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[Differences in sexual development-S2k guideline update].

S Krege1, F Eckoldt2, A Richter-Unruh3

  • 1Direktorin der Klinik für Urologie, Kinderurologie und Urol. Onkologie, Ev. Kliniken Essen Mitte, Huyssens-Stiftung, Henricistr. 92, 45136, Essen, Deutschland. s.krege@kem-med.com.

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Summary
This summary is machine-generated.

This updated guideline for differences in sexual development (DSD) prioritizes affected individuals' self-determination and psychological support, recommending delayed medical interventions. It reflects a paradigm shift in DSD care.

Keywords:
CommunicationProtection of fertilityPsychological supportRight of self-determinationTumor risk of the gonads

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Area of Science:

  • Medical Ethics
  • Endocrinology
  • Genetics

Background:

  • Historically, early childhood gender reassignment surgery for differences in sexual development (DSD) often conflicted with later-identified gender identities.
  • This created significant distress and incongruence for affected individuals.

Purpose of the Study:

  • To revise and update interdisciplinary guidelines for DSD care, incorporating the perspectives of affected individuals and support groups.
  • To ensure medical practices align with the self-determination and evolving needs of individuals with DSD.

Main Methods:

  • A comprehensive literature search was conducted for each of the 12 guideline chapters.
  • Recommendations were developed by 18 professional societies, 3 support groups, and working groups.
  • Consensus was reached through voting during four conferences.

Main Results:

  • The guideline emphasizes the right to self-determination for individuals with DSD and outlines new legal considerations.
  • It recommends postponing medical interventions unless essential for primary diagnostics, prioritizing psychological support for patients and parents.
  • Detailed analysis of gonadal tumor risk and fertility preservation is included.

Conclusions:

  • The revised guideline signifies a paradigm shift in managing DSD, focusing on individual autonomy and well-being.
  • Projects like DSD Care and Empower-DSD are crucial for implementing these updated recommendations in practice.