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Sex reassignment: A challenging problem - current medical and islamic guidelines
A S Al Herbish1, N A Al Jurayyan, A M Abo Bakr
1Departments of Pediatrics, Surgery, and Radiology, King Khalid University Hospital, Department of Pediatrics, Security Forces Hospital, and Pediatric Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Annals of Saudi Medicine
|January 1, 1996
Summary
Ambiguous genitalia can lead to incorrect sex assignment. Most genetic females refused sex reassignment, influenced by sociocultural factors and delayed diagnosis, unlike genetic males.
Area of Science:
- Endocrinology
- Genetics
- Pediatrics
Background:
- Sexual ambiguity presents complex medical and psychosocial challenges.
- Incorrect sex assignment can result from ambiguous genitalia, leading to severe consequences.
- Children diagnosed beyond the neonatal period pose significant management difficulties.
Purpose of the Study:
- To analyze cases of sexual ambiguity requiring sex reassignment.
- To investigate factors influencing the acceptance or refusal of sex reassignment.
- To highlight the need for national consensus on managing sexual ambiguity.
Main Methods:
- Retrospective review of 30 patients with indicated sex reassignment.
- Analysis of genetic sex, specific enzyme deficiencies or insensitivity, and assigned sex.
- Evaluation of patient decisions regarding sex reassignment and contributing factors.
Main Results:
- 90% of patients were genetic females with hydroxylase deficiencies (21- or 11-).
- 10% were genetic males with androgen insensitivity or 5-alpha-reductase deficiency.
- 33% of genetic females refused sex reassignment, citing preference for male assignment, delayed diagnosis, and sociocultural factors.
Conclusions:
- Sociocultural factors and delayed diagnosis significantly impact sex reassignment decisions in genetic females.
- Genetic males in this cohort accepted sex reassignment when indicated.
- A national consensus, supported by religious recommendations, is crucial for managing sexual ambiguity.
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