Factors contributing to sex assignment and reassignment decisions in Turkish children with 46,XY disorders of sex development.
BACKGROUND
Sex assignment decisions for children with disorders of sex development (DSD) should be based on integrative assessments of relevant biological and psychosocial characteristics.


OBJECTIVE
To investigate the factors that contributed to sex assignment decisions for children with 46,XY DSD.


METHODS
Sixty-one children recruited from a clinical sample were evaluated.


METHODS
Findings of endocrinological and psychiatric evaluations were entered into a logistic regression analysis.


RESULTS
Gender identity was the strongest correlate of assigned sex. External genital under-virilization, sex announced at birth and toy/ activity preferences were predominant predictors. Twelve children, six of whom were prepubertal, were reassigned to male sex.


CONCLUSIONS
Psychological factors seem to be as influential on sex reassignment decisions as are endocrinological and social factors, especially if the disorder is diagnosed at an older age. Prepubertal gender conversion is possible, which implies the importance of follow-up during childhood.
Department of Child Psychiatry, Ankara University, Turkey. ruslu@medicine.ankara.edu.tr
R
R
Uslu
D
D
Oztop
O
O
Ozcan
S
S
Yilmaz
M
M
Berberoğlu
P
P
Adiyaman
M
M
Cakmak
E
E
Kerimoğlu
G
G
Ocal
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005783:Gender Identity; D006801:Humans; D007223:Infant; D008297:Male; D025064:Sex Chromosome Disorders / Q000628:therapy*; D014189:Transsexualism; D014421:Turkey