TY - JOUR
T1 - Deciding on gender in children with intersex conditions: Considerations and controversies
AU - Thyen, Ute
AU - Richter-Appelt, Hertha
AU - Wiesemann, Claudia
AU - Holterhus, Paul Martin
AU - Hiort, Olaf
N1 - Funding Information:
We are grateful for extensive advice and recommendations concerning a draft of the manuscript from Heino F. Meyer-Bahlburg, Department of Psychiatry, Division of Child Psychiatry and Program of Developmental Psycho-endocrinology, Columbia University, New York, USA. We would like to thank Eva Kleinemeier and Dr Eva Hampel for helping with the literature search and editing the manuscript. The authors received no funding for the preparation of this manuscript but acknowledge the support of the Deutsche Forschungsgemeinschaft (DFG) and the Bundesministerium für Bildung und Forschung (BMBF) by funding several of our study group’s research projects related to disorders of somatosexual differentiation.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2005
Y1 - 2005
N2 - Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.
AB - Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.
UR - http://www.scopus.com/inward/record.url?scp=12344303072&partnerID=8YFLogxK
U2 - 10.2165/00024677-200504010-00001
DO - 10.2165/00024677-200504010-00001
M3 - Scientific review articles
C2 - 15649096
AN - SCOPUS:12344303072
SN - 1175-6349
VL - 4
SP - 1
EP - 8
JO - Treatments in Endocrinology
JF - Treatments in Endocrinology
IS - 1
ER -