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April 27, 1957


JAMA. 1957;163(17):1645. doi:10.1001/jama.1957.02970520079025

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To the Editor:—  Dr. Irving F. Stein has very kindly forwarded to me a copy of his letter regarding my article on intersexuality. In this letter he states, "Exploratory laparotomy, recommended by Dr. Morris, is entirely unwarranted so long as there are safe and practical methods of visual diagnosis available. Pneumoroentgenography qualifies as such a method."I am afraid the fault is mine for not making my point clearer in the article. The only reason for early surgical exploration (not necessarily laparotomy) is to make a biopsy study of the gonads in order to avoid the error of rearing the patient in the wrong sex. The necessity for surgical determination of sex is limited to the cases with intersexual genital development in which congenital adrenal hyperplasia has been ruled out. Even in these cases, the answer would be given by the somatic sex chromatin except for the fact that in

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