Gender assignment surgery on children with disorders of sex development: a case report and discussion from South Africa

@article{Rebelo2008GenderAS,
  title={Gender assignment surgery on children with disorders of sex development: a case report and discussion from South Africa},
  author={Ethelwyn Eleonore Rebelo and Christopher Paul Szabo and Graeme J. Pitcher},
  journal={Journal of Child Health Care},
  year={2008},
  volume={12},
  pages={49 - 59}
}
This case report highlights the dilemma faced by staff with regard to the timing of surgery on a child with a disorder of sex development living in a large, lower socio-economic class, South African, urban township. In this community, children with disorders of sex development can sometimes become an object of interest and ridicule or are thought to be bewitched. Many parents of children with such disorders find it difficult to protect their offspring from the marginalization and rejection that… 
Parents need to protect: influences, risks and tensions for parents of prepubertal children born with ambiguous genitalia.
TLDR
The dilemmas that parents face in the complex and challenging situation following the birth of a child with ambiguous genitalia require early support from insightful professionals such as nurses, drawing attention to the parents' need to be knowledgeable about the impact that disorders of sex development can have on family's emotional, psychosocial well-being and decision-making.
Why do ‘we’ perform surgery on newborn intersexed children?
TLDR
P phenomenologically, why parents decide to have their children undergo genital surgery when it is not necessary for the child’s physiological functions is examined and a critical perspective on the surgical practice is provided.
Women With Amenorrhea and Men With Menstruation: The Qualitative Experiences of People With Disorders of Sex Development in Nigeria.
TLDR
The women with DSD in this study showed a generally poor knowledge of menarche, menstruation, and puberty, indicating that their parents had ignored the initial symptoms of DSD.
Intersex and transgender activism in South Africa
South Africa has come a long way concerning the legal treatment of trans* (in medical literature often categorised as transgenderism, transsexuality, gender dysphoria, or gender identity disorder)
Experiences of people living with disorders of sex development and sex reassignment as per pdf: Meta‐ethnography of qualitative studies as per pdf
TLDR
There is a need to explore the experiences of nurses in the management of disorders of sex development, and a range of physical, psychological, social, and sexual experiences which affect their quality of life.
Searching for harmony: parents' narratives about their child's genital ambiguity and reconstructive genital surgeries in childhood.
TLDR
For the parents seeking a sense of harmony between their child's genital ambiguity and gender during childhood, searching for this harmony became a dynamic and evolving process, which was built on their knowledge and increasing willingness to engage with professionals, negotiate their social worlds, emotional responses and belief systems.
Ethical perspectives on the management of disorders of sex development in children
TLDR
This work is distributed under the terms of the License http://creativecommons.org/licenses/by-nc/3.0/.
International Considerations & Variations in Practice: An African Perspective
Despite the socio-economic and geopolitical differences across continents, there is an accelerating awareness and recognition of the natural variations of an individual’s sexual orientation, gender
Commentary Beyond Good Intentions
TLDR
This commentary proposes that normalizing interventions for atypical sex anatomies, both historical and ongoing, be recognized as a kind of medical error, and that attention be focused not simply on prevention, but on repair.
...
...

References

SHOWING 1-10 OF 45 REFERENCES
Sex Reassignment at Birth: Long-term Review and Clinical Implications
This article is a long-term follow-up to a classic case reported in pediatric, psychiatric, and sexological literature. The penis of an XY individual was accidentally ablated and he was subsequently
Pediatric ethics and the surgical assignment of sex.
TLDR
There should be a moratorium on surgery for infants with ambiguous genitalia or loss of the penis; it is argued that the medical profession should complete comprehensive lookback studies to assess the outcomes of past interventions; and efforts should be made to undo the effects of past deception.
True hermaphroditism in southern Africa: the clinical picture
  • R. Wiersma
  • Medicine
    Pediatric Surgery International
  • 2004
TLDR
The previously reported high incidence (51%) of this condition, as well as some of the unusual features of true hermaphroditism in this region are highlighted.
Gender assignment and reassignment in 46,XY pseudohermaphroditism and related conditions.
TLDR
Recommendations on the assignment and reassignment of gender based on the expected optimal outcome in terms of psychosexual, reproductive, and overall psychologic/psychiatric functioning are reviewed.
Sex reassignment at birth.
  • J. Benjamin
  • Medicine
    Archives of pediatrics & adolescent medicine
  • 1997
TLDR
The article outlined the case of an XY child raised as a female after losing his penis in a surgical accident at 8 months of age and the point was made that the most important organ that determines sexual preference is the brain, not the genitalia.
Consensus Statement on Management of Intersex Disorders
TLDR
The Lawson Wilkins Paediatric Endocrine Society (LWPES) and the EPE considered it timely to review the management of intersex disorders from a broad perspective, to review data on longer term outcome and to formulate proposals for future studies.
Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth.
TLDR
Routine neonatal assignment of genetic males to female sex because of severe phallic inadequacy can result in unpredictable sexual identification, which should be reexamined in the light of these findings.
Attitudes of adult 46, XY intersex persons to clinical management policies.
TLDR
The majority of adult patients with intersexuality appeared to be satisfied with gender and genital status, and did not support major changes in the prevailing policy, however, a significant minority was dissatisfied and endorsed policy changes.
Management of Intersexuality: Guidelines for Dealing With Persons With Ambiguous Genitalia
TLDR
Suggestions on how to manage cases of traumatized or ambiguous genitalia are offered, based on experiences, the input of some trusted colleagues, the comments of intersexed persons of various origins, and the best interpretation of the reading of the literature.
Experiment of Nurture: Ablatio Penis at 2 Months, Sex Reassignment at 7 Months, and a Psychosexual Follow-up in Young Adulthood
TLDR
It was concluded that gender identity is sufficiently incompletely differentiated at birth as to permit successful assignment of a genetic male as a girl, in keeping with the experiences of rearing.
...
...