de-stigmatising, aimed to maximise personal agency with shared responsibility for achieving best outcomes via multi-professional teamwork. Recent commentaries regarding healthcare for children with different sex development (DSD), have noted service-level pitfalls including poor teamwork and underuse of early and integrated psychological intervention. Psychological research regarding the variously termed DSD, Variations in Sex Development (VSD, Variation in Sex Characteristics (VSC), or intersex, has historically centred around the assessment of sex differences, gender identity and the impact of including hormone influences on brain and behaviour. Psychological research in this specialist area has not focussed on the evaluation of specific clinical interventions or psychotherapeutic models but has investigated psychological aspects of multi-professional healthcare provision. There are new goals for psychological care of children with variation or difference in sex development. These require a framework of good communication to enable those receiving care to come to know and articulate their own hopes for treatment and support. Paediatric psychological intervention studies involving larger clinical groups such as diabetes, provide evidence applicable to DSD populations. A risk of stigma is recognised as inherent to some physical interventions within routine paediatric care of people with variations or differences in sex development. Psychological care and intervention should be aimed at minimising these risks via questioning and examining their assumed need. Psychological approaches can provide a foundation for ethical and rights-based multi-professional care of children with variation or difference in sex development.