Editing Disorders of Sexual Differentiation (section)

=== Management ===
*'''Gender assignment'''
**Issues related to the diagnosis-specific potential for normal sexual functioning and fertility and the risk of gonadal malignancy should be addressed.
**'''In the setting of a 46,XX karyotype and masculinized female, gender assignment is usually appropriately female.'''
***In '''CAH''', cortisol suppresses the undesired androgen; and if '''maternal androgen''' is responsible for virilization, its discontinued stimulation is corrective. In both cases there are normal ovaries and müllerian-derived structure, and a '''normal reproductive potential exists.'''
**'''If the karyotype is 46,XY, the issue is a more complex one and includes factors such as penile length and evidence of androgen insensitivity'''.
**Gender role refers to aspects of behavior that distinguish males and females. The development of gender identity is poorly understood, but is influenced by prenatal and postnatal factors. Individual conflicts with gender identity are central to the concept of gender dysphoria
**'''The best predictor of adult gender identity is initial gender assignment'''
***'''Deferring the issue of gender assignment until patients reach an age at which they may declare their own gender identity is not recommended'''
*Parameters of optimal gender policy outlined in the management of ambiguous genitalia by:
**Reproductive potential (if attainable at all)
**Good sexual function
**Minimal medical procedures
**An overall gender-appropriate appearance
**A stable gender identity
**Psychosocial well-being