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Gaceta médica de México
On-line version ISSN 2696-1288Print version ISSN 0016-3813
Abstract
VALDEZ-MARTINEZ, Edith; MARQUEZ-GONZALEZ, Horacio and BEDOLLA, Miguel. Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality. Gac. Méd. Méx [online]. 2024, vol.160, n.2, pp.179-186. Epub Oct 25, 2024. ISSN 2696-1288. https://doi.org/10.24875/gmm.23000460.
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.
Keywords : Adolescent; Bioethics; Intellectual disability; Hysterectomy; Medicalization.