The accompanying review [1] continues to call for a moratorium on all genital surgery among children with disorders of sex development who have significant genital differentiation problems citing publications from the DSD Working Group [2]. Those not familiar with the long-term position of the author [3] should realize that this call for a moratorium was first made decades ago. This type of position is inherently polarizing and, if adopted, would simply introduce a different type dogma in place of the earlier employed optimal gender approach and ignores the data showing improvements in the care of DSD patients since the optimal gender approach was abandoned.
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