77. Stress, anxiety, and depression among parents of children with sexual development disorders at Vietnam National Children's Hospital in 2025 and related factors

Tran Thi Thu Thuy, Vu Chi Dung, Nguyen Thi Trang Nhung, Tran Trung Kien, Tran Mai Anh

Main Article Content

Abstract

Disorders of sex development (DSD) are congenital abnormalities of chromosomes, gonads, or anatomy. Having children with DSD can create significant psychological pressure on parents as they must make difficult decisions with healthcare professionals, such as gender assignment, surgery, long-term treatment, and concerns about stigma. This study was conducted at the Vietnam National Children’s Hospital to (1) describe the prevalence of stress, anxiety, and depression among parents of children with DSD, and (2) identify related factors. Parents of children with DSD attending outpatient care were assessed using the DASS-21 scale and associated variables. Results showed that the prevalence of stress, anxiety, and depression among parents was 16.8%, 22.4%, and 9.6%, respectively. Factors associated with parental mental health included educational level, parental role (mother or father), child’s age, and perceived parent-focused stigma.

Article Details

References

1. Cools M, Nordenström A, Robeva R, et al. Caring for individuals with a difference of sex development (DSD): a Consensus Statement. Nat Rev Endocrinol. 2018 Jul;14(7):415-29.
2. Sax L. How common is intersex? a response to Anne Fausto-Sterling. J Sex Res. 2002 Aug;39(3):174-8.
3. Silver EJ, Westbrook LE, Stein RE. Relationship of parental psychological distress to consequences of chronic health conditions in children. J Pediatr Psychol. 1998 Feb;23(1):5-15.
4. Duguid A, Morrison S, Robertson A, et al. The psychological impact of genital anomalies on the parents of affected children. Acta Paediatr Oslo Nor 1992. 2007 Mar;96(3):348-52.
5. Bộ Y tế. Quyết định 1972/QĐ-BYT 2013 công nhận cơ sở đủ điều kiện can thiệp y tế để xác định lại giới tính. Available from: https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-1972-QD-BYT-2013-cong-nhan-co-so-du-dieu-kien-can-thiep-y-te-de-xac-dinh-lai-gioi-tinh-212947.aspx.
6. Thomas S, Ryan NP, Byrne LK, et al. Psychological Distress Among Parents of Children With Chronic Health Conditions and Its Association With Unmet Supportive Care Needs and Children’s Quality of Life. J Pediatr Psychol. 2023 Oct 14;49(1):45-55.
7. Tran TD, Tran T, Fisher J. Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women. BMC Psychiatry. 2013 Jan 12;13:24.
8. Rolston AM, Gardner M, Vilain E, et al. Parental Reports of Stigma Associated with Child’s Disorder of Sex Development. Int J Endocrinol. 2015;2015:980121.
9. Saktini F, Fitrikasari A, Asikin HG, et al. Parental stress parameter difference after caring for congenital adrenal hyperplasia children with genital ambiguity. Arch Ment Health. 2024 Jun;25(1):31.
10. DASS. DASS FAQ - Frequently Asked Questions. Accessed July 29, 2025. https://www2.psy.unsw.edu.au/dass/DASSFAQ.htm
11. Phạm Thị Thu Cúc. Tìm hiểu một số yếu tố liên quan đến tress, trầm cảm và lo âu ở cha/mẹ trẻ tự kỷ tại Bệnh viện Nhi Thái Bình năm 2021. Tạp chí Y học Việt Nam. 2025;550(1). doi:10.51298/vmj.v550i1.14079
12. Traino KA, Roberts CM, Fisher RS, et al. Stigma, Intrusiveness, and Distress in Parents of Children with a Disorder/Difference of Sex Development. J Dev Behav Pediatr JDBP. 2022 Sep 1;43(7):e473-82.
13. Brathwaite R, Magorokosho N, Namuwonge F, et al. Typology and correlates of parental stress among caregivers of children with DBDs in low-resourced communities in Uganda. PLOS Glob Public Health. 2023;3(8):e0002306. doi:10.1371/journal.pgph.0002306
14. Lin PY, Chou WJ, Hsiao RC, et al. Association of Affiliate Stigma with Parenting Stress and Its Moderators among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder. Int J Environ Res Public Health. 2023;20(4):3192. doi:10.3390/ijerph20043192
15. Sanders C, Carter B, Goodacre L. Parents need to protect: influences, risks and tensions for parents of prepubertal children born with ambiguous genitalia. J Clin Nurs. 2012;21(21-22):3315-3323. doi:10.1111/j.1365-2702.2012.04109.x