October 1997

Management of IntersexualityGuidelines for Dealing With Persons With Ambiguous Genitalia

Author Affiliations

From the Department of Anatomy and Reproductive Biology, Pacific Center for Sex and Society, University of Hawaii-Manoa, John A. Burns School of Medicine, Honolulu (Dr Diamond); and the Department of Psychiatric Services, Ministry of Health, Victoria, British Columbia (Dr Sigmundson). Dr Sigmundson is now with the Department of Psychiatry, University of British Columbia, Vancouver.

Arch Pediatr Adolesc Med. 1997;151(10):1046-1050. doi:10.1001/archpedi.1997.02170470080015

Following the publication of our article about a classic case of sex reassignment,1 the media attention was rapid and widespread,2-4 as was the reaction of many clinicians. Some wanted to comment or ask questions, but many contacted us directly or indirectly, asking for specific guidelines on how to manage cases of traumatized or ambiguous genitalia.5

Below we offer our suggestions. We first, however, add this caveat: these recommendations are based on our experiences, the input of some trusted colleagues, the comments of intersexed persons of various origins, and the best interpretation of our reading of the literature. Some of these suggestions are contrary to today's common management procedures. We believe, however, that many of those procedures should be modified. These guidelines are not offered lightly. We anticipate that time and experience will dictate that some aspects be changed and such revisions will improve the next set of

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