Normal and Variant Sex Development

Sex development is the biological pathway for any species to allow reproduction and therefore survival over generations. This has led to highly complex arrangements during evolution to allow offspring to differentiate into either male or female. Interestingly, many of the morphologic patterns arise from common denominators and their genetic pathways have been elucidated. Furthermore, the phenotype of any individual's being male or female is largely dependent on endocrine influences from the developing gonad. Many of the pathways have been described as being altered leading to a variant sex development, which is referred to in the medical terminology as Differences or Disorders of Sex Development (DSD). People with DSD have taught us a lot not only about the biological basis of sex development, but also about the medical management and social acceptance of such conditions. Recent discussions both in the professional fields and among societal stakeholders have led to a rethinking of personal rights, social participation, and concepts of gender in general.