{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:34:17Z","timestamp":1793694857154,"version":"4.5.1"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100007161","name":"Boston University","doi-asserted-by":"publisher","award":["H-41907"],"award-info":[{"award-number":["H-41907"]}],"id":[{"id":"10.13039\/100007161","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007265","name":"Boston University School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Social Science &amp; Medicine"],"published-print":{"date-parts":[[2023,7]]},"DOI":"10.1016\/j.socscimed.2023.116047","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T13:54:25Z","timestamp":1687614865000},"page":"116047","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":39,"special_numbering":"C","title":["Intersex people's perspectives on affirming healthcare practices: A qualitative study"],"prefix":"10.1016","volume":"329","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-8157","authenticated-orcid":false,"given":"Darius","family":"Haghighat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-6336","authenticated-orcid":false,"given":"Tala","family":"Berro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8008-8548","authenticated-orcid":false,"given":"Lillian","family":"Torrey Sosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-2188","authenticated-orcid":false,"given":"Kayla","family":"Horowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bria","family":"Brown-King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1712-6403","authenticated-orcid":false,"given":"Kimberly","family":"Zayhowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9\u201310","key":"10.1016\/j.socscimed.2023.116047_bib1","first-page":"1019","article-title":"Gonadal malignancy risk and prophylactic gonadectomy in disorders of sexual development","volume":"28","author":"Abac\u0131","year":"2015","journal-title":"J. Pediatr. Endocrinol. Metabol."},{"key":"10.1016\/j.socscimed.2023.116047_bib2","series-title":"AMA Code of Medical Ethics: Patient Privacy & outside Observers to the Clinical Encounter","author":"American Medical Association","year":"2016"},{"key":"10.1016\/j.socscimed.2023.116047_bib3","doi-asserted-by":"crossref","DOI":"10.1002\/jgc4.1621","article-title":"Practice resource-focused revision: standardized pedigree nomenclature update centered on sex and gender inclusivity: a practice resource of the National Society of Genetic Counselors","author":"Bennett","year":"2022","journal-title":"J. Genet. Counsel."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib4","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1002\/(SICI)1520-6300(200003\/04)12:2<151::AID-AJHB1>3.0.CO;2-F","article-title":"How sexually dimorphic are we? Review and synthesis","volume":"12","author":"Blackless","year":"2000","journal-title":"Am. J. Hum. Biol."},{"issue":"77","key":"10.1016\/j.socscimed.2023.116047_bib5","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"issue":"1","key":"10.1016\/j.socscimed.2023.116047_bib6","article-title":"Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches","volume":"21","author":"Braun","year":"2021","journal-title":"Counsel. Psych. Res."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib7","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.healthpol.2012.02.018","article-title":"How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient\u2013physician interaction","volume":"105","author":"Budych","year":"2012","journal-title":"Health Pol."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib8","first-page":"205","article-title":"Intersex variations, human rights, and the international classification of diseases","volume":"20","author":"Carpenter","year":"2018","journal-title":"Heal. Hum. Rights"},{"key":"10.1016\/j.socscimed.2023.116047_bib10","series-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"Creswell","year":"2018"},{"key":"10.1016\/j.socscimed.2023.116047_bib11","article-title":"Towards an agency-based model of intersex, variations of sex characteristics (VSC) and DSD\/dsd health","volume":"1","author":"Crocetti","year":"2020","journal-title":"Cult. Health Sex."},{"key":"10.1016\/j.socscimed.2023.116047_bib12","series-title":"Contesting Intersex: the Dubious Diagnosis","author":"Davis","year":"2015"},{"key":"10.1016\/j.socscimed.2023.116047_bib13","series-title":"Making Sense of Intersex: Changing Ethical Perspectives in Biomedicine","author":"Feder","year":"2014"},{"key":"10.1016\/j.socscimed.2023.116047_bib14","series-title":"Epistemic Injustice: Power and the Ethics of Knowing","author":"Fricker","year":"2007"},{"issue":"1","key":"10.1016\/j.socscimed.2023.116047_bib15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/MED.0000000000000460","article-title":"Ethical issues with early genitoplasty in children with disorders of sex development","volume":"26","author":"Harris","year":"2019","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"10.1016\/j.socscimed.2023.116047_bib16","article-title":"Intersex lived experience: trauma and posttraumatic growth in narratives","volume":"1","author":"Hart","year":"2021","journal-title":"Psych. Sexual."},{"key":"10.1016\/j.socscimed.2023.116047_bib17","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.socscimed.2016.12.047","article-title":"Negotiating intersex: a case for revising the theory of social diagnosis","volume":"175","author":"Jenkins","year":"2017","journal-title":"Soc. Sci. Med."},{"issue":"6","key":"10.1016\/j.socscimed.2023.116047_bib18","doi-asserted-by":"crossref","first-page":"608.e1","DOI":"10.1016\/j.jpurol.2017.03.035","article-title":"Attitudes towards \u201cdisorders of sex development\u201d nomenclature among affected individuals","volume":"13","author":"Johnson","year":"2017","journal-title":"J. Pediatr. Urol."},{"issue":"1","key":"10.1016\/j.socscimed.2023.116047_bib19","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/14647001211062740","article-title":"The harms of medicalisation: intersex, loneliness and abandonment","volume":"23","author":"Jones","year":"2022","journal-title":"Fem. Theor."},{"issue":"5","key":"10.1016\/j.socscimed.2023.116047_bib20","doi-asserted-by":"crossref","first-page":"794","DOI":"10.21037\/tau.2016.08.09","article-title":"Malignancy in disorders of sex development","volume":"5","author":"Kathrins","year":"2016","journal-title":"Transl. Androl. Urol."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib21","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1210\/jc.2011-1441","article-title":"Satisfaction with genital surgery and sexual life of adults with XY disorders of sex development: results from the German clinical evaluation study","volume":"97","author":"K\u00f6hler","year":"2012","journal-title":"J. Clin. Endocrinol. Metabol."},{"key":"10.1016\/j.socscimed.2023.116047_bib22","series-title":"Intersex Critiques: Notes on Intersex, Disability, and Biomedical Ethics","author":"Koyama","year":"2003"},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib23","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/s41443-021-00422-x","article-title":"Psychosocial care and support in the field of intersex\/diverse sex development (dsd): counselling experiences, localisation and needed improvements","volume":"33","author":"Lampalzer","year":"2021","journal-title":"Int. J. Impot. Res."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib24","first-page":"e488","article-title":"& in collaboration with the participants in the international consensus conference on intersex organized by the lawson wilkins pediatric endocrine society and the European society for paediatric endocrinology","volume":"118","author":"Lee","year":"2006","journal-title":"Consens. Stat. Manag. Inter. Disord. Pediatr."},{"issue":"3","key":"10.1016\/j.socscimed.2023.116047_bib25","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1159\/000442975","article-title":"Global disorders of sex development update since 2006: perceptions, approach and care","volume":"85","author":"Lee","year":"2016","journal-title":"Horm. Res. Paediatr."},{"issue":"8","key":"10.1016\/j.socscimed.2023.116047_bib26","doi-asserted-by":"crossref","first-page":"897","DOI":"10.4158\/EP171758.OR","article-title":"Observed deficiencies in medical student knowledge of transgender and intersex health","volume":"23","author":"Liang","year":"2017","journal-title":"Endocr. Pract."},{"issue":"5","key":"10.1016\/j.socscimed.2023.116047_bib27","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1055\/s-0035-1548793","article-title":"Building trust: the history and ongoing relationships amongst DSD clinicians, researchers, and patient advocacy groups","volume":"47","author":"Lossie","year":"2015","journal-title":"Horm. Metab. Res."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib28","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/19419899.2018.1453862","article-title":"Making sense of \u2018Intersex\u2019 and \u2018DSD\u2019: how laypeople understand and use terminology","volume":"9","author":"Lundberg","year":"2018","journal-title":"Psych. Sexual."},{"issue":"13","key":"10.1016\/j.socscimed.2023.116047_bib29","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual. Health Res."},{"issue":"2","key":"10.1016\/j.socscimed.2023.116047_bib30","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/ajmg.c.31563","article-title":"Challenges in educating patients and parents about differences in sex development","volume":"175","author":"McCauley","year":"2017","journal-title":"Am. J. Med. Genet. Part C: Seminars in Medical Genetics"},{"issue":"9","key":"10.1016\/j.socscimed.2023.116047_bib31","doi-asserted-by":"crossref","first-page":"e379","DOI":"10.3928\/19382359-20210818-02","article-title":"Medical trauma in LGBTQIA youth: adapting trauma-informed affirming clinical practices","volume":"50","author":"Ramos","year":"2021","journal-title":"Pediatr. Ann."},{"issue":"4\u20135","key":"10.1016\/j.socscimed.2023.116047_bib32","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1080\/00224499.2019.1578331","article-title":"Intersex or diverse sex development: critical review of psychosocial health care research and indications for practice","volume":"56","author":"Roen","year":"2019","journal-title":"J. Sex. Res."},{"issue":"3","key":"10.1016\/j.socscimed.2023.116047_bib33","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jogc.2020.05.015","article-title":"Prenatal genetic testing for intersex conditions in Canada","volume":"43","author":"Saulnier","year":"2021","journal-title":"J. Obstet. Gynaecol. Can."},{"issue":"8","key":"10.1016\/j.socscimed.2023.116047_bib34","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1111\/jsm.12214","article-title":"Shaping parents: impact of contrasting professional counseling on parents' decision making for children with disorders of sex development","volume":"10","author":"Streuli","year":"2013","journal-title":"J. Sex. Med."},{"issue":"6","key":"10.1016\/j.socscimed.2023.116047_bib35","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/jmwh.13189","article-title":"Consent in pelvic care","volume":"65","author":"Tillman","year":"2020","journal-title":"J. Midwifery Wom. Health"},{"issue":"8","key":"10.1016\/j.socscimed.2023.116047_bib36","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1111\/1467-9566.12974","article-title":"Gender destinies: assigning gender in Disorders of Sex Development-Intersex clinics","volume":"41","author":"Timmermans","year":"2019","journal-title":"Sociol. Health Illness"},{"issue":"3","key":"10.1016\/j.socscimed.2023.116047_bib37","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jpurol.2013.11.016","article-title":"Caregivers of children with a disorder of sex development: associations between parenting capacities and psychological distress","volume":"10","author":"Wolfe-Christensen","year":"2014","journal-title":"J. Pediatr. Urol."},{"issue":"1","key":"10.1016\/j.socscimed.2023.116047_bib38","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/0533316405049369","article-title":"Queer theory","volume":"38","author":"Watson","year":"2005","journal-title":"Group Anal."},{"issue":"6","key":"10.1016\/j.socscimed.2023.116047_bib39","doi-asserted-by":"crossref","first-page":"334","DOI":"10.14423\/SMJ.0000000000001261","article-title":"Transgender-competent health care: lessons from the community","volume":"114","author":"Zatloff","year":"2021","journal-title":"South. Med. J."},{"issue":"5","key":"10.1016\/j.socscimed.2023.116047_bib40","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1093\/eurpub\/cky226","article-title":"A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities","volume":"29","author":"Zeeman","year":"2019","journal-title":"Eur. J. Publ. Health"},{"issue":"3","key":"10.1016\/j.socscimed.2023.116047_bib41","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/1464700109343258","article-title":"Why do \u2018we\u2019perform surgery on newborn intersexed children? The phenomenology of the parental experience of having a child with intersex anatomies","volume":"10","author":"Zeiler","year":"2009","journal-title":"Fem. Theor."}],"container-title":["Social Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953623004045?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953623004045?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T16:01:56Z","timestamp":1759507316000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953623004045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":40,"alternative-id":["S0277953623004045"],"URL":"https:\/\/doi.org\/10.1016\/j.socscimed.2023.116047","relation":{},"ISSN":["0277-9536"],"issn-type":[{"value":"0277-9536","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Intersex people's perspectives on affirming healthcare practices: A qualitative study","name":"articletitle","label":"Article Title"},{"value":"Social Science & Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.socscimed.2023.116047","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"116047"}}