Or, how intersexed peeps are likely to get screwed again...The original articleis a relatively neutral piece questioning the knee-jerk assumption of XX kerotype = female.
QuoteAim. The purpose of this study was to analyze the clinical management of an individual diagnosed as a female pseudohermaphrodite with congenital adrenal hyperplasia (CAH) simple virilizing form four decades ago but who currently lives as a monogamous heterosexual male.
Results. Analysis of reported values for 17-ketosteroids, 17-hydroxycorticosteroids, from 24-hour urine samples during an 8-year period showed poor adrenal suppression in spite of adherence to treatment. A recent MRI study confirmed the presence of hyperplastic adrenal glands as well as the presence of a prepubertal uterus. Semistructured interviews with the individual confirmed a life history consistent with a male gender identity.
Conclusions. Although the American Academy of Pediatrics recommends that XX intersex individuals with CAH should be assigned to the female sex, this practice harms some individuals as they may self-identify as males. In the absence of comorbid psychiatric factors, the discrepancy between infant sex assignment and gender identity later in life underlines the need for a reexamination of current standards of care for individuals diagnosed with CAH.
Unfortunately, a
responce to the first article, one more likely to be read by physicians, at least of the American type opines (read: my interpolation) that the
John Hopkins treatment reassignment of the genitals of intersexed infants to correspond with their sex kerotype as standard operating procedure should remain in effect.
QuoteFirst, despite genital ambiguity, this child was assigned male without a comprehensive medical evaluation. Second, a definitive diagnosis and associated female reassignment took place at 20 months, a problematic age for such physician-imposed gender reassignment.
...
If the patient had received proper medical care at birth, later patient-initiated gender change to male might have been less likely.
...
The simple-virilizing variant of CAH, which was this patient's condition, represents the lower end of both prenatal androgenization and behavioral masculinization and, therefore, appears to be an even less likely candidate for assignment to the male gender at birth than the more severe salt-wasting variant. Yet, even in the latter, female gender identity is the common outcome despite markedly masculinized gender-related behavior.
