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A multidisciplinary approach to the management of children with complex genital anomalies

Nature Clinical Practice Endocrinology & Metabolism volume 3, pages 668–669 (2007)Cite this article

According to Greek mythology, the prophet Tiresias was transformed into a woman by the goddess Hera, married and had children, only to regain his masculinity 7 years later. Medical science is still greatly inferior to the powers of the Olympian gods: the management of intersex disorders remains one of the most difficult challenges a physician can face. Unfortunately, the current approach to patient care (especially in the most complex cases) relies mainly on restricted evidence-based data and accumulated personal experience. In this Viewpoint, I discuss the need for a multidisciplinary strategy in the management of complex genital anomalies.

A key issue in patient management is that of terminology, as it greatly affects our communication with parents and the affected individual.1 Various terms have been used to describe the disharmony between chromosomal gender and phenotype characteristic of an ateliotic XY or a virilized XX individual. Such terms include 'complex genital anomaly', 'ambiguous external genitalia', 'intersex disorder', and 'hermaphroditism'. As all of these terms can be psychologically traumatic and socially stigmatizing, a consensus meeting held in 2006 proposed the term 'disorders of sex development'.2 My personal feeling, however, is that a definition devoid of the terms sex and disorder—such as 'defective differentiation of the genital system'—should be introduced.

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  1. First Department of Pediatrics, Athens University School of Medicine, “Aghia Sophia” Children's Hospital, Athens 11527, Greece adacou@med.uoa.gr

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  1. C Dacou-Voutetakis is Emeritus Professor of Pediatric Endocrinology at Athens University School of Medicine, Athens, Greece.,

    Catherine Dacou-Voutetakis

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  1. Catherine Dacou-Voutetakis
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Dacou-Voutetakis, C. A multidisciplinary approach to the management of children with complex genital anomalies. Nat Rev Endocrinol 3, 668–669 (2007). https://doi.org/10.1038/ncpendmet0620

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