Hermaphrodism: Recommendations Concerning Case Management

Hampson, Joan G.; Money, John; Hampson, John

doi:10.1210/jcem-16-4-547

Cited by 51 publications

(18 citation statements)

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“…It is clear that these three factors are present in the clinical history of Juan/Ana. The first two factors correlate with a theory developed in the 1950s by Dr. John Money and the Hampsons [11,12] and developed further by Money and Ehrhardt in the 1970s who established the hypothesis that humans are born with what they called “psychosexual neutrality”[35]. This leads to the conclusion that an individual can be reared as either male or female, despite their chromosomal or gonadal sex if assigned before 2 years of age.…”

Section: Discussionmentioning

confidence: 71%

“…The “optimal gender policy” by John Money and the Hampsons in the 1950s proposed that humans are born psychosexually neutral, and that the sex of rearing plays a pivotal role in gender identity formation. They proposed that a clinical decision regarding sex assignment should take place prior to the second year of life and that children should not become aware of their sex history in order to avoid psychological distress and/or doubts about the assigned sex [11,12]. An important shift in the clinical management of these cases is full disclosure of medical information to the affected parents and their participation in the decision‐making process, a paradigm that is known as “full consent policy”[6,13–16].…”

Section: Introductionmentioning

confidence: 99%

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Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia

Jorge

Echeverri

Medina

et al. 2008

The Journal of Sexual Medicine

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Introduction In spite of significant changes in the management policies of intersexuality, clinical evidence show that not all pubertal or adult individuals live according to the assigned sex during infancy. Aim The purpose of this study was to analyze the clinical management of an individual diagnosed as a female pseudohermaphrodite with congenital adrenal hyperplasia (CAH) simple virilizing form four decades ago but who currently lives as a monogamous heterosexual male. Methods We studied the clinical files spanning from 1965 to 1991 of an intersex individual. In addition, we conducted a magnetic resonance imaging (MRI) study of the abdominoplevic cavity and a series of interviews using the oral history method. Main Outcome Measures Our analysis is based on the clinical evidence that led to the CAH diagnosis in the 1960s in light of recent clinical testing to confirm such diagnosis. Results Analysis of reported values for 17-ketosteroids, 17-hydroxycorticosteroids, from 24-hour urine samples during an 8-year period showed poor adrenal suppression in spite of adherence to treatment. A recent MRI study confirmed the presence of hyperplastic adrenal glands as well as the presence of a prepubertal uterus. Semistructured interviews with the individual confirmed a life history consistent with a male gender identity. Conclusions Although the American Academy of Pediatrics recommends that XX intersex individuals with CAH should be assigned to the female sex, this practice harms some individuals as they may self-identify as males. In the absence of comorbid psychiatric factors, the discrepancy between infant sex assignment and gender identity later in life underlines the need for a reexamination of current standards of care for individuals diagnosed with CAH.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia

Jorge

Echeverri

Medina

et al. 2008

The Journal of Sexual Medicine

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“…When to perform surgery and the appropriate surgical management of the infant with ambiguous genitalia or DSD have been matters of contention for some time, especially since the initial studies by Money 27 were challenged. Each case is different, but certain guidelines have been established by our GMT.…”

Section: Appropriate Surgical Managementmentioning

confidence: 99%

Guidelines for Evaluating and Managing Children Born with Disorders of Sexual Development

Douglas¹,

Axelrad²,

Brandt³

et al. 2012

Pediatr Ann

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C hildren born with disorders of sexual differentiation (DSD) pose numerous challenges for the parents, family, and treating physicians. The pediatrician is usually the fi rst medical contact for newborns with DSD or for toddlers and children who present with DSD at a later time. Several years ago, we formed a Gender Medicine Team (GMT) at Baylor College of Medicine and Texas Children's Hospital (TCH) to explore and evaluate the most appropriate management strategies, which had long been a matter of concern and contention. Subsequently, the GMT, composed of experts in the fi elds of endocrinology, ethics, genetics, gynecology, psychology, pediatric surgery, and urology, formed a Task Force to evaluate the information available from our own experiences and from reviews of the literature. Utilizing the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system to assess the evidence and recommendations, the Task Force developed a consensus statement for clinical management of DSD and for making appropriate sex assignments.

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“…6 Where specious disorders of the past-draeptomania and homosexuality being the most notorious examples-are ''inventions'' of their time, intersex conditions resist comparable characterization as productions of history. 7 While some individuals with intersex conditions embrace an intersex identity, many do not identify this way (and conversely, many who are not born with a genetic or endocrine disorder 4 See e.g., [17,25]. 5 The first official recognition of these abuses was dramatically rendered in a series of the 1999 decisions of the Supreme Court of Colombia (Sentencia SU-337/00; Sentencia T-551/99).…”

Section: The Perils Of a Medicalized Identitymentioning

confidence: 99%

Normalizing Medicine: Between “Intersexuals” and Individuals with “Disorders of Sex Development”

Feder

2009

Health Care Anal

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In this paper, I apply Michel Foucault's analysis of normalization to the 2006 announcement by the US and European Endocrinological Societies that variations on the term "hermaphrodite" and "intersex" would be replaced by the term, "Disorders of Sex Development" or DSD. I argue that the change should be understood as normalizing in a positive sense; rather than fighting for the demedicalization of conditions that have significant consequences for individuals' health, this change can promote the transformation of the conceptualization of intersex conditions from "disorders like no other" to "disorders like many others." Understood in these terms, I conclude, medical attention to those with atypical anatomies should be recast from a preoccupation with "normal appearance" to the concern with human flourishing that is the proper object of medical attention.

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Hermaphrodism: Recommendations Concerning Case Management

Cited by 51 publications

References 0 publications

Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia

Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia

Guidelines for Evaluating and Managing Children Born with Disorders of Sexual Development

Normalizing Medicine: Between “Intersexuals” and Individuals with “Disorders of Sex Development”

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