Patients with androgen biosynthetic defects, partial androgen insensitivity syndrome are usually assigned to the male gender.33 The optimum timing for feminising genitoplasty
is not determined.34-35 On the other hand, it may be recommended to repair the ambiguousgenitalia in males at 6 to 18 months of age.36
In fact, nearly 90% of patients believe that feminizing genitoplasty
procedures should be performed within the first year of life (Binet, Hubert Lardy, Francois-Fiquet, & Poli-Merol, 2016)--a powerful affirmation of the medical community's current practice.
Reconstructive urology self-assessment of genital anatomy, sexual sensitivity and function in women: Implications for genitoplasty
. BJU International, 94(4), 589-594.
Some had not yet started feminising or masculinising hormone treatments, whereas others were on courses of hormone treatment, or had already had some facial or other surgery, and a small number were on the waiting list for genitoplasty
In a staff, bringing together endocrinologists and pediatric surgeons, the majority opinion was to maintain the female gender of the child after parental consent and achieve a feminizing genitoplasty
(vaginoplasty and clitoridoplasty) with bilateral gonadectomy.
Three former surgeons also argued in a policy paper titled "Re-Thinking Genital Surgeries on Intersex Infants" that cosmetic genitoplasty
should be deferred unless children are old enough to voice their view.
Ransley, "Self-assessment of genital anatomy, sexual sensitivity and function in women: Implications for genitoplasty
," BJU International, vol.
This article will, however, review the advantages of early and delayed genitoplasty
and cosmetic genital alteration for infants with a subgroup of DSD, such as 46 XX newborns with CAH (virilized females), and 46,XY infants with androgen insensitivity syndrome and 5-alpha-reductase deficiency (feminized or undervirilized males).
Treatment generally performed is phalloplasty or feminizing genitoplasty
Terry, "Feminizing genitoplasty
in adult transsexuals: early and long-term surgical results," The British Journal of Urology International, vol.
Development of feminizing genitoplasty
for gender dysphoria.
Corporeal sparing dismembered clitoroplasty: an alternative technique for feminizing genitoplasty
. J Urol.