Ambiguous genitalia

Determining the sex of a newborn baby is usually a simple matter. Routine examination of the external genitalia will, in most cases, identify the sex of the infant. But when this is not a clear-cut decision, due to some birth defect, the gender identity must be rapidly, but carefully, assigned. If there are palpable sex organs in the genital region and an identifiable uterus, the gender assigned must be female, regardless of any phallic structure. These infants have a genetic defect in the Y chromosome or a translocation of the testis-determining factor to one of the X chromosomes. The specific diagnosis may be made by a Southern blot analysis. Any testicular tissue should be surgically removed to avoid virilization or growth of tumors in the future. Newborns without palpable gonads, but with a uterus, should be assigned the female gender. Virilization may be due to a variety of abnormalities. Babies without any palpable gonads or uterus, but with a phallic structure of at least 2 cm, should be assigned the male gender. If the phallus is inadequate or absent, the female gender should be assigned. This defect may require hormonal therapy or appropriate surgical intervention. Newborns with symmetrically descended gonads and no uterus should be assigned the male gender. In the presence of an anatomic defect, the baby should be examined for other organ malformations. Rapid gender assignment is critical to the proper care of the infant and the psychological well-being of the child and family. (Consumer Summary produced by Reliance Medical Information, Inc.)