The diagnosis and management of intersex

The patient whose genitalia are ambiguous or are inappropriate for the assigned sex presents the physician with a set of problems requiring a thorough grasp of sexual differentiation, development and function. Although several reviews have covered various aspects of these matters, these texts do not cover recent advances in understanding normal and abnormal sexual development nor do they provide an integrated guide to the management of intersex cases. Our objectives are to show the clinical relevance of recent advances in understanding the determinants of normal and abnormal sexual differentiation, to indicate the improved diagnostic procedures now available and to provide specific guidelines for optimal case management in the light of current medical knowledge and psychological and ethical understanding.