Vaginal construction and treatment providers’ experiences: a qualitative analysis

Roen, Katrina; Creighton, Sarah M.; Hegarty, Peter and Liao, Lih-Mei (2018). Vaginal construction and treatment providers’ experiences: a qualitative analysis. Journal of Pediatric and Adolescent Gynecology, 31(3) pp. 247–251.

DOI: https://doi.org/10.1016/j.jpag.2018.01.001

URL: https://doi.org/10.1016/j.jpag.2018.01.001

Abstract

Objective<br />
To investigate specialist clinicians’ experiences of treating vaginal agenesis.<br />
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Design<br />
Semi-structured interviews.<br />
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Setting<br />
12 hospitals in Sweden and the UK.<br />
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Sample<br />
32 health professionals connected to multidisciplinary teams including medical specialists and psychologists.<br />
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Methods<br />
Theoretical thematic analysis of recorded verbatim data.<br />
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Results<br />
The gynecologist and psychologist interviewees share certain observations including the importance of psychological readiness for and appropriate timing of treatment. Three overlapping themes are identified in our theoretical analysis of the MDT clinicians’ talk: 1) The stigma of vaginal agenesis and the pressure to be ‘normal’ can lead patients to minimize the time, effort, physical discomfort and emotional cost inherent in treatment. 2) Under pressure, treatment may be presented to patients with insufficient attention to the potential psychological impact of the language used. Furthermore, the opportunity to question what is ‘normal’ in sex is generally not take up. It can be challenging to help the women to transcend their medicalized experiences to come to experiencing their bodies as sexual and enjoyable. 3) The reality of treatment demands, which is not always adequately processed prior to treatment, can lead to discontinuation with treatment and even disengagement with services.<br />
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Conclusions<br />
Whilst the MDT clinicians in this study emphasized the importance of psychological input in vaginal construction, such input may need to proactively question social norms about how women’s genital should appear and function. Furthermore, rather than steering patients (back) to treatment, the entire MDT could more explicitly question social norms and help the women to do the same. By shifting the definition of success from anatomy to personal agency, the clinical focus is transformed from treatment to women.<br />

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