Table 3

Factor loadings after varimax rotation and Cronbach’s α of the SSS-DSD:

(A) Parental report (n=81)
Questions	Components
Questions	1*	2†	3‡	4§
Stigma elicited by genital atypicality*
01a. Can other people see that your child has genitals that are (slightly) different from that of other children?	0.60	0.44	0.07	−0.14
01b. How stressful is this to you?	0.72	0.22	0.31	−0.09
01c¶. Open-ended question: Can you tell us more about this?
02a. Do you think that other people look at your child because of their atypical genitalia?	0.64	0.38	−0.05	0.19
02b. How stressful is this to you?	0.73	0.13	0.17	0.21
05a. Do other people speak negatively about your child because of their atypical genital or physical appearance?	0.65	−0.05	0.27	0.24
05b. How stressful is this to you?	0.67	−0.10	0.34	0.14
06a. Do people speak negatively about you because of your child?	0.76	−0.07	−0.18	0.13
06b. How stressful is this to you?	0.73	−0.11	−0.17	0.15
11a. Is your child called names or teased by other children because of their atypical genital or physical appearance?	0.40	0.03	0.24	0.55
11b. How stressful is this to you?	0.41	0.02	0.44	0.49
Stigma elicited by physical atypicality or cross gender role behaviour†
03a. Can other people see that your child has an atypical physical appearance?	−0.09	0.76	0.07	0.35
03b. How stressful is this to you?	−0.14	0.52	0.18	0.48
04a. Do you think that other people look at your child because of their atypical physical appearance?	0.39	0.67	−0.21	0.16
04b. How stressful is this to you?	0.17	0.57	0.13	−0.01
07a. Does your child show more cross-gender role behaviour compared with other children? For parents of daughters: Does your daughter prefer more masculine activities than other girls? For parents of sons: Does your son prefer more feminine activities compared with other boys?	−0.06	0.87	0.10	0.20
07b. How stressful is this to you?	−0.01	0.91	0.04	0.02
08a. Do other people speak or behave negatively about your child because of their cross-gender role behaviour? (Daughters: masculine behaviour and interests? Sons: feminine behaviour and interests?)	0.11	0.44	−0.08	−0.05
Experiences with social exclusion‡
09a. Do other people isolate your child because of atypical of their genital/physical appearance?	−0.03	0.34	0.76	0.19
09b. How stressful is this to you?	0.04	0.24	0.85	0.03
10a. Do other people isolate you because of your child?	0.17	−0.10	0.86	−0.13
10b. How stressful is this to you?	0.21	−0.12	0.82	−0.14
12a. Is your child isolated by other children because of their atypical genital or physical appearance?	−0.09	0.00	0.75	0.45
12b. How stressful is this to you?	0.02	−0.08	0.88	0.22
Emotional reactions§
13a. Does your child suffer from emotional problems because of their atypical genital or physical appearance?	0.26	0.00	−0.07	0.75
13b. How stressful is this to you?	0.13	0.02	−0.03	0.82
13 c. How frequent was your child sad?	0.09	0.06	−0.05	0.55
13d. How frequent was your child depressed?	0.01	−0.01	0.07	0.82
13g. How frequent was your child shy?	−0.14	0.14	0.13	0.71
13h. How frequent was your child socially withdrawn?	−0.11	0.34	0.13	0.61
13e. How frequent was your child angry?	0.01	0.19	0.20	0.37
13f. How frequent was your child aggressive?	0.12	0.05	0.28	0.24
14. Are you worried about your child’s future?	0.20	−0.01	0.05	0.29
15. Is it difficult for you to accept your child?	0.25	0.07	0.02	−0.12

*Stigmatisation due to genital ambiguity and stress evoked by such experiences (α=0.86).
†Stigmatisation due to atypical physical appearance or displayed cross-gender role behaviour and stress evoked by such experiences (α=0.84).
‡Social exclusion or isolation due to DSD and stress evoked by being rejected or isolated (α=0.88).
§Reported emotional problems seen in the child and parental stress evoked these emotional problems (α=0.85).
¶Each question 1–12 was followed by an open-ended question: Can you tell us more about this? Example?
SSS-DSD, Social Stigmatisation Scale–disorder of sex development.