Ambiguous genitalia

Genital reconstructive surgery was pioneered between 1930 and 1960 by urologist Hugh Hampton Young and other surgeons at Johns Hopkins Hospital in Baltimore and other major university centers. Understanding of intersex conditions was relatively primitive, based on identifying the type of gonad(s) by palpation or by surgery. Since ability to determine even the type of gonads in infancy was limited, sex of assignment and rearing were determined mainly by the appearance of the external genit ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Surgical pioneering and the discovery that gender is constructed

The goals of surgery, outlined at the beginning of this article have not changed, but some types of surgery have been discontinued. The primary ongoing controversy surrounds timing of feminizing surgery for virilized girls with CAH. Alhough surgical sex reassignments (to female) of XY males with unambiguous micropenis or penile injury had been dwindling in the 1990s, few if any have been done since. Accounts of spontaneous self-reassignment since then have also reduced the reassignment to female of several other forms of XY ambiguity ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Controversy

Congenital adrenal hyperplasia (CAH) refers to any of several autosomal recessive diseases resulting from defects in steps of the synthesis of cortisol from cholesterol by the adrenal glands. Most of these diseases involve excessive or defective production of sex steroids and can pervert or impair development of primary or secondary sex characteristics in affected infants, children, and adults. Only a small minority of people with CAH can be said to have an intersex condition, but this attracted American public attention in the late 1990s and ...

Including:

• Congenital adrenal hyperplasia - Overview of the multiple types of CAH
• Congenital adrenal hyperplasia - Genetics
• Congenital adrenal hyperplasia - Biochemistry
• Congenital adrenal hyperplasia - History

Read more here: » Congenital adrenal hyperplasia: Encyclopedia - Congenital adrenal hyperplasia

Regardless of the "representativeness" of the advocacy groups, the doctors began to listen. Within a short time re-evaluation of intersex management was a major topic in the journals and the meetings of the pediatric endocrinologists and urologists. There was no international "registry" of genital reconstructive surgery. Most cases of this type of surgery were being carried out in a relatively small number of centers. Several of the larger institutions embarked on individual and collaborative retrospective outcome studies, attempting to cont ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Outcomes and statistics

By 1990, biological factors were being reported for a wide variety of human behaviors and personality characteristics. The idea that culture accounted for all the differences between men and women seemed as obsolete as psychotherapy for homosexuality. A more abrupt and sweeping re-evaluation of reconstructive genital surgery began about 1997, triggered by a combination of factors. One of the major factors was the rise of patient advocacy groups that expressed dissatisfaction with several aspects of their own past treatments. The polit ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years

Throughout the 1980s pediatric surgery textbooks recommended female assignment and feminizing reconstructive surgery for XY infants with a severely inadequate phallus. Nevertheless, in the 1980s several factors began to induce a decline in the frequency of certain types of genital surgery. Pediatric endocrinologists had realized that some boys with micropenis had deficiency of growth hormone which could be improved with hormones rather than surgery, and over the next decade a couple of reports suggested adult outcome as males was not as bad ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Complications arise both in the theories and in the patients

By the 1960s, the young specialties of pediatric surgery and pediatric urology at children's hospitals were universally admired for bringing infant birth defect surgery to new levels of success and safety. These specialized surgeons began to repair wider varieties of birth defects at younger ages with better results. Earlier correction reduced the social "differentness" of a child with a cleft lip, or club foot, or skull malformation, or could save the life of an infant with spina bifida. Genital corrective surgeries in infancy were j ...

See also:

History of intersex surgery, History of intersex surgery - Surgical pioneering and the discovery that gender is constructed, History of intersex surgery - Triumph of infant surgery and nurture over nature, History of intersex surgery - Complications arise both in the theories and in the patients, History of intersex surgery - Nature back on top: surgeons go from hero to villain in 3 years, History of intersex surgery - Outcomes and statistics, History of intersex surgery - Controversy

Read more here: » History of intersex surgery: Encyclopedia II - History of intersex surgery - Triumph of infant surgery and nurture over nature

Because of the multiplicity of conditions, many different diagnostic tests are used for screening. An abnormal result is often followed by a subsequent "definitive test" to confirm the suspected diagnosis. Common screening tests used in the last sixty years: Ferric chloride test (turned colors in reaction to various abnormal metabolites in urine) Ninhydrin paper chromatography (detected abnormal amino acid patterns) Guthrie bacterial inhibition assay (detected a few amino acids in excessive amounts in blood) Quantitative plasma amino acids, quantitative urine ...

See also:

Inborn error of metabolism, Inborn error of metabolism - Major categories of inherited metabolic diseases, Inborn error of metabolism - Manifestations and presentations, Inborn error of metabolism - Diagnostic techniques, Inborn error of metabolism - Newborn screening, Inborn error of metabolism - Management

Read more here: » Inborn error of metabolism: Encyclopedia II - Inborn error of metabolism - Diagnostic techniques

Cortisol is an adrenal steroid hormone necessary for life; production begins in the second month of fetal life. Inefficient cortisol production results in rising levels of ACTH, which in turn induces overgrowth (hyperplasia) and overactivity of the steroid-producing cells of the adrenal cortex. The defects causing adrenal hyperplasia are congenital (i.e., present at birth). Cortisol deficiency in CAH is usually partial, and not the most serious problem for an affected person. Synthesis of cortisol shares steps with synth ...

See also:

Congenital adrenal hyperplasia, Congenital adrenal hyperplasia - Overview of the multiple types of CAH, Congenital adrenal hyperplasia - Genetics, Congenital adrenal hyperplasia - Biochemistry, Congenital adrenal hyperplasia - History

Read more here: » Congenital adrenal hyperplasia: Encyclopedia II - Congenital adrenal hyperplasia - Overview of the multiple types of CAH

An Italian anatomist, Luigi De Crecchio provided the earliest known description of a case of probable CAH. I propose in this narrative that it is sometimes extremely difficult and even impossible to determine sex during life. In one of the anatomical theaters of the hospital..., there arrived toward the end of January a cadaver which in life was the body of a certain Joseph Marzo... The general physiognomy was decidedly male in all respects. There were no feminine curves to the body. There was a heavy beard. There was some delicacy of str ...

See also:

Congenital adrenal hyperplasia, Congenital adrenal hyperplasia - Overview of the multiple types of CAH, Congenital adrenal hyperplasia - Genetics, Congenital adrenal hyperplasia - Biochemistry, Congenital adrenal hyperplasia - History

Read more here: » Congenital adrenal hyperplasia: Encyclopedia II - Congenital adrenal hyperplasia - History