DSD/intersex: historical context and current perspectives

J Pediatr Endocrinol Metab. 2023 Jan 12;36(3):234-241. doi: 10.1515/jpem-2022-0582. Print 2023 Mar 28.

Abstract

Intersex/Disorders/Differences of sex development conditions have been recognized for millennia. An organized approach was adopted in the 1960-70s using the philosophy that gender identity was fluid and malleable. Consequences of this approach were the lack of disclosure, stigmatization, and excessive surgery to "normalize" the genitalia. Often this led to quality of life issues for those patients. There have been many modifications in approach since then to avoid the problems noted. There is consensus on many of these changes (e.g. disclosure) but continued controversy on others (e.g. the benefits of early surgery). This review summarizes the historical context and the current areas of consensus and controversy.

Keywords: DSD; gender identity; genital surgery; intersex; tumor risk.

Publication types

  • Review

MeSH terms

  • Consensus
  • Disorders of Sex Development* / surgery
  • Female
  • Gender Identity*
  • Genitalia
  • Humans
  • Male
  • Quality of Life