Concerns Regarding Gynecological Aspects of Brazilian Girls and Women With Down Syndrome: A Cross-Sectional Study of Caregivers’ Opinions

Positive Review
1. The study addresses a significant gap in research by specifically exploring the concerns of caregivers of girls and women with Down syndrome (DS) regarding gynecological aspects. This unique focus contributes valuable insights to the understanding of the challenges faced by this particular demographic.
2 The cross-sectional design involving 100 caregivers of females with DS aged 9 years or older provides a comprehensive snapshot of the concerns related to puberty, menstruation, sexuality, and contraception methods, offering a broad understanding of these caregivers' perspectives.
3 The conclusion emphasizes the necessity to guide caregivers, primary care physicians, and gynecologists about the challenges related to the menstrual period in females with DS. This recommendation provides practical implications for healthcare professionals to better support this population.

Negative Review
1The study's generalizability is hindered by potential participant homogeneity, as it only includes caregivers of females with DS. A more diverse participant pool would enhance the external validity and applicability of the findings to a broader population.
2. The caregivers' responses may be influenced by social desirability bias, particularly regarding sensitive topics such as sexuality. The study could benefit from incorporating methods to mitigate this bias, ensuring more accurate insights into the caregivers' concerns.
3.While the study identifies caregivers' concerns, it lacks in-depth exploration of the underlying reasons or specific challenges they face in dealing with puberty, menstruation, and sexuality in females with DS. A qualitative component or additional probing questions could provide a richer understanding of the caregiver experience.