title: Holistic management of DSD.
abstract: Disorder of sex development (DSD) presents a unique challenge, both diagnostically and in terms of acute and longer-term management. These are relatively rare conditions usually requiring a multidisciplinary approach from the outset and the involvement of a tertiary centre for assessment and management recommendations. This article describes the structure of the multidisciplinary team (MDT) at our centre, with contributions from key members of the team regarding their individual roles. The focus is on the newborn referred for assessment of ambiguous genitalia, rather than on individuals who present in the adolescent period or at other times, although the same MDT involvement is likely to be required. The approach to the initial assessment and management is discussed and the subsequent diagnosis and follow-up presented, with emphasis on the importance of careful transition and long-term support.
authors.affiliation: Department of Endocrinology, Great Ormond Street Hospital NHS Trust, London WC1N 3JN, UK. cbrain@nhs.net
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Brain
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Creighton
authors.forename: Imran
authors.initials: I
authors.lastname: Mushtaq
authors.forename: Polly A
authors.initials: PA
authors.lastname: Carmichael
authors.forename: Angela
authors.initials: A
authors.lastname: Barnicoat
authors.forename: John W
authors.initials: JW
authors.lastname: Honour
authors.forename: Victor
authors.initials: V
authors.lastname: Larcher
authors.forename: John C
authors.initials: JC
authors.lastname: Achermann
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D012734:Disorders of Sex Development / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004704:Endocrinology; D005260:Female; D006694:Holistic Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008967:Molecular Biology; D010348:Patient Care Team / Q000941:ethics; D012017:Referral and Consultation; D014572:Urology