Thanks to Powell and colleagues for their comments. The guideline hopefully makes clear that doing a hysterectomy for menstrual management is NOT supported by this document or the American Academy of Pediatrics. This document was not meant to address sterilization, which is a different topic than menstrual management or contraception. Sterilization for women with disabilities is addressed in other reports from the American College of Obstetrics and Gynecologists and the American Academy of Pediatrics. The reason that both hysterectomy and endometrial ablation were discussed in this report is because referrals are still made to gynecologists with this request. The authors agree that all adolescents should be included in health care decisions to the extent of their abilities and that is stated throughout the report. This report does not cover comprehensive reproductive health care and all its facets for teenagers with disabilities. The intention of the report was to assist pediatricians in recognizing the importance of an alliance with patient and/or parent that through shared decision-making best menstrual management options can be found. In the “initial visit” section, a confidential interview with all adolescents is recommended including a discussion about desire for sexual activity and contraceptive needs.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
- Copyright © 2016 by the American Academy of Pediatrics