Disorders of sexual development and gender identity: guidelines for psycho-medical management

Journal title RIVISTA DI SESSUOLOGIA CLINICA
Author/s Adele Fabrizi, Emanuela Napoli, Gaetano Gambino
Publishing Year 2011 Issue 2011/1
Language Italian Pages 20 P. 35-54 File size 141 KB
DOI 10.3280/RSC2011-001003
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The term "Disorders of sexual differentiation" (DSDs) indicates a series of clinical conditions in which chromosome, gonadal and/or phenotypical sex development is atypical. Sex assignment to newborns with ambiguous genitalia may raise important bioethical issues in physicians, surgeons and parents and may often influence the structuring of sex identity and gender identification. In 2006 the Intersex Society of North America (ISNA) proposed new guidelines for the treatment of DSDs. Differently from previously recommended procedures, the ISNA is in favour of delaying medical and surgical interventions on genitalia until adulthood. Furthermore, the ISNA underlines that such interventions should be performed only in the case of real and imminent threats to the physical health of the individual and provided there are definite evidence-based or predictive indices. The present work reviews the scientific literature on the topic in order to describe how positions on medical sex-assignment have changed over time, to analyze gender identity development in such clinical conditions and to highlight the main factors necessary for an adequate psycho-medical management of DSDs.

Keywords: Disorders of sex development, intersex, management, genital surgery, gender identity, clinical guidelines

Adele Fabrizi, Emanuela Napoli, Gaetano Gambino, Disordini della differenziazione sessuale e sviluppo dell’identità di genere: linee guida per il management psico-medico in "RIVISTA DI SESSUOLOGIA CLINICA" 1/2011, pp 35-54, DOI: 10.3280/RSC2011-001003