Abstract

This paper discusses the management of three DSD cases with difficult sex assignment at a US center. The goal of this report was to explore factors involved in parental decision making and the challenge to reconcile respect for the child’s integrity with parental rights to make decisions in what they believe is best for their child. The authors propose a team management approach, which carefully assesses risks and opportunities associated with either gender pathway and discusses with the parents the various treatment options. Pillars of such an approach are provision of full information, psychosocial support and time for parents to consider all the options.

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