<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0016-3813</journal-id>
<journal-title><![CDATA[Gaceta médica de México]]></journal-title>
<abbrev-journal-title><![CDATA[Gac. Méd. Méx]]></abbrev-journal-title>
<issn>0016-3813</issn>
<publisher>
<publisher-name><![CDATA[Academia Nacional de Medicina de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0016-38132024000200179</article-id>
<article-id pub-id-type="doi">10.24875/gmm.23000460</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Histerectomía no terapéutica en jóvenes mexicanas con discapacidad intelectual: una realidad problematizada]]></article-title>
<article-title xml:lang="en"><![CDATA[Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valdez-Martínez]]></surname>
<given-names><![CDATA[Edith]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Márquez-González]]></surname>
<given-names><![CDATA[Horacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bedolla]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Coordinación de Investigación en Salud Unidad de Investigación Médica en Epidemiología Clínica]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de México "Federico Gómez" Servicio de Investigación Clínica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Investigador independiente  ]]></institution>
<addr-line><![CDATA[San Antonio Texas]]></addr-line>
<country>Estados Unidos</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<volume>160</volume>
<numero>2</numero>
<fpage>179</fpage>
<lpage>186</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0016-38132024000200179&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0016-38132024000200179&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0016-38132024000200179&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La histerectomía no terapéutica en niñas y adolescentes con discapacidad intelectual (DI) es una práctica aceptable, aun cuando se carece de razón ética prescriptiva.  Objetivos: Determinar la magnitud de la práctica de la histerectomía en niñas y adolescentes con DI, y explorar los factores emic asociados a esta práctica.  Material y métodos: Estudio multicéntrico e intersectorial con método mixto.  Resultados: Los resultados cuantitativos mostraron que 50 de 234 histerectomías reportadas correspondieron a mujeres con DI. El promedio de edad a la cirugía fue de 15 ± 2.9 años. La histerectomía abdominal profiláctica fue el procedimiento predominante y las justificaciones fueron control de fertilidad, manejo de la higiene menstrual y riesgo de abuso sexual. El análisis cualitativo de 15 grupos focales reveló que la principal preocupación de los padres fue cómo manejar la enfermedad índice y la salud reproductiva de sus hijas; percibieron positivamente la menstruación, expresaron su miedo a morir y dejarlas sin ayuda, resaltaron el control de la fertilidad y ninguno aprobó la histerectomía.  Conclusiones: Los organismos que definen políticas de salud necesitan crear una nueva filosofía que evite el enfoque reduccionista del actual modelo biomédico, el cual separa (en el proceso salud-enfermedad) la interdependencia entre los seres humanos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason.  Objectives: To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure.  Material and methods: Multicenter, intersectoral study with a mixed methods design.  Results: The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents´ main concern was how to manage their daughters´ index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy.  Conclusions: The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Adolescente]]></kwd>
<kwd lng="es"><![CDATA[Bioética]]></kwd>
<kwd lng="es"><![CDATA[Discapacidad intelectual]]></kwd>
<kwd lng="es"><![CDATA[Histerectomía]]></kwd>
<kwd lng="es"><![CDATA[Medicalización]]></kwd>
<kwd lng="en"><![CDATA[Adolescent]]></kwd>
<kwd lng="en"><![CDATA[Bioethics]]></kwd>
<kwd lng="en"><![CDATA[Intellectual disability]]></kwd>
<kwd lng="en"><![CDATA[Hysterectomy]]></kwd>
<kwd lng="en"><![CDATA[Medicalization]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Márquez-González]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Valdez-Martínez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bedolla]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hysterectomy for the management of menstrual hygiene in women with intellectual disability. A systematic review focusing on standards and ethical considerations for developing countries]]></article-title>
<source><![CDATA[Front Public Health]]></source>
<year>2018</year>
<volume>6</volume>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nettetlon]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[The sociology of health and illness]]></source>
<year>2006</year>
<edition>Second edition</edition>
<publisher-loc><![CDATA[Cambridge, United Kingdom ]]></publisher-loc>
<publisher-name><![CDATA[Polity Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zola]]></surname>
<given-names><![CDATA[IK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Medicine as an institution of social control]]></article-title>
<source><![CDATA[Socio Rev]]></source>
<year>1972</year>
<volume>20</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>487-504</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Conrad]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bergey]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Medicalization:sociological and anthropological perspectives]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<source><![CDATA[International Encyclopaedia of the Social &amp;Behavioural Sciences]]></source>
<year>2015</year>
<edition>Second edition</edition>
<page-range>105-9</page-range><publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<collab>Secretaría de Desarrollo Social</collab>
<source><![CDATA[Diagnóstico sobre la situación de las personas con discapacidad]]></source>
<year>2016</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Sedesol]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="">
<collab>Coneval</collab>
<source><![CDATA[Medición de la Pobreza. Resultados de pobreza en México 2022 a nivel nacional y por entidades federativas]]></source>
<year></year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pluye]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hong]]></surname>
<given-names><![CDATA[QN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Combining the power of stories and the power of numbers:mixed methods research and mixed studies reviews]]></article-title>
<source><![CDATA[Annu Rev Public Health]]></source>
<year>2014</year>
<volume>35</volume>
<page-range>29-45</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hulley]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Cummings]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Browner]]></surname>
<given-names><![CDATA[WS]]></given-names>
</name>
<name>
<surname><![CDATA[Grady]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Newman]]></surname>
<given-names><![CDATA[TB]]></given-names>
</name>
</person-group>
<source><![CDATA[Diseño de investigaciones clínicasn]]></source>
<year>2014</year>
<edition>Cuarta</edition>
<publisher-loc><![CDATA[Barcelona, España ]]></publisher-loc>
<publisher-name><![CDATA[Lippincott Williams and Wilkins]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Márquez-González]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Valdez-Martínez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bedolla]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical epidemiological and ethical aspects of hysterectomy in young females with intellectual disability:a multicentre study of public hospitals in Mexico City]]></article-title>
<source><![CDATA[Front Public Health]]></source>
<year>2021</year>
<volume>9</volume>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dawson]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Trapp]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Bioestadística médica]]></source>
<year>2014</year>
<edition>Cuarta</edition>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Manual Moderno]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The focus group guidebook]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Krueger]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<source><![CDATA[The focus group kit]]></source>
<year>1998</year>
<publisher-loc><![CDATA[London, United Kingdom ]]></publisher-loc>
<publisher-name><![CDATA[SAGE Publications Ltd]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flores-Medina]]></surname>
<given-names><![CDATA[MdR]]></given-names>
</name>
<name>
<surname><![CDATA[Valdez-Martínez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Márquez-González]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Qualitative focus groups with professionals of special education and parents of young females with intellectual disability exploring experiences with menstrual hygiene management and the trigger for the non-therapeutic hysterectomy in Mexico]]></article-title>
<source><![CDATA[Healthcare]]></source>
<year>2022</year>
<volume>10</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1690</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kuzel]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sampling in qualitative inquiry]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Crabtree]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[WL]]></given-names>
</name>
</person-group>
<source><![CDATA[Doing qualitative research]]></source>
<year>1992</year>
<edition>Second edition</edition>
<page-range>31-44</page-range><publisher-loc><![CDATA[London, United Kingdom ]]></publisher-loc>
<publisher-name><![CDATA[SAGE Publications Ltd]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sandelowski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sample size in qualitative research]]></article-title>
<source><![CDATA[Res Nurs Health]]></source>
<year>1995</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>179-83</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<source><![CDATA[Directorio Nacional de Asociaciones de y para Gente con Discapacidades]]></source>
<year>2002</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Instituto Nacional de Estadística y Geografía]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Clarke]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Using thematic analysis in psychology]]></article-title>
<source><![CDATA[Qual Res Psychol]]></source>
<year>2006</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>77-101</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Clarke]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Can I use TA?Should I use TA?Should I not use TA?Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches]]></article-title>
<source><![CDATA[Couns Psychother Res]]></source>
<year>2021</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>37-47</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brabers]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
<name>
<surname><![CDATA[Rademakers]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Groenewegen]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
<name>
<surname><![CDATA[van Dijk]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[de Jong]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[What role does health literacy play in patients'involvement in medical decision-making?]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2017</year>
<volume>12</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Rivera]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz del Ángel]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[México:el reto de ser mujer dentro de una estructura patriarcal]]></article-title>
<source><![CDATA[Asparkía]]></source>
<year>2021</year>
<volume>38</volume>
<page-range>41-58</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beauchamp]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Childress]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<source><![CDATA[Principles of biomedical ethics]]></source>
<year>2001</year>
<edition>Fifth edition</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Oxford University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lonergan]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[Understanding and being:an introduction and companion to insight]]></source>
<year>1987</year>
<publisher-loc><![CDATA[Toronto ]]></publisher-loc>
<publisher-name><![CDATA[Edwing Mellen Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernard]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
<name>
<surname><![CDATA[Gravlee]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
</person-group>
<source><![CDATA[Handbook of methods in cultural anthropology]]></source>
<year>2014</year>
<edition>Second edition</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Rowman and Littlefield]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
