title: Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care.
abstract: The goal of this update regarding the diagnosis and care of persons with disorders of sex development (DSDs) is to address changes in the clinical approach since the 2005 Consensus Conference, since knowledge and viewpoints change. An effort was made to include representatives from a broad perspective including support and advocacy groups. The goal of patient care is focused upon the best possible quality of life (QoL). The field of DSD is continuously developing. An update on the clinical evaluation of infants and older individuals with ambiguous genitalia including perceptions regarding male or female assignment is discussed. Topics include biochemical and genetic assessment, the risk of germ cell tumor development, approaches to psychosocial and psychosexual well-being and an update on support groups. Open and on-going communication with patients and parents must involve full disclosure, with the recognition that, while DSD conditions are life-long, enhancement of the best possible outcome improves QoL. The evolution of diagnosis and care continues, while it is still impossible to predict gender development in an individual case with certainty. Such decisions and decisions regarding surgery during infancy that alters external genital anatomy or removes germ cells continue to carry risk.
authors.affiliation: Department of Pediatrics, Penn State College of Medicine, Hershey, Pa., USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
authors.forename: Anna
authors.initials: A
authors.lastname: Nordenström
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Houk
authors.forename: S Faisal
authors.initials: SF
authors.lastname: Ahmed
authors.forename: Richard
authors.initials: R
authors.lastname: Auchus
authors.forename: Arlene
authors.initials: A
authors.lastname: Baratz
authors.forename: Katharine
authors.initials: K
authors.lastname: Baratz Dalke
authors.forename: Lih-Mei
authors.initials: LM
authors.lastname: Liao
authors.forename: Karen
authors.initials: K
authors.lastname: Lin-Su
authors.forename: Leendert H J
authors.initials: LH
authors.lastname: Looijenga
authors.forename: Tom
authors.initials: T
authors.lastname: Mazur
authors.forename: Heino F L
authors.initials: HF
authors.lastname: Meyer-Bahlburg
authors.forename: Pierre
authors.initials: P
authors.lastname: Mouriquand
authors.forename: Charmian A
authors.initials: CA
authors.lastname: Quigley
authors.forename: David E
authors.initials: DE
authors.lastname: Sandberg
authors.forename: Eric
authors.initials: E
authors.lastname: Vilain
authors.forename: Selma
authors.initials: S
authors.lastname: Witchel
mesh_terms: D012734:Disorders of Sex Development / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D046468:Sexual Development