46XX, CAH, Masculinised Genitalia and Gender Assignment

[Butterfly]

46XX, CAH, Masculinised Genitalia and Gender Assignment
A.E. Brain
By Zoe Brain
19 January, 2011


http://aebrain.blogspot.com/2011/01/46xx-cah-masculinised-genitalia-and.html


There is ample historical verification of 46,XX congenital adrenal hyperplasia (CAH) patients being born with essentially male genitalia while outcome information is scant. Prior to glucocorticoid therapy, most patients died very young from adrenal insufficiency. Most available reports from later childhood, contain little information concerning sexual identity. Reports on older individuals lack adequate information about sexual identity and quality of life. The difficulty in assessing the relative impact of multiple dynamic environmental factors on the development of sexual identity, self- and body esteem and overall adjustment to life is clear. Nevertheless, it remains unclear whether those infants whose masculine genitalia at birth resulted in an initial male assignment would have enjoyed a better adult outcome had they been allowed to remain male rather than the female reassignment that most received.