ESPE Abstracts

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Traditional medical management of children born with atypical genitals includes genital surgery during early childhood. Young children cannot give informed consent and surgery is usually undertaken after a decision made by the multidisciplinary team with parental input. Long-term outcomes are uncertain and there is scanty research supporting the benefits of surgery on physical or mental well-being. Adult patients clearly describe the distress of multiple genital operations dur...

The new care paradigm for DSD promoted by the Chicago Consensus of 2005 raised many psychological challenges, the most important being the way decisions regarding the sex of rearing and diagnosis communication are made. The traditional care paradigm, sustained by a binary sex categorization, suggested that for newborns, the decision about the sex of rearing should be made as soon as possible and no later than 18 months of life and that little should be said to the involved per...

Decisions for children not able to consent must aim at promoting the well-being of the child and future adult and minimize physical and psychosocial risks. In atypical sex development, well-being is a complex category comprising physical and psychosocial health (present as well as long-term). The child has a right to a gendered identity, bodily integrity, fertility, quality of life including sexual life, and mental health. However, patient well-being is a normative concept and...