Changes in the management of children with intersex conditions

摘要

About a decade ago, a spate of articles were published that reviewed and criticized the overall management of newborns with intersex conditions.1'2 These articles stimulated critical examination of the broad area of intersexuality and of its management. The following three specific recommendations were made: stop all infant cosmetic genital surgeries until evidence-based medicine proves their necessity; conduct research to assess whether such surgeries are justified; and practice complete honesty when advising parents and patients about intersex conditions. Further recommendations included the caution that a small or absent penis alone should not justify male-to-female sex reversals. Suggestions on management principles (made on the basis of the knowledge available at that time) were also offered.3 In this Viewpoint we review whether practices have changed in response to these early recommendations.