Painting; Cleft Nouveau, by Ealish Swif
Cleft Nouveau, by Ealish Swif

Anna Paganini - Experiences of living with cleft lip and palate A gender perspec


Anna Paganini defended on December 9 her thesis for Medicine Doctorate at Sahlgrenska Academy, Institute of Clinical Sciences, Department of Orthopaedics

Title of the thesis: Experiences of living with cleft lip and palate - a gender perspective

Anna Paganini
Photo: Martin Paganini

Link to the doctoral thesis


The primary aim of this thesis was to investigate the influence of gender on the CL/P population with regard to treatment, self-reported appearance, psychosocial adjustment, and subjective experiences.

Study I, a retrospective chart review that investigated whether there were any gender differences in the number of aesthetic surgical treatment received, found that women received more treatment than men.

Studies II– III used the questionnaires DAS24, LOT-Rs, and Brief- COPE to investigate appearance-related distress as well as dispositional optimism and coping. Study II found that women reported higher appearance-related social anxiety and avoidance than men, and analysis showed that not only cleft features but general appearance issues caused distress.

Study III showed that appearance-related distress among women was significantly correlated with several coping strategies as well as low levels of optimism, whereas in men it was found to be correlated wit h low levels of pessimism.

Study IV was a qualitative interview study of young adults, and a content analysis of the interviews was conducted. The interviews reveal ed a group of generally well-adjusted young adults, but participants also described a duality where they felt both normal and at the same time different, and this feeling varied over time and in different situations. They all described the influence of gender norms. This thesis illuminates the need for gender awareness in the treatment and outcomes of CL/P.

Unilateral läpp- och gomspalt
Figure 1.Unilateral cleft lip and palate, view from below and view from the frontexterior Illustrations by Johanna Hedborg

Supervisor: Hans Mark
C-supervisor: Martin Persson
Opponent: Ronald P Strauss, University of North Carolina, Chapel Hill, NC, USA
Examining Committee: Stefan Nilsson, Daniel Nowinski and Elisabet Wentz