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Changes over time in sex assignment for disorders of sex development

Zofia Kolesinska1, S Faisal Ahmed2, Marek Niedziela1

  • 1Poznan University of Medical Sciences, Poznan, Poland;

Pediatrics
|August 6, 2014
PubMed

Insights

The likelihood of infants with disorders of sex development being raised as boys has significantly increased over time. This trend suggests a shift in sex assignment practices for these conditions.

Area of Science:

  • Pediatric Endocrinology
  • Genetics
  • Reproductive Health

Background:

  • Disorders of Sex Development (DSD) encompass a range of conditions affecting sexual development.
  • Sex assignment is a critical decision for infants with DSD.
  • Temporal trends in sex assignment practices for DSD are not well-established.

Purpose of the Study:

  • To investigate temporal trends in sex assignment for infants with specific Disorders of Sex Development.
  • To analyze changes in the proportion of infants raised as male or female over time.

Main Methods:

  • Retrospective analysis of cases from the International Disorder of Sex Development (I-DSD) Registry.
  • Categorization of DSD types including partial androgen insensitivity syndrome (PAIS), disorder of gonadal development (DGD), and disorder of androgen synthesis (DAS).
  • Division of cases into birth cohorts: before 1990, 1990-1999, and after 1999. Assessment of external genitalia appearance using the external masculinization score.

Main Results:

  • Infants assigned male had significantly higher external masculinization scores than those assigned female across all DSD types and cohorts.
  • The proportion of infants raised as boys increased significantly over time: 35% before 1990, 41% from 1990-1999, and 68% after 1999.
  • A clear temporal trend shows an increasing likelihood of male sex assignment for infants with DSD.

Conclusions:

  • While external genitalia appearance is associated with sex assignment, practices have shifted towards assigning male sex more frequently.
  • This observed change in sex assignment practices for DSD warrants further investigation into its long-term health implications.
  • Future research should focus on the impact of evolving sex assignment trends on the health outcomes of individuals with DSD.
Abstract

Keywords:
DSDatypicaldifferencesgendergenitaliaintersex

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