Xiaoping's (pseudonym) mother and father took the test sheet and went to the Guangzhou Women and Children's Medical Center to find a teenager ** doctor. The doctor said it was up to the patient. Mom whispered, "There are some things we don't want her to know about ......”
The doctor was a little puzzled, and was stunned after seeing the child's electronic medical record, and then asked"You first took her to the doctor because she didn't have her period, right? ”
Mom said yes, the female classmates all menstruated, and the daughter didn't come, so the parents took her to other hospitals for examination, and accidentally found that the daughter had a high testosterone, that is, a high androgen!
Normal female androgens 19nmol L, while Xiaoping's androgens are as high as 3252nmol L, which is 30 times more than the level of a normal adult male.
This indication is entirely that of a boy.
Moreover, the SRY gene was also detected in her body (the SRY gene should not be detectable in normal women).
The chromosomes were also tested and the result was 46xy (46xx for normal females). Biologically, it's entirely masculine.
That is to say,This 14-year-old girl, Xiaoping, is actually a man!
The above plot is from the second season of the documentary "Hello, Pediatrician".
Why do parents hide their children's illness? Because they love their daughters so much, they can't bear to face such cruel truths in the flower season. But what next?
About the initial diagnosis of the condition
The doctor asked her parents, "Is there a lot of hair on Xiaoping's body?" ”
Mom said that there is no hair, it is ordinary body hair, and the hair is not even as much as that of the mother, and there is no hair. If the only abnormality is that the child is very strong, it can be said that he is fat.
After the doctor understood the situation, he let the ignorant Xiaoping in, and the child had no idea what was going on.
The doctor asked your child if he was feeling unwell. Xiaoping said not at all. The mother added that children are less sick from an early age.
Then the doctor examined Xiaoping and found that she had normal female characteristics on her body.
Later, the doctor let Xiaoping go out and told her mother privately that Xiaoping's situation was called"Androgen insensitivity syndrome".It is a rare disease with an incidence of about20,000 to 1 in 100,000.
Xiaoping has a male gonada that secretes normal levels of androgens. However, she is deficient in androgen receptors, so she is unable to develop secondary sex characteristics such as the Adam's apple, which is unique to men.
Xiaoping's mother has done a lot of examinations with her child, but she has always wondered: is the child a boy or a girl? Do I need medication or surgery? Is it possible for a daughter to become a boy?
Parents raised Xiaoping as a daughter from childhood to adulthood, and they couldn't accept her becoming a man at all.
The best plan to be discussed by the doctor
Among the examination materials brought by Xiaoping's mother, some hospitals believe that Xiaoping has a stunted uterus.
However, the doctors of Guangzhou Women and Children's Medical Center had doubts about this, and after careful consideration, they believed that they should do an MRI to check whether the child had a uterus or whether there was **.
Normal** is external, but it cannot be ruled out that it will grow in the abdominal cavity. The doctor is most worried about the ** lesion, the older the age, the higher the probability of malignant transformation. If this is the case, surgical excision** is done.
Parents are also most worried about the lesion, because it can be life-threatening.
After the MRI results came out, the doctor found no obvious gonads**. This is unreasonable, because androgens are so high, there should be **.
Later, the doctor organized a multidisciplinary consultation, including the chief doctors of genetics, urology, imaging, and endocrinology**.
The director of the imaging department believes that the uterus, which is considered to be "dysplasia", is most likely not a uterus, but **. Specifically, laparoscopy is needed to see if the gonads are in the first place and whether there are any abnormal changes.
Experts discussed whether to do surgery to remove the gonads, and finally concluded that if the gonads are not cancerous, they can wait until the child is 18 years old and obtain the child's consent before deciding whether to remove it.
Later,Xiaoping underwent laparoscopy, which showed that the gonads in the body were **, and no cancerous tissue was found. The doctor decided to preserve the gonads and let them go to the hospital for regular follow-up check-ups.
Mom and Dad want her to grow up healthy and happy
Xiaoping is a very cheerful child. While waiting for the doctor's consultation, she asked her parents, "Is it that after seeing this disease, I don't have to come again?" ”
Mom and Dad were silent at the same time. They didn't want to lie to the child, but they had to lie to her.
It can be seen from the documentary that Mom and Dad love Xiaoping very much.
When my mother talked to the doctor, she couldn't help but cry. She was worried about her daughter's health, and she couldn't stop her tears when she thought that her daughter would not have a chance to be a mother again.
She is not worried about issues such as inheritance, but she is sad that her daughter may have some regrets in her life.
Dad was also very devastated, he couldn't accept it at all, and the big man couldn't help crying in front of the camera:"None of our family has this problem, why would my daughter have? When I went to the hospital for an examination, I said that your daughter is all male inside, and she really can't accept ...... at all”
Although he can't accept it in his heart and feels very sorry for his children, as a father, he must calm down, consider his wife's feelings, and stabilize his daughter's emotions at the same time.
Their collapse was understood by the doctor, so he had to comfort them: "The child's situation is a blessing in misfortune, at least she does not have the appearance of a man and a woman." From the point of view of appearance, Xiaoping is completely a girl, which actually avoids some of the most direct discrimination. ”
As for whether to tell the daughter about this, the doctor felt that the parents' concerns were right. After all, the child is still young, and if she knows, it may have an impact on her psychology and life.
Of course, the mother also knows that sooner or later this will have to be told to the child. It's just that she wants her child to face this difficult subject later. No matter which child it is, it's all the meat that fell from the mother's body.
Mom and Dad took Xiaoping for many check-ups, and at first they were devastated. But as they learn more and more information, they don't care so much anymore and now care most about their children's physical and mental health. Their only wish is for their children to grow up healthy and happy.
Xiaoping may encounter a lot of trouble in the future, but with the love and support of her parents, she will eventually find herself and grow into the best version of herself.
Finally, I also called on society and families to give more tolerance and understanding to this special group of people. Because they have never done anything wrong, they should not suffer some unwarranted malice.
Reference: Season 2 of the documentary "Hello, Pediatrician".