Male pseudohermaphroditism: Factors determining the gender of rearing in Saudi Arabia

Taha, Saud A.

doi:10.1016/0090-4295(94)90082-5

Cited by 21 publications

(11 citation statements)

References 8 publications

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“…Reports from other cultures, such as India [11][12][13], Turkey [14], Saudi Arabia [15], Malaysia [16] and Thailand [17] indicate a strong tradition for Asian and Middle Eastern parents to select male gender for their children born with ambiguous genitalia. In a country like India or Pakistan, DSD patients raised male, even if they are infertile, are more likely to achieve economic independence than patients raised female who are infertile.…”

Section: Rumour and Discriminationmentioning

confidence: 99%

Disorders of sex development (DSDs), their presentation and management in different cultures

Warne

Raza

2008

Rev Endocr Metab Disord

114

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The way disorders of sex development (DSD) are viewed and managed in different cultures varies widely. They are complex conditions and even well-educated lay people find them difficult to understand, but when families are very poor and lacking in basic education, and the health system is starved of resources, traditional beliefs, folk remedies and prejudice combine to make the lives of children and adults with DSD extremely difficult and sad. Rumour and discrimination isolate them from their communities and they become devalued. People with DSDs desire the same things in life as everyone else-to find someone who will love them, to be valued as human beings, to feel at home in their own bodies, to be able to have satisfactory sexual relations should these be desired, to be able to trust their medical advisers and to be integrated into the general community. Long term outcome studies have been published from many countries, but these studies have not necessarily been critical of the values that underpinned the type of treatment given to the patients. There is a need for standardized instruments that would allow a true comparison of the quality of outcomes from the patients' perspective. Much could be done to improve equity between rich and poor countries for the benefit of people with DSDs. A focus on developing cheap, robust diagnostic tests, making essential medicines available for all, training surgeons to do better operations, educating health professionals, families and the general community in order to break down prejudice against people with DSDs, and training mental health workers in this specialized field, would do much to alleviate the burden of the condition.

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Section: Rumour and Discriminationmentioning

confidence: 99%

Disorders of sex development (DSDs), their presentation and management in different cultures

Warne

Raza

2008

Rev Endocr Metab Disord

114

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“…Where man is the traditional breadwinner and the woman is the housewife and mother, economic and social factors are more important than sexual potential [10][11][12]. In our population a common preference is for male offspring, to care for parents or to inherit family property.…”

Section: Fig 1 Two Of the Patients With F-cah Who Remained 'Male' mentioning

confidence: 99%

“…However, the problem becomes impossible to solve with the concurrent development of masculine identity in delayed cases. It is also accepted that attitudes towards sex of rearing in latediagnosed patients with intersexual disorders in Eastern countries are very different from those in Europe [8][9][10][11][12][13]. Thus the aim of this study was to determine the factors governing the decision-making process in 70 genotypic females with CAH.…”

Section: Introductionmentioning

confidence: 99%

Gender assignment in female congenital adrenal hyperplasia: a difficult experience

Özbey¹,

Darendeliler²,

Kayserili

et al. 2004

BJU International

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OBJECTIVETo report experience of gender (re)assignment in genotypic female (46XX) patients with congenital adrenal hyperplasia (f‐CAH), a difficult and stressful experience if complicated with delayed presentation and inadvertent assignment.PATIENTS AND METHODSBetween 1983 and 2002, 70 patients with f‐CAH were counselled for gender assignment. The age at diagnosis and operation, the degree of virilization, parental consanguinity, the gender preference of the families, and the factors governing the decision‐making process were determined.RESULTSForty‐one (59%) patients presented after the neonatal period. All parents had already assumed or were advised of a gender for their children, based on the suggestive appearance of the external genitalia. Consequently, 49 patients were reared as female and 21 as ‘male’. Only nine of these ‘males’ could be reassigned as females (mean age at presentation 7.87 months, sd 10.42). Twelve children had to be reared as ‘male’ (mean age at presentation 55.8 months, sd 32.42) in compliance with the parents’ and the study group's decision, and appropriate masculinizing reconstructive surgery was undertaken. The difference in the mean age of those reassigned as female and those who remained ‘male’ was significant (P < 0.001). The parental consanguinity rate among the families was especially high in the ‘male’ patients.CONCLUSIONSIt is extremely difficult to correct the gender of patients with f‐CAH when they present at >2.5 years old. Furthermore, the delay in diagnosis and the male bias in choice of gender in our population might be a result of strong social pressures on families, influenced by cultural, traditional and economic factors.

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“…In societies where males enjoy greater privileges in terms of social status, education, and economic independence, families may opt for male sex. Taha and Maqbool (1995) described 14 XY males with micropenis from Saudi Arabia, 11 of whom were assigned the female sex by the midwives at birth (Taha, 1994). These children presented peripubertally with complaints of absence of female pubertal development and development of facial hair or deepening of voice.…”

mentioning

confidence: 96%

Apparent Male Gender Identity in a Patient with Complete Androgen Insensitivity Syndrome

et al. 2009

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Male pseudohermaphroditism: Factors determining the gender of rearing in Saudi Arabia

Cited by 21 publications

References 8 publications

Disorders of sex development (DSDs), their presentation and management in different cultures

Disorders of sex development (DSDs), their presentation and management in different cultures

Gender assignment in female congenital adrenal hyperplasia: a difficult experience

Apparent Male Gender Identity in a Patient with Complete Androgen Insensitivity Syndrome

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