Sexual ambiguity and malformation in Zambia: challenges in surgical management

This article addresses the complexity in diagnosis, gender assignment and management in patients with sexual ambiguity and malformed sexual organs. Between 1984 and 1993, nine children and 10 adult patients with this ailment were treated in the University Teaching Hospital, Lusaka, Zambia. All children had clitorovaginoplasty and adults had different surgical procedures such as feminisation and masculinisation operations. Methods, means and the manner in which we manage these patients in the midst of a scarcity of expert manpower and sophisticated equipment are discussed. Need for a specialised clinic for better management, teaching and research of this unfortunate and highly sensitive congenital defect has been emphasised.