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This study aimed to evaluate courtesy stigma and the adaptation process of parents of children with Down syndrome based on semi\u2010structured interviews with 23 Japanese parents. The interview themes were (a) negatively perceived interpersonal experiences and coping strategies; (b) information disclosure and others\u2019 responses; and (c) positively perceived interpersonal experiences. The interview data were transcribed and analyzed based on a grounded theory approach. The results suggested that parents perceived and experienced multidimensional courtesy stigma, and they used various coping strategies categorized in combinations of passive\u2013active and internal\u2013external. All parents disclosed information about their child's diagnosis to others, and reverse disclosure (i.e., revealing own relations with people with disabilities) was characteristically observed thereafter. Through active interaction and reflection, the parents cultivated social relationships, compassion, world views, and community involvement, which led to the transcendent stage. However, internal conflict as a mediator between people with and without Down syndrome re\u2010emerged even after achieving the transcendent stage. These findings could help to develop interventions in genetic counseling for parents to deal with interpersonal relationship difficulties.<\/jats:p>","DOI":"10.1002\/jgc4.1541","type":"journal-article","created":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T10:14:02Z","timestamp":1640340842000},"page":"746-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Courtesy stigma of parents of children with Down syndrome: Adaptation process and transcendent stage"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6779-7059","authenticated-orcid":false,"given":"Motoko","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Clinical Genetics Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Institute for Human Life Innovation Ochanomizu University  Tokyo 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