Gender Confusion

Alterina Hofan airings case only iceberg of the many people with genital ambiguity in Indonesia. but this case shows the irony that people with genital ambiguity still fall victim to public ignorance
As an illustration Alterina prosecutors demanded seven years in prison for allegedly falsifying identity sebelunya women become men in December 2006. Though known as the Alter indrom Klinefelter patients. Patients with XXY chromosomes like the physical features of women, such as breast growth and no appearance of hair in some parts of the body, but androgynous men are genetically.
Klinefelter syndrome is just one of many cases of genital ambiguity> confusion is due to chromosomal aberrations or gene mutations, also alleged there is an external influence. such as the use of hormonal drugs in pregnant women.
Generally the disease is not caused by transcription factors. But for the case of Congenital adrenal hyperplasia (CAH), illness of parents who have obtained gene carrier (carrier). CAH sufferers are women who have an enlarged clitoris until it resembles a penis, so often identified as a man. Broadly speaking, people with genital ambiguity can be male with female physical or otherwise, as in the case of CAH. Symptoms vary depending on the stage. Usually, men who suffer from gender confusion to have small testes and penis, accompanied by the growth of breasts. In fact, there is also to have hypospadias or leaking of the urethra between the scrotum (testicles) so that urine does not exit through the tip of the penis. If this case happened to women, the patient will look like men because the breast is not growing, menyeruapi enlarged clitoris penis, development of the body becomes like a man and sometimes berjakun. chances of people with genital ambiguity 1: 4500 births.

Early Detection
genital ambiguity or intersex, in contrast to transsexuals. In the confusion of gender, physical development does not correspond to genes or chromosomes, whereas in the case of transsexuals do not fit with the psychic of the patients concerned. Genetically and physically transsexual patients do not experience the problem, it's just that mental condition does not correspond to physical development.
To overcome the gender bias is needed early detection of chromosome examination and Deoxyribonucleid Acid (DNA) in newborns, in addition to physical appearance, to see the presence or absence of abnormality. In order to avoid detection and legal impact psikolgis acceptable penderitakarena genital ambiguity at a later date.
Under certain conditions during pregnancy examination is also required to ensure the presence or absence of defects in the fetus. This check is done if there is a certain risk to the mother, such as women over the age of 35, never having children who suffer from gender bias and have had recurrent miscarriages. Error identification of sex in the newborn can be fatal front of his mature later. Sebbagai example, someone who is genetically male sex, but life as a woman since childhood, will be familiar with a worldview and a woman's sexual orientation. So when it was decided to be restored to men, not only altered the physical but also psychological side ... not easy.

Psychological musty
Before it was decided to change sex, the team physician should already know the sex chromosomes and in accordance with the psychological aspects of the patient. Patients will experience a long process through various consultations. Usually involved a variety of specialties in the medical team such as genetics, andrology, urology, psychology, psychiatry, anesthesia, endocrinology, radiology, clinical pathology should also be involved religious scholars.
Psychic condition of patients is strongly influenced by the surrounding environment. The existence of society's negative assessment of the physical condition is concerned with making it difficult to shut down and accept his situation, other factors are education and sosilisasi about gender confusion so that people can understand better about this problem. During this time constraint in this disease is low awareness of patients to check themselves.

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Avoid going to School

Avoid going to school was about 5% of all school-age children and affects girls and boys equally. Children are sensitive to the possibility of wrong behavior frightened by a strict teacher or nagging. Young children tend to be malingering or making excuses to avoid school. The child may complain of abdominal pain, nausea, or other symptoms that give reason to stay home. Some children refuse to go directly to the school. As an alternative, the child can go to school without difficulty but become agitated or experiencing various symptoms during study hours, often frequently to the infirmary. Avoidance of school tends to lead to poor academic performance, difficulties in the family, and difficulties with peers. A child who avoids school must immediately return to school, so she does not miss school work. If avoidance is so intense school-related activities and the child if the child does not respond to simple persuasion by parents or teachers, submit to a psychologist or psychiatrist probably help.
Every child handles stress differently. Certain behaviors that help children deal with stress include thumb sucking, nail biting, and, sometimes, hitting his head.
Thumb sucking (or sucking a pacifier) is a normal part of early childhood, and most children stop at the time they are 1 or 2 years, but sometimes goes to their school age. Sometimes the thumb sucking is normal in times of stress, but the habit of sucking past the age of about 5 years can change the shape of the palate, causing changes in the line of the teeth, and make harassed by other children. Sometimes thumb prolonged basis could be a sign of emotional disturbance.
Every child immediately stopped sucking his thumb. Parents should be prevented only if their child's dentist advised them as well, or if they feel their child's thumb sucking is socially unhealthy. Parents need to gently encourage the child to understand why it is good to stop. Once the child indicates a willingness to stop, gentle good start. This could be followed by a symbolic award mounted directly on the thumb, such as colored bands, polished fingernails, or draw a star with a dye that contains no toxins, if necessary, additional tools, such as a plastic shield around the thumb, elbow splint overnight to prevent a child from bending, or 'paint' your thumb with a bitter substances could be used. Nail biting is a common problem in young children. Habits are usually lost when the child gets older, but usually associated with stress and anxiety. Children who are motivated to quit can be taught to substitute with other habits (eg, twirling a pencil).
Hitting his head and swung his head rhythmically is common among healthy young children. It reminds parents, the child is not in issue and actually gain comfort from these activities.
Children usually are often rocked his body, rolled, and hit his head between the ages of 18 months to 2 years, but the action is repetitive sometimes still occur in older children and adolescents.
Children with autism and certain other developmental problems can also bang their head.

TREATMENT
Treatment should include communication between parents and school personnel, diligent attendance at school, and sometimes include the family and child therapy with a psychologist. Therapy includes treatment that is based on the same cause behavioral techniques for coping with stress at school.

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