%0 Journal Article
%T Does Patient
%A Ashelee Yang
%A Beverly M. Yashar
%A Catherine E. Keegan
%A David E. Sandberg
%A Eric Vilain
%A Laura A. Siminoff
%A Margarett Shnorhavorian
%A Melissa Gardner
%A Patricia Y. Fechner
%A Stefan Timmermans
%J Journal of Health and Social Behavior
%@ 2150-6000
%D 2018
%R 10.1177/0022146518802460
%X Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies about the appropriateness and timing of surgery, generating clinical uncertainty about decision making. Since 2006, medical experts and patient advocates have argued for putting the child¡¯s needs central as patient-centered care. Based on audio recordings of 31 parent¨Cclinician interactions in three clinics of disorders of sex development, we analyze how parents and clinicians decide on genital surgery. We find that clinicians and parents aim for parent-centered rather than infant-centered care. Parents receive ambivalent messages about surgery: while clinicians express caution, they also present the surgery as beneficial. We examine how parents and clinicians reach agreement about surgery¡ªdifferentiating parents who push strongly for surgery from parents who do not express any preconceived preferences about surgery and parents who resist surgery. We conclude that clinicians use clinical uncertainty about surgery strategically to direct parents toward perceived clinically appropriate decisions
%K decision making
%K disorders of sex development
%K genital surgery
%K intersex
%K patient-centered care
%K patient¨Cdoctor communication
%U https://journals.sagepub.com/doi/full/10.1177/0022146518802460