Sexual identity in congenital adrenal hyperplasia

Bosi, Isabelle; Holmes-Walker, Jane; Lau, Namson S; Bate, Slavica; Anderson, Gail; Kohn, Michael; Clarke, Simon

doi:10.1111/jpc.14912

Cited by 1 publication

(2 citation statements)

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“…However, the association between cerebral androgen imprinting, degree of virilization and gender dysphoria is inconsistent. 8,14 The sex assignment should maximize the functional, psychological and sexual needs. The considerations include the ability to procreate, develop secondary sexual characteristics that align with the gender of rearing and the reconstruction of external genitalia to achieve sexual gratification.…”

Section: Discussionmentioning

confidence: 99%

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Perspectives on early sex assignment and communication with parents in children with disorders of sexual development

et al. 2022

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Disorders of sexual development are a heterogeneous group of disorders in which chromosomal, gonadal or anatomical sex development is atypical. The majority of these children are recognized at birth by ambiguous genitalia. Legal and societal pressures require the physician and parents to assign sex rapidly. Though sex assignment is undebated in several disorders of sexual development, many others need an individualized approach to gender-related concerns. Gender dysphoria is prevalent in disorders of sexual development, and early gender-defining surgeries have potentially lifelong consequences. We use two cases, one of partial androgen insensitivity and another of simple virilizing congenital adrenal hyperplasia to illustrate that in disorders of sexual development, the ethical management principles remain the same at their core despite the vast differences in phenotypes. Sex assignment should maximize functional, psychological and sexual needs. Sex assigned should coincide with gender identity. We propose that we manage such children with the mutual participation of the physician, parents and the child. Though the parents and the physician have the child's best interests when making a decision, the child's developing autonomy should be protected. The communication of the health provider to the parent must be honest if early sex assignment is difficult.

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Section: Discussionmentioning

confidence: 99%

“…6 In children with DSD, this proportion is higher. [7][8][9] Children with DSD also experience gender variance.…”

Section: Introductionmentioning

confidence: 99%