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Disorders (differences) of sexual development encompass a variety of conditions with atypical development of chromosomal, gonadal, or anatomic sex. Three of the most common differences of sex development conditions include congenital adrenal hyperplasia, complete androgen insensitivity, and Turner syndrome. Obstetrician-gynecologists who care for affected individuals in their practice must be familiar with the genetic, endocrine, and anatomic considerations of the most common conditions to provide optimal care. As women with these conditions transition to adult care, the gynecologist needs to assess the patient's understanding and educate her regarding her diagnosis and ongoing medical care. All of these conditions may affect self-perception, mental health, fertility, sexual function, and bone and cardiovascular health. Women with congenital adrenal hyperplasia need lifelong endocrine management and require genetic counseling before pregnancy. Women with androgen insensitivity syndrome require counseling regarding gonadectomy and hormone replacement therapy and may require vaginal elongation for intercourse. Most women with Turner syndrome experience premature ovarian insufficiency and require long-term estrogen replacement. Women with Turner syndrome often have congenital anomalies and autoimmune disorders, which require regular monitoring and care during adulthood. The purpose of this review is to provide the obstetrician-gynecologist who cares for adult women with the most common disorders (differences) of sexual development conditions an outline of the current recommendations for screening and ongoing health care with particular emphasis on the underlying genetics, management of subfertility, infertility and sexual concerns, approach to hypogonadism, and understanding of associated comorbidities.

Objective: To estimate the rate of erroneous and unverifiable publications in applications for an obstetrics and gynecology residency and to determine whether there were associated characteristics that could assist in predicting which applicants are more likely to erroneously cite their publications., Methods: This was a review of the Electronic Residency Application Service applications submitted to the University of Washington obstetrics and gynecology residency for the 2008 and 2009 matches. Publications reported to be peer-reviewed articles and abstracts were searched by querying PubMed, Google, and journal archives (first tier), topic-specific databases (second tier), and by e-mailing journal editors (third tier). Errors were categorized as minor, major, and unverified., Results: Five-hundred forty-six (58%) of 937 applicants listed a total of 2,251 publication entries. Three-hundred fifty-three applicants (37.7%) listed 1,000 peer-reviewed journal articles and abstracts, of which 751 were reported as published and 249 as submitted or accepted. Seven-hundred seventy (77.0%) publications were found by a first-tier search, 51 (5.1%) were found by a second-tier search, 23 (2.3%) were found by a third-tier search, and 156 (15.6%) were unverified. Of the 353 applicants listing peer-reviewed articles or abstracts, 25.5% (90 of 353) committed major errors, 12.5% (44 of 353) committed minor errors, and 24.1% (85 of 353) had articles or abstracts that were unverified., Conclusion: Most applicants reported their publications accurately or with minor errors; however, a concerning number of applicants had major errors in their citations or reported articles that could not be found, despite extensive searching. Reported major and unverified publication errors are common and should cause concern for our specialty, medical schools, and our entire medical profession.