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Management of 46,XY Differences/Disorders of Sex Development (DSD) Throughout Life
Amy B Wisniewski1, Rafael L Batista2, Elaine M F Costa2
1Psychology Department, Oklahoma State University, Stillwater, Oklahoma.
Insights
This review updates clinical care for 46,XY disorders of sex development (DSD), focusing on diagnosis, treatment, and long-term outcomes. It highlights the need for interdisciplinary care and further research into specific etiologies and interventions for improved patient quality of life.
Area of Science:
- Pediatric Endocrinology
- Genetics
- Reproductive Medicine
Background:
- Disorders of Sex Development (DSD) encompass congenital conditions with sex development discordance.
- Significant advancements in managing 46,XY DSD have occurred since 2006.
- Current understanding requires updates on patient outcomes and care strategies.
Purpose of the Study:
- To comprehensively review current knowledge on 46,XY DSD.
- To address key aspects including diagnosis, treatment, and quality of life.
- To identify areas needing further research and collaboration.
Main Methods:
- Literature review of recent advancements in 46,XY DSD care.
- Synthesis of data on morbidity, mortality, diagnostics, and treatment outcomes.
- Identification of knowledge gaps and future research priorities.
Main Results:
- Progress in clinical care for 46,XY DSD patients and families.
- Emphasis on interdisciplinary healthcare teams and molecular diagnosis.
- Recognition of areas requiring further investigation, such as genitoplasty and long-term quality of life.
Conclusions:
- Interdisciplinary care and molecular diagnosis are crucial for 46,XY DSD management.
- Further research is essential to optimize long-term outcomes, fertility, and sexual function.
- Continued collaboration and patient registries are vital for advancing care.
Abstract:
Differences/disorders of sex development (DSD) are a heterogeneous group of congenital conditions that result in discordance between an individual's sex chromosomes, gonads, and/or anatomic sex. Advances in the clinical care of patients and families affected by 46,XY DSD have been achieved since publication of the original Consensus meeting in 2006. The aims of this paper are to review what is known about morbidity and mortality, diagnostic tools and timing, sex of rearing, endocrine and surgical treatment, fertility and sexual function, and quality of life in people with 46,XY DSD. The role for interdisciplinary health care teams, importance of establishing a molecular diagnosis, and need for research collaborations using patient registries to better understand long-term outcomes of specific medical and surgical interventions are acknowledged and accepted. Topics that require further study include prevalence and incidence, understanding morbidity and mortality as these relate to specific etiologies underlying 46,XY DSD, appropriate and optimal options for genitoplasty, long-term quality of life, sexual function, involvement with intimate partners, and optimizing fertility potential.
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