[Forms of intersexuality in childhood (pathogenesis--clinical aspects--diagnosis--therapy)]

There is a need for early diagnosis and classification of different forms of intersex in children. Biochemical disorders lead to deviations of the normal fetal sex determination. Development anomalies can be generally classified as aberrations of the development of the ovaries (Pseudohermaphroditismus femininus) and abnormalities of the development of the testes (Pseudohermaphroditismus masculinus). Based on a preliminary clinical diagnosis of sexual ambiguity, analytical methods such as chromosome analysis, detection of sex hormones and their metabolites in serum and urine and the determination of hormone-patterns in the skin of the external genitalia are of great importance. Diagnosis of the proper sex may be considered a medical emergency because of the serious psychologic problems for the parents and the child, if sex is errouneously or oncertainly assigned. Diagnosis should be completed within the first few prenatal months of an intersex child in order to schedule a therapy that will determine it's life. Therapy is primarily based on administration of androgenizing or progestional substances and surgical interventions. Additional psychotherapeutic treatment should start in the early formative childhood years to allow a normal cognitive development and maturation of the child according to it's sexual identity.