Management of neonates and children with male pseudohermaphroditism

Twenty-five patients with male pseudohermaphroditism were treated. Causes included (1) inadequate testosterone production, (2) incomplete conversion of testosterone to dihydrotestosterone, and (3) insufficient androgen-binding protein at the target cell. These various problems can be defined accurately today. These infants should be studied early to define which gender role is more appropriate. Change in gender assignment later can be disastrous. An individual raised in the female role, but with incomplete internal structures, can cope with life better than one raised in the male role but lacking a satisfactory phallus. In general, we believe most male pseudohermaphrodites should be raised as females, performing appropriate alterations at an early age.