Purpose:
The purpose of this study is to explore the lived experience of females with congenital adrenal hyperplasia (CAH) who have undergone feminizing genitoplasty, FG (clitorectomy, clitoral reduction, and vaginoplasty) as told from a hermeneutic perspective.

Background:
Research has shown that gender identity, genital appearance, gender role and gender behavior in CAH females does warrant expedited genital surgery. Prior to the female reaching the age of consent, parents or guardians often make treatment decisions without input from the child who will live with the results of these decisions regarding an important aspect of life. To date the majority of research has focused on quantitative data in relation to sensation and validated tools that measure sexual satisfaction. An extensive review of the literature revealed no qualitative studies addressing this issue from adult females with CAH who have had FG.

Procedure for data collection and treatment of data:
The primary setting for this investigation is the Division of Urology at the University of Texas Health Science Center Houston (UTHSCH). Purposive sampling was used to select females 18 years of age and older who have CAH and have undergone FG as a minor. The sample population was obtained from the records of the pediatric urology service at UTHSCH Division of Urology. Demographic data is collected on all study participants prior to a face-to-face interview composed of a grand tour question and probes conducted by the PI. The interview is taped with both a digital and cassette recorder. After verbatim transcription and validation, the narrative undergoes thematic analysis guided by the methodology of van Manen. This study of seven participants revealed the following themes: Normalcy, Being Different, Relationships, Decision Making, Knowledge Deficits, Having Children, and Disclosure.

Conclusions and Implications:
Themes extracted from this pilot study reveal the need for further investigation. Additional interviews are necessary to achieve thematic saturation crucial to understanding the lived experience of this population. Understanding the experience of these women may help to alleviate the controversies associated with expedited genital surgery associated with CAH.