title: The basis of gender assignment in disorders of somatosexual differentiation.
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.
authors.affiliation: Clinical Research Group Intersex - From Gene to Gender KFO 111, Department of Paediatrics, University of Lübeck, Lübeck, Germany. hiort@paedia.ukl.mu-luebeck.de
authors.forename: Olaf
authors.initials: O
authors.lastname: Hiort
authors.forename: Ute
authors.initials: U
authors.lastname: Thyen
authors.forename: Paul-Martin
authors.initials: PM
authors.lastname: Holterhus
mesh_terms: D012734:Disorders of Sex Development / Q000175:diagnosis* / Q000503:physiopathology; D005783:Gender Identity; D005835:Genitalia / Q000601:surgery; D006066:Gonads / Q000196:embryology*; D006801:Humans; D007231:Infant, Newborn; D012732:Sex Determination Analysis