Page 153 - Abstract Book KONIKA 18

Developmental Behavioral & Community Pediatrics

P-DBCP-043
Gender Role Behaviour Issues in Teenage Girl
with Congenital Adrenal Hyperplasia

Isti Ansharina Kathin, Bernie Endyarni Medise, Aman Bhakti Pulungan
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background Prepubertal adolescent with congenital adrenal hyperplasia (CAH) may have issues in gender
role behavior due to excessive fetal adrenal androgen production and in-utero “virilization” of the brain.
Good hormonal control has effects on gender identity of patients with CAH. Objective To present gender
behaviour issue which associated with socio-cultural background, religion, and inadequate treatment of
CAH. Case A 12 year-old female routinely went to pediatric endocrinology clinic. Her mother complained
about her daughter who loved playing football just like the boys, even though she has been raising her as a
girl. She had deep voice and walked like a boy. Her menstrual cycle was irregular. Sometimes she exerted
rude behaviour, being disrespectful, rebellious and obstinate. However, she had no difficulties in making
friends. General physical examination was normal, Tanner stage axilla 1, mammae 3, pubic hair 4 and 1.5
centimeters phallus. She had her chromosome analysis at 1 month-old and the result was 46,XX. She had
lifetime replacement therapy with 15 mg/m hydrocortisone daily orally. The compliance was poor due to
2
drug availability and boredom of taking medicine every day. Pediatric Symptoms Checklist 17 Items (PSC-
17) total score was 20. Furthermore, Strengths and Difficulties Questionnaire (SDQ) showed behavioral
problems. She was on long term follow up plan and was advised to maintain a good compliance to her
medication. She also being monitored by Developmental Behavioral & Community Pediatrics Division for
her behavioral problems. Conclusion A teenage girl with CAH often had problems in gender role behavior.
Longterm follow up was very important particularly on medication compliance and behavioral treatment.
Keywords: CAH; adolescent; gender role behavior

KONIKA XVIII Abstract Book 105