The basis of gender assignment in disorders of somatosexual differentiation

Horm Res. 2005:64 Suppl 2:18-22. doi: 10.1159/000087748.

Abstract

Sex assignment of patients with disorders of somatosexual differentiation is a controversial topic. The aim is to enable the patient to develop a stable gender identity during childhood, adolescence and adulthood. Enormous advances have recently been made in our knowledge of the molecular mechanisms of sexual differentiation and it is understood that long-term outcome may depend on the underlying diagnosis. There is increasing evidence that genital development is dependent on the action of androgenic steroids; moreover, both androgens and oestrogens may have an impact on other developing organs including neuronal structures such as the brain. Long-term outcome studies on the various intersexuality disorders are desperately needed in order to establish a basis for evidence-based medicine regarding sex assignment and treatment options. Premature decisions leading to irreversible interventions before an accurate diagnosis has been established must be avoided.

MeSH terms

  • Disorders of Sex Development / diagnosis*
  • Disorders of Sex Development / physiopathology
  • Gender Identity*
  • Genitalia / surgery
  • Gonads / embryology*
  • Humans
  • Infant, Newborn
  • Sex Determination Analysis*