Absence des organes génitaux internes chez la femme : enjeux et répercussions sur l’identité sexuelle

Abstract

ObjectivesMayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare congenital malformation of the female internal organs. This disorder causes the uterus and vagina to be absent and affects one in 4,500 newborn girls. In a psychodynamic approach and in a qualitative and quantitative perspective, we aim to highlight some of the issues raised by the syndrome and its treatment, in particular the creation of a “neo-vagina”, in terms of the establishment of sexual identity among the women involved. MethodsOur research is based on an interdisciplinary, triangular process in which patient, doctor and clinical psychologist work together in specialized medical consultations. The data collection process also includes individual clinical research interviews between the young women and the clinical psychologist. The study involved seventeen patients. ResultsOn the basis of this study, it is possible to identify both fantasmatic and physical representations specific to MRKH patients. Most of these representations (summarized in a table) are common to the majority of the patients, some are specific to a few young women, and relate to their body image perception and their sexual investment. DiscussionThe study is based on single interviews, apart from two patients (ten interviews each). However, we are currently providing long-term follow-up. ConclusionIn most cases, there is a fetishist issue related to the phallic dimension of the neo-vagina and a high investment in bodily appearance and/or external signs of femininity.