Dr Schwarz questions one of the statements in our article about sex reassignment.1 He wonders if we would not raise those individuals with CAIS as females. Indeed he is correct. We would raise as girls those phenotypically female individuals with CAIS. This is in keeping with our original statement because these individuals, because of their lack of adequate or functional androgen receptors, are born without the ability to respond to androgens as typical males and thus do not have a typical XY body or nervous system. The usual prenatal androgenization of an XY nervous system is missing in these individuals and is thereby biased female. Pubertal androgen will not change this picture.2
Our recommendations for individuals with androgen insensitivity syndrome are set forth with more detail in our Commentary in this issue of the Archives.3 We recommend that individuals with CAIS grades 1 through 3 be raised
Diamond M, Sigmundson HK. Sex Reassignment at Birth-Reply. Arch Pediatr Adolesc Med. 1997;151(10):1064. doi:10.1001/archpedi.1997.02170470098027
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