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Ambiguous Genitalia and Differences of Sexual Development (DSD)
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Note: Genital appearance during childhood is less important than sexual function in the adult years.Early surgical intervention can impair sexual functionSexual development of the brain is influenced by androgens and impacts gender identity. Some CAH patients may develop a male gender identity. As such, clitoral surgery or sex assignment surgery should be delayed until puberty or until the patient can provide informed consentGender identity assessments should be performed by psychology before any surgical interventionThese decisions are best made in consultation with a multidisciplinary team skilled in dealing with these conditions
Surgical treatment of disorders of sexual development
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rafael V. Pieretti, Patricia K. Donahoe
The diagnostic evaluation of patients with penile agenesis includes a renal ultrasound (US), pelvic MRI, retrograde urethrogram, and, in cases associated with an imperforate anus, a distal colonogram through the mucous fistula, using hydrosoluble contrast material (Figure 80.23). The colonogram can be combined with an antegrade VCUG via the cutaneous vesicostomy. An experienced medical team must evaluate newborns with penile agenesis. Families must be given all available information regarding sex assignment, surgical procedures, and immediate and long-term results so that they can make a decision which is in the best interest of their child. Genetic evaluation with whole genomic sequencing is recommended for genetic counseling and for understanding etiology.
Maternal plasma cell-free DNA screening
Published in Moshe Hod, Vincenzo Berghella, Mary E. D'Alton, Gian Carlo Di Renzo, Eduard Gratacós, Vassilios Fanos, New Technologies and Perinatal Medicine, 2019
Another potential source for a false-positive could arise when there is a “vanished” twin, i.e., where an initially twin pregnancy reduces to a singleton. If the nonviable fetus is abnormal and there is persistence of placental tissue, a false-positive could occur (37). As well as contributing to the false-positive rate, these cases are sometimes identified through discordance of fetal sex ascertained by cfDNA compared with ultrasound or at birth. Incorrect fetal sex assignment has also been attributed to a maternal transplant when the donor was male (38).
Embracing Complexity: Variation in Faculty’s Attitudes Toward Inclusive Measures of Gender and Sexuality in Social and Health Sciences Research
Published in Journal of Homosexuality, 2023
Jennifer Tabler, Jamie A. Snyder, Rachel M. Schmitz, Claudia Geist, Carlos M. Gonzales
While major funding institutions such as the National Institutes of Health (NIH) have made concerted efforts in calling for more research focused on the experiences of sexual and gender minorities (SGMs) (see NIH 2019, NOT-MD-19-001), there remains systemic resistance to assessing gender beyond the cisgender binary tied to biological sex assignment of male or female and the assumed gender identities of man or woman (Cameron & Stinson, 2019; Magliozzi et al., 2016). Despite increased calls for LGBTQ+ research in areas such as transgender health, a lack of scientific knowledge endures, notably tied to the use of non-standardized measures of gender and health that have not been sufficiently validated (Lombardi, 2018; MacCarthy, Reisner, Nunn, Perez-Brumer, & Operario, 2015). The insufficient attention paid to gender and sexual diversity in various domains of social and health science research can obscure the significance of inequalities operating at multiple levels of the social world and hinder the development of interventions and policies aimed at improving LGBTQ+ people’s lives.
Comparing conceptions of gender, sexuality and lesbian identity between baby boomers and millennials
Published in Journal of Lesbian Studies, 2022
Ella Ben Hagai, Rachelle Annechino, Tamar Antin
To further account for gender variance, current transgender inclusive psychological models deconstruct gender into several components, facets, or dimensions. For example, Charlotte Tate’s (Tate et al., 2014) Gender Bundle Model suggests that there are five components of gender that come together into a gender identity bundle. Following empirical research on gender variant children and adults, these components include: (1) sex assignment at birth, (2) the gender a person feels they belong to or identify with, (3) the extent to which a person understands and follows gender role behavior, (4) gender presentation and (5) how people evaluate their gender ingroup compared to outgroups. In psychology, Sari Van Anders,(2015) Sexual Configuration Theory reiterates previous distinctions between sexual attraction, sexual behavior, and identity while further accounting for variability in the extent to which people may be attracted to a particular kind of gender/gender expression/sex (ex., masculine men, nonbinary people, butches or femmes), or have a more fluid disposition that is not specifically oriented toward a particular gender/sex.
The Entanglement of Being: Sexuality Inside and Outside the Binary
Published in Studies in Gender and Sexuality, 2021
Many argue that we are not essentially “born this way” but become this way. As Simone de Beauvoir (2009) famously wrote, “One is not born a woman but becomes one.” Butler (1990) skillfully illustrates how dominant discourses (imperceptibly woven through language, manners, social customs, and medical and legal practices) produce the very identities they appear to be naturalizing. We are not born with a gender but become gendered. Once sex assignment is pronounced in utero or at birth, the child is shaped and formed through repeated scripted acts, consistently affirming the preferred gender and sexual expressions. This is not a simple classification, but a becoming, through which the subject is embodied and socially intelligible according to prevailing binaries. Most importantly to Butler, this performance—this making of gender—however scripted and sculpted, fortunately always fails. When one fails, an uneasy yet vital conflict is felt, and agency can be cultivated (Butler, 1993). Through this critical lens, queer theory articulates a self-conscious social and political stance: The subject becomes more nuanced, less sure of itself, and more attuned to the multiple compromises and pragmatic effects that characterize identity mobilization.