The Sexual Body
Roger Cooter, John Pickstone in Medicine in the Twentieth Century, 2020
Seven stages of the development of gender identity are currently defined: the chromosomes, the gonads, the hormones, the internal sexual organs, the external genitalia, secondary sexual characteristics, gender assigned at birth, and the gender identity that the individual makes for her or himself. Each of these leads on to the next stage, but problems can occur at any point, and thus (at the time of writing) chromosomal tests are being performed on Olympic athletes to determine whether they are ‘really’ qualified to compete as men or women. Given the deep discomfort around ambiguity of gender, when children are born with ambiguous genitalia (there is a long medical literature of this), the attending doctor may make a fairly arbitrary assignment to one or the other, and a different dominant sex may emerge at puberty.
The external genitalia
Kevin G Burnand, John Black, Steven A Corbett, William EG Thomas, Norman L Browse in Browse’s Introduction to the Symptoms & Signs of Surgical Disease, 2014
Intersex is divided into: Female (46XX) with inappropriate virilization (female pseudohermaphrodite). The most common example is congenital adrenal hyperplasia, which accounts for 85 per cent of all ambiguous genitalia.Incomplete virilization of a male (46XY) – a male pseudohermaphrodite.Gonadal dysgenesis with abnormal sex chromosomes, e.g. Turner’s syndrome (45X0) and Klinefelter’ssyndrome (47XXY).True hermaphrodites, where both ovarian and testicular tissue coexist. This is very rare.
Endocrinology and gonads
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
11.11. Congenital adrenal hyperplasia (21-hydroxylase deficiency)is associated with high plasma 17-hydroxyprogesterone levels.is a common cause of ambiguous genitalia in newborn girls.may be associated with salt wasting.is associated with high plasma Cortisol levels.may be complicated by infertility.
Ovotestis at 18 years: an accidental discovery in an internally displaced persons’ camp in North-Eastern Nigeria
Published in Journal of Obstetrics and Gynaecology, 2019
Hadiza Abdullahi Usman, Bala Mohammed Audu, Mohammed Bukar, Ahmed A. Mayun
The therapeutic goals in the management of DSD are centred on ensuring an individual with a sound psychosocial and sexual fulfilment in life. The patient and her parents had counselling and psychosocial support by experts, including religious clerics. This is an important goal in the care of DSD to minimise the risk of creating a social outcast (Nthumba et al. 2008). This patient had dominant clinical and functional feminine features and therefore had genitoplasty with the resection of the right ovotesticular tissue, which is discordant with her sex of rearing. The gonadectomy would reduce the risk of a gonadal malignancy (Liu et al. 2014). The option of the Modified Randolph–Hung reduction clitoroplasty offered to this patient would ensure that the orgasmic function and the erectile sensation of the clitoris are maintained. This is superior to a clitoridectomy, as it preserves the glans and its neurovascular bundle. The management of OT-DSD in the adolescent and the adult is quite challenging and associated with psychological trauma. The need for a thorough examination of the external genitalia of new-borns and the appropriate referral of those with ambiguous genitalia early in life will minimise the psychological trauma associated with the management of these cases later in life. This patient benefited from the volunteer service scheme of the Society of Gynaecology and Obstetrics of Nigeria (SOGON), which extended its services to the IDP camp.
The XY Female: Exploring Care for Adolescent Girls with Complete Androgen Insensitivity Syndrome
Published in Comprehensive Child and Adolescent Nursing, 2020
Kate Davies
Diagnostic pathways (Ahmed et al., 2015) can advise on the investigations and examinations that should be undertaken when a team is presented with an infant, child or adolescent with a DSD. Specific care pathways are suggested and implemented for the management of infants with ambiguous genitalia (Davies, 2019), including exploring the clinical status of the baby, their history, maternal and family history, and family knowledge and expectations, followed by a detailed assessment, resulting in an ultimate diagnosis and plan of care. Conversely, however, a small group of DSD can present in adolescence, encompassing girls presenting with primary amenorrhea (where menses have not yet commenced), girls with virilization, such as hirsutism or clitoromegaly, or boys with delayed puberty.
Cancer Care Considerations for Sexual and Gender Minority Patients
Published in Oncology Issues, 2019
Mandi L. Pratt-Chapman, Jennifer Potter
Invisibility of intersex people in mainstream society (approximately 1.7 percent of the population)3 is even greater.18 Research to optimize healthcare of intersex people is severely lacking, and education on what is known about intersex medical management is sparse in current medical school curricula.9 Though only a portion of intersex people have ambiguous genitalia, it is vital to note that the longstanding practice of surgical intervention for ambiguous genitalia is not medically indicated and leads to unnecessary and painful lifelong repercussions—including high potential for additional surgeries and infections. In 2017 three former U.S. surgeons general called for a moratorium on intersex infant genital surgeries.19
Related Knowledge Centers
- Gonad
- Hermaphrodite
- Phenotype
- Sexual Characteristics
- Klinefelter Syndrome
- Chromosome
- Sex Organ
- Sex Assignment
- Definitions of Intersex
- Late Onset Congenital Adrenal Hyperplasia