ABSTRACT

Up until very recently sex assignment in neonates with ambiguous genitalia was based on the surgeon’s ability to reconstruct the genitalia.2,3 This resulted in many XY children with ambiguous genitalia, a small phallus or an absent phallus secondary to trauma being assigned female gender, believing that nurture alone would be sufficient to establish a gender identity congruent to the sex of assignment. There is a mounting body of evidence indicating that this traditional paradigm is seriously flawed.4-6 The ensuing sections will attempt to present some of the data supporting this idea and a new paradigm for management of intersex patients.