{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:09:38Z","timestamp":1784790578238,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Variations in Sex Characteristics (VSC) also called Differences in\/Disorders of Sex Development (DSD) include a range of conditions of congenital abnormalities of the reproductive system. Either the internal and\/or external genital tract are affected, presenting as androgenisation of the external genitalia, or incomplete formation of the vagina and uterus, and\/or gonads. We previously developed a model of the core psychological impact of diagnosis\/medical treatment of one of these conditions, namely utero\u2010vaginal\u2010agenesis or Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser Syndrome (MRKH), and a Cognitive\u2010Behavioural Therapy of MRKH (CBT\u2010MRKH) based on this, a randomized\u2010controlled\u2010trial of which showed improved psychological outcomes in participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The current study reviews both the consolidation of CBT\u2010MRKH and its subsequent adaptation to CBT\u2010MRKH\/DSD+ to reach a wider VSC\/DSD audience, who similarly experience a threat to their sense of self\/identity following diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A qualitative audit of therapy notes was completed, of both 2 further CBT\u2010MRKH group programs run, and a 3rd and 4th series, of its broadened\/deepened CBT\u2010MRKH\/DSD+ version. This audit focused on participants' experiences of therapy and impact on view of self\/self\u2010beliefs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants collectively valued the group support, and the techniques used such as the therapeutic writing tasks and cognitive restructuring of negative beliefs, plus VSC\/DSD\u2010specific tools\/skills training. The collective quotes illustrate the marked positive changes participants experienced in terms of their view of themselves and their condition, emotions processed, and adaptive self\u2010schemata and coping developed throughout therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Taking the results from CBT\u2010MRKH we were able to apply it to a broader VSC\/DSD audience with success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70133","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:22:23Z","timestamp":1776230543000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Cognitive Behavioural Therapy for Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser Syndrome Adapted for Other Disorders of Sex Development: A Qualitative Study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5384-4155","authenticated-orcid":false,"given":"J. G.","family":"Heller\u2010Boersma","sequence":"first","affiliation":[{"name":"Royal Hospital for Women &amp; University of New South Wales (UNSW)  Sydney New South Wales Australia"},{"name":"Queen Charlotte's &amp; Chelsea Hospital  London UK"},{"name":"City University  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. K.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Queen Charlotte's &amp; Chelsea Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. L.","family":"Rose","sequence":"additional","affiliation":[{"name":"Queen Charlotte's &amp; Chelsea Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Deans","sequence":"additional","affiliation":[{"name":"Royal Hospital for Women &amp; University of New South Wales (UNSW)  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"670","volume-title":"Pediatric Endocrinology","author":"Sperling M. A.","year":"2008"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.50.3.277"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13296"},{"key":"e_1_2_7_5_1","article-title":"The Psychosocial Impact of Disorders of Sexual Development","volume":"2","author":"Ravendran K.","year":"2019","journal-title":"Journal of Sexual Medicine and Reproductive Health"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465809990051"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(99)00123-0"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.03.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem167"},{"key":"e_1_2_7_10_1","volume-title":"SCL\u201090\u2010R Administrative, Scoring and Procedures Manual\u2010II","author":"Derogatis L. 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G.Heller\u2010Boersma \u201cScaling Your Mountains with Mayer\u2010Rokitansky\u2010K\u00fcster\u2010Hauser (MRKH) Syndrome and Differences of Sex Development (DSD) from the Adolescent into the Adult Years \u2013 The Notches Programme \u2013 A Roadmap\/Guide for Mind\u2010Body Health \u201dSubmitted."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2015-2093"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001672"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC-20-0304"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2017-000132"},{"issue":"3","key":"e_1_2_7_17_1","first-page":"5752","article-title":"Utilization of Health Care Services and Satisfaction With Care in Adults Affected by Disorders of Sex Development (DSD)","volume":"29","author":"Thuyen U.","year":"2014","journal-title":"Journal of General Internal Medicine"},{"key":"e_1_2_7_18_1","volume-title":"Finding Meaning \u2013 The Sixth Stage of Grief","author":"Kessler D.","year":"2019"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70133","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.70133","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:34:47Z","timestamp":1784788487000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.70133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/ajo.70133"],"URL":"https:\/\/doi.org\/10.1111\/ajo.70133","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-02-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70133"}}