Iran University of Medical Sciences, Iran
Azadeh Memarian has completed her Forensic and legal medicine spiciality at the age of 34 years from Tehran University of medical sciences.
Autism consists of a group of developmental brain disorders, collectively called autism spectrum disorder (ASD). Teenagers with learning and physical disabilities are more likely to have menstrual problems than the general populations. The parents of a 12-year-old girl with ASD and intellectual disability requested that she undergo hysterectomy because of her numerous problems of puberty (menstruation), including poor hygiene and polluting herself and the environment, not allowing anyone to place or change the pads, and changes in mood and physical health before her period. After the legal medicine organization reviewed her medical records, physical examinations, and medical consultations with a gynecologist and psychiatry, surgery was not accepted. Hysterectomy (surgery) performed because of the age of the child is not recommended, either physically or morally. The use of hormone replacement therapy has side effects, such as osteoporosis. In these cases, it seems that noninvasive methods (behavioral therapy and learning care skills) under the care of welfare experts are more effective and morally acceptable. In our Islamic society, we attempt to provide justice and prevent any assault to intellectually disabled females. We emphasize individual and social benefits and make decisions about each case separately due to the range of IQ, physical ability, social and cultural level of the family, and ethical principles. This review emphasizes that care must be individualized. The decision for treatment must rest on a multidisciplinary team consisting of gynecologists, psychologists, and forensic specialists and is based on Islamic and ethical law in legal medicine organizations .