children s health issues
Genital Birth Defects
Treatment of Genital Birth Defects
For genital defects, surgery For ambiguous genitals, sometimes gender assignment surgery and hormones Most children who have genital defects need surgery to correct the defects. Some minor defects do not need surgery. Regarding children with ambiguous genitals, children's sex chromosomes (that is, whether they are a genetic female with XX chromosomes or a genetic male with XY chromosomes) are an important factor, but other things also must be considered. For example, the hormones the fetus was exposed to in the uterus can have a significant effect. However, this effect may not be apparent until children are old enough to begin acting like one gender or another or to think of themselves as one gender or another ( Gender Identity ). Because children's behavior and gender identity do not always match their genetic gender, it is important not to make the gender assignment too soon. Waiting is not harmful because it is not essential to assign a gender during infancy. A multidisciplinary care team that includes the pediatrician, endocrinologists (specialists in hormone disorders), geneticists, urologists, and possibly psychiatrists can advise parents facing this challenging decision. When appropriate and indicated, surgery is done and children are given hormones. Children may need to take hormones for the rest of their life. 