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Perspective ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pediatr. | doi: 10.3389/fped.2018.00339

Navigating Surgical Decision Making in Disorders of Sex Development (DSD)

  • 1Department of Pediatrics, Michigan Medicine, University of Michigan, United States
  • 2Child Health Evaluation and Research Center, University of Michigan, United States
  • 3Department of Pediatrics, School of Medicine, University of Michigan, United States

Surgical management of disorders of sex development (DSD) is associated with contentious debate between and within stakeholder communities. While the intent of surgical management of the genitals and gonads is to benefit the patient physically and psychosocially, these goals have not always been achieved; reports of harm have surfaced. Harm experienced by some patients has resulted in the emergence of an activist platform calling for a moratorium on all surgical procedures during childhood – excepting those forestalling threats to life within the childhood years. This ban is not universally endorsed by patient advocacy groups. Parents, meanwhile, continue to need to make decisions regarding surgical options for their young children. Constructive paths forward include implementation of Consensus Statement recommendations that call for comprehensive and integrated team care, incorporating mental health services and adopting shared decision making.

Keywords: Disorders of sex development (DSD), Intersex, Surgery, Pediatrics, shared decision making

Received: 09 Sep 2018; Accepted: 22 Oct 2018.

Edited by:

Alexander Springer, Medizinische Universität Wien, Austria

Reviewed by:

Andres Gomez Fraile, Hospital Universitario 12 De Octubre, Spain
Baran Tokar, Eskişehir Osmangazi University, Turkey  

Copyright: © 2018 Sandberg and Gardner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. David E. Sandberg, Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, United States,