Management of the infant with ambiguous genitalia
- Christopher P Houk, MD
Christopher P Houk, MD
- Associate Professor of Pediatrics
- Georgia Regents University
- Lynne L Levitsky, MD
Lynne L Levitsky, MD
- Associate Professor of Pediatrics
- Harvard Medical School
- Section Editors
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Mitchell E Geffner, MD
Mitchell E Geffner, MD
- Section Editor — Pediatric Endocrinology
- Professor of Pediatrics
- Keck School of Medicine, University of Southern California
Individuals with a congenital discrepancy between external genitalia and gonadal and chromosomal sex are classified as having a disorder of sex development (DSD) . Many of these individuals present as newborns with an atypical genital appearance often termed "ambiguous genitalia". The birth of an infant with ambiguous genitalia presents a unique set of challenging management issues.
Psychosexual development is influenced by multiple factors including:
●Genes involved in sexual development
●Gender differences in brain structure
●Prenatal androgen exposure
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- INITIAL STABILIZATION
- Fluid and electrolytes
- Family coping
- Further evaluation
- GENDER DECISIONS
- Traditional approach
- - Limitations
- Follow-up studies
- - Functional and cosmetic outcomes
- - Psychosocial outcomes
- Current approaches
- - Consensus statement
- - Alternative guidelines
- Our approach
- - Gender assignment
- - Genital surgery
- LONG-TERM MANAGEMENT
- Psychosexual issues
- Medical concerns
- - Gonads
- - Sex steroids
- - Other complications
- SUPPORT GROUPS AND INTERNET SITES
- SUMMARY AND RECOMMENDATIONS
- Initial management
- Gender assignment and surgery
- Long-term issues