![]() ![]() There is a drumbeat condemning, and calling for a moratorium on, elective genital and gonadal surgery without the individual's informed consent ( 3). ![]() Evidence of controversy exists in the medical literature, social media, human rights organizations' deliberations, courts of law, and government legislatures. ![]() Recommendations for a team approach were repeated in the 2016 update ( 2) which noted unresolved questions regarding genital and gonadal surgery performed before children are competent to provide informed consent. Given their complexity, Consensus Statement recommendations for optimal DSD care include an experienced multidisciplinary team of pediatric subspecialists in endocrinology, surgery, and/or urology, psychology/psychiatry, gynecology, genetics, and neonatology adding social work, nursing, and medical ethics, if available. DSD comprise many discrete diagnoses ranging from those associated with few phenotypic differences between affected and unaffected individuals to those where questions arise regarding gender of rearing, gonadal tumor risk, genital surgery, and fertility. The 2006 Consensus Statement on Management of Intersex Disorders introduced and defined “disorders of sex development” (DSD) as congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical ( 1). ![]()
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