Response to Sexual Ambiguity — A Social Predicament: Case Report

Abstract

The paper presents a case with sex ambiguity and its diagnosis and management. I agree with the authors that Disorders of Sex Development (DSD) are really challenging, particularly when they present beyond childhood. They are actually not uncommon in Saudi Arabia and neighboring countries where consanguinity is prevalent [2]. (2) The paper did not include the endocrine tests or the opinion of an endocrinologist to come up with the diagnosis of androgen insensitivity, be it partial or complete. (3) The authors failed to include a reasonably rich literature from Islamic countries particularly Saudi Arabia, which addressed many aspects of the problem from both medical and cultural points of view [3-10]. I feel that it is worth referring to the Saudi experience particularly to the Islamic guidelines on DSD, which were distilled from the work of official Islamic scholars and published in a medical journal for guidance [3]. This is particularly important for a distinguished journal produced in Saudi Arabia.

Reversal of Prediabetes in Saudi Adults: Results from an 18 Month Lifestyle Intervention

“…The rapid industrial development in Saudi Arabia led to a remarkable increase in the standards of living, consequently adopting a more Western lifestyle, which resulted in unhealthy dietary patterns and low levels of physical activity, factors that led to the increase in prevalence of T2DM across the country by over 25% in the adult population. By 2030, this rate is expected to double [6][7][8][9][10]. In a recent study, the prevalence of T2DM in Saudi Arabia is 27.6% in females and 34.1% in males [11], with T2DM onset averaging 57.5 years in males and 53.4 years in females [11].…”

Psychiatric Approach Management of Ambiguous Genitalia in Children and Teenagers

“…[1,7]. Atypical sex development leads to sexual ambiguity and infertility [8]. The incidence of ambiguous genitalia is 1:4500 to 1:5000 live births, with 50% of cases of 46 XY having a known cause and 20% overall diagnosed molecularly [9].…”