Challenges Encountered by Pediatric Health Care Professionals while Dealing With Intersex Children and their Parents: A Qualitative Study at Karachi, Pakistan

Monday, 30 July 2012

Shela Akbar Ali Hirani, MScN, BScN
School of Nursing, Aga Khan University, Karachi, Pakistan

Learning Objective 1: Realize the challenges faced by Pakistani pediatric health care professionals while dealing with intersex children and their parents

Learning Objective 2: Gain insight about the emerging bioethical issues while caring for intersex children and their parents in Pakistani context

Purpose: Clinical presentation of ambiguous genitalia is one of the rare but challenging situations that emerge various bioethical issues at the Pediatric settings. In Pakistan very few initiatives have been undertaken to explore the challenges encountered by Pediatric health care professionals while dealing with intersex children and their parents. Therefore, this study aims at exploring the experiences of Pakistani pediatric healthcare professionals while caring for intersex children and parents.

Methods: While utilizing descriptive exploratory design, this study was conducted at a private tertiary care hospital of Karachi, Pakistan. The study received approval from the Ethical Review Committee of the indentified setting. A semi-structure interview guide was utilized to conduct in-depth interviews with the pediatric health care professionals including two Pediatric nurses and two Pediatric physicians, each from outpatient and inpatient unit of the selected Pediatric setting.

Results: All the study participants indicated that caring for intersex children and their families is challenging as the condition is considered as taboo and as one of the social emergencies in the Pakistani pediatric setting. The commonly faced challenges of Pediatric health care professionals were highlighted as: the dilemma of declaring the child’s exact gender, parental preference for male sex, limited expertise of health care professionals, non-compliance of treatment, time constrains, and long term management of the condition.

Conclusion: In Pakistan, care of Intersex children and their families presents several challenges for the pediatric health care professionals. To effectively care for intersex children and their parents at Pakistani pediatric setting, need was viewed to enhance collaborative approach among pediatric health team and assure proper training of pediatric health care professionals during their undergraduate studies.