Psychological Aspects of Androgen Insensitivity Syndrome- A Case Report

Abstract

Listen

Translate article

Introduction: Androgen insensitivity syndrome (AIS) is a condition that results in the partial or complete inability of the cell to respond to androgens. A person with androgen insensitivity syndrome can experience significant psychological distress secondary to the ambiguity concerning their sexual anatomy. Psychological evaluation and management of a case of Androgen insensitivity syndrome brought up as a female experiencing such distress is reported here. Case history: A 25 years aged female patient working as a police constable, was referred for psychiatric evaluation for repeated attempts to commit suicide secondary to depression and anxiety arising out of her sexual ambiguity . She had consulted a gynaecologist for not having attained menarche. Ultrasonography of abdomen showed aplastic uterus with streak ovaries. According to chromosome analysis, she was a phenotypic female with male karyotype-46, XY (sex reversal). Her testosterone levels were increased. She had undergone prophylactic laparoscopic gonadectomy . The impact of test results made her anxious and sad. Her sexual ambiguity resulted in worry about getting transformed into a hijda (Eunuch) which led to repeated attempts to commit suicide. Psychiatric intervention consisted of antidepressants and counselling sessions aimed at coming to terms with ambiguity about her gender. Conclusion: Androgen insensitivity syndrome, although very rare, can result in considerable psychiatric morbidity. Apart from gynaecological and endocrinal aspects , addressing associated psychological issues is essential to reduce psychiatric morbidity and increase quality of life.