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Pediatric management of ambiguous and traumatized genitalia
1Department of Anatomy and Reproductive Biology, University of Hawaii, John A. Burns School of Medicine, Honolulu, USA.
Insights
Current management of ambiguous genitalia is insufficient. A moratorium on cosmetic sex reassignment surgery is recommended, emphasizing honesty, counseling, and follow-up studies for intersexuality and trauma cases.
Area of Science:
- Pediatric endocrinology
- Genitourinary surgery
- Medical ethics
Background:
- Management of ambiguous genitalia lacks evidence-based guidelines.
- Current practices for traumatized genitalia require evaluation.
- Input from intersex individuals is crucial for ethical care.
Purpose of the Study:
- To evaluate the current standard of care for ambiguous and traumatized genitalia.
- To propose evidence-based principles for medical management.
- To address ethical considerations in surgical interventions.
Main Methods:
- Review of published intersexuality cases and traumatized genitalia management protocols.
- Inclusion of perspectives from intersex individuals.
- Presentation of independent research on intersexuality.
Main Results:
- Existing pediatric recommendations for ambiguous or traumatized genitalia are inadequate.
- A need for follow-up studies to inform treatment decisions is identified.
- Evidence-based medical management principles are proposed.
Conclusions:
- Recommend a moratorium on cosmetic sex reassignment surgery.
- Advocate for instituting follow-up studies on past cases.
- Emphasize honesty and counseling as core components of treatment.
Purpose:
The present standard of practice in the management of ambiguous and traumatized genitalia was evaluated.
Materials And Methods:
Published cases of intersexuality and protocols for the management of traumatized genitalia were reviewed with consideration of the input of intersexual individuals. Independent research on different types of intersexuality is also presented.
Results:
The present standard pediatric recommendations and precepts for the management of ambiguous or traumatized genitalia are wanting. Followup studies on which to base treatment decisions are needed. Evidence based principles of medical management are proposed.
Conclusions:
A moratorium on sex reassignment cosmetic surgery is recommended. Also recommended are that followup studies should be instituted on past cases, and honesty and counseling should be the core of initial and subsequent treatment.