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Guidelines for evaluating and managing children born with disorders of sexual development

Ganka Douglas1, Marni E Axelrad, Mary L Brandt

  • 1Baylor College of Medicine Texas Children’s Hospital, Houston, TX 77030, USA.

Pediatric Annals
|April 13, 2012
PubMed

Insights

Disorders of Sexual Differentiation (DSD) present complex challenges. A multidisciplinary Gender Medicine Team developed evidence-based guidelines for DSD clinical management and sex assignment using the GRADE system.

Area of Science:

  • Pediatric Endocrinology
  • Genetics
  • Medical Ethics

Background:

  • Disorders of Sexual Differentiation (DSD) create significant challenges for families and healthcare providers.
  • Pediatricians are often the initial point of contact for children with DSD.
  • Management strategies for DSD have historically been contentious.

Purpose of the Study:

  • To develop consensus-based clinical management guidelines for DSD.
  • To establish recommendations for appropriate sex assignment in DSD cases.
  • To address the long-standing concerns regarding DSD care.

Main Methods:

  • Formation of a multidisciplinary Gender Medicine Team (GMT) at Baylor College of Medicine and Texas Children's Hospital.
  • Establishment of a Task Force to review institutional experience and existing literature.
  • Application of the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system to appraise evidence and formulate recommendations.

Main Results:

  • A consensus statement for the clinical management of DSD was developed.
  • Evidence-based recommendations for sex assignment in DSD were formulated.
  • The GRADE system guided the assessment of evidence quality and strength of recommendations.

Conclusions:

  • The developed consensus statement provides a framework for managing DSD.
  • The guidelines aim to standardize and improve care for children with DSD.
  • This work addresses the need for clear, evidence-based approaches to DSD management and sex assignment.

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