ORIGINAL ARTICLE Parents’ narratives about their experiences of their child’s reconstructive genital surgeries for ambiguous genitalia Caroline Sanders, Bernie Carter and Lynne Goodacre Aim.The aim of this study was to initiate an exploration of parents’ understanding and experiences of their child’s recon- structive genital surgeries for ambiguous genitalia. Background. The determination of gender for a child born with ambiguous genitalia is a complex medical and social process influenced by biological, psychological, social and cultural factors. Two main approaches exist; one promotes interventions (optimal gender policy) while the other suggests delaying interventions (informed consent policy) until the child can contribute to the decision. Methods. An exploratory narrative inquiry design was chosen. Data were collected through narrative interviews with a pur- posive non-random sample of 10 parents of eight children (aged 0–11 years) who had ambiguous genitalia. Results. Parents’ stories reflected strong protective instincts towards their children along with feelings of shock and disbelief. Parents’ social construction of gender influenced their attitudes and beliefs about their child’s ambiguous genitalia and the need for surgery. Parents’ desired to be ‘good parents’ and do what they perceived as ‘right’ for their child. They considered genital surgery as a necessity primarily relying on medical advice to guide them at times of uncertainty and confusion. Parents rarely shared stories about their child’s surgeries/genitalia outside of the couple relationship and these stories were often referred to as ‘secrets’. Conclusion. Having a child with ambiguous genitalia was perceived as problematic and brought about changes in roles, responsibilities, goals and social status as a parent beyond those usually associated with parenthood. Relevance to clinical practice. These early findings help increase awareness of parents’ experiences and of the problems and emotional challenges that parents face when their child is born with genital ambiguity. Key words: ambigious genitalia, children, families, genital surgery, narrative, nurses, nursing Accepted for publication: 30 January 2007 Introduction The concept of gender is biologically complex while domi- nant social theories suggest that the body is shaped, constrained and even invented by society and not purely a biological phenomenon (Shilling 2003). Complex concepts inform individual sexuality including gender identity, gender role and sex (Diamond 2004). Gender is constructed on the premise that the body has only one sex with the genitalia functioning in line with the gender identity (Hester 2004). Language and imagery help to foster gender identity and perpetuate a specific view of what is natural, expected, acceptable and normal about either biological sex (Kessler 1990). Authors: Caroline Sanders, RCN, RN, PGD, BSc(hons), PhD student, UCLancs, Specialist Urology Nurse, Royal Liverpool Children’s Hospital, Liverpool, UK; Bernie Carter, PhD, PGCE, BSc, RSCN, SRN, Professor of Children’s Nursing, Department of Nursing (BB 429), University of Central Lancashire, Preston, UK; Lynne Goodacre, PhD, DipCOT, Senior Lecturer, Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, UK Correspondence: Caroline Sanders, c/o DPS, Royal Liverpool Children’s Hospital, Eaton Rd, Liverpool, L12 2AP. Telephone: 0151 252 5852. E-mail: caroline.sanders@rlc.nhs.uk Ó 2007 The Authors. Journal compilation Ó 2007 Blackwell Publishing Ltd, Journal of Clinical Nursing, 17, 3187–3195 3187 doi: 10.1111/j.1365-2702.2007.02006.x