First adolescent romantic and sexual experiences in individuals with differences of sex development/intersex conditions
Open accessAbstract
PURPOSE: Adolescence is an important period for sexual development, including sexual debut. The purpose of this study was to assess first romantic and sexual experiences and debut age in individuals with differences of sex development (DSD/intersex) and compare these with age-matched and gender-matched population control values. METHODS: Questionnaire data on sociodemographic characteristics, romantic and sexual milestones (e.g., masturbation, dating), satisfaction with sexual life and sexual activity at follow-up, self-esteem, and feelings of femininity or masculinity were collected from 976 participants in Europe with a DSD condition. Participants were divided into six diagnostic subgroups based on their diagnostic classification: women with Turner syndrome, congenital adrenal hyperplasia, 46XY-DSD nonvirilized, and 46XY-DSD female partially virilized conditions and men with 46XY-DSD male or Klinefelter syndrome. Age-specific and gender-specific reference values were retrieved from a Dutch population sample. RESULTS: Individuals with DSD were less likely to reach each of the romantic and sexual milestones compared to their peers without these conditions and they were significantly older when reaching these milestones. Between clinical subgroups, individuals with Klinefelter were significantly older when reaching milestones and in the female groups and individuals with Turner were the least likely to reach milestones. Furthermore, a higher age when reaching several romantic and sexual milestones was correlated with lower self-esteem, lower satisfaction with sexual life, and lower sexual frequency at follow-up. DISCUSSION: Due to a difference in biopsychosocial context, individuals with DSD often experience a different and/or delayed sexual development during adolescence. Healthcare providers should be aware of these differences in adolescents with DSD and their sexual development to optimize affirmative counseling.
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Compared with individuals with premature ovarian insufficiency, individuals with TS showed a delay in median age at first relationship, irrespective of the age at start of estrogen treatment.
“Compared with individuals with premature ovarian insufficiency, individuals with TS showed a delay in median age at first relationship, irrespective of the age at start of estrogen treatment (below or above 14 years of age).”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [558]
In the DSD Life Study, among all participants, those with TS showed the oldest debut age of sexual activity among individuals with DSD.
“A study of first romantic and sexual experiences in the DSD Life Study558 showed that amongst all participants, those with TS showed the oldest debut age of sexual activity amongst individuals with DSD.”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [558]
Fewer women with TS had ever had sexual intercourse, and those who did were older at first intercourse.
“Further, fewer women with TS had ever had sexual intercourse, and those who did were older at first intercourse.”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [558]
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References 38 · Cited by 12
- Authors
- de Brouwer, I. J., Suijkerbuijk, M., van de Grift, T. C., & Kreukels, B. P. C.
- Affiliations
- Amsterdam Public Health (NL)
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2022-12
- Volume
- 71
- Issue
- 6
- Pages
- 688-695
- ISSN
- 1054-139X (ISSN-L)
- OpenAlex
- W4295018409
- Cited by
- 12
- References
- 38
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 1
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Adolescent Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Funders
- European Commission Seventh Framework Programme for Research and Technological Development Health (305,373)
- Seventh Framework Programme
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Keywords
- disorders of sex development, intersex, adolescent sexual development, sexual initiation, romantic experience, Klinefelter syndrome, Turner syndrome, congenital adrenal hyperplasia, 46,XX disorders of sex development, 46,XY disorders of sex development, self-esteem, sexual satisfaction, sexual frequency
- MeSH terms
- Adolescent, Female, Humans, Male, Surveys and Questionnaires, Self Concept, Sexual Behavior, Disorders of Sex Development, Sexual Development
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