Sex assignment for newborns with ambiguous genitalia and exposure to fetal testosterone: attitudes and practices of pediatric urologists

The Journal of Pediatrics
David A DiamondAlan B Retik

Abstract

Sex assignment to newborns with ambiguous genitalia is controversial. Our objective was to determine the attitudes and practices of pediatric urologists on this subject. A survey of fellows in the Urology Section of the American Academy of Pediatrics was completed by 185/228 (81%). The survey referred to two cases, masculinized 46XX congenital adrenal hyperplasia (CAH) and 46XY cloacal exstrophy. Questions referred to sex assignment, timing of surgery, decision making process, and respondent demographics. For masculinized 46XX CAH, virtually all respondents favored female sex assignment. The most important factor was potential fertility. For 46XY cloacal exstrophy, two thirds favored the male sex. The most important factor was potential androgen brain imprinting, whereas in selecting female assignment, it was difficulty creating a functional phallus. Respondent characteristics associated with assigning female sex were longer duration in practice (>15 years) and affiliation with training programs. Most respondents advocated a team approach to decision making with parental involvement and early surgery (<18 months). Pediatric urologists are in strong consensus about sex assignment for newborns with ambiguous genitalia from CAH, a...Continue Reading

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Citations

Oct 29, 2010·International Journal of Pediatric Endocrinology·Ganka DouglasV Reid Sutton
Aug 6, 2014·Nature Reviews. Endocrinology·Valerie A ArboledaEric Vilain
Apr 2, 2011·Seminars in Pediatric Surgery·Timothy M Phillips
Oct 27, 2009·Journal of Pediatric Urology·Lynn L WooJohn W Brock
Dec 9, 2009·Advances in Pediatrics·Marni E AxelradLefkothea P Karaviti
Jul 14, 2009·Journal of Pediatric Urology·H MirheydarM DiSandro
Apr 7, 2009·Obstetrics and Gynecology Clinics of North America·Lisa Allen
Oct 18, 2011·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Marcia L FeldkampJohn C Carey
Jun 24, 2010·The Urologic Clinics of North America·Sarah M LambertThomas F Kolon
Jun 15, 2010·Best Practice & Research. Clinical Endocrinology & Metabolism·S Faisal Ahmed, Martina Rodie
Feb 11, 2012·Korean journal of urology·Kun Suk Kim, Jongwon Kim
Nov 7, 2007·Nature Clinical Practice. Endocrinology & Metabolism·Milton Diamond, Hazel G Beh
Sep 22, 2007·Current Opinion in Obstetrics & Gynecology·Zeina M Nabhan, Peter A Lee
Sep 22, 2007·Current Opinion in Obstetrics & Gynecology

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